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Introduction. Evidence is consistent with increased screen viewing time among children and adolescents, and anticipation at the age at which children interact with media devices. Incorrect use of technology, as well as overuse, may lead to serious consequences. This study aims to revise scientific international literature and to describe the potential eye risks correlated to screen viewing time in the pediatric age. Materials and Methods. A review of the literature was performed according to the PRISMA 2020 guidelines, using the search terms “media device” and “eye” with the filter “age 0–18”. Results. Analyzing the international literature, we found 26 articles. Pre-myopia, myopia, digital eye strain, and acute acquired comitant esotropia were listed as potential and time-related consequences associated with the incorrect use of media devices among children and adolescents. Discussion. Family education on media device exposure and potential risk for children and adolescents’ sight in case of prolonged digital/screen exposure is required. During pediatric check controls, a dialogue with families on prolonged media device use at a close distance should be undertaken. Pediatricians and ophthalmologists should consider screen viewing time in case of ocular problems.

Abstract Background In literature, a few reports described an association between paraneoplastic pemphigus (PNP) and Castelman’s disease (CD), but no consensus have been proposed for the diagnostic-therapeutical approach. Aim of this study is to present a case report and explore the relationship between PNP and CD in pediatric patients, focusing on clinical manifestations, histopathological findings, treatment and outcome to find elements for an early diagnosis. Case presentation We present the clinical case of a 13 years old girl with a challenging diagnosis of PNP and CD who underwent therapy at first with Rituximab and then with Siltuximab, for the control of symptoms. Conclusions Reviewing literature, 20 clinical cases have been described in the pediatric age. Diagnosis may be challenging, requiring an average of 3 months (range from 3 weeks to 2 years). In all cases, the initial manifestations were mucocutaneous lesions, especially oral lesions with poor response to conventional treatment. Systemic symptoms may be present as well. Therapeutical approach is still discussed with no consensus. Almost all patients received corticosteroids with poor response. Other drugs including azathioprine, methotrexate, cyclosporine and monoclonal antibodies have been evaluated for the control of the disease. Further studies and experimental trials urge to define the diagnostic criteria and therapy protocol.

Substantia nigra is an important neuronal structure, located in the ventral midbrain, that exerts a regulatory function within the basal ganglia circuitry through the nigro-striatal pathway. Although its subcortical connections are relatively well known in human brain, very little is known about its cortical connections. The existence of a direct cortico-nigral pathway has been demonstrated in rodents and primates but only hypothesized in humans. In this study, we aimed at evaluating cortical connections of substantia nigra in vivo in human brain, by using probabilistic constrained spherical deconvolution tractography on magnetic resonance diffusion weighted imaging data. We found that substantia nigra is connected with cerebral cortex as a whole, with the most representative connections involving prefrontal cortex, precentral and postcentral gyri and superior parietal lobule. These results may be relevant for the comprehension of the pathophysiology of several neurological disorders involving substantia nigra, such as parkinson’s disease, schizophrenia and pathological addictions.