It is estimated that around 20% of patients with systemic lupus erythematosus (SLE) have their onset in childhood but there have been conflicting data about the prevalence and severity of the clinical features in different age classes. We conducted this study to analyse the clinical features of patients with pediatric SLE (pSLE) with onset in infancy, prepubertal and postpubertal age. The charts of patients followed at the Department of Pediatrics, University of Padua, who met the criteria for SLE diagnosis, were reviewed. Patients were divided into three groups based on age at disease onset: group A, patients < or =2 years old, group B patients aged between 2 and 10 years, group C patients between 11 and 16 years of age. The clinical and laboratory characteristics of each group were compared. Forty-two patients with pSLE entered the study: 2 were diagnosed before the age of 2 years, 11 between 2 and 10 years and 29 between 10 and 16 years. Eleven more patients with infantile (onset <2 years) SLE (iSLE) were found by a systematic literature search on PubMed and EmBASE and added for analysis to the group A. The female preponderance was significant only in postpubertal patients (F:M = 6.3: 1) whereas the other two groups presented a similar F:M ratio (1.2: 1). In comparison with the other two groups, iSLE showed a significantly higher prevalence of cardiovascular and pulmonary involvement, anemia and thrombocytopenia and a shorter disease duration at time of diagnosis. The postpubertal group showed a higher frequency of musculoskeletal involvement and leukopenia. In prepubertal patients there was no female preponderance and the frequency of clinical features was intermediate between infantile and postpubertal patients. Complement fractions level, antinuclear antibodies (ANA), anti-dsDNA, anti-cardiolipin antibodies and lupus anti-coagulant autoantibodies were not significantly different in the three groups. In general, the prevalence of internal organs involvement in pSLE seems to decrease with age. In infants, SLE is more severe than in the following ages. Postpubertal patients have a strong female preponderance and more specific signs of disease at onset. Prepubertal patients have an intermediate disease severity and no gender predilection.

This study presents a new measure of the hemodynamic changes to an auditory stimulus in newborns. Nineteen newborns born at 28-41 wk and aged 1 to 49 d were studied in waking and/or sleeping state, for a median time of 4 min 40 s before, 2 min 40 s during, and 3 min 5 s after an acustic stimulus (tonal sweep of frequency increasing from 2 to 4 kHz, intensity 90 dB SPL) originating 5 cm from the external auditory meatus. The emitter and detector optodes were placed over the left or right temporal region, corresponding to T3 or T4 EEG electrodes. Near-infrared transmission spectroscopy (NIRS) through tissue is made possible by the transparency of biologic tissue to light in the near-infrared region (750 -1000 nm). The noninvasive nature of the technique and the portability of the device, combined with the relative transparency of the neonatal head, explain the early applications of the machine in neonatal intensive care units, to the observation of hemodynamic brain responses. Our study presents a method for applying NIRS to the testing of central auditory response in newborns by using an acustic stimulus, a tonal sweep with a frequency increasing from 2 to 4 KHz. The incident near-infrared light from the transmitting optode is scattered through the tissues, and the reflected light is read by a receiving optode. The amount of the light that a compound absorbs is dependent upon the wavelength of the incident light upon it, and is described by the spectrum of a single compound. Brain absorption of the light is due to the main cerebral chromophores, oxyhemoglobin (HbO 2 ), deoxyhemoglobin (Hb), and oxidized cytochrome oxidase (CtOx) and is determined by the oxygenation status of the compound. Through NIRS we measured the loss of the intensity due to absorption of the incident photons by these solutes; this loss or attenuation is usually measured in units of OD (OD) and can be calculated using the Beer-Lambert law. For an absorbing compound dissolved in a nonabsorbing medium, the attenuation (A) is proportional to the concentration of the compound in the solution (c), the specific extinction coefficient of the compound (␣) and the optical path length (

<b>Background -</b> International literature documents that children and adolescents infected with the coronavirus develop moderate symptoms and a favourable prognosis. However, the pandemic has had a major impact on children’s health and the paediatricians’ work. The clinical work of paediatricians has significantly changed. <br> <b>Aims, materials and methods -</b> A qualitative pilot research was conducted thanks to the participation of 13 privileged witnesses. Through an anonymous questionnaire, the present research detected the changes in the overall activity of the Italian family paediatrician and the impact of the pandemic on their professional activity during the lockdown. The thematic analysis of the answers made it possible to focus on the main changes of the paediatric profession and explore the characteristics of its resilience, highlighting the most significant difficulties that paediatricians faced during Phase 1. <br> <b>Results and discussion -</b> What was lost in the clinical activity, towards the patient with acute pathology or in the prevention activity, has been regained with a new use of known means, such as telephone and email, or thanks to the use of new tools such as WhatsApp and video (telemedicine): those that were subsidiary means before the pandemic have become effective and permanent endowments of the paediatrician after the lockdown. Together with the technical acquisition, the professional identity has been strengthened in terms of shared professionalism, especially as to relationships with colleagues and the collaboration of families.