Evaluation of the accuracy of a non-invasive hemoglobin-monitoring device in schoolchildren.

BACKGROUND: Iron deficiency anemia (IDA) is a public health problem in children and adolescents that is characterized by reduced hemoglobin (Hb) levels. Non-invasive monitoring devices can measure Hb levels continuously without pain or discomfort; however, little is known about their accuracy in children and adolescents. This study estimated the accuracy of a non-invasive Hb monitor in this age group. METHODS: Participants were outpatients visiting the Tokyo Metropolitan Children's Medical Center for blood tests between January and March 2019. Hb levels were measured using both non-invasive Astrim Fit monitoring devices and invasive blood collection followed by automated analysis. Bland-Altman analysis assessed the agreement between the two measurements. RESULTS: Overall, 120 schoolchildren (9-15 years old, 51 % female) were enrolled. The non-invasive measuring device recorded Hb levels of 13.5 ± 1.6 g/dL (mean ± standard deviation [SD]), while the mean Hb level obtained from the collected blood was 13.7 ± 1.7 g/dL. Therefore, the mean difference of bias and SD of precision was 0.17 ± 1.95 g/dL. Values of lower and upper limits of agreement were -3.65 and 3.99, respectively. There was no systematic fixed or proportion bias. Fifty-nine participants (49 %) had a relative error of ± 0.10. CONCLUSION: The Astrim Fit non-invasive Hb monitor can be used to evaluate Hb levels among schoolchildren for health promotion or research purposes because of its extremely low bias (or precision), no systematic biases (including fixed or proportion biases), and positive correlation between non-invasive monitoring and blood drawing. However, it is difficult to assess Hb levels in children and adolescents using the Astrim Fit device for diagnostic purposes.

[Establishing indicators for diagnosis of cholinergic crisis].

Cholinergic crisis is an adverse effect of an anticholinesterase agent, which is one of the cholinergic agents. Cholinergic crisis may induce serious conditions such as breathing difficulties. Cholinergic crisis is often diagnosed by an abnormally low level of serum cholinesterase (ChE). However, ChE value is not an appropriate indicator of cholinergic crisis since it has a high inter-individual variation, even though its intra-individual variation is low. Therefore, an indicator with less inter-individual variation capable of preventing the risk of cholinergic crisis was investigated. The results of correlation test between ChE and serum albumin (Alb) showed a strong positive correlation; r = 0.778 in BCG method(Bromo cresol green method) and r = 0.766 in the BCP-improved method for Alb. In addition, the variations of Alb values are much lower than the drastic depression of ChE values in cholinergic crisis. Thus, it is considered that the ratio of ChE and Alb (ChE/Alb) can be a useful indicator of cholinergic crisis. As a result of ROC (Receiver operating characteristic) analysis, the ratios of ChE and Alb values using the BCG method (ChE/Alb (BCG)) were 20.7, 87.0, 156.8 for the Cutoff value, Likelihood ratio and Odds ratio respectively. When using the BCP-improved method for Alb, the ratios of ChE and Alb (ChE/Alb(BCP improved)) were 25.0, 93.7, 180.1 for the Cutoff value, Likelihood ratio and Odds ratio respectively. The ChE/Alb ratio appears to be an excellent indicator of cholinergic crisis diagnosis since it shows a high likelihood ratio as well as a high odds ratio.

[History of the histological staining survey in the Tokyo Metropolitan Hospital].

The Tokyo metropolitan hospital society of chief medical technologist has carried out a staining survey once a year since 1992. This staining survey is performed to plan improvements of the staining technology at each hospital and reduction of differences among hospitals. This report describes the examination results for PAS stain, Papanicolaou stain, and PAM stain.