SUMMARY The HemoCue haemoglobinometer was evaluated as part of a programme to screen children aged 11-36 months for anaemia when they attended a routine immunisation clinic. Paired capillary blood samples were collected and measured on the haemoglobinometer and on a Coulter counter model S. Measurements made from bottle collected capillary samples were more precise than those made from single drops of blood. After compensation for a fixed bias the haemoglobinometer had a sensitivity of 0-85 and a specificity of 0-94 when used to detect anaemia.Careful attention must be paid to the method of blood collection. We suggest that cuvettes are filled from bottle collected capillary samples rather than single blood droplets taken direct from the finger. The haemoglobinometer was reliable, simple to use with the minimum of training, and proved to be suitable for use in a community child health clinic.Iron deficiency anaemia in children retards the attainment of developmental milestones, causes growth to slow down, and increases the risk of infection.' 2 These factors have led to calls for routine screening for anaemia in infants.5 The ability to measure haemoglobin concentration quickly, accurately, and with minimal trauma will form an important part of any screening programme.The HemoCue haemoglobinometer (Clandon Scientific) is a portable machine that measures haemoglobin by photometric assay with disposable plastic cuvettes. Only 10 ,ul of blood is required and the result is shown on a liquid crystal display within 60 seconds. It is accurate and precise when used on mixed venous blood in laboratory conditions.6This study was designed to evaluate the system in an infant welfare clinic using finger prick blood samples. Subjects and methodsParents of children aged 11 to 36 months attending four different immunisation clinics in east London were invited to participate in a programme to screen their child for anaemia. Parents were approached on arrival at the clinic and were given a short verbal and written description of the test. The verbal information was always given by the same person (AFM).Translators were present, and the written description was available in English, Urdu, Bengali, Punjabi, and Gujarati. The screening test was always undertaken after immunisation.Finger prick blood was sampled using a spring loaded lancet device (Autolet). No preparation (such as warming the finger) was necessary. This blood was collected into a 1-8 ml bottle containing edetic acid. A cuvette was filled directly from the finger (direct method) and a second cuvette was filled from the specimen in edetic acid after it had been carefully agitated (bottle method). Cuvettes were measured immediately they had been filled. The remainder of the specimen in edetic acid was sent for routine laboratory analysis on a Coulter counter 'S' at the Whipps Cross Hospital haematology laboratory.Results that were below the 95% reference range for haemoglobin concentration (<110 g/l) were classified as anaemic.7Standardisation of the HemoCue to the Coul...

The association between patterns of milk intake and anaemia was studied during a sur-

NUT midline carcinoma (NMC) is a rare, genetically defined, highly lethal undifferentiated carcinoma occurring in the midline location of the neck, head or mediastinum. We present the case of a 23 year-old otherwise healthy Chinese male immigrant who presented with complaints of sore throat and right sided neck mass. The initial treatment was for likely EBV infection with streptococcal superinfection. Although continued investigation was pursued shortly after initial presentation, the mass had enlarged and become necrotic with significant nodal involvement. The mass was diagnosed as an NMC tumor with a novel three-way translocation t(9;15;19; q34;q13; p13.1). Despite aggressive treatment, the patient's condition progressed rapidly and he died within 3 months of initial diagnosis. Standard therapeutic interventions have been ineffective in the treatment of NMC. Earlier diagnosis could allow characterization of the natural progression of this entity, and allow more time for intervention or development of novel therapies, potentially related to molecular targets. This continues to require a high index of suspicion and early imaging with cytogenetic and immunohistochemical confirmation.

Continued improvements in diagnostic accuracy using magnetic resonance (MR) imaging will require development of methods for tissue analysis that complement traditional qualitative MR imaging studies. Quantitative MR imaging is based on measurement and interpretation of tissue-specific parameters independent of experimental design, compared with qualitative MR imaging, which relies on interpretation of tissue contrast that results from experimental pulse sequence parameters. Quantitative MR imaging represents a natural next step in the evolution of MR imaging practice, since quantitative MR imaging data can be acquired using currently available qualitative imaging pulse sequences without modifications to imaging equipment. The article presents a review of the basic physical concepts used in MR imaging and how quantitative MR imaging is distinct from qualitative MR imaging. Subsequently, the article reviews the hierarchical organization of major applicable pulse sequences used in this article, with the sequences organized into conventional, hybrid, and multispectral sequences capable of calculating the main tissue parameters of T1, T2, and proton density. While this new concept offers the potential for improved diagnostic accuracy and workflow, awareness of this extension to qualitative imaging is generally low. This article reviews the basic physical concepts in MR imaging, describes commonly measured tissue parameters in quantitative MR imaging, and presents the major available pulse sequences used for quantitative MR imaging, with a focus on the hierarchical organization of these sequences. RSNA, 2017.