Objective: Cognitive impairments are a devastating consequence of acquired brain injury (ABI) in children. Current pediatric tools for assessing cognitive impairments are generally time intensive and applicable only to a restricted age span. The National Institutes of Health Toolbox–Cognition Battery (NIHTB-CB) is a standardized, tablet-based cognitive assessment that has been normed across the life span in the general population and validated in adults with brain injuries. However, its clinical utility and validity has not yet been demonstrated in pediatric patients with brain injuries. The current study examines the feasibility of NIHTB-CB administration in both a pediatric inpatient and day treatment rehabilitation setting. Design: The NIHTB-CB was attempted in 40 children with ABI aged 4–18 years within 1 year of injury in pediatric rehabilitation settings. Results: Of the 40 participants tested, 38 (95%) were able to complete the full battery and 28 were able to complete it in 1 session. The average time to complete the NIHTB-CB for our sample was 40.2 min. Barriers to completion included both external (scheduling conflicts) and internal (fatigue, attention, and behavioral) limitations. Cohort results are consistent with expected impairments following ABI. Conclusions: This study demonstrates the feasibility of using the NIHTB-CB in postacute pediatric inpatient rehabilitation and day-treatment clinical settings following ABI. The NIHTB-CB has the potential to provide a quick, standardized assessment of cognitive function during the rehabilitation process. Further longitudinal studies of NIHTB-CB using larger samples will be needed to determine its validity, test-retest capabilities, and clinical utility.

Apparently healthy persons (n = 425) s well s 264 patients characterized by an iron concentration in serum < 7.2 μιηοΐ/ΐ were examined. A latent iron deficiency was defined s a concentration of ferritin < 20 μg/l (males) and < 15 μ^Ι (females), without anaemia; manifest iron deficiency defined by an additional presence of hypochromic microcytic anaemia.Fifty-nine of 425 (= 14%) apparently healthy persons showed a latent iron deficiency. In the remaining 366 we established the following reference intervals for the concentration of transferrin in serum [μιηοΐ/ΐ]: 25.2-45.3 (males), 29.1-54.5 (females, < 25 years of age) and 25.3-48.6 (females, > 25 years of age). Eight of 59 (= 14%) apparently healthy persons with latent iron deficiency had a transferrin concentration above the reference interval.Sixty-one of 264 (= 23%) patients with an iron concentration < 7.2 μπιοΐ/ΐ showed a ferritin concentration < 20 μg/l (males) and < 15 μg/l (females). Thirty-eight of these 61 patients (= 62%) had a manifest iron deficiency. In 18 of these 38 patients (= 47%) the transferrin concentration was increased.For our 264 patients we determined the diagnostic validity of an increased transferrin concentration for diagnosis of iron deficiency, assuming an iron deficiency if the concentration of ferritin remained below the discrimination values mentioned above: The diagnostic sensitivity was 36%, the diagnostic specificity 97%, the predictive value of the positive test result 79% and the predictive value of the negative test result 83%.It can be concluded that the diagnostic validity of transferrin determination is inferior to that of ferritin measurement with respect to the diagnosis of iron deficiency. This especially applies to diagnostic situations in which the prevalence of iron deficiency is far lower than in the present study: e. g., given a prevalence of iron deficiency anaemia of 0.81% s it can be observed in the general population the predictive value of the positive test result only amounts to 11.3%.Thus, determination of transferrin conceiitratiori does not yield further Information, so that this test should no longer be used in the diagnosis of iron deficiency.n. o uc ιοη j ron faficiency is categorized s follows (for review see Iron deficiency is the most common deficiency caused j c o)): world-wide by faulty feeding. About 10-12% of all adults are characterized by a negative iron balance, in chil-(a) Prelatent iron deficiency is characterized by an indren the frequency is higher and in pregnant women the creased absorption of iron (e. g., in the course of the value is more than 50%. Iron deficiency anaemia makes 59 Fe 2 * whole-body retention test) s well s by a deup more than 70% of all kinds of anaemia (1).creased amount of stored iron within the bone marrow.

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