Validation of Irma Cgea/crenk One Method of Evaluation of the Vitamin D at the Regional Center of Nuclear Study Laboratory of Kinshasa

The aim of the present study was to validate the method IRMA CGEA/CRENK for the evaluation of the vitamin D status by comparison to the commercial method DIASORIN. A blood sample was obtained from 30 volunteers with a good health state in general population (11 women and 19 men) to determine serum 25(OH) D, concentrations by all those methods. Using local laboratory cutoffs, vitamin D insufficiency and deficiency was defined as 25(OH) D values of 4-14 ng/ml and ˂ 4 ng/ml, respectively; vitamin D sufficiency as ≥15ng/ml [23]. Statistical analyses were performed using Excel 12.0 and SPSS 21 statistical software’s. Mean and standard deviation (SD), were used to evaluate the mean of vitamin D of the two methods. Student t TEST was used to compare mean of the two methods.  P value ≤ 0.05 defined the level of statistical significance. PEARSON correlation coefficient (r) was performed to evaluate the correlation between the two methods.  An r=0 means the missing of correlation: r<0 means a negative correlation; r=1 means a positive and perfect correlation; 0, 75<r<1 means a positive and strong correlation.  The concordance between IRMA CGEA/CRENK and the commercial method DIASORIN has been definite as the missing of statistic difference between the means of vitamin D with the two methods and a positive correlation between the levels of vitamin D of the two methods. The coefficient kappa was calculated for avoiding the rate of random in the concordance. The variations of the coefficient Kappa is ±1.  K= -1 means total discordance.  K=+1 means an absolute concordance. K near 0 means a mean concordance explain by random. K>0, 8 (80%) is the limit of the better concordance. No statistic difference was observed between the means of vitamin D of the method IRMA CGEA/CRENK and the commercial method DIASORIN (p=0,330).  The coefficient of correlation was: r = 0, 96. The equation of correlation was: y =1,429 + 1, 02 x (y= IRMA CGEA/CRENK, x= DIASORIN Commercial).  The coefficient kappa = 0, 85. 

Degenerative adversarial neuroimage nets for brain scan simulations: Application in ageing and dementia

Accurate and realistic simulation of high-dimensional medical images has become an important research area relevant to many AI-enabled healthcare applications. However, current state-of-the-art approaches lack the ability to produce satisfactory high-resolution and accurate subject-specific images. In this work, we present a deep learning framework, namely 4D-Degenerative Adversarial NeuroImage Net (4D-DANI-Net), to generate high-resolution, longitudinal MRI scans that mimic subject-specific neurodegeneration in ageing and dementia. 4D-DANI-Net is a modular framework based on adversarial training and a set of novel spatiotemporal, biologically-informed constraints. To ensure efficient training and overcome memory limitations affecting such high-dimensional problems, we rely on three key technological advances: i) a new 3D training consistency mechanism called Profile Weight Functions (PWFs), ii) a 3D super-resolution module and iii) a transfer learning strategy to fine-tune the system for a given individual. To evaluate our approach, we trained the framework on 9852 T1-weighted MRI scans from 876 participants in the Alzheimer's Disease Neuroimaging Initiative dataset and held out a separate test set of 1283 MRI scans from 170 participants for quantitative and qualitative assessment of the personalised time series of synthetic images. We performed three evaluations: i) image quality assessment; ii) quantifying the accuracy of regional brain volumes over and above benchmark models; and iii) quantifying visual perception of the synthetic images by medical experts. Overall, both quantitative and qualitative results show that 4D-DANI-Net produces realistic, low-artefact, personalised time series of synthetic T1 MRI that outperforms benchmark models

Uterine Leiomyoma in Kinshasa, the Capital of the Democratic Republic of Congo

The aim of the present study was to determine the particularities of Uterine Leiomyomas among Congolese in Kinshasa the capital of the Democratic Republic of Congo (DRC) in the present conditions of medical practices. A sample of 644 patients with uterine leiomyoma were selected from 6440 cases of uterine leiomyoma among 30395 patients treated in gynecology units of three medical institutions of Kinshasa (University hospital of Kinshasa, Saint joseph hospital and Edith medical center) from January Ist ,2003 to December 31,2012. The study is a descriptive one. The following variables were taken account: medical history [age, age at menarche, parity, education, civil state, history of UL, symptoms and body mass index (BMI)]; lifestyle (smoking, alcohol intake); ultrasounds characteristics; hysteroslpingographies characteristics, treatment, and direct cost of treatment. Statistical analysis were performed using Excel 12.0 software. Demographic, clinical, ultrasound, hysterosalpingography and treatment data were evaluated using descriptive statistics: mean, standard deviation (SD), and percentage (%) as appropriate. The frequency of uterine leiomyoma was 21, 18%. That one concern mainly patients at 35 years old or more [49, 6% (35-44years), ?45years (20, 6%)], singles (70, 4%), null parous (59,4%), having a high level of study (university: 54, 6%), history of UL (56, 7%), and alcohol intake (75, 5%). Hemorrhage (33, 2%) and pelvic pain (31, 6%) are the most frequent expression of those tumors. The most of those patients have excess weight (43, 1%) or obesity (46, 5%). The majority of uterine leiomyoma was corporeal (82, 9%) intramuscular (42, 4%) and their number didn’t overtake five by patient (70, 8%) in majority of cases. Majoration of the uterine cavity (46, 5%) and Fallopian tubes obstructions (30, 6%) are the most frequent abnormalities in hysterosalpingography. Myomectomy is the main treatment (65, 2%). The mean of direct cost were 803$USA and 884$ USA for myomectomy and hysterectomy respectively

Leveraging Ellipsoid Bounding Shapes and Fast R-CNN for Enlarged Perivascular Spaces Detection and Segmentation

Enlarged perivascular spaces (EPVS) are small fluid-filled spaces surrounding blood vessels in the brain. They have been found to be important in the development and progression of cerebrovascular disease, including stroke, dementia, and cerebral small vessel disease. Their accurate detection and quantification are crucial for early diagnosis and better management of these diseases. In recent years, object detection techniques such as Mask R-CNN approach have been widely used to automate the detection and segmentation of small objects. To account for the tubular shape of these markers we use ellipsoid shapes instead of bounding boxes to express the location of individual elements in the implementation of the Fast R-CNN. We investigate the performance of this model under different modality combinations and find that the T2 modality alone, as well as the combination of T1+T2, deliver better performance

The value of subtraction MRI in detection of amyloid-related imaging abnormalities with oedema or effusion in Alzheimer's patients: An interobserver study

BACKGROUND: Immunotherapeutic treatments targeting amyloid-β plaques in Alzheimer's disease (AD) are associated with the presence of amyloid-related imaging abnormalities with oedema or effusion (ARIA-E), whose detection and classification is crucial to evaluate subjects enrolled in clinical trials. PURPOSE: To investigate the applicability of subtraction MRI in the ARIA-E detection using an established ARIA-E-rating scale. METHODS: We included 75 AD patients receiving bapineuzumab treatment, including 29 ARIA-E cases. Five neuroradiologists rated their brain MRI-scans with and without subtraction images. The accuracy of evaluating the presence of ARIA-E, intraclass correlation coefficient (ICC) and specific agreement was calculated. RESULTS: Subtraction resulted in higher sensitivity (0.966) and lower specificity (0.970) than native images (0.959, 0.991, respectively). Individual rater detection was excellent. ICC scores ranged from excellent to good, except for gyral swelling (moderate). Excellent negative and good positive specific agreement among all ARIA-E imaging features was reported in both groups. Combining sulcal hyperintensity and gyral swelling significantly increased positive agreement for subtraction images. CONCLUSION: Subtraction MRI has potential as a visual aid increasing the sensitivity of ARIA-E assessment. However, in order to improve its usefulness isotropic acquisition and enhanced training are required. The ARIA-E rating scale may benefit from combining sulcal hyperintensity and swelling. KEY POINTS: • Subtraction technique can improve detection amyloid-related imaging-abnormalities with edema/effusion in Alzheimer's patients. • The value of ARIA-E detection, classification and monitoring using subtraction was assessed. • Validation of an established ARIA-E rating scale, recommendations for improvement are reported. • Complementary statistical methods were employed to measure accuracy, inter-rater-reliability and specific agreement

Vitamin D Deficiency and Risk of Uterine Leiomyoma among Congolese Women. A Hospital-Based Case-Control Study

The aim of the present study was to assess the relationship, between Vitamin D deficiency and uterine leiomyoma in Congolese women.From April 1 to October 31, 2014, 216 patients with ultrasound diagnosis of uterine leiomyoma (cases) and 216 women without this condition (controls) recruited in six medical facilities in Kinshasa were enrolled in the present study. A single blood sample was obtained from all participants to assess serum17β-estradiol and progesterone concentration using RIA and 25(OH) D by IRMA. Vitamin D deficiency was defined as 25(OH) D levels <4 ng/mL and <12 ng/mL using local and IOM cut-off levels, respectively. Chi square, Student t and Mann Whitney tests were used for group comparison. Logistic regression analysis was used to identify factors associated with Vitamin D deficiency. Vitamin D deficiency was observed in 17.1% and 47.7% of patients with ULM using local and IOM criteria defining different steps of vitamin D respectively. Compared to controls, the difference was statistically significant only when using local criteria (17.7% vs 10.2%; p = 0.028).ULM main risk factors were age ≥35 years (aOR=2,974; 95%CI 1,702-5,139; p = 0,001); null parity (aOR=3,951;95%CI 2,311-6,754;  p= 0,001). Familial history of ULM (aOR=2,619; 95% CI 1,376-4,986; p =0,003) personal history of ULM a(OR3,776; 95% CI 1,885-7,565;  p=0,001); absence of menopause(OR5,502; 95% CI 2,615-11,517; p= 0,001); high serum progesterone levels (aOR 2,320 95% CI1,136-4,711; p= 0,021),   alcohol consumption  (aOR0,295; 95 % CI 0,150-0,580; p= 0,001) and Vitamin D deficiency(aOR2,153; 95% CI 1,035-4,517; p=  0,040).  Vitamin D deficiency was a common finding in patients with ULM and emerged as one of the main risk factors. However, this relationship need to be confirmed with a representative sample of women with ULM

The relation between APOE genotype and cerebral microbleeds in cognitively unimpaired middle- and old-aged individuals

Positive associations between cerebral microbleeds (CMBs) and APOE-ε4 (apolipoprotein E) genotype have been reported in Alzheimer's disease, but show conflicting results. We investigated the effect of APOE genotype on CMBs in a cohort of cognitively unimpaired middle- and old-aged individuals enriched for APOE-ε4 genotype. Participants from ALFA (Alzheimer and Families) cohort were included and their magnetic resonance scans assessed (n = 564, 50% APOE-ε4 carriers). Quantitative magnetic resonance analyses included visual ratings, atrophy measures, and white matter hyperintensity (WMH) segmentations. The prevalence of CMBs was 17%, increased with age (p < 0.05), and followed an increasing trend paralleling APOE-ε4 dose. The number of CMBs was significantly higher in APOE-ε4 homozygotes compared to heterozygotes and non-carriers (p < 0.05). This association was driven by lobar CMBs (p < 0.05). CMBs co-localized with WMH (p < 0.05). No associations between CMBs and APOE-ε2, gray matter volumes, and cognitive performance were found. Our results suggest that cerebral vessels of APOE-ε4 homozygous are more fragile, especially in lobar locations. Co-occurrence of CMBs and WMH suggests that such changes localize in areas with increased vascular vulnerability

Bcl2, Bax and LMP1 Genes Expression in Uterine Leiomyoma Tissue According to Vitamin D Status among Congolese Women

The objective of this paper is to describe genes expression patterns of the anti-apoptotic Bcl2 and pro apoptotic Bax as well as EBV infection marker LMP1 in, leiomyoma tissue according to patients vitamin D status. To investigate the relationship between alterations of genes expression patterns and serum vitamin D levels, samples from 105 women undergoing surgery for uterine leiomyoma in 6 hospitals in Kinshasa from April 1 to October 31, 2014 were obtained for genes expression analysis of Bcl-2, Bax and LMP-1 genes. Genes expression in leiomyomas was measured by immunohistochemistry. Serum vitamin D levels were determined by IRMA. Association between vitamin D status and genes expression was assessed using logistic regression analysis. From 105 women providers of leiomyoma tissues examined, 41 were sufficients in vitamin D, 36 were insufficients and 28 deficients. In uterine leiomyoma tissues obtained Bcl2 was expressed in 96 (91.4%) of samples with low, moderate and high expression observed in 33.3%, 32.4% and 25.7%, respectively. The differences in Bcl2 expression between the three subgroups of vitamin D categories were not statistically significant.As a mirror of Bcl2 expression, Bax protein was not expressed in the majority (n = 95, 90.5%) of samples. Similar to Bcl2, the differences in Bax expression between the three subgroups of vitamin D categories did not reach the level of statistical significance. Of the 105 leiomyoma tissue examined, LMP1 was observed in 30 (28.6%) of samples and showed a tendency towards increased expression with the decline in vitamin D levels; however, the tendency was fairly not statistically significant.In multivariate analysis, predictors of Bcl2 expression were age, parity, and overweight/obesity and insufficiency/deficiency vitamin D; however, the differences observed were not statistically significant. The same predictors were also associated with Bax expression but once again the observed differences were not statistically significant. Vitamin D deficiency, the only predictor significantly associated with LMP1 expression, conferred a 3.9 fold greater risk (aOR 3.9; 95% CI 1.068-14.242; p = 0.039) of expressing LMP1 in leiomyoma tissue.In the present study, Bcl2 gene expression in ULM tissues tended to increase with the decline in vitamin D levels but observed differences were not statistically significant. In contrast, LMP1 gene expression was significantly associated with vitamin D deficiency. In spite of methodological limits, these findings do suggest a role of Vitamin D deficiency in the development and progression of ULM