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Background: Celiac disease, a prevalent autoimmune disorder, frequently coexists with various syndromes and autoimmune conditions. The leading cause of acquired hypothyroidism, wherein T cells target the thyroperoxidase enzyme, causing irreversible damage to the thyroid gland. According to the conflicting results presented in the studies, we aimed to determine the relationship between celiac disease and thyroid ultrasound findings. Materials and Methods: 62 patients who were referred to the hospital and suffering from celiac disease were included in the study. After obtaining informed consent from the patients, a questionnaire related to demographic characteristics, including age and sex, was completed, and the patients were subjected to ultrasonography of the thyroid gland. The collected information was entered into SPSS software version 16 for data analysis. Results: The mean duration of celiac disease was 6.03 years. No cases of heterogeneity were found in the thyroid ultrasonography of the healthy control group, but in the group of celiac patients, 24 cases (38.7%) had heterogeneous thyroids. In the ultrasound examination, the average volume of the left and right lobes and the thickness of the thyroid isthmus in the group of celiac patients was significantly smaller than that of healthy individuals. (P<0.05). In the sonographic examination of the thyroid of patients with celiac disease, six patients who had a heterogeneous appearance also had Hashimoto's. The prevalence of thyroid nodularity was 35.5% in celiac patients and 5.7% in the control group (P<0.001). Conclusion: Thyroid ultrasonography in patients with celiac disease shows gland shrinkage, diffuse heterogeneity, nodularity, and typical manifestations of Hashimoto's thyroiditis compared with the normal population. [ABSTRACT FROM AUTHOR]

Background: Notwithstanding the encouraging results of previous studies reporting on the efficiency of deep learning (DL) in COVID‐19 prognostication, clinical adoption of the developed methodology still needs to be improved. To overcome this limitation, we set out to predict the prognosis of a large multi‐institutional cohort of patients with COVID‐19 using a DL‐based model. Purpose: This study aimed to evaluate the performance of deep privacy‐preserving federated learning (DPFL) in predicting COVID‐19 outcomes using chest CT images. Methods: After applying inclusion and exclusion criteria, 3055 patients from 19 centers, including 1599 alive and 1456 deceased, were enrolled in this study. Data from all centers were split (randomly with stratification respective to each center and class) into a training/validation set (70%/10%) and a hold‐out test set (20%). For the DL model, feature extraction was performed on 2D slices, and averaging was performed at the final layer to construct a 3D model for each scan. The DensNet model was used for feature extraction. The model was developed using centralized and FL approaches. For FL, we employed DPFL approaches. Membership inference attack was also evaluated in the FL strategy. For model evaluation, different metrics were reported in the hold‐out test sets. In addition, models trained in two scenarios, centralized and FL, were compared using the DeLong test for statistical differences. Results: The centralized model achieved an accuracy of 0.76, while the DPFL model had an accuracy of 0.75. Both the centralized and DPFL models achieved a specificity of 0.77. The centralized model achieved a sensitivity of 0.74, while the DPFL model had a sensitivity of 0.73. A mean AUC of 0.82 and 0.81 with 95% confidence intervals of (95% CI: 0.79–0.85) and (95% CI: 0.77–0.84) were achieved by the centralized model and the DPFL model, respectively. The DeLong test did not prove statistically significant differences between the two models (p‐value = 0.98). The AUC values for the inference attacks fluctuate between 0.49 and 0.51, with an average of 0.50 ± 0.003 and 95% CI for the mean AUC of 0.500 to 0.501. Conclusion: The performance of the proposed model was comparable to centralized models while operating on large and heterogeneous multi‐institutional datasets. In addition, the model was resistant to inference attacks, ensuring the privacy of shared data during the training process. [ABSTRACT FROM AUTHOR]

Background: According to the significance of extraintestinal symptoms in inflammatory bowel disease (IBD) patients and their connection with obesity, we aimed to investigate the prevalence of fatty liver in IBD patients of Sayyad Shirazi Hospital in Gorgan, Iran, in relation to obesity, anthropometric indicators and body image in these patients. Methods: Forty patients with IBD were recruited from all registered patients at the Golestan Research Center of Gastroenterology and Hepatology, following the specified inclusion and exclusion criteria. After obtaining written informed consent and filling in the questionnaire, the demographic and anthropometric indicators, and variables related to the disease were measured. The liver sonography was performed on all patients and graded by an expert radiologist. Data were analyzed using SPSS Version 16.0 statistical software at the significance level of 0.05. Results: We showed no significant difference between the distribution of demographic and anthropometric indicators in different groups of IBD patients. However, we demonstrated that the inappropriate values of HDL (0.004) and high values of LDL (0.015) were associated with fatty liver in IBD patients. Our findings also showed that NAFLD was significantly associated with overweight and obesity among IBD patients (P = 0.003). Conclusion: Our findings showed the epidemiological burden of NAFLD in IBD patients. Since fatty liver was associated with obesity, it is recommended that IBD patients be screened for risk factors associated with NAFLD to prevent liver disease. [ABSTRACT FROM AUTHOR]

Background: Assessing the measurable chest computed tomography (CT) scan cardiac parameters can help us evaluate cardiovascular involvement and risk stratification in patients with coronavirus disease 2019 (COVID-19). Objectives: This study investigated the measurable chest cardiac CT indices and their association with predicting outcomes in patients with COVID-19. Patients and Methods: Patients with confirmed COVID-19 were included in the study from March up to June 2020 and underwent chest CT scans on admission. The following parameters were analyzed: The extent and pattern of lung involvement, cardiothoracic ratio (CTR), pulmonary artery to aorta ratio (PA/A), pericardial effusion, pleural effusion, and inferior vena cava (IVC) diameter through low-dose CT scan. The association between cardiac indices and patients and the extent of lung involvement outcome was evaluated by logistic regression, Cox regression, and linear regression, respectively. Results: A total of 176 COVID-19 patients (51.1% men and 48.9% women) were enrolled in the study. Of them, 55 patients (31.25%) died, and 121 patients were discharged (68.75%). Themeanage of participants was 64.9 ± 15.09 years. CTR > 0.49 wasmorefrequentamong deceased patients (50.9% vs. 31.4%, P = 0.018) and was associated with non-significant increases in odds ratio (OR) and hazard ratio (HR) (OR = 1.75, P = 0.11; HR= 1.43, P = 0.19). Moreover, PA/A> 1 was morecommonin deaths (52.7% vs. 32.2%; P = 0.012) and significantly increased OR but not HR (OR = 1.99; P = 0.04; HR = 1.36; P = 0.26). The moderate and severe pleural effusion was noticeably associated with prolonged hospitalization (HR = 4.09, P = 0.01; HR = 3.37, P = 0.02, respectively). The IVC diameter and pericardial effusion were not significantly correlated with outcomes. Conclusion: Cardiac indices in chest CT of COVID-19 patients can be accounted for the prediction of patient outcomes in the clinic, such as PA/A > 1 ratio, which increases the likelihood of in-hospital deaths. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CD), or as it is called gluten enteropathy, could result in various complications such as liver abnormalities. Nonalcoholic fatty liver disease (NAFLD) affects 25.2% of individuals worldwide and has become one of the most common causes of cirrhosis. This study aimed to report the frequency of fatty liver in ultrasonography of patients with CD in Golestan province, Northeast Iran. Materials and Methods: In this cross-sectional study, patients diagnosed with CD based on a positive anti-tTG Ab and proved by small bowel biopsy were recruited between March 2018 and March 2020 (N=80), through the registry system located in Golestan Research Center of Gastroenterology and Hepatology, Northeast Iran. Ultrasonography was performed and the fatty liver diagnosis was done based on attenuation of the liver itself (less than 40 Hounsfield Unit (HU)) or in comparison with the spleen (liver attenuation≤10, than spleen). Results: Among 80 patients with CD (46 women, mean age 39.13±12.5 years), fatty liver was reported in 34 (43.5%), which was mild in 31 (39%), moderate in 2 (2.5%), and severe in 1 (1.3%) patients. One cirrhosis and no hepatomegaly were found. Conclusion: In the present study, fatty liver was seen in 43.5% of our patients, which is a large amount. It may be suggested to do a closer follow-up of the complications of CD. [ABSTRACT FROM AUTHOR]

Background: Considering the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, which causes coronavirus disease 2019 (COVID-19), we aimed to report the clinical features of 427 patients with COVID-19 and the outcomes after one-month admission to major teaching hospitals in the northeast of Iran. Materials and Methods: Data of patients hospitalized with COVID-19 from 20 February 2020 to 20 April 2020 was analyzed using the R software. The cases and their outcomes were monitored up to one month following their admission. Results: Among 427 patients with a median age of 53 years (50.8% male), 81 (19%) were directly admitted to the ICU ward, and 68 (16%) died during the study. The mean (SD) lengths of hospital stay were significantly higher in the non-survivors (6 (9) days) than survivors (4 (5) days) (P = 0.018). Ventilation need was reported in 67.6% of the non-survivors and 0.8% of the survivors (P < 0.001). Cough (72.8%), fever (69.3%), and dyspnea (64.0%) were the most common symptoms. There were more comorbidities in the severe cases (73.5%) and non-survivor (77.5%). Liver and kidney damage were significantly more common in non-survivors. Ninety percent of the patients had at least one abnormal chest CT scan finding, including crazy paving and consolidation patterns (27.1%), followed by the ground-glass opacity (24.7%). Conclusion: Results showed that the patients’ age, underlying comorbidities, levels of SpO2, and laboratory findings at the time of admission may predict the progress of the disease and can be considered mortality-related factors. [ABSTRACT FROM AUTHOR]

The novel coronavirus infection is a global health concern in 2020. Computerized tomography (CT) scan has an important role in diagnosis and follow-up with the course of the disease. The most common radiologic findings in patients are bilateral peripheral patchy ground-glass opacities and consolidations. Although in a few cases, as we reported, we encountered some rare manifestations such as pneumothorax, pneumomediastinum, and subcutaneous emphysema, which imply distinct concerns about the management and outcome of the disease. Pulmonary interstitial emphysema develops due to an increase in alveolar pressure or because of alveolar rupture, secondary to alveolar membrane damage by the virus and proceed to such a complication. Therefore, it is crucial to be aware of the complications of novel coronavirus infection in the deterioration of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Celiac disease (CD), or as it is called Gluten enteropathy, could result in various complications such as liver abnormalities. Non-alcoholic fatty liver disease (NAFLD) affected 25.2% of individuals worldwide and has become one of the most common causes of cirrhosis. This study aimed to report the frequency of NAFLD, patients with CD in Golestan province, Northeast of Iran. Methods: In this cross-sectional study, patients diagnosed with celiac disease based on a positive anti-tTG Ab and proved in small bowel biopsy were recruited between March 2018 and March 2020 (N=80), through the registry system located in Golestan Research Center of Gastroenterology and Hepatology, Northeast of IRAN. Ultrasonography was performed and NAFLD diagnosis was done based on attenuation of the liver itself (less than 40 Hounsfield Unit (HU)) or in comparison with the spleen (liver attenuation≤10, then spleen). Results: Among 80 CD patients (46 female, mean 39.13±12.5 years) NAFLD was reported in 34(43.5%), which was mild in 31(39%), moderate in 2 (2.5%) and severe in 1 (1.3%). One Cirrhosis and no hepatomegaly had been found. Conclusion: In the present study NAFLD was seen in 43.5% of our CD patients that composed a large amount. This may be suggested to do closer follow-up of the complications in celiac disease. [ABSTRACT FROM AUTHOR]

Background: Liver cancer (LC) is among the most common and fatal cancers worldwide. A four-fold increasing trend is reported for LC age-standardized mortality rate (ASMR) in Iran within 1990-2015. In the present study, we aimed to report the incidence rate of LC during the 13-year establishment of the Golestan population-based cancer registry (GPCR). Methods: Age-standardized incidence rate (ASIR) per 100 000 person-years was calculated using CanReg5 software. The Joint point regression analysis was used to assess the temporal trends in incidence rate of LC. Results: During the study period, GPCR registered 575 of LC cases, of which 373 (64.9%) were men and 297 (51.6%) lived in rural areas. The mean (SD) age of LC in men and women were 60.3 (17.2) and 58.0 (17.1), respectively. The ASIR of LC was significantly higher in men than women (4.7 vs. 2.6; P value < 0.01) and a minimal increasing trend in LC incidence was observed in both sexes. The incidence rate of LC was significantly higher in rural areas compared to the urbans (3.91 vs. 3.40; P value = 0.04). In the last 13 years, rural population had a significant increasing trend in ASIR of LC (average annual percent change [AAPC] = 7.85, P value = 0.005). Conclusion: LC was more prevalent in men among both urban and rural populations. The results showed a significant increasing trend in rural areas that requires Golestan health care system to take action in controlling the burden of LC in rural areas. [ABSTRACT FROM AUTHOR]