Background and Aims A few case reports of autoimmune hepatitis–like liver injury have been reported after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccination. We evaluated clinical features, treatment response and outcomes of liver injury following SARS‐CoV‐2 vaccination in a large case series. Approach and Results We collected data from cases in 18 countries. The type of liver injury was assessed with the R‐value. The study population was categorized according to features of immune‐mediated hepatitis (positive autoantibodies and elevated immunoglobulin G levels) and corticosteroid therapy for the liver injury. We identified 87 patients (63%, female), median age 48 (range: 18–79) years at presentation. Liver injury was diagnosed a median 15 (range: 3–65) days after vaccination. Fifty‐one cases (59%) were attributed to the Pfizer‐BioNTech (BNT162b2) vaccine, 20 (23%) cases to the Oxford‐AstraZeneca (ChAdOX1 nCoV‐19) vaccine and 16 (18%) cases to the Moderna (mRNA‐1273) vaccine. The liver injury was predominantly hepatocellular (84%) and 57% of patients showed features of immune‐mediated hepatitis. Corticosteroids were given to 46 (53%) patients, more often for grade 3–4 liver injury than for grade 1–2 liver injury (88.9% vs. 43.5%, p = 0.001) and more often for patients with than without immune‐mediated hepatitis (71.1% vs. 38.2%, p = 0.003). All patients showed resolution of liver injury except for one man (1.1%) who developed liver failure and underwent liver transplantation. Steroid therapy was withdrawn during the observation period in 12 (26%) patients after complete biochemical resolution. None had a relapse during follow‐up. Conclusions SARS‐CoV‐2 vaccination can be associated with liver injury. Corticosteroid therapy may be beneficial in those with immune‐mediated features or severe hepatitis. Outcome was generally favorable, but vaccine‐associated liver injury led to fulminant liver failure in one patient.

Background and goals: The aims of the present study were to investigate the natural history of cirrhosis and to determine trends in the etiology of cirrhosis. Methods: Between January 2001 and January 2018, a total of 1341 patients had been diagnosed with cirrhosis were included. Results: A total of 898 cirrhotic patients, who were followed for at least six months were included into the analysis. The median age was 54 years. The median Child-Pugh and MELD scores were 7.5 and 11, respectively. Ascites (51%) was the most common causes of decompensation. Chronic viral hepatitis was the most frequent cause of cirrhosis (58%). Hepatitis B virus (HBV) infection was the main etiology (34%), followed by hepatitis C virus (HCV) infection (18%). Among 129 patients with cryptogenic cirrhosis (CC), 60 had metabolic abnormalities. If these 60 patients with CC were considered to have non-alcoholic fatty liver disease (NAFLD)-related cirrhosis, the proportion of NAFLD-related cirrhosis increased from 1.8% to 8.0%. At admission, 74 patients (8%) had been diagnosed with hepatocellular carcinoma (HCC). A new HCC developed in 80 patients during the follow-up period. The probability of developing HCC was 3.9% at 12 months. Logistic regression analysis showed that the development of HCC was significantly associated with older age (p<0.001), male gender (p<0.001), viral etiology (p=0.026) and baseline high aspartate aminotransferase level (p=0.01). Overall, 104 cirrhotic patients died. In conclusion: HBV and HCV remain the leading causes of etiology in cirrhosis and HCC. However, NAFLD-related cirrhosis is recognized is recognized as a growing burden.

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Bu araştırmanın amacı, Anadolu Lisesi ve Spor Lisesinde öğrenim gören öğrencilerin beden eğitimi ve spora ilişkin tutumlarını belirlemektir. Belirlenen bu tutumların da sosyo-demografik değişkenler, lisanslı spor yapma, spor dışı bir etkinliğe katılım ve ailesinde spor yapan olup olmamasına göre farklaşıp farklılaşmadığını değerlendirmektir. Bu amaç doğrultusunda gerekli izinler alındıktan sonra Anadolu Lisesi ve Spor Lisesinde araştırma hakkında öğrencilere bilgilendirme yapılmıştır. Araştırmaya gönüllü katılmak isteyenlere Demirhan ve Altay (2001) tarafından geliştirilen Beden Eğitimi ve Spor Tutum Ölçeği, 58 spor lisesi ve 82 anadolu lisesi olmak üzere toplam 140 öğrenciye uygulanmıştır. Veriler SPSS 16.00 Paket programında analiz edildiğinde normal dağılım gösterdiğinden parametrik testlerle analiz edilmiştir. Sonuçta; 10. sınıftakiler, düzenli spor dışı etkinliğe katılanlar, 15-16 yaş grubunda olanlar, Spor Lisesinde okuyanlar lehine beden eğitimi ve spor dersine yönelik tutumlar anlamlı derecede yüksek bulunmuştur. Yaşanan yerin özelliği, anne ve baba eğitimi, gelir düzeyi, okul başarısı, cinsiyet, lisanslı spor yapma değişkenleri açısından ise istatiksel olarak anlamsız bulunmuştur.

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