{"id":1132,"date":"2020-05-21T07:00:00","date_gmt":"2020-05-21T04:00:00","guid":{"rendered":"http:\/\/acilbulten.net\/?p=1132"},"modified":"2021-11-10T22:38:16","modified_gmt":"2021-11-10T19:38:16","slug":"gunumuzun-yeni-bagimlilik-araci","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/aciltipbulteni\/2020\/05\/21\/gunumuzun-yeni-bagimlilik-araci\/","title":{"rendered":"G\u00fcn\u00fcm\u00fcz\u00fcn Yeni Ba\u011f\u0131ml\u0131l\u0131k Arac\u0131"},"content":{"rendered":"\n
\"elektronik
Herbert A. Gilbert<\/span><\/em><\/strong><\/figcaption><\/figure><\/div>\n\n\n\n

Elektronik Sigara (E-Sigara)<\/h2>\n\n\n\n
\"ayhan<\/figure><\/div>\n\n\n\n

Yazar: Ayhan \u00d6zhasenekler <\/em><\/strong> Erciyes \u00dcniversitesi\u2019nde T\u0131p Fak\u00fcltesini, Dicle \u00dcniversitesi\u2019nde Acil T\u0131p Uzmanl\u0131\u011f\u0131n\u0131 bitirdi. Diyarbak\u0131r Devlet Hastanesinde mecburi hizmet sonras\u0131, evi \u2013 ailesi olarak g\u00f6rd\u00fc\u011f\u00fc Dicle Acil T\u0131p Ailesinde \u00d6\u011fretim \u00dcyeli\u011fine ba\u015flad\u0131. Halen Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t \u00dcniversitesi T\u0131p Fak\u00fcltesi Acil T\u0131p AD \u00d6\u011fretim \u00dcyesi, Dekan Yard\u0131mc\u0131s\u0131, Ankara \u015eehir Hastanesi Acil T\u0131p Klini\u011fi E\u011fitim G\u00f6revlisi, TATD YK \u00fcyesidir. EKG\u2019yi gece g\u00fcnd\u00fcz anlatacak kadar sever. Sim\u00fclasyon merakl\u0131s\u0131, T\u0131p E\u011fitiminin \u015fimdilik alayl\u0131s\u0131d\u0131r<\/strong>.<\/p>\n\n\n\n

E \u2013 sigara normal sigaraya g\u00f6re daha az zararl\u0131 m\u0131d\u0131r?<\/strong><\/p><\/blockquote>\n\n\n\n

E- sigaralar, nikotin sal\u0131verici sistem (Electronic Nicotin Delivering System -mENDS) olarak bilinirler. Yanarak de\u011fil, \u00e7ok y\u00fcksek \u0131s\u0131yla \u0131s\u0131t\u0131larak elde edilen buhar\u0131n inhalasyonu mant\u0131\u011f\u0131na dayanmaktad\u0131r.  D\u00fc\u015f\u00fck \u0131s\u0131yla \u0131s\u0131t\u0131lan \u00e7e\u015fitleri de mevcuttur. \u0130lk formu 1965\u2019te Herbert A. Gilbert taraf\u0131ndan ABD\u2019 de \u00fcretilmi\u015f.<\/p>\n\n\n\n

\u0130lk kez 2004 y\u0131l\u0131nda \u00c7inli Eczac\u0131 Hon Link taraf\u0131ndan Ruyan ad\u0131yla \u00c7in pazar\u0131na girmi\u015ftir.<\/p>\n\n\n\n

\"elektronik
The Ruyan<\/strong><\/figcaption><\/figure>\n\n\n\n

2013 y\u0131l\u0131nda ABD\u2019 de patent ba\u015fvurusunda “Sigara yerine kullan\u0131lmak \u00fczere ve sigara b\u0131rakmak i\u00e7in” <\/em><\/strong>yaz\u0131lm\u0131\u015ft\u0131r.<\/p>\n\n\n\n\n\n\n\n

Patent ba\u015fvurusundan sonra e-sigaran\u0131n sadece sigara i\u00e7enler taraf\u0131ndan de\u011fil, sigara i\u00e7meyenler taraf\u0131ndan da kullan\u0131m\u0131, hatta normal sigara ile birlikte kullan\u0131m\u0131 (dual kullan\u0131m) artm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

\"e
e-sigara kullan\u0131m oranlar\u0131<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n

\u00d6zellikle ABD ve di\u011fer \u00fclkelerde kullan\u0131m ya\u015f\u0131 ortaokul \u00e7a\u011f\u0131na kadar d\u00fc\u015fm\u00fc\u015ft\u00fcr. Kalem benzeri Cigalike, tank sistemleri ve m\u00fchendislik harikalar\u0131 denen (IQOS, JUUL gibi) \u00e7e\u015fitleri bulunmaktad\u0131r. \u00d6zellikle son teknolojik \u00fcr\u00fcnler ABD\u2019de marketlerde kontrols\u00fcz bir \u015fekilde sat\u0131lmaktad\u0131r. Bu, gen\u00e7ler aras\u0131nda kullan\u0131m s\u0131kl\u0131\u011f\u0131n\u0131n artmas\u0131na neden olmu\u015ftur. Ayr\u0131ca son d\u00f6nemlerde bu teknolojik \u00fcr\u00fcnlerde ba\u011f\u0131ml\u0131l\u0131k yap\u0131c\u0131 maddelere de rastlan\u0131lmaktad\u0131r. \u0130\u00e7erisinde farkl\u0131 dozlarda nikotin, formaldehid, propilen glikol, gliserol, t\u00fct\u00fcn spesifik nitrozaminler, benzen, asetaldehid, tatland\u0131r\u0131c\u0131lar, a\u011f\u0131r metaller bulunmaktad\u0131r.<\/p>\n\n\n\n

\"sigara\"<\/figure><\/div>\n\n\n\n

Sigara \u015firketleri taraf\u0131ndan yap\u0131lan bir\u00e7ok \u00e7al\u0131\u015fmada normal sigara ile kar\u015f\u0131la\u015ft\u0131r\u0131lm\u0131\u015f, i\u00e7erisindeki zararl\u0131 maddelerin normal sigaraya g\u00f6re daha az oldu\u011fu savunulmu\u015ftur. Ama unutulmamal\u0131d\u0131r ki, zararl\u0131 \u015feylerin az olmas\u0131, hi\u00e7 olmamas\u0131 anlam\u0131na gelmemektedir.<\/strong> Sonu\u00e7ta her t\u00fcrl\u00fc sigara, Uluslararas\u0131 Kanser Ara\u015ft\u0131rmalar\u0131 Ajans\u0131 taraf\u0131ndan Grup 1 kanserojen olarak bildirilmi\u015ftir.<\/p>\n\n\n\n

Sa\u011fl\u0131k \u00fczerine etkileri, bir\u00e7ok sistemi ilgilendirmekle beraber en \u00e7ok solunum sistemi ile ilgilidir. E-sigara ili\u015fkili akci\u011fer hastal\u0131\u011f\u0131 (EVALI); semptomlar\u0131n ba\u015flang\u0131c\u0131ndan \u00f6nceki 90 g\u00fcnde e-sigara kullan\u0131m\u0131 \u00f6yk\u00fcs\u00fc, pulmoner infiltrasyon, tetkiklerde enfeksiyon bulgular\u0131n\u0131n olmamas\u0131, alternatif tan\u0131 olmamas\u0131 (romatolojik, kardiyak, neoplastik) kriterlerinin varl\u0131\u011f\u0131 olarak tan\u0131mlanmaktad\u0131r.<\/p>\n\n\n\n\n\n\n\n

E – sigaraya ba\u011fl\u0131 zehirlenmeler, ABD\u2019de s\u0131kl\u0131kla \u00e7ocukluk \u00e7a\u011f\u0131nda ve oral al\u0131m \u015feklinde likitlerin i\u00e7ilmesi \u015feklinde g\u00f6r\u00fclmektedir. Bu zehirlenmelerin \u00e7o\u011fu kazara zehirlenmeler olup, likit \u00fczerinde \u00e7ocu\u011fun ilgisini \u00e7eken g\u00f6rsellerin olmas\u0131, farkl\u0131 kokular i\u00e7ermesi buna sebep olmaktad\u0131r. <\/p>\n\n\n\n

Literat\u00fcrde dermal, ok\u00fcler, enjeksiyona ba\u011fl\u0131 zehirlenmelere de rastlanmaktad\u0131r. Bilin\u00e7li olan zehirlenmeler s\u0131kl\u0131kla gen\u00e7 ya\u015fta g\u00f6r\u00fclmekte ve likit i\u00e7eri\u011fi ile birlikte opioid ve marihuanna gibi ba\u011f\u0131ml\u0131l\u0131k yapan maddelerin kar\u0131\u015ft\u0131r\u0131larak hem oral yolla al\u0131nmas\u0131 ve\/veya IM\/IV enjeksiyonu \u015feklinde g\u00f6r\u00fclmektedir. Bu t\u00fcr zehirlenmelerde s\u0131kl\u0131kla kardiyovask\u00fcler ve n\u00f6rolojik semptomlar g\u00f6r\u00fclmektedir. Bu t\u00fcr zehirlenmelere ba\u011fl\u0131 \u00f6l\u00fcmlerde, \u00f6lenlerin kan \u00f6rneklerinde, sa\u011f kalanlara g\u00f6re y\u00fcksek oranda nikotin d\u00fczeyleri saptanm\u0131\u015ft\u0131r. Zehirlenmeler d\u0131\u015f\u0131nda y\u00fcksek \u0131s\u0131yla \u00e7al\u0131\u015fma mekanizmas\u0131n\u0131n bir sonucu olarak, a\u011fz\u0131nda e-sigara cihaz\u0131 patlayan, a\u011f\u0131z ve di\u015f yaralanmas\u0131 olan hastalar, cihaz\u0131 yutan hastalar da bildirilmektedir.<\/p>\n\n\n\n

Pasif etkilenim e-sigarada da olmakta, pasif etkilenime maruz kalan hastalar\u0131n kanlar\u0131nda nikotin d\u00fczeylerinde art\u0131\u015f g\u00f6r\u00fclmektedir. \u015eu anda \u00fclkemizin de i\u00e7inde oldu\u011fu yakla\u015f\u0131k 20 \u00fclkede sat\u0131\u015f ve kullan\u0131m\u0131 yasaklanm\u0131\u015ft\u0131r. Ancak denetim yetersizli\u011fi y\u00fcz\u00fcnden her yerde kullan\u0131ld\u0131\u011f\u0131 da bilinmektedir. Baz\u0131 \u00fclkelerde de kullan\u0131m\u0131na s\u0131n\u0131rlama getirilmi\u015ftir.<\/p>\n\n\n\n

\"elektronik
D\u00fcnyada elektronik sigara kullan\u0131m\u0131<\/strong><\/figcaption><\/figure>\n\n\n\n

CDC\u2019nin son verilerine g\u00f6re, D\u00fcnyada e-sigaraya ba\u011fl\u0131 47 \u00f6l\u00fcm bildirilmi\u015ftir. Bu hastalar\u0131n Bronkoalveoler Lavaj (BAL) s\u0131v\u0131lar\u0131nda Vitamin E asetat isimli kanserojen ve Tetrahidrokannabinol (THC) tespit edildi\u011fi bildirilmi\u015ftir.<\/p>\n\n\n\n

Az zararl\u0131 olmas\u0131, hi\u00e7 olmamas\u0131 anlam\u0131na gelmez, ikisi de zararl\u0131<\/strong><\/p><\/blockquote>\n\n\n\n

Sonu\u00e7 olarak zararl\u0131 oldu\u011fu bilinen bir \u015feyin, daha az zararl\u0131 d\u00fc\u015f\u00fcncesiyle kullan\u0131lmas\u0131 \u00f6nerilmemektedir. E- sigara ve normal sigaran\u0131n kullan\u0131m\u0131 ve sat\u0131\u015f\u0131 kontrol alt\u0131na al\u0131nmazsa, d\u00fcnya \u00e7ap\u0131nda b\u00fcy\u00fck bir halk sa\u011fl\u0131\u011f\u0131 sorunu olarak \u00f6zellikle de \u00e7ocuklar\u0131 ve gen\u00e7leri etkileyecektir.<\/p>\n\n\n\n

Kaynak\u00e7a<\/strong><\/p>\n\n\n\n

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  2. U.S. Department of Health and Human Services. E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2016<\/li>
  3. Eriksen M, Mackay J, Schluger N, Gomeshtapeh F.I,  Drope J. The Tobacco Atlas. Fifth Edition 2015.tobaccoatlas.org<\/li>
  4. Layden JE, Ghinai I, Pray I, et al. Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin \u2013 Preliminary Report. The New England journal of medicine. 2019<\/li>
  5. Maessen GC, Wijnhoven AM, Neijzen RL, Paulus MC, van Heel DAM, Bomers BHA, Boersma LE, Konya B, van der Heyden MAG. Nicotine intoxication by e-cigarette liquids: a study of case reports and pathophysiology. Clin Toxicol (Phila). 2019 Jul 9:1-8. doi: 10.1080\/15563650.2019.1636994. [Epub ahead of print]<\/li>
  6. .cdc.gov\/tobacco\/basic_information\/e-cigarettes\/severe-lung-disease<\/a><\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"

    Elektronik Sigara (E-Sigara) Yazar: Ayhan \u00d6zhasenekler Erciyes \u00dcniversitesi\u2019nde T\u0131p Fak\u00fcltesini, Dicle \u00dcniversitesi\u2019nde Acil T\u0131p Uzmanl\u0131\u011f\u0131n\u0131 bitirdi. Diyarbak\u0131r Devlet Hastanesinde mecburi hizmet sonras\u0131,…<\/p>\n","protected":false},"author":1599,"featured_media":1142,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10015],"tags":[50,82,90,175],"class_list":["post-1132","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sosyal-blog-yazisi","tag-bagimlilik","tag-e-sigara","tag-elektronik-sigara","tag-tutun"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts\/1132","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/users\/1599"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/comments?post=1132"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts\/1132\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/media\/1142"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/media?parent=1132"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/categories?post=1132"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/tags?post=1132"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}