{"id":490,"date":"2020-02-05T20:25:43","date_gmt":"2020-02-05T17:25:43","guid":{"rendered":"https:\/\/www.aciltipakademisi.org\/?p=490"},"modified":"2021-11-16T04:10:02","modified_gmt":"2021-11-16T01:10:02","slug":"olgu-sunumu-yazimi-care-kilavuzu","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/atak\/2020\/02\/05\/olgu-sunumu-yazimi-care-kilavuzu\/","title":{"rendered":"Olgu sunumu yaz\u0131m\u0131: CARE k\u0131lavuzu"},"content":{"rendered":"\n<p>Bu yaz\u0131n\u0131n ilk b\u00f6l\u00fcm\u00fcnde olgu sunumunun \u00f6nemini tart\u0131\u015faca\u011f\u0131z. Daha sonra a\u015fama a\u015fama nas\u0131l olgu sunumu yaz\u0131l\u0131r sorusuna CARE k\u0131lavuzu e\u015fli\u011finde cevap arayaca\u011f\u0131z.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>1-Olgu sunumunun \u00f6nemi<\/strong><\/h3>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Olgu sunumu ne i\u015fe yarar?<\/strong><\/h4>\n\n\n\n<p>Kongreye eli bo\u015f gidilmez, bari bir\u015feyler yazal\u0131m. Ya da do\u00e7entlik dosyas\u0131 olu\u015fturuyoruz dosyada olsun biraz. \u00c7\u00f6mez asistan\u0131n ilk akademik karalamas\u0131 niyetiyle bir olgu yazd\u0131ral\u0131m. Ya da her neyse i\u015fte biz yazal\u0131m dursun elbet bir i\u015fe yarar.<\/p>\n\n\n\n<p>Yukar\u0131daki endikasyonlar zaman zaman ba\u015fvurdu\u011fumuz ve itiraf edelim tamamen d\u0131\u015flayamad\u0131\u011f\u0131m\u0131z olgu sunumu yazma motivasyon noktalar\u0131. Olgu sunumu bu ama\u00e7larla da yaz\u0131labilir ama akademik de\u011feri ve katk\u0131s\u0131 malum olundu\u011fu \u00fczere s\u0131f\u0131ra yak\u0131n olacakt\u0131r.<\/p>\n\n\n\n<p>Olgu sunumu ne zaman akademik katk\u0131 sunar\/faydal\u0131d\u0131r?<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Yeni bir hastal\u0131k tan\u0131ml\u0131yorsa<\/li><li>Bilinen bir hastal\u0131\u011f\u0131n s\u0131ra d\u0131\u015f\u0131 prezantasyonunu bildiriyorsa<\/li><li>Bir hastal\u0131\u011f\u0131n patogenezini yeni bir bak\u0131\u015f a\u00e7\u0131s\u0131 ile a\u00e7\u0131kl\u0131yorsa<\/li><\/ul>\n\n\n\n<p>\u0130kincil olarak:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Zor bir klinik durumu, ay\u0131r\u0131c\u0131 tan\u0131y\u0131 tart\u0131\u015f\u0131yorsa<\/li><li>Bir tedavinin nadir bir advers etkisini bildiriyorsa<\/li><li>\u0130leride yap\u0131lacak \u00e7al\u0131\u015fmalara temel olu\u015fturuyorsa<\/li><li>Medikal e\u011fitime katk\u0131 sunuyorsa<\/li><\/ul>\n\n\n\n<p>Peki, AS mesainizde ilgin\u00e7 oldu\u011funu d\u00fc\u015f\u00fcnd\u00fc\u011f\u00fcn\u00fcz bir vaka geldi. Peki ya sonra?<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Vaka neden ilgin\u00e7 geldi? Gerek\u00e7eniz yeterli mi?<\/li><li>Sizin olguyu y\u00f6netmede zorluk ya\u015faman\u0131z bu olgunun ilgin\u00e7, nadir odlu\u011fu anlam\u0131na gelmez. Bu sebeple etkin bir literat\u00fcr taramas\u0131 yapmal\u0131y\u0131z, hatta daha k\u0131demli meslek arkada\u015flar\u0131m\u0131zla bunu payla\u015fmal\u0131y\u0131z. Literat\u00fcr taramas\u0131 sonras\u0131nda vakan\u0131n ne kadar ilgin\u00e7 oldu\u011fu ya da yeni bilgi sunup sunmad\u0131\u011f\u0131n\u0131 anlamak m\u00fcmk\u00fcn.<\/li><li>Olmazsa olmaz bir detay; hasta onam\u0131. Sonradan hastaya ula\u015famama olas\u0131l\u0131\u011f\u0131 sebebiyle m\u00fcmk\u00fcnse hasta taburcu edilmeden onam al\u0131nmal\u0131. Bir\u00e7ok dergide \u00f6rnek onam formu bulunmaktad\u0131r, \u00e7o\u011funlukla bir derginin format\u0131na uygun al\u0131nm\u0131\u015f onam\u0131 \u00e7o\u011fu ba\u015fka dergi de yeterli kabul etmektedir. \u00d6rnek olarak <a href=\"http:\/\/www.turkjemergmed.com\/files\/patient-consent-form-turk-j-emerg-med.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">BURADAN<\/a> Turkish Journal of Emergency Medicine dergisinin \u00f6rnek hasta onam formuna ula\u015fabilirsiniz.<\/li><\/ul>\n\n\n\n<p>Bu \u00f6n haz\u0131rl\u0131klar sonras\u0131nda olgu sunumunu yazmaya ba\u015flayabiliriz. Bu noktada temel motivasyonumuz nadir g\u00f6r\u00fclen, zor y\u00f6netilen veya karma\u015f\u0131k bir klinik durumu \u201c\u00e7al\u0131\u015fma arkada\u015flar\u0131m\u0131za bildirmek&#8221; olmal\u0131d\u0131r.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Olgu sunumlar\u0131 ne kadar \u00f6nemlidir?<\/strong><\/h4>\n\n\n\n<p>Kan\u0131t piramidinde olgu sunumlar\u0131 insan\u0131 i\u00e7eren ilk basamakta yer almaktad\u0131r. \u00dczerinde yer alan bilimsel \u00e7al\u0131\u015fmalara k\u0131yasla daha d\u00fc\u015f\u00fck kan\u0131t de\u011ferine sahiptir. As\u0131l amac\u0131 ise bir fark\u0131ndal\u0131k olu\u015fturarak o konuda ara\u015ft\u0131rma makaleleri yap\u0131lmas\u0131na \u0131\u015f\u0131k tutmakt\u0131r asl\u0131nda. Tek ba\u015f\u0131na bir olgu sunumu takip eden \u00e7al\u0131\u015fmalarla desteklenmeksizin t\u0131p prati\u011fini direk olarak de\u011fi\u015ftiremez.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.acilci.net\/wp-content\/uploads\/2018\/03\/Resim1-300x261.png\" alt=\"\" class=\"wp-image-25011\" \/><\/figure><\/div>\n\n\n\n<p>Yaz\u0131n\u0131n en ba\u015f\u0131ndaki yanl\u0131\u015f motivasyonlarla yaz\u0131lan bir olgu sunumunun bilim denizine katk\u0131s\u0131 bazen bir damla bile olmazken a\u015fa\u011f\u0131daki \u00f6rneklerdeki olgu sunumlar\u0131 bir\u00e7ok ara\u015ft\u0131rma makalesinden dahi daha \u00f6nemli katk\u0131lar sunmu\u015ftur.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>Olgu sunumu \u00f6rne\u011fi1:<\/strong><\/h5>\n\n\n\n<p>En \u00e7ok bilinen talidomid \u00f6rne\u011fidir. 1961 tarihli bir olgu sunumu bize ayn\u0131 annenin iki fokomelili \u00e7ocu\u011funun anomali sebebinin annenin gebeli\u011fi s\u0131ras\u0131nda kulland\u0131\u011f\u0131 talidomid olabilece\u011fini bildirdi. Takip eden \u00e7al\u0131\u015fmalarda gebelerde konjenital anomali oran\u0131n\u0131n %1.5 civar\u0131nda iken Talidomid kullananlarda oran\u0131n %20\u2019lere \u00e7\u0131kt\u0131\u011f\u0131 g\u00f6sterilmi\u015f (1).<\/p>\n\n\n\n<p>Talidomid 1950\u2019li y\u0131llarda gebelerde bulant\u0131\/kusmay\u0131 engellemek i\u00e7in piyasaya s\u00fcr\u00fclen, sedatif \u00f6zellikleri de olan bir ila\u00e7. Avrupa \u00fclkelerinde yayg\u0131n kullan\u0131lm\u0131\u015f; ila\u00e7 Kuzey Amerika pazar\u0131na girmeye \u00e7al\u0131\u015fm\u0131\u015f o y\u0131llarda. Sonu\u00e7 olarak g\u00fcvenlik profili yeterli olmad\u0131\u011f\u0131 i\u00e7in FDA\u2019den onay al\u0131nam\u0131yor ve t\u0131p prati\u011finden \u00e7\u0131k\u0131yor.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>Olgu sunumu \u00f6rne\u011fi 2:<\/strong><\/h5>\n\n\n\n<p>Biz hen\u00fcz AIDS nedir bilmezken 1981 de bir olgu serisinde 5 hastada Pneumocystis carini pn\u00f6monisi bildiriliyor. T-lenfosit say\u0131lar\u0131n\u0131n azalmas\u0131, hastalar\u0131n ya e\u015fcinsel olmalar\u0131 ya da ayn\u0131 i\u011fneyi kullanan ila\u00e7 ba\u011f\u0131ml\u0131s\u0131 ki\u015filer olmas\u0131 gibi detaylarla adeta HIV risk fakt\u00f6rleri ve klini\u011fi anlat\u0131lm\u0131\u015f (2). Ayn\u0131 y\u0131l sonuna kadar benzer 270 vaka bildiriliyor. En nihayet 1982\u2019de CDC ilk defa AIDS tan\u0131m\u0131n\u0131 kullan\u0131yor ve olgu serisinden 3 y\u0131l sonra 1984\u2019de HIV vir\u00fcs\u00fc tan\u0131mlan\u0131yor. Bu olguda bir olgu serisi ile ba\u015flayan s\u00fcrecin ileri \u00e7al\u0131\u015fmalar konusunda nas\u0131l bir pencere a\u00e7t\u0131\u011f\u0131n\u0131 ve HIV vir\u00fcs\u00fcnden 3 y\u0131l \u00f6nce klinik tabloyu neredeyse hatas\u0131z \u015fekilde tan\u0131mlad\u0131\u011f\u0131n\u0131 g\u00f6r\u00fcyoruz.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>Olgu sunumu \u00f6rne\u011fi 3:<\/strong><\/h5>\n\n\n\n<p>\u0130deal olgu \u00f6rneklerinde daha yak\u0131n tarihli bir olgu \u00f6rne\u011fini tart\u0131\u015fal\u0131m. 53 ya\u015f kad\u0131n hasta iskemik SVO ile gelmi\u015f. Hastada May-Turner sendromu (MTS) oldu\u011fu tespit edilmi\u015f. Ayr\u0131ca ASD de mevcutmu. MTS de Sa\u011f common iliyak arter sol common iliyak arteri bask\u0131l\u0131yor (iliyak kompresyon sendromu da denir). Bu da tromboza e\u011filime sebep oluyor. Toplumda g\u00f6r\u00fclme oran\u0131 %20. ASD veya patent FO varsa paradoksik emboli olabiliyor. 1\/2000 kad\u0131nda MTS-SVO olabiliyor. Bu olgu sunumu bize diyor ki SVO hastan\u0131z kad\u0131n ise, dikkat! MTS olabilir bu SVO\u2019nun sebebi ve etiyolojide bu se\u00e7ene\u011fi de ak\u0131lda bulundurun diyor. D\u00fc\u015f\u00fcn\u00fcnce her 2000 SVO kad\u0131n hastan\u0131z\u0131n bir tanesinin etiyolojisini ayd\u0131nlatman\u0131za yarayan bir bilgi bu olgu sunumu sayesinde bilim denizine eklenmi\u015f oluyor.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>Olgu sunumu \u00f6rne\u011fi 4:<\/strong><\/h5>\n\n\n\n<p>Son olgu sunumu \u00f6rne\u011fimiz 2016 y\u0131l\u0131ndan. Mevcut bilgilere g\u00f6re Zika vir\u00fcs 1 hf dan fazla s\u00fcre ge\u00e7en gebelerde seroloji takibi \u00f6nerilmiyor. \u0130lgili olguda enfeksiyondan 10 hf sonra dahi hem annede hem amniyon s\u0131v\u0131s\u0131nda zikavir\u00fcs izole ediliyor. Fetal beyin anomalileri tespit ediliyor ve 20. hf da gebelik sonland\u0131r\u0131l\u0131yor. Sonu\u00e7: Zika vir\u00fcs ge\u00e7iren gebelerde gebelik boyunca hem seroloji hem fetal beyin takibi \u00f6neriliyor. Bir olgu sunumu yerle\u015fik genel bilginin yetersiz oldu\u011funu ortaya \u00e7\u0131kar\u0131yor.<\/p>\n\n\n\n<p>Yukar\u0131daki d\u00f6rt \u00f6rnek olduk\u00e7a iddial\u0131 olgu sunumlar\u0131. Tabi ki sadece bu olgulara bakarak t\u00fcm t\u0131p prati\u011fi de\u011fi\u015fmiyor ancak \u00f6nceki bilimsel kan\u0131tlarda yer almayan yeni bilgileri akademik d\u00fcnyaya sunarak bu konuda ara\u015ft\u0131rma makaleleri yap\u0131lmas\u0131na sebep olmu\u015f hepsi. Takip eden ara\u015ft\u0131rma makalelerinin de olgu sunumu ile paralel seyretmesi sonras\u0131 t\u0131p prati\u011fini de\u011fi\u015ftiren s\u00fcrecin ilk anahtar\u0131 olarak olduk\u00e7a b\u00fcy\u00fck i\u015f ba\u015farm\u0131\u015f oluyorlar.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Bir olgu sunumunun s\u0131n\u0131rlar\u0131:<\/strong><\/h4>\n\n\n\n<p>Her ne kadar bu d\u00f6rt \u00f6rnekteki olgu sunumlar\u0131 bir \u00e7\u0131\u011f\u0131 ba\u015flatan ilk kar tanesi gibi davran\u0131p prati\u011fimizi de\u011fi\u015ftirse de olgu sunumlar\u0131n\u0131n s\u0131n\u0131rlar\u0131n\u0131 bilmek \u00f6nemlidir.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Bir \u00e7ok kar\u0131\u015ft\u0131r\u0131c\u0131 fakt\u00f6r vard\u0131r. Sizin olgunuzdaki tedavi sebebiyle d\u00fczelmedi hasta, belki tedavi olmasa da d\u00fczelecekti.<\/li><li>Bulgular genellenemez. \u00d6rnek olarak A ilac\u0131 sizin hastan\u0131zda i\u015fe yaram\u0131\u015f olabilir ama herkeste etkili olaca\u011f\u0131 yorumu tek olgu \u00fczerinden yap\u0131lamaz.<\/li><li>Literat\u00fcr taramas\u0131n\u0131 yeterli yapmazsan\u0131z sizin olgunuzun ilk vaka oldu\u011funu iddia edersiniz ama belki siz yeterli literat\u00fcr taramas\u0131 yapamad\u0131n\u0131z. Oysa bu olgu literat\u00fcre g\u00f6re de\u011fil, sizin tecr\u00fcbenize g\u00f6re yeni ya da ilgin\u00e7 bir vakayd\u0131.<\/li><li>T\u0131bbi hatalar, k\u00f6t\u00fc uygulamalar olgu sunumunda tart\u0131\u015f\u0131labilir ancak \u00f6rnek g\u00f6sterilemez. Siz STEMI hastas\u0131na heparin yapmam\u0131\u015f ve taburcu etmi\u015f olabilirsiniz ve hasta \u00f6lmemi\u015ftir. Buradan yola \u00e7\u0131k\u0131p STEMI hastalar\u0131nda heparin gereksizdir diyemezsiniz.<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>2-Olgu sunumu yazma<\/strong><\/h3>\n\n\n\n<p>Art\u0131k olgu sunumu nas\u0131l yaz\u0131l\u0131r k\u0131sm\u0131na ge\u00e7ebiliriz. \u00d6ncelikle olgu sunumlar\u0131 i\u00e7eri\u011fine g\u00f6re tan\u0131 ili\u015fkili, tedavi ili\u015fkili ya da tan\u0131 ve tedavi ili\u015fkili olabilir.<\/p>\n\n\n\n<p>Ayr\u0131ca olgu say\u0131s\u0131na g\u00f6re tek olu sunuluyorsa olgu sunumu, birden fazla olgu sunuluyorsa olgu serisi denmektedir.<\/p>\n\n\n\n<div class=\"wp-block-image wp-image-25012 size-medium\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.acilci.net\/wp-content\/uploads\/2018\/03\/1-300x181.png\" alt=\"\" class=\"wp-image-25012\" \/><figcaption>Olgu say\u0131s\u0131 = 1 ise Olgu sunumu<\/figcaption><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image wp-image-25013 size-medium\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.acilci.net\/wp-content\/uploads\/2018\/03\/2-300x192.png\" alt=\"\" class=\"wp-image-25013\" \/><figcaption>Olgu say\u0131s\u0131 &gt;1 ise Olgu serisi<\/figcaption><\/figure><\/div>\n\n\n\n<p>Olgu sunumu yazarken \u00f6nerilen bir k\u0131lavuz <strong>CARE<\/strong> (<strong>CA<\/strong>se <strong>RE<\/strong>port) k\u0131lavuzundan faydalanaca\u011f\u0131z. \u0130lk defa 2013 y\u0131l\u0131nda uluslararas\u0131 bir ara\u015ft\u0131rmac\u0131 grubu taraf\u0131ndan ortaya at\u0131lm\u0131\u015ft\u0131r. International Congress on Peer Review and Biomedical Publication\u2019da sunulmu\u015ftur. Yazar, hakem, edit\u00f6r, klinisyen ve hastalar\u0131 olabildi\u011fince ortak dille konu\u015fmaya \u00e7a\u011f\u0131r\u0131r (5). 2013 deki yay\u0131na ek olarak ayn\u0131 ekip 2017 y\u0131l\u0131nda ayn\u0131 k\u0131lavuzun g\u00fcncellenmesi de\u011fil de detayl\u0131 a\u00e7\u0131klamas\u0131n\u0131 yapt\u0131klar\u0131 k\u0131lavuz a\u00e7\u0131klamas\u0131n\u0131 yay\u0131nlad\u0131lar (6).<\/p>\n\n\n\n<p>Olgu sunumunu yazarken CARE k\u0131lavuzuna g\u00f6re yazarsan\u0131z di\u011fer yazarlarla ortak bir dil kullanm\u0131\u015f olursunuz. Unutmay\u0131n ki yaz\u0131n\u0131z\u0131 de\u011ferlendirecek hakemler ve edit\u00f6rler de bu k\u0131lavuza uyguna bakacaklard\u0131r.&nbsp;<a href=\"http:\/\/www.care-statement.org\" target=\"_blank\" rel=\"noreferrer noopener\">http:\/\/www.care-statement.org<\/a> adresinden k\u0131lavuz d\u00f6k\u00fcmanlar\u0131na ula\u015fabilirsiniz. Ne yaz\u0131k ki T\u00fcrk\u00e7e \u00e7evirisi yok ancak daha \u00f6nce sitemizde CARE k\u0131lavuzu check list Haldun Ako\u011flu hocam\u0131z taraf\u0131ndan sunulmu\u015ftu, yaz\u0131ya <a href=\"https:\/\/www.acilci.net\/care-vaka-sunumu-yazarken-bulunmasi-gereken-icerik-listesi\/\" target=\"_blank\" rel=\"noreferrer noopener\">BURADAN<\/a> ula\u015fabilirsiniz.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Kimler yazar olmal\u0131?<\/strong><\/h4>\n\n\n\n<p>K\u0131lavuz e\u015fli\u011finde basmak basamak yaz\u0131m a\u015famas\u0131na ge\u00e7meden \u00f6nce kimler yazar olmal\u0131 konusuna de\u011finmek istiyorum.<\/p>\n\n\n\n<p>Vakay\u0131 ilk g\u00f6ren, tan\u0131 koyan, taburcu eden, hoca, kanka, kons\u00fcltan, yaz\u0131y\u0131 ingilizceye \u00e7eviren hepsi yazar olarak yaz\u0131l\u0131yor genelde. Sosyal endikasyonlarla yaz\u0131lsalarda Uluslararas\u0131 Medikal Dergi Edit\u00f6rleri Komitesi (ICMJE) kriterlerine g\u00f6re hi\u00e7 biri yazar olmay\u0131 hak etmiyor. ICMJE kriterlerine g\u00f6re \u015fu ki\u015filer yazar olabilirler:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Olgu sunumunun dizayn\u0131 ve hastadaki bulgular\u0131n yorumlanmas\u0131 s\u0131ras\u0131nda belirgin katk\u0131 sunmas\u0131 VE<\/li><li>\u0130lk tasla\u011f\u0131n olu\u015fturulmas\u0131 veya kritik revizyon a\u015famas\u0131nda katk\u0131 sunmas\u0131 VE<\/li><li>Yaz\u0131n\u0131n son versiyonunun onaylamas\u0131 VE<\/li><li>Yaz\u0131n\u0131n her noktas\u0131ndaki sorunlar ve bunlar\u0131n \u00e7\u00f6z\u00fcmleriyle ilgili di\u011fer ara\u015ft\u0131rmac\u0131larla fikir birli\u011fi i\u00e7inde olmas\u0131<\/li><\/ul>\n\n\n\n<p>Dikkat ederseniz veya de\u011fil VE ba\u011flac\u0131 kullan\u0131\u015fm\u0131\u015f. Yani 4 kriterin d\u00f6rd\u00fc de sa\u011flanm\u0131\u015f olmal\u0131d\u0131r ki o ki\u015fi yazar olmay\u0131 hak etmi\u015f olsun. Di\u011fer kankalar\u0131n\u0131za vs en sondaki te\u015fekk\u00fcr k\u0131sm\u0131nda yer verip g\u00f6n\u00fcllerini alabilirsiniz.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Olgu sunumu yaz\u0131m a\u015famalar\u0131:<\/strong><\/h4>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>1-Ba\u015fl\u0131k (Title)<\/strong><\/h4>\n\n\n\n<p>Bilgilendirici olmal\u0131. \u00c7o\u011fu okur olguyu ba\u015fl\u0131\u011f\u0131yla de\u011ferlendirir. M\u00fcmk\u00fcnse \u201colgu sunumu\u201d ibaresini i\u00e7ermeli \u201cA case of\u2026\u201d \u201ca case report\u201d gibi. Ortaya \u00e7\u0131kan klinik durum ya da tedavi abart\u0131ya ka\u00e7madan, net \u015fekilde ifade edilmeli.<\/p>\n\n\n\n<p>\u00d6rnek: \u00abIntravenous lipid emulsion therapy for acute synthetic cannabinoid intoxication: a case report\u00bb&nbsp; veya bu bir olgu serisi ise&nbsp; \u00abIntravenous lipid emulsion therapy for acute synthetic cannabinoid intoxication: clinical experience in four cases\u00bb<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>2-Anahtar kelimeler (Key words)<\/strong><\/h4>\n\n\n\n<p>MeSH s\u00f6zl\u00fc\u011fe uygun olarak se\u00e7ilmelidir.&nbsp; Pubmed.com\u2019daki MeSH s\u00f6zl\u00fckte bulunan anahtar kelimeler se\u00e7ilmelidir. \u00c7\u00fcnk\u00fc arayanlar bu kelimelre g\u00f6re arayacakt\u0131r yaz\u0131n\u0131z\u0131. Bu s\u00f6zl\u00fckte bulunmayan anahtar kelimeler (nadir \u00f6zel isimler) kullan\u0131labilir. Genelde &nbsp;2-5 adet&nbsp; anahtar kelime gerekli ki \u00e7o\u011fu dergi en az 3 adet istiyor. Anahtar kelimelerden birinin \u201ccase report\u201d olmas\u0131 yine yaz\u0131n\u0131z\u0131n bulunabilirli\u011fini art\u0131racakt\u0131r. Ba\u015fl\u0131ktaki \u00f6rne\u011fe anahtar kelime ararsak:<\/p>\n\n\n\n<p>\u00abIntravenous lipid emulsion therapy for acute synthetic cannabinoid intoxication: clinical experience in four cases\u00bb<\/p>\n\n\n\n<p>Keywords: Fat emulsions; Cannabinoids; intoxication; case report<\/p>\n\n\n\n<p>Dikkat! Lipid emulsion ifadesi MeSH veri taban\u0131nda olmad\u0131\u011f\u0131ndan fat emulsions se\u00e7ilmi\u015f.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>3- \u00d6zet (Abstract)<\/strong><\/h4>\n\n\n\n<p>Olgu sunumunun en \u00f6nemli b\u00f6l\u00fcm\u00fcd\u00fcr. \u00c7\u00fcnk\u00fc \u00e7o\u011fu okur ba\u015fl\u0131k ve \u00f6zete bakarak yaz\u0131y\u0131 okuyup okumayaca\u011f\u0131na karar verir.<\/p>\n\n\n\n<p>Dergiden dergiye de\u011fi\u015fmekle beraber 100-300 kelime ile s\u0131n\u0131rland\u0131r\u0131lmal\u0131d\u0131r.<\/p>\n\n\n\n<p>\u00d6zette k\u0131saltma ve referanslamadan ka\u00e7\u0131n\u0131lmal\u0131d\u0131r. Yine dergi kurallar\u0131 de\u011fi\u015fiklik g\u00f6sterir ve baz\u0131 dergi giri\u015f, olgu sunumu ve tart\u0131\u015fma diye yap\u0131land\u0131r\u0131lm\u0131\u015f \u00f6zet isterken baz\u0131lar\u0131 da yap\u0131land\u0131r\u0131lmam\u0131\u015f \u00f6zet istemekteler. Yap\u0131land\u0131r\u0131lmam\u0131\u015f \u00f6zette herhangi bir b\u00f6l\u00fcm belirtmeden d\u00fcz metin \u015feklinde \u00f6zet yaz\u0131l\u0131r. Yap\u0131land\u0131r\u0131lm\u0131\u015f \u00f6zet \u00f6rne\u011finde dikkat edilmesi gerekenler a\u015fa\u011f\u0131daki g\u00f6rselde anlat\u0131lm\u0131\u015ft\u0131r:<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.acilci.net\/wp-content\/uploads\/2018\/03\/Ekran-Resmi-2018-03-25-13.44.50-1024x404.png\" alt=\"\" class=\"wp-image-25015\" \/><\/figure><\/div>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>4- Giri\u015f (Introduction)<\/strong><\/h4>\n\n\n\n<p>Olabildi\u011fince k\u0131sa tutulmal\u0131d\u0131r.&nbsp; Literat\u00fcrden faydalan\u0131larak okuyucuya konu tan\u0131t\u0131l\u0131r. Konuyla ilgili en \u00f6nemli \u00e7al\u0131\u015fmalara at\u0131f yap\u0131l\u0131r. Ancak detayl\u0131 literat\u00fcr tart\u0131\u015fmas\u0131 ve kar\u015f\u0131la\u015ft\u0131rmal\u0131 literat\u00fcr tart\u0131\u015fmalar\u0131 tart\u0131\u015fma b\u00f6l\u00fcm\u00fcne saklanmal\u0131. 2 veya 3 paragraf halinde yaz\u0131labilir:<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.acilci.net\/wp-content\/uploads\/2018\/03\/Ekran-Resmi-2018-03-25-13.47.07-1024x227.png\" alt=\"\" class=\"wp-image-25016\" \/><\/figure><\/div>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>5- Olgu sunumu (Case report\/presentation)<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li>Hastan\u0131n demografik bilgileri<\/li><li>Ana \u015fikayeti<\/li><li>T\u0131bbi, ailevi ve psikososyal \u00f6zge\u00e7mi\u015fi &amp; komorbiditeleri<\/li><li>Tan\u0131sal y\u00f6ntemler &amp; tan\u0131sal zorluklar:\n<ul><li>Tan\u0131y\u0131 ne ile koydunuz.<\/li><li>D\u00fc\u015f\u00fcnd\u00fc\u011f\u00fcn\u00fcz tan\u0131ya \/ \u00f6n tan\u0131ya giden mant\u0131\u011f\u0131n a\u00e7\u0131klanmas\u0131<\/li><\/ul>\n<\/li><li>Yap\u0131lan giri\u015fim ve tedavi(ler)in uygun doz ve birimlerle anlat\u0131lmas\u0131\n<ul><li>Tedaviler, neden o tedavinin se\u00e7ildi\u011fi, ila\u00e7 dozlar\u0131, varsa giri\u015fim y\u00f6ntemleri net \u015fekilde belirtilmeli.<\/li><li>Alternatif tedavi y\u00f6ntemleri ya da \u00f6nerilen dozlar\u0131n d\u0131\u015f\u0131nda dozlar verilmesi gibi modifikasyonlar varsa nedenleri a\u00e7\u0131klanmal\u0131.<\/li><\/ul>\n<\/li><li>Tedaviye hastan\u0131n fizyolojik ve gerekliyse laboratuvar yan\u0131t\u0131 belirtilmeli.<\/li><li>Hastan\u0131n sonlan\u0131m\u0131 a\u00e7\u0131k \u015fekilde anlat\u0131lmal\u0131 (ex oldu, taburcu oldu vs).<\/li><\/ul>\n\n\n\n<p>Olgu sunumu k\u0131sm\u0131nda yorum yapmay\u0131n. Ger\u00e7e\u011fi gizlemeyin, mesela ilk geli\u015finde tan\u0131 atlan\u0131p ikinci ba\u015fvuruda tan\u0131 konmu\u015fsa bunu saklamay\u0131n. Tansiyonu iyiydi, vitallerinde sorun yoktu gibi genel ge\u00e7er ifadeler kullanmay\u0131n, her veriyi a\u00e7\u0131k\u00e7a yaz\u0131n, birimleri eklemeyi unutmay\u0131n. Kronolojik zaman ak\u0131\u015f\u0131na uyun. E\u011fer \u00e7ok uzun s\u00fcren \u00e7ok fazla tan\u0131 tedavi a\u015famalar\u0131ndan olu\u015fan karma\u015f\u0131k bir olgu ise bir g\u00f6rsel ya da tablo ile a\u015fama a\u015fama saat saat yap\u0131lanlar\u0131 zaman \u00e7izelgesi \u015feklinde de verebilirsiniz ancak bu \u015fart de\u011fil.<\/p>\n\n\n\n<p>Yine bu b\u00f6l\u00fcmde klinik i\u00e7i sorunlar\u0131 payla\u015fmay\u0131n. Kons\u00fcltana ula\u015famaman\u0131z, hastan\u0131n yatamamas\u0131 gibi detaylar kimseyi ilgilendirmiyor.<\/p>\n\n\n\n<p>En \u00f6nemli noktalardan birisi de hastan\u0131n anonimle\u015ftirilmesidir. Hastan\u0131n a\u00e7\u0131k kimli\u011fi ya da hastay\u0131 \u00e7a\u011fr\u0131\u015ft\u0131racak detaylar verilmemelidir. \u015eu veriler olgu sunumu b\u00f6l\u00fcm\u00fcnde olmamal\u0131d\u0131r:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>\u0130sim<\/li><li>Spesifik co\u011frafik b\u00f6lge\/\u015fehir<\/li><li>Do\u011fum\/\u00f6l\u00fcm tarihleri<\/li><li>Yat\u0131\u015f\/taburculuk tarihleri<\/li><li>Telefon\/fax numaras\u0131, eposta adresi<\/li><li>Ki\u015fisel kay\u0131t numaralar\u0131 (kimlik no, hasta dosya no vs)<\/li><li>Biyometrik belirte\u00e7ler:<\/li><li>Foto\u011fraf ve g\u00f6r\u00fcnt\u00fcler.\n<ul><li>Bunlar gerekliyse, mesela hastan\u0131n y\u00fcz\u00fcn\u00fcn g\u00f6r\u00fcnmesi olgu i\u00e7in \u015fartsa, ayr\u0131ca onam al\u0131nmal\u0131d\u0131r, a\u00e7\u0131k\u00e7a bu k\u0131s\u0131mlar belirtilmelidir!<\/li><\/ul>\n<\/li><\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>6- Tart\u0131\u015fma (discussion)<\/strong><\/h4>\n\n\n\n<p>1.Olgu sunumunun g\u00fc\u00e7l\u00fc ve k\u0131s\u0131tl\u0131 yanlar\u0131n\u0131 belirtin?<\/p>\n\n\n\n<p>2.\u0130lgili literat\u00fcr\u00fc tart\u0131\u015f\u0131n<\/p>\n\n\n\n<p>3.Bu vaka ile var\u0131lan sonucu vurgulay\u0131n. Sonuca nas\u0131l ula\u015f\u0131ld\u0131\u011f\u0131n\u0131 neden sonu\u00e7 ili\u015fkisini belirterek a\u00e7\u0131klay\u0131n.<\/p>\n\n\n\n<p>4.Eve g\u00f6t\u00fcr\u00fclecek dersi sonu\u00e7 (conclusion) olarak belirtin.<\/p>\n\n\n\n<p>1-Vakan\u0131z\u0131 \u00f6zel k\u0131lan g\u00fc\u00e7l\u00fc yan\u0131 vurgulay\u0131n. Neden \u00e7ok \u00f6zeldi bu vaka? \u00d6ncekilerden ay\u0131ran neydi? Ancak k\u0131s\u0131tl\u0131l\u0131klar\u0131n\u0131 da belirtin. Mesela bonzai vakas\u0131 sundunuz ama kan ya da idrarda sentetik kannabinoid tespit edilmediyse, bu bir k\u0131s\u0131tl\u0131l\u0131kt\u0131r. Tan\u0131y\u0131 hikaye ve klinikle koydu\u011funuzu belirtmeniz gerekir.<\/p>\n\n\n\n<p>2-Literat\u00fcr tart\u0131\u015f\u0131rken gereksiz literat\u00fcrden ka\u00e7\u0131n\u0131n. Hepimizin tez yazma s\u00fcrecindeki acemili\u011finden kalan bir al\u0131\u015fkanl\u0131k olankonuyla ilgili ilgisiz her \u00e7al\u0131\u015fmay\u0131 tart\u0131\u015fmaya eklemek bizim \u00e7al\u0131\u015fmam\u0131z\u0131 g\u00fc\u00e7l\u00fc k\u0131lmaz. Hedefe y\u00f6nelik ilgili literat\u00fcr\u00fc tart\u0131\u015f\u0131n. Ayr\u0131ca o konudaki en \u00f6nemli sistematik derleme, metaanaliz ya da randomize kontroll\u00fc \u00e7al\u0131\u015fmalar\u0131 tart\u0131\u015fmaya almazken kan\u0131t d\u00fczeyi d\u00fc\u015f\u00fck bir \u00e7al\u0131\u015fma ya da olgu sunumunu almak da yetersiz literat\u00fcr tart\u0131\u015fmas\u0131 olacakt\u0131r.<\/p>\n\n\n\n<p>\u015eart olmamakla beraber literat\u00fcr tart\u0131\u015fmas\u0131 3 paragrafta yap\u0131labilir. \u0130lk paragrafta toplay\u0131c\u0131 \u00f6zet yap\u0131l\u0131r. Konu ile ilgili en \u00f6nemli \u00e7al\u0131\u015fmalardan al\u0131nt\u0131 yap\u0131l\u0131r. \u0130kinci paragrafta sizin \u00f6nermenizi destekleyen, \u00fc\u00e7\u00fcnc\u00fc paragrafta da desteklemeyen \u00e7al\u0131\u015fmalar\u0131 tart\u0131\u015fabilirsiniz.<\/p>\n\n\n\n<p>3-En \u00f6nemli nokta ise vaka ile ula\u015ft\u0131\u011f\u0131n\u0131z sonuca nas\u0131l ula\u015ft\u0131\u011f\u0131n\u0131z\u0131 iyi a\u00e7\u0131klaman\u0131z. Size g\u00f6re filanca ila\u00e7 filanca klinikten sorumludur mesela.Y a da tan\u0131n\u0131zda eminsinizdir ama yetersiz ay\u0131r\u0131c\u0131 tan\u0131 yapt\u0131ysan\u0131z ya da bunu a\u00e7\u0131k\u00e7a yazmad\u0131ysan\u0131z tan\u0131n\u0131z dahi \u015f\u00fcpheli bulunabilir. Ay\u0131r\u0131c\u0131 tan\u0131y\u0131 detayl\u0131 belirtin. Yani siz okuyucuyu, hakemleri ula\u015ft\u0131\u011f\u0131n\u0131z sonuca ikna etmelisiniz. Di\u011fer olas\u0131l\u0131klar\u0131 nas\u0131l d\u0131\u015flad\u0131\u011f\u0131n\u0131z\u0131, iddia etti\u011finiz sonu\u00e7 ile sizin nedeninizin ili\u015fkisini a\u00e7\u0131k\u00e7a vurgulamal\u0131s\u0131n\u0131z, detayl\u0131 bir savunmas\u0131n\u0131 yapmal\u0131s\u0131n\u0131z. Aksi taktirde maksad\u0131n\u0131 a\u015fan bir \u00e7\u0131kar\u0131m yapt\u0131\u011f\u0131n\u0131z d\u00fc\u015f\u00fcn\u00fcl\u00fcp vakan\u0131z direk reddedilebilir.<\/p>\n\n\n\n<p>4-\u00c7al\u0131\u015fman\u0131zdan bir sonu\u00e7-conclusion \u00e7\u0131kar\u0131n. \u00c7ok iddial\u0131 olmayan, eldeki vakan\u0131n sonu\u00e7lar\u0131n\u0131 literat\u00fcr e\u015fli\u011finde veren bir iki c\u00fcmle ile sonucu vurgulay\u0131n.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>7- Te\u015fekk\u00fcr<\/strong><\/h4>\n\n\n\n<p>ICMJE\u2019nin yazar katk\u0131s\u0131 kriterleri d\u0131\u015f\u0131ndaki katk\u0131 veren herkes bu b\u00f6l\u00fcme al\u0131nabilir.&nbsp; Yazar kriterlerine uymayan kanka, kons\u00fcltan, hem\u015fire gibi vakada bir \u015fekilde dolayl\u0131 da olsa katk\u0131s\u0131 bulunan herkesi bu k\u0131s\u0131mda onurland\u0131rabilirsiniz.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u00c7al\u0131\u015fmam neden kabul edilmedi?<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li>Orijinal de\u011fildi<\/li><li>Yaz\u0131m dili uygun de\u011fildi (dil &amp; jargon)<\/li><li>Neden \u2013 sonu\u00e7 ili\u015fkisi kurulmam\u0131\u015ft\u0131, yetersizdi.<\/li><li>G\u00f6nderdi\u011finiz dergi olgu sunumu yay\u0131nlam\u0131yordu, yay\u0131nlamak istemiyordu<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Kaynaklar<\/strong><\/h3>\n\n\n\n<p>1-McBride WG. Thalidomide and congenital abnormalities. Lancet 1961;ii:1358.<\/p>\n\n\n\n<p>2- CDC. Pneumocystis pneumonia e Los Angeles. Morbidity Mortality Weekly Rep 1981;30(21):250e2.<\/p>\n\n\n\n<p>3- Rison R, Helfgott M. Acute paradoxical embolic cerebral ischemia secondary to possible May-Thurner syndrome and an atrial septal defect: a case report. J Med Case Rep 2013;7:172.<\/p>\n\n\n\n<p>4- Driggers RW, Ho CY, Korhonen EM, Kuivanen S et al. Zika Virus Infection with Prolonged Maternal Viremia and Fetal Brain Abnormalities. N Engl J Med. 2016 Jun 2;374(22):2142-51. doi: 10.1056\/NEJMoa1601824. Epub 2016 Mar 30.<\/p>\n\n\n\n<p>5- CARE guidelines for case reports: explanation and elaboration document. Riley DS, Barber MS, Kienle GS, Aronson JK, von Schoen-Angerer T, Tugwell P, Kiene H, Helfand M, Altman DG, Sox H, Werthmann PG, Moher D, Rison RA, Shamseer L, Koch CA, Sun GH, Hanaway P, Sudak NL, Kaszkin-Bettag M, Carpenter JE, Gagnier JJ. J Clin Epidemiol. 2017 Sep;89:218-235. doi: 10.1016\/j.jclinepi.2017.04.026. Epub 2017 May 18.<\/p>\n\n\n\n<p>6- Riley, D. S., Barber, M. S., Kienle, G. S., Aronson, J. K., von Schoen-Angerer, T., Tugwell, P., &#8230; &amp; Werthmann, P. G. (2017). CARE guidelines for case reports: explanation and elaboration document.&nbsp;Journal of clinical epidemiology,&nbsp;89, 218-235.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bu yaz\u0131n\u0131n ilk b\u00f6l\u00fcm\u00fcnde olgu sunumunun \u00f6nemini tart\u0131\u015faca\u011f\u0131z. Daha sonra a\u015fama a\u015fama nas\u0131l olgu sunumu yaz\u0131l\u0131r sorusuna CARE k\u0131lavuzu e\u015fli\u011finde cevap arayaca\u011f\u0131z.&hellip;<\/p>\n","protected":false},"author":1561,"featured_media":495,"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":[22,10014],"tags":[],"class_list":["post-490","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-makale-yazimi-yazilari","category-akademik-blog-yazisi"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/atak\/wp-json\/wp\/v2\/posts\/490","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/atak\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/atak\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/atak\/wp-json\/wp\/v2\/users\/1561"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/atak\/wp-json\/wp\/v2\/comments?post=490"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/atak\/wp-json\/wp\/v2\/posts\/490\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/atak\/wp-json\/wp\/v2\/media\/495"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/atak\/wp-json\/wp\/v2\/media?parent=490"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/atak\/wp-json\/wp\/v2\/categories?post=490"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/atak\/wp-json\/wp\/v2\/tags?post=490"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}