{"id":3717,"date":"2024-03-18T08:19:07","date_gmt":"2024-03-18T05:19:07","guid":{"rendered":"https:\/\/tatd.org.tr\/toksikoloji\/?p=3717"},"modified":"2024-03-18T08:19:08","modified_gmt":"2024-03-18T05:19:08","slug":"e-cigarette-and-vaping-use-associated-lung-injury-evali-elektronik-sigara-ve-urunlerine-bagli-ortaya-cikan-akciger-hasari","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/toksikoloji\/2024\/03\/18\/e-cigarette-and-vaping-use-associated-lung-injury-evali-elektronik-sigara-ve-urunlerine-bagli-ortaya-cikan-akciger-hasari\/","title":{"rendered":"E-cigarette and Vaping Use Associated Lung Injury (EVALI): Elektronik Sigara ve \u00dcr\u00fcnlerine Ba\u011fl\u0131 Ortaya \u00c7\u0131kan Akci\u011fer Hasar\u0131"},"content":{"rendered":"\n

G\u00fcn\u00fcm\u00fczde elektronik sigara ya da \u0131s\u0131t\u0131lm\u0131\u015f t\u00fct\u00fcn kullan\u0131m\u0131 gittik\u00e7e artmaktad\u0131r. T\u00fct\u00fcn end\u00fcstri firmalar\u0131n\u0131n bir\u00e7o\u011fu, sigaraya g\u00f6re yan etkisinin az oldu\u011funu savunarak, sigaraya alternatif olarak g\u00f6stererek yayg\u0131nla\u015ft\u0131rmaya \u00e7al\u0131\u015ft\u0131\u011f\u0131 bu maddeler s\u00f6ylendi\u011fi kadar masum de\u011fildir. Biz de bu yaz\u0131m\u0131zda 2020 y\u0131l\u0131nda New England Journal of Emergency Medicine<\/em><\/strong><\/a>\u2019da yay\u0131nlanm\u0131\u015f Hospitalizations and Deaths Associated with EVALI<\/em><\/a>\u2019yi<\/em> ele alarak en \u00f6l\u00fcmc\u00fcl komplikasyonunu ele alaca\u011f\u0131z.1<\/sup><\/p>\n\n\n\n

Giri\u015f<\/h1>\n\n\n\n

Elektronik sigara ve \u0131s\u0131t\u0131lm\u0131\u015f t\u00fct\u00fcn \u00fcr\u00fcnleri Amerika Birle\u015fik Devletleri\u2019nde ilk olarak 2007\u2019de kullan\u0131lmaya ba\u015flam\u0131\u015f ve zamanla kullan\u0131m\u0131 artm\u0131\u015ft\u0131r. Bu \u00fcr\u00fcnlerin \u00fcretti\u011fi aerosoller tipik olarak nikotin, tatland\u0131r\u0131c\u0131lar,katk\u0131 maddeleri, tetrahidrokanabinol (THC), kanabis ve kanabidiol gibi maddeler i\u00e7erebilir. T\u00fcketici i\u00e7erdi\u011fi maddelere g\u00f6re pek \u00e7ok kimyasal maddeye maruz kalm\u0131\u015f olur. \u00c7\u00f6z\u00fcc\u00fcler de dahil olmak \u00fczere elektronik sigaradaki maddelerin kalitesini ve bile\u015fimini kontrol etmeye y\u00f6nelik \u00e7ok az d\u00fczenleme mevcuttur.<\/p>\n\n\n\n

A\u011fustos 2019\u2019da ulusal bir salg\u0131n olmas\u0131 ile birlikte Hastal\u0131k Kontrol ve Koruma Merkezi (Centers for Disease Control and Prevention-CDC) <\/em>EVALI\u2019yi (e<\/strong>-cigarette and v<\/strong>aping use a<\/strong>ssociated l<\/strong>ung i<\/strong>njury) yak\u0131n incelemeye ba\u015flam\u0131\u015ft\u0131r. EVALI g\u00f6r\u00fclen hastalar\u0131n \u00e7o\u011funda THC i\u00e7eren \u00fcr\u00fcn\u00fc kullan\u0131ld\u0131\u011f\u0131 tespit edilmi\u015ftir ve \u00e7o\u011funda hastane yat\u0131\u015f\u0131 gerekmi\u015ftir. Bir\u00e7o\u011fu da kritik hasta bak\u0131m\u0131na ve solunum deste\u011fine ihtiya\u00e7 duymu\u015ftur. THC\u2019ye ek olarak vitamin E asetat\u2019\u0131n kullan\u0131lmas\u0131 EVALI salg\u0131n\u0131 ile y\u00fcksek derecede ba\u011flant\u0131l\u0131 oldu\u011fu g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. EVALI vakalar\u0131 ile vaka bazl\u0131 bildirimlerin olmas\u0131na ra\u011fmen bu hastalarla ilgili verilerin k\u0131s\u0131tl\u0131 kalm\u0131\u015ft\u0131r. Bunun \u00fczerine \u00e7al\u0131\u015fma ekibi ulusal bir \u00e7al\u0131\u015fma planlayarak EVALI g\u00f6r\u00fclen hastalar\u0131 incelemi\u015flerdir. B\u00f6ylece EVALI nedeniyle hastane yat\u0131\u015f\u0131 gereken hastalar\u0131 inceleyerek klinisyenin hastal\u0131\u011f\u0131n klinik karakteristi\u011fini anlamalar\u0131 ve \u00f6l\u00fcmle ili\u015fkili riskleri belirlemek ama\u00e7lanm\u0131\u015ft\u0131r. Yine bu fark\u0131ndal\u0131\u011f\u0131 artt\u0131rmak ad\u0131na 3 adet de \u00f6l\u00fcmle sonlanan vaka sunumuna bu yaz\u0131da yer verilmi\u015ftir.<\/p>\n\n\n\n

Metodoloji<\/h1>\n\n\n\n

\u00c7al\u0131\u015fmaya A\u011fustos 2019 ile Ocak 2020 aras\u0131nda EVALI tan\u0131s\u0131 konan ya da \u015f\u00fcphesi olup CDC\u2019ye bildirilen hastalar dahil edilmi\u015ftir. Bu s\u00fcre\u00e7 boyunca ABD\u2019den 50 eyaletten bildirim yap\u0131lm\u0131\u015ft\u0131r. Esas olarak vakalar EVALI nedenli \u00f6len ve \u00f6lmeyen olarak iki gruba ayr\u0131lm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

Sonu\u00e7lar<\/h1>\n\n\n\n

\u00c7al\u0131\u015fman\u0131n kapsad\u0131\u011f\u0131 s\u00fcre boyunca 2558 hasta dahil edilmi\u015f ve bunlar\u0131n 60\u2019\u0131 \u00f6l\u00fcmle sonu\u00e7lanm\u0131\u015ft\u0131r. \u00d6len hastalar\u0131n %53\u2019\u00fc (32\/60) erkek iken, ya\u015fayan hastalar\u0131n %67\u2019si (1666\/2498) erkektir. \u00d6len hastalar\u0131n ya\u015f ortancas\u0131 51 (aral\u0131k: 15-75) iken ya\u015fayan hastalar\u0131n ya\u015f ortancas\u0131 24 (aral\u0131k: 13-85) olarak g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Her hastada \u0131rk ve etnik grup verisine ula\u015f\u0131lamasa da \u00f6len hastalar\u0131n %80\u2019i (39\/49) non-hispanik beyaz iken, ya\u015fayan hastalar\u0131n %61\u2019inin (1104\/1818)\u2019i non-hispanik beyaz oldu\u011fu g\u00f6r\u00fclm\u00fc\u015ft\u00fcr (Tablo 1).<\/p>\n\n\n\n

\u00d6l\u00fcmle sonu\u00e7lanan vakalar\u0131n hastaneye ba\u015fvuru an\u0131nda %73\u2019\u00fcnde (40\/55) hipoksi, %46\u2019s\u0131nda (25\/54) ta\u015fikardi ve %50\u2019sinde (26\/52) takipne g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Yine bu hastalar\u0131n ba\u015fvuru an\u0131nda %71\u2019inde (37\/52) l\u00f6kositoz (WBC>11.000 her milimetre k\u00fcbik alanda h\u00fccre), %64\u2019\u00fcnde (29\/45) n\u00f6trofil bask\u0131nl\u0131\u011f\u0131 (n\u00f6trofil\/WBC > %80) g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. \u00d6l\u00fcmle sonu\u00e7lanan hastalar\u0131n %93\u2019\u00fc hastanede \u00f6lm\u00fc\u015ft\u00fcr.<\/p>\n\n\n\n

 <\/td>\u00d6len Vakalar (n=60)<\/td>\u00d6lmeyen Vakalar (n=2498)<\/td><\/tr>
Erkek cinsiyet,%<\/td>53 (32\/60)<\/td>1666 (67)<\/td><\/tr>
Ya\u015f, ortanca [aral\u0131k]<\/td>51 [15-75]<\/td>24 [13-85]<\/td><\/tr>
Non-hispanik beyaz, %<\/td>80 (39\/49)<\/td>61 (1104\/1818)<\/td><\/tr>
Solunum yolu hastal\u0131\u011f\u0131, %<\/td>44 (25\/57)<\/td>26 (371\/1429)<\/td><\/tr>
Kardiyak hastal\u0131k, %<\/td>47 (26\/55)<\/td>10 (115\/1169)<\/td><\/tr>
Herhangi bir mental rahats\u0131zl\u0131k, %<\/td>65 (32\/49)<\/td>41 (575\/1398)<\/td><\/tr>
Obezite, %<\/td>52 (26\/50)<\/td>Veri yok<\/td><\/tr>
Daha \u00f6nce bir sa\u011fl\u0131k kurulu\u015funa ba\u015fvuru, %<\/td>46 (25\/54)<\/td>21 (479\/2320)<\/td><\/tr>
Tablo 1:<\/strong> \u00d6l\u00fcm g\u00f6r\u00fclen ve g\u00f6r\u00fclmeyen vakalar\u0131n demografik \u00f6zellikleri<\/td><\/tr><\/tbody><\/table><\/div><\/figure>\n\n\n\n

Vaka 1: \u00d6nceden var olan \u00e7oklu t\u0131bbi durumlar<\/h2>\n\n\n\n

Ast\u0131m, KOAH, morbid obezite, kalp yetmezli\u011fi \u00f6yk\u00fcleri olan hasta ciddi nefes darl\u0131\u011f\u0131 \u015fikayetiyle hastaneye ba\u015fvurmu\u015f. THC, kannabidiol ve nikotin i\u00e7eren elektronik sigara kullan\u0131m\u0131 da tarif etmekteymi\u015f. \u015eikayetleri 8 g\u00fcn i\u00e7erisinde ilerlemi\u015f. Hastaya geni\u015f spektrumlu antibiyotik, di\u00fcretik, bronkodilat\u00f6r, sistemik glukokortikoid ve BPAP tedavisi uygulanm\u0131\u015f. Tedaviye ra\u011fmen 48 saat i\u00e7erisinde ARDS geli\u015fmi\u015f ve hastaya ent\u00fcbasyon ile birlikte mekanik ventilasyona ge\u00e7ilmi\u015f. Var olan bir\u00e7ok medikal hastal\u0131k ve solunum yetmezli\u011fi nedeniyle de\u011ferlendirme ve tedavi kararlar\u0131 komplike olmu\u015f. Hasta pron pozisyonuna getirilmesine ra\u011fmen ventilasyon ve oksijenizasyon sa\u011flanmas\u0131nda zorluk ya\u015fanm\u0131\u015f. Hasta yat\u0131\u015f\u0131n\u0131n 21. g\u00fcn\u00fcnde vefat etmi\u015f. <\/p>\n\n\n\n

Vaka 2: Tekrarlayan Semptomlar<\/h2>\n\n\n\n

Hasta 2 g\u00fcn i\u00e7erisinde geli\u015fen \u015fikayetler ile 2 farkl\u0131 hastaneye ba\u015fvurmu\u015f ve bu ba\u015fvurular\u0131nda toplum kaynakl\u0131 pn\u00f6moni tan\u0131s\u0131 ile antibiyotik ve antiemetik re\u00e7ete edilerek taburcu edilmi\u015f. 3 g\u00fcn sonra ise tekrardan bir ba\u015fka hastaneye ba\u015fvurmu\u015f ve bu ba\u015fvurusunda yat\u0131\u015f\u0131 yap\u0131lm\u0131\u015f. Geni\u015f spektrumlu antibiyotik tedavisine ge\u00e7ilirken bronkodilat\u00f6r tedavi de ba\u015flanm\u0131\u015f. Hasta nikotin i\u00e7eren ama THC i\u00e7ermeyen elektronik sigara kulland\u0131\u011f\u0131n\u0131 beyan etmi\u015f. Hastan\u0131n izleminde solunum stresinin artmas\u0131 ve ate\u015finin olmas\u0131 ile sistemik glukokortikoid tedavisine ba\u015flanm\u0131\u015f. Hasta yat\u0131\u015f\u0131n\u0131n 5. g\u00fcn\u00fcnde levofloksasin ve glukokortikoid tedavi ile taburcu edilmi\u015f.<\/p>\n\n\n\n

Taburculuktan 2 g\u00fcn sonra bulant\u0131, kusma ve halsizlik \u015fikayetleri devam etmekteymi\u015f. Hasta yak\u0131nlar\u0131n\u0131n hastay\u0131 yan\u0131ts\u0131z bulmas\u0131 \u00fczerine tekrar hastaneye ba\u015fvuru olmu\u015f, uygun res\u00fcsitasyona ra\u011fmen hasta kurtar\u0131lamam\u0131\u015f. Daha sonra kulland\u0131\u011f\u0131 \u00fcr\u00fcn \u00fczerine yap\u0131lan incelemerde elektronik sigaran\u0131n THC ve vitamin E i\u00e7erdi\u011fi tespit edilmi\u015f.<\/p>\n\n\n\n

Vaka 3: \u0130lk hastane yat\u0131\u015f\u0131 s\u0131ras\u0131nda glukokortikoid tedavisi almayan hasta<\/h2>\n\n\n\n

Hasta \u015fikayetlerinin ba\u015flamas\u0131 \u00fczerine ayaktan poliklini\u011fe ba\u015fvurmu\u015f ve viral gastroenterit tedavisi ile taburcu edilmi\u015f. \u015eikayetlerinin 6. g\u00fcn\u00fcnde ba\u015f a\u011fr\u0131s\u0131, bulant\u0131, kusma ve ishal ile tekrardan hastaneye ba\u015fvurmu\u015f ve dehidratasyon g\u00f6r\u00fclmesi \u00fczerine hastaneye yat\u0131\u015f\u0131 yap\u0131lm\u0131\u015f. Yat\u0131\u015f\u0131n\u0131n 4. g\u00fcn\u00fcnde akci\u011fer grafisinde bilateral intertisyel i\u015faretlenmeler g\u00f6r\u00fclm\u00fc\u015f ve hastaya azitromisin tedavisi ba\u015flanm\u0131\u015f. Hasta nikotin i\u00e7eren elektronik sigara kulland\u0131\u011f\u0131n\u0131 beyan etmi\u015f. Hastan\u0131n daha da k\u00f6t\u00fcle\u015fmesi \u00fczerine yo\u011fun bak\u0131ma devredilmi\u015f. Yat\u0131\u015f\u0131n\u0131n 15. g\u00fcn\u00fcnde hasta bu \u00fcr\u00fcnleri kullanmamas\u0131 \u00f6nerilerek taburcu edilmi\u015f. Hasta 24. g\u00fcnde solunum \u015fikayetlerinin devam etmesi \u00fczerine tekrardan ba\u015fvurmu\u015f ve ent\u00fcbasyon ihtiyac\u0131 geli\u015fmi\u015f. Bunun \u00fczerine glukokortikoid tedavisi ba\u015flanm\u0131\u015f. Hasta 40. g\u00fcn\u00fcnde ekstrakorporal membran oksijenizasyon tedavisine al\u0131nm\u0131\u015f. 41. g\u00fcnde \u015fiddetli hipotansiyon ve kardiyak arrest nedenli kaybedilmi\u015f. Hastan\u0131n kulland\u0131\u011f\u0131 \u00fcr\u00fcn analiz edildi\u011finde hint ya\u011f\u0131 i\u00e7erdi\u011fi saptanm\u0131\u015f.<\/p>\n\n\n\n

Tart\u0131\u015fma<\/h1>\n\n\n\n

Bu \u00e7al\u0131\u015fmada \u00f6l\u00fcmc\u00fcl olan ve olmayan EVALI vakalar\u0131n\u0131n klinik karakteristikleri incelendi. \u00d6l\u00fcm g\u00f6r\u00fclen hastalar\u0131n ya\u015f ortancalar\u0131 daha y\u00fcksek g\u00f6r\u00fclm\u00fc\u015f ve \u00f6l\u00fcm g\u00f6r\u00fclen hastalarda daha y\u00fcksek oranda kronik medikal rahats\u0131zl\u0131klar saptanm\u0131\u015f. Normalde \u00f6l\u00fcm g\u00f6r\u00fclmeyen vakalarda daha s\u0131kl\u0131kla g\u00f6r\u00fclmesine ra\u011fmen \u00f6l\u00fcm g\u00f6r\u00fclen baz\u0131 vakalar\u0131n da gastrointestinal semptomlarla (bulant\u0131, diyare) ba\u015fvurdu\u011fu izlenmi\u015f. Dolay\u0131s\u0131yla konstitusyonel semptomlar, gastrointestinal semptomlarla ba\u015fvuran, elektronik sigara kullan\u0131c\u0131lar\u0131nda klinisyen EVALI\u2019yi akl\u0131nda tutmal\u0131d\u0131r.<\/p>\n\n\n\n

\u00d6l\u00fcm g\u00f6r\u00fclen vakalar\u0131n %63\u2019\u00fcnde ARDS geli\u015fmi\u015ftir. Bu hastalar\u0131n y\u00f6netiminde kan\u0131t d\u00fczeyi bazl\u0131 yakla\u015f\u0131mlar uygulanmal\u0131d\u0131r.<\/p>\n\n\n\n

THC kullan\u0131m\u0131n\u0131n yasad\u0131\u015f\u0131 olmas\u0131 sebebiyle, hasta \u00f6yk\u00fcleri g\u00fcvenilir olmayabilir. Bu hastalarda hekim-hasta gizlili\u011finin korunarak detayl\u0131 anamnez almak \u00f6nemlidir.<\/p>\n\n\n\n

EVALI hastalar\u0131n\u0131n 2\/3\u2019\u00fcnde mental hastal\u0131k \u00f6yk\u00fcs\u00fc bulunmaktad\u0131r. Bu hastalar\u0131n altta yatan zihinsel sa\u011fl\u0131k sorunlar\u0131 ele al\u0131nmal\u0131, hastane bak\u0131m\u0131, taburculuk planlamas\u0131 ve taburculuk sonras\u0131 bak\u0131m bununla birlikte y\u00f6netilmelidir.<\/p>\n\n\n\n

\u00d6l\u00fcmle sonu\u00e7lanan vakalarda obezite %52 oran\u0131nda g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. \u00d6l\u00fcmle sonu\u00e7lanmayan grupta bu veri olmamas\u0131na ra\u011fmen normal pop\u00fclasyonda %40 civarlar\u0131nda g\u00f6r\u00fclmesi nedeniyle \u00f6len grupta daha y\u00fcksek oranda g\u00f6r\u00fcld\u00fc\u011f\u00fc d\u00fc\u015f\u00fcn\u00fclmektedir. Obezite solunum hastal\u0131klar\u0131 i\u00e7in \u00f6nemli bir risk fakt\u00f6r\u00fcd\u00fcr, pulmoner fizyolojik parametrelerde ciddi de\u011fi\u015fikliklere sebep olur ve solunumsal hastal\u0131klar\u0131 komplike etmektedir. Ayr\u0131ca yeterli mekanik ventilasyon sa\u011flanmas\u0131n\u0131 da zorla\u015ft\u0131rmaktad\u0131r.<\/p>\n\n\n\n

Glukokortikoid kullan\u0131m\u0131yla ilgili k\u0131s\u0131tl\u0131 veri bulunmas\u0131na ra\u011fmen EVALI hastalar\u0131nda faydal\u0131 olaca\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclmektedir. Hastaneye yat\u0131\u015f\u0131 yap\u0131lan, ciddi solunum yetmezli\u011fi olan hastalarda verilmesi \u00f6nerilmektedir. \u00d6zellikle antibiyotik tedavisinden ve solunum deste\u011finden fayda g\u00f6rmeyen hastalarda hasta bazl\u0131 doz ayarlamalar\u0131 yap\u0131larak uygulanmas\u0131 \u00f6nerilmektedir.<\/p>\n\n\n\n

Hastaneye yat\u0131\u015f\u0131 yap\u0131lan vakalar\u0131n yakla\u015f\u0131k olarak yar\u0131s\u0131n\u0131n daha \u00f6nceden bir ba\u015fka merkeze ba\u015fvurdu\u011fu g\u00f6r\u00fclmektedir. Dolay\u0131s\u0131yla bu hastalar\u0131n erken tan\u0131nmas\u0131 ve uygun tedavinin erken ba\u015flanmas\u0131 ile sonlan\u0131mlar\u0131n iyile\u015febilece\u011fi d\u00fc\u015f\u00fcn\u00fclmektedir.<\/p>\n\n\n\n

Ast\u0131m, KOAH, kardiyak rahats\u0131zl\u0131k ve herhangi bir mental rahats\u0131zl\u0131\u011f\u0131 olan hastalarda EVALI daha s\u0131k g\u00f6r\u00fclmektedir. Bu t\u00fcr hastal\u0131\u011f\u0131 olan ki\u015filerde halk sa\u011fl\u0131\u011f\u0131 uygulay\u0131c\u0131lar\u0131 ve aile hekimleri elektronik sigara kullan\u0131m\u0131n\u0131 ve maruziyetin azalt\u0131lmas\u0131na u\u011fra\u015fmal\u0131d\u0131r.<\/p>\n\n\n\n

Kaynaklar<\/h1>\n\n\n\n
    \n
  1. Werner AK, Koumans EH, Chatham-Stephens K et al. Hospitalizations and Deaths Associated with EVALI. N Engl J Med. 2020 Apr 23;382(17):1589-1598. doi: 10.1056\/NEJMoa1915314.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    G\u00fcn\u00fcm\u00fczde elektronik sigara ya da \u0131s\u0131t\u0131lm\u0131\u015f t\u00fct\u00fcn kullan\u0131m\u0131 gittik\u00e7e artmaktad\u0131r. T\u00fct\u00fcn end\u00fcstri firmalar\u0131n\u0131n bir\u00e7o\u011fu, sigaraya g\u00f6re yan etkisinin az oldu\u011funu savunarak, sigaraya…<\/p>\n","protected":false},"author":1237,"featured_media":3718,"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":[1,10014,10019],"tags":[27,144,10022,406,449],"class_list":["post-3717","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","category-akademik-blog-yazisi","category-tft","tag-acil-tip","tag-elektronik-sigara","tag-tft","tag-toksikoloji","tag-zehirlenme"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts\/3717","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/users\/1237"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/comments?post=3717"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts\/3717\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/media\/3718"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/media?parent=3717"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/categories?post=3717"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/tags?post=3717"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}