{"id":24387,"date":"2022-03-28T09:00:19","date_gmt":"2022-03-28T06:00:19","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/?p=24387"},"modified":"2022-03-28T10:37:51","modified_gmt":"2022-03-28T07:37:51","slug":"kizamik-kabakulak-kizamikcik-asi-uygulamasi-sonrasi-gelisen-parotit-ve-orsit-olgulari","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2022\/03\/28\/kizamik-kabakulak-kizamikcik-asi-uygulamasi-sonrasi-gelisen-parotit-ve-orsit-olgulari\/","title":{"rendered":"K\u0131zam\u0131k-Kabakulak-K\u0131zam\u0131k\u00e7\u0131k A\u015f\u0131 Uygulamas\u0131 Sonras\u0131 Geli\u015fen Parotit ve Or\u015fit Olgular\u0131"},"content":{"rendered":"

G\u0130R\u0130\u015e<\/h2>\n

K\u0131zam\u0131k, kabakulak ve k\u0131zam\u0131k\u00e7\u0131k (KKK) a\u011f\u0131r sekellere ve \u00f6l\u00fcme yol a\u00e7abilen, a\u015f\u0131 ile \u00f6nlenebilir bula\u015f\u0131c\u0131 hastal\u0131klard\u0131r. Bu hastal\u0131klar\u0131n \u00f6nlenmesinde kullan\u0131lan KKK a\u015f\u0131lar\u0131, canl\u0131-aten\u00fce a\u015f\u0131lar olup \u00fclkemizde 2006 y\u0131l\u0131ndan bu yana 12. ayda ve ilk \u00f6\u011fretimin ilk y\u0131l\u0131nda 6-7 ya\u015f grubunda olmak \u00fczere 2 doz olarak uygulanmaktad\u0131r (1, 2). Bu a\u015f\u0131lar eri\u015fkinler i\u00e7in \u00f6nerilen a\u015f\u0131 \u015femalar\u0131nda da yer almakta ve hastal\u0131k ge\u00e7irdi\u011fine dair serolojik veya 2 doz KKK a\u015f\u0131s\u0131 uyguland\u0131\u011f\u0131na ili\u015fkin kan\u0131t\u0131 olmayan t\u00fcm eri\u015fkinlere uygulanmas\u0131 \u00f6nerilmektedir (3). Sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131, artan maruziyet riskleri nedeniyle KKK a\u015f\u0131lamas\u0131 i\u00e7in \u00f6ncelikli gruplar i\u00e7erisinde yer almaktad\u0131r.<\/p>\n

KKK a\u015f\u0131s\u0131, g\u00fcvenli bir a\u015f\u0131 olarak kabul edilmektedir (1). A\u015f\u0131 sonras\u0131 en s\u0131k bildirilen yan etkiler; a\u015f\u0131 yerinde lokal reaksiyonlar, ate\u015f, artrit, artralji, lenfadenopati (LAP) ve genellikle a\u015f\u0131dan sonraki 7-10. g\u00fcnlerde ba\u015flayan ve yakla\u015f\u0131k 2 g\u00fcn s\u00fcren k\u0131zam\u0131k benzeri d\u00f6k\u00fcnt\u00fcd\u00fcr. Daha nadir olarak, olgular\u0131n %1\u2019den az\u0131nda; parotit, or\u015fit, aseptik menenjit, trombositopeni ve ciddi alerjik reaksiyonlar g\u00f6r\u00fclebilece\u011fi bildirilmi\u015ftir (2, 3).<\/p>\n

Bu yaz\u0131da, sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131na uygulanan, Edmonston-Zagreb k\u0131zam\u0131k, Leningrad-Zagreb (L-Z) kabakulak ve Wistar RA 27\/3 k\u0131zam\u0131k\u00e7\u0131k su\u015flar\u0131n\u0131 i\u00e7eren k\u0131zam\u0131k-kabakulak-k\u0131zam\u0131k\u00e7\u0131k (KKK) a\u015f\u0131s\u0131 (Tresivac\u00ae, \u201cSerum Institute of India\u201d, Hindistan) sonras\u0131nda geli\u015fen 12 parotit ve or\u015fit olgusu (10 parotit ve 2 or\u015fit) de\u011ferlendirildi.<\/p>\n

OLGULAR<\/h2>\n

Ankara Gazi \u00dcniversitesi Hastanesi eri\u015fkin ba\u011f\u0131\u015f\u0131klama poliklini\u011fine 3 g\u00fcn art arda tek tarafl\u0131 boyunda \u015fi\u015flik ve a\u011fr\u0131 \u015fikayetiyle sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n ba\u015fvurdu\u011fu ve bulgular\u0131n parotit ile uyumlu oldu\u011fu saptand\u0131. S\u00f6z konusu sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131na 13-22 g\u00fcn \u00f6nce KKK a\u015f\u0131s\u0131 uyguland\u0131\u011f\u0131 tespit edildi. \u0130lk ba\u015fvuran sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131nda kabakulak IgM pozitifli\u011fi de g\u00f6sterilerek, kabakulak ili\u015fkili parotit tan\u0131s\u0131 konuldu. Sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 aras\u0131nda benzer \u015fikayetleri olan ki\u015filerin tan\u0131mlamas\u0131 nedeniyle gerekli de\u011ferlendirmeler yap\u0131l\u0131ncaya kadar merkezimizde KKK a\u015f\u0131 uygulamas\u0131 durduruldu. A\u015f\u0131laman\u0131n durdurulmas\u0131 ile ilgili olarak; T.C Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 Halk Sa\u011fl\u0131\u011f\u0131 Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fc A\u015f\u0131 ile \u00d6nlenebilir Hastal\u0131klar Dairesi Ba\u015fkanl\u0131\u011f\u0131\u2019na, Ankara \u0130l Sa\u011fl\u0131k M\u00fcd\u00fcrl\u00fc\u011f\u00fc\u2019ne ve T\u00fcrkiye \u0130la\u00e7 ve T\u0131bbi Cihaz Kurumu\u2019na gerekli bildirimler yap\u0131ld\u0131.<\/p>\n

\"\"<\/a>

Tablo 1.<\/strong> Olgular\u0131n A\u015f\u0131, Demografi, Klinik ve Serolojik Sonu\u00e7 Bilgileri<\/p><\/div>\n

Geriye d\u00f6n\u00fck olarak yap\u0131lan de\u011ferlendirmede Nisan ay\u0131n\u0131n 2. haftas\u0131 ve May\u0131s ay\u0131n\u0131n ilk haftas\u0131nda benzer \u015fikayetleri g\u00f6steren 12 sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131 oldu\u011fu saptand\u0131. Olgular eri\u015fkin a\u015f\u0131 poliklini\u011finde de\u011ferlendirilmi\u015f olup 10 sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131nda parotit (bir olguda bilateral) ve 2 sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131nda ise parotit ve tek tarafl\u0131 or\u015fit (acil servis ba\u015fvurular\u0131 mevcuttur) geli\u015fti\u011fi saptand\u0131. Serolojik de\u011ferlendirme yap\u0131lan 9 sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131nda kabakulak IgM pozitifli\u011fi g\u00f6sterildi. On iki sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131na uygulanan a\u015f\u0131 ve tarihi, tespit edilen klinik bulgular ve ba\u015flama tarihleri ile serolojik test sonu\u00e7lar\u0131 Tablo 1\u2019de sunuldu. A\u015f\u0131 uygulamas\u0131na ili\u015fkin bulgular\u0131n ortaya \u00e7\u0131kt\u0131\u011f\u0131 d\u00f6nem ile \u00f6nceki d\u00f6nemler kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda 01 Nisan 2021 tarihi itibariyle merkezimizde uygulanan a\u015f\u0131n\u0131n de\u011fi\u015fti\u011fi ve daha \u00f6nce uygulanmayan bir a\u015f\u0131n\u0131n uygulanmaya ba\u015fland\u0131\u011f\u0131 tespit edildi. Merkezimizde 01 Nisan itibariyle T.C Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 taraf\u0131ndan temin edilen Edmonston-Zagreb k\u0131zam\u0131k, Leningrad-Zagreb (L-Z) kabakulak ve Wistar RA 27\/3 k\u0131zam\u0131k\u00e7\u0131k su\u015flar\u0131n\u0131 i\u00e7eren k\u0131zam\u0131k-kabakulak-k\u0131zam\u0131k\u00e7\u0131k (KKK) a\u015f\u0131s\u0131 (Tresivac\u00ae, \u201cSerum Institute of India\u201d, Hindistan)\u00a0 <\/span>uyguland\u0131\u011f\u0131 saptand\u0131. Uygulanan a\u015f\u0131lar\u0131n 3 farkl\u0131 grupta yer almas\u0131 nedeniyle 01 Nisan 2021 tarihi ile a\u015f\u0131 uygulanan ve ula\u015f\u0131labilen t\u00fcm sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 yeniden de\u011ferlendirildi. Toplam 138 a\u015f\u0131 uygulamas\u0131 yap\u0131ld\u0131\u011f\u0131 ve bu a\u015f\u0131lar\u0131n 88\u2019inin k\u0131zam\u0131k, 4\u2019\u00fcn\u00fcn k\u0131zam\u0131k\u00e7\u0131k ve 63\u2019\u00fcn\u00fcn kabakulak seronegatifli\u011fi nedeniyle uyguland\u0131\u011f\u0131 saptand\u0131. A\u015f\u0131 uygulanan sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n %54.6\u2019s\u0131 kabakulak IgG pozitif, %45.6\u2019s\u0131 ise kabakulak IgG negatif olup 12 (%8.7) semptomatik olguda tan\u0131mlanan yan etkilerin kabakulak seronegatif grupta geli\u015fti\u011fi saptand\u0131. Olgulardaki ve a\u015f\u0131 i\u00e7eri\u011findeki kabakulak virus su\u015flar\u0131 ile ilgili de\u011ferlendirmeler Halk Sa\u011fl\u0131\u011f\u0131 Laboratuvar\u0131 ile y\u00fcr\u00fct\u00fclm\u00fc\u015f olup parotit geli\u015fen bir hastada t\u00fck\u00fcr\u00fckte kabakulak PCR pozitifli\u011fi saptand\u0131. Ancak saptanan d\u00fc\u015f\u00fck viral y\u00fck nedeniyle a\u015f\u0131 ile ili\u015fkisi de\u011ferlendirilemedi.<\/p>\n

Semptomatik sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131na, parotit semptom s\u00fcresine g\u00f6re ortalama 5 ila 8 g\u00fcn damlac\u0131k ve temas izolasyonu \u00f6nerildi. Parotit geli\u015fen olgular\u0131n semptomlar\u0131 2 hafta i\u00e7erisinde gerileyerek kayboldu. Or\u015fit geli\u015fen olgular\u0131n \u015fikayetleri gerilemekle birlikte her iki or\u015fit olgusunda infeksiyon geli\u015fen testiste atrofi tespit edildi. Olgulardan kaynakl\u0131 ikincil bula\u015f tespit edilmedi.<\/p>\n

\u0130RDELEME<\/h2>\n

\u00c7al\u0131\u015fmam\u0131z uygulanmakta olan kabakulak a\u015f\u0131s\u0131 ile parotit ve or\u015fit olgular\u0131ndaki art\u0131\u015f aras\u0131ndaki ili\u015fkiyi ortaya koydu. A\u015f\u0131 sonras\u0131 nadiren geli\u015fmesi beklenilen parotit s\u0131kl\u0131\u011f\u0131n\u0131n, \u00fclkemizde ara verildikten sonra yeniden uygulanmaya ba\u015flanan L-Z kabakulak su\u015fu i\u00e7eren KKK a\u015f\u0131s\u0131 sonras\u0131nda belirgin olarak artt\u0131\u011f\u0131 saptand\u0131. Deneyimli ve ula\u015f\u0131labilir bir eri\u015fkin a\u015f\u0131lama merkezi taraf\u0131ndan a\u015f\u0131n\u0131n uygulanmas\u0131, ili\u015fkili yan etkilerin saptanmas\u0131n\u0131 ve y\u00f6netimini kolayla\u015ft\u0131rm\u0131\u015ft\u0131r.<\/p>\n

KKK a\u015f\u0131 i\u00e7eri\u011finde bulunan k\u0131zam\u0131k a\u015f\u0131s\u0131, Schwarz, Edmonston ve Moraten su\u015flar\u0131ndan; k\u0131zam\u0131k\u00e7\u0131k a\u015f\u0131s\u0131, insan diploid h\u00fccre k\u00fclt\u00fcrlerinden \u00fcretilen Wistar RA 27\/3 su\u015fundan; kabakulak a\u015f\u0131s\u0131 ise Urabe Am 9, Rubini, Leningrad-3, L-Z, Jeryl Lynn, RIT 4385 su\u015flar\u0131ndan \u00fcretilmektedir (4, 5). KKK a\u015f\u0131s\u0131 iyi tolere edilen ve nadiren ciddi yan etki geli\u015fime neden olan bir a\u015f\u0131d\u0131r (6). A\u015f\u0131 sonras\u0131nda ate\u015f (< %15), d\u00f6k\u00fcnt\u00fc (%5), lenfadenopati (%5 \u00e7ocuklar, <%20 eri\u015fkinler), artralji-artrit (%10-30) ve parotit (<%1) geli\u015febilece\u011fi belirtilmektedir (6). Daha nadir olarak anafilaksi ve n\u00f6rolojik (ensefalopati, ensefalit, aseptik menejit , n\u00f6bet vb.) yan etkiler de bildirilmi\u015ftir (6). A\u015f\u0131n\u0131n kabakulak komponenti ile ili\u015fkili en s\u0131k bildirilen yan etki, genellikle a\u015f\u0131dan sonra 24 saat i\u00e7erisinde geli\u015fen ve 2-3 g\u00fcn i\u00e7erisinde kendili\u011finden gerileyen enjeksiyon yerinde a\u011fr\u0131 ve hassasiyettir (7). Nadir olarak ortaya \u00e7\u0131kan di\u011fer a\u015f\u0131 ile ili\u015fkili yan etkiler; parotit, or\u015fit, d\u00f6k\u00fcnt\u00fc, purpura, imm\u00fcn trombositopeni (\u0130TP), artrit, sensorin\u00f6ral i\u015fitme kayb\u0131 ve aseptik menenjit geli\u015fimidir. KKK a\u015f\u0131s\u0131 i\u00e7erisinde yer alan kabakulak \u015fu\u015fu ili\u015fkili olarak yan etkilerin ve s\u0131kl\u0131klar\u0131n\u0131n de\u011fi\u015febilece\u011fi g\u00f6sterilmi\u015f olup \u00f6zellikle a\u015f\u0131 su\u015fu ile aseptik menenjit geli\u015fimi aras\u0131ndaki ili\u015fki tan\u0131mlanm\u0131\u015ft\u0131r: Y\u00fcz bin doz a\u015f\u0131 sonras\u0131 L-3 su\u015fu ile 20-100, L-Z su\u015fu ile 2-90\u00a0 <\/span>ve Urabe su\u015fu ile 9-100 aseptik menenjit olgusu bildirilmi\u015ftir (7). Aseptik menenjit geli\u015fimine en az yol a\u00e7t\u0131\u011f\u0131 bildirilen kabakulak su\u015funun Jeryl Lynn oldu\u011fu belirtilmektedir (4, 7). A\u015f\u0131n\u0131n i\u00e7eri\u011findeki su\u015fa ba\u011fl\u0131 olarak parotit s\u0131kl\u0131klar\u0131 da de\u011fi\u015fkenlik g\u00f6stermekte olup a\u015f\u0131 sonras\u0131 parotit s\u0131kl\u0131\u011f\u0131 Jeryl Lynn su\u015funda %1.6, Urabe su\u015funda %1-2, L-Z su\u015funda %2.8 olarak saptanm\u0131\u015ft\u0131r (7). Benzer \u015fekilde Urabe su\u015fu sonras\u0131nda or\u015fit geli\u015fiminin Jeryl Lynn su\u015fu ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda minimal de olsa artt\u0131\u011f\u0131 belirtilmektedir (7).<\/p>\n

T\u00fcrkiye\u2019de KKK a\u015f\u0131s\u0131 2006 y\u0131l\u0131nda rutin a\u015f\u0131 \u015femas\u0131na eklenmi\u015ftir. Bu tarihten itibaren Jeryl Lynn, Urabe Am 9 kabakulak su\u015flar\u0131 i\u00e7eren KKK a\u015f\u0131lar\u0131 uygulanm\u0131\u015ft\u0131r (8). A\u015f\u0131n\u0131n \u00f6zellikle birinci basamak sa\u011fl\u0131k kurulu\u015flar\u0131nda yayg\u0131n olarak uygulanmas\u0131na kar\u015f\u0131n, ili\u015fkili parotit s\u0131kl\u0131klar\u0131nda beklenilenin \u00fczerinde bir art\u0131\u015fa ili\u015fkin yay\u0131nlanm\u0131\u015f ve ula\u015f\u0131labilir veri bulunmamaktad\u0131r. Acar ve arkada\u015flar\u0131n\u0131n (9), askeri personelin kitlesel a\u015f\u0131lamas\u0131nda, monovalan k\u0131zam\u0131k a\u015f\u0131s\u0131 yerine Edmonston-Zagreb k\u0131zam\u0131k, Leningrad-Zagreb kabakulak ve Wistar RA 27\/3 k\u0131zam\u0131kc\u0327\u0131k sus\u0327lar\u0131n\u0131 ic\u0327eren k\u0131zam\u0131k- kabakulak-k\u0131zam\u0131kc\u0327\u0131k (KKK) as\u0327\u0131s\u0131 (Tresivac\u00ae<\/span>, Serum Institute of India, Hindistan) kullan\u0131m\u0131 sonras\u0131nda parotit gelis\u0327en 10 olguyu sunan \u00e7al\u0131\u015fmalar\u0131nda, parotit geli\u015fimi L-Z kabakulak su\u015fu ile ili\u015fkilendirilmi\u015ftir. Benzer \u015fekilde \u00e7al\u0131\u015fmam\u0131z da,\u00a0 <\/span>parotit ve or\u015fit olgular\u0131n\u0131n, merkezimizde uzun s\u00fcredir uygulanmakta olan Jeryl Lynn su\u015fu i\u00e7eren KKK a\u015f\u0131s\u0131 yerine L-Z kabakulak su\u015fu i\u00e7eren a\u015f\u0131n\u0131n uygulanmas\u0131 sonras\u0131nda geli\u015fti\u011fini g\u00f6sterdi. Parotit ve or\u015fit olgular\u0131n\u0131n, kabakulak seronegatif sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131nda saptanmas\u0131 ve farkl\u0131 lot numaras\u0131na sahip a\u015f\u0131lar ile de geli\u015fmesi L-Z kabakulak su\u015fu ile ili\u015fkili oldu\u011funu d\u00fc\u015f\u00fcnd\u00fcrm\u00fc\u015ft\u00fcr. Hastal\u0131k etkeni olan kabakulak su\u015fu ve a\u015f\u0131 su\u015fu aras\u0131ndaki ili\u015fkinin molek\u00fcler y\u00f6ntemlerle do\u011frulanmas\u0131 \u00f6nerilmektedir (10). Bir parotit olgumuzda al\u0131nan t\u00fck\u00fcr\u00fck \u00f6rne\u011finde kabakulak PCR pozitifli\u011fi tespit edilmi\u015f olup a\u015f\u0131 su\u015fuyla ili\u015fkisi d\u00fc\u015f\u00fck viral y\u00fck nedeniyle de\u011ferlendirilemedi.<\/p>\n

Sonu\u00e7 olarak, KKK a\u015f\u0131s\u0131 i\u00e7erisinde yer alan kabakulak su\u015funa ba\u011fl\u0131 parotit ve or\u015fit olgular\u0131n\u0131n geli\u015febilece\u011fi ak\u0131lda tutulmal\u0131d\u0131r. \u00d6zellikle L-Z kabakulak su\u015funu i\u00e7eren a\u015f\u0131lar\u0131n, parotit ve or\u015fit geli\u015fimi ile ili\u015fkili olabilece\u011fi sonucu, kitlesel a\u015f\u0131lama i\u00e7in kullan\u0131lacak a\u015f\u0131lar\u0131n se\u00e7iminde dikkate al\u0131nmal\u0131d\u0131r. A\u015f\u0131 uygulamas\u0131 sonras\u0131 yan etki izleminin ve gerekli bildirimlerin ivedilikle yap\u0131lmas\u0131 \u00f6nem ta\u015f\u0131maktad\u0131r.<\/p>\n","protected":false},"excerpt":{"rendered":"

G\u0130R\u0130\u015e K\u0131zam\u0131k, kabakulak ve k\u0131zam\u0131k\u00e7\u0131k (KKK) a\u011f\u0131r sekellere ve \u00f6l\u00fcme yol a\u00e7abilen, a\u015f\u0131 ile \u00f6nlenebilir bula\u015f\u0131c\u0131 hastal\u0131klard\u0131r. Bu hastal\u0131klar\u0131n \u00f6nlenmesinde kullan\u0131lan KKK a\u015f\u0131lar\u0131, canl\u0131-aten\u00fce a\u015f\u0131lar olup \u00fclkemizde 2006 y\u0131l\u0131ndan bu yana 12. ayda ve ilk \u00f6\u011fretimin ilk y\u0131l\u0131nda 6-7 ya\u015f grubunda olmak \u00fczere 2 doz olarak uygulanmaktad\u0131r (1, 2). Bu a\u015f\u0131lar eri\u015fkinler i\u00e7in \u00f6nerilen a\u015f\u0131 […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5131],"tags":[5396,3347,5395,4255,3965],"class_list":["post-24387","post","type-post","status-publish","format-standard","hentry","category-olgu-sunumu","tag-asi-yan-etkileri","tag-kabakulak","tag-kkk-asisi","tag-orsit","tag-parotit"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/24387","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=24387"}],"version-history":[{"count":3,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/24387\/revisions"}],"predecessor-version":[{"id":24694,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/24387\/revisions\/24694"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=24387"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=24387"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=24387"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}