Search

This study aimed to evaluate the effects of physiotherapy methods combined with respiratory and relaxation exercises on patients with major depression. This randomized, controlled trial included 42 patients with a sedentary lifestyle, comprising 21 males and 21 females with a mean age of 37.78±11.67 years (range, 20-60 years). The experimental (n:22)and control groups (n:20) were evaluated using the Beck Depression and Anxiety Score, Visual Analog Score, Patient Health Questionnaire-15, Generalized Anxiety Disorder 7-Items, and Patient Health Questionnaire-9. In both the experimental group and control group, a statistically significant difference was found in all parameters over time, with greater improvements made in the experimental group than in the control group in all the parameters. A rehabilitation program combined with respiratory and relaxation exercises applied in addition to standard treatment, can obtain more successful outcomes in major depression treatment. [Med-Science 2020; 9(4.000): 837-43]

Bu araştırmanın amacı Sözbilimsel Yapı Kuramının metinlerdeki önemli bilgileri belirlemede ve özetlemede nasıl kullanılabileceğine ilişkin bir görünüm sunmaktır. Araştırmaya 204 lisans öğrencisi ve 2 alan uzmanı katılmıştır. Araştırmada veri toplamak için bir bilgi verici metin Sözbilimsel Yapı Kuramına göre birimlerine ayrılmıştır. Lisans öğrencilerinden bu birimleri önem düzeylerine göre puanlamaları, alan uzmanlarından ise birimlerin görevlerini belirlemeleri istenmiştir. Elde edilen veriler üzerinde Krippendorff's Alpha, Kappa, Pearson korelasyon analizi ve betimsel istatistikler yapılmıştır. Araştırma sonuçlarına göre uzmanlar metindeki birimleri belirlemede orta düzeyde uyum içindedir. Öğrenciler Sözbilimsel Yapı Kuramının ortaya koyduğu çekirdek ve eklenti ayrımının sezgisel olarak farkındadır. Araştırmanın sonucuna göre Sözbilimsel Yapı Kuramının bilgi verici metinlerdeki önemli bilgileri belirleme ve özetlemede sunduğu katkılar sınırlıdır. Diğer kuramların da işe koşulmasıyla bilgi verici metinlerdeki önemli bilgileri belirlemede ve metinler özetlemede daha iyi sonuçlar elde edilebileceği öngörülmektedir.

In this paper, we propose a supervised learning approach based on an Artificial Neural Network (ANN) model for real-time classification of subtasks in a physical human-robot interaction (pHRI) task involving contact with a stiff environment. In this regard, we consider three subtasks for a given pHRI task: Idle, Driving, and Contact. Based on this classification, the parameters of an admittance controller that regulates the interaction between human and robot are adjusted adaptively in real time to make the robot more transparent to the operator (i.e. less resistant) during the Driving phase and more stable during the Contact phase. The Idle phase is primarily used to detect the initiation of task. Experimental results have shown that the ANN model can learn to detect the subtasks under different admittance controller conditions with an accuracy of 98% for 12 participants. Finally, we show that the admittance adaptation based on the proposed subtask classifier leads to 20% lower human effort (i.e. higher transparency) in the Driving phase and 25% lower oscillation amplitude (i.e. higher stability) during drilling in the Contact phase compared to an admittance controller with fixed parameters.

Theclimatic parameters needed to estimate evaporation are not easily obtained inmany regions for various reasons. By obtaining reliable data, estimation of evaporationfor irrigation planning and protection of water resources can be made with lessdata and easily. In this study, the evaporation from the Class Aevaporation vessels, which are used for the estimation of evaporation anddeveloped for this purpose, are estimated by comparing the values measured inmeteorological stations and the evaporation through Penman (PM) andKohler-Nordenson-Fox (KNF) equations, and their performance in semi-aridclimatic conditions is evaluated comparatively. For this purpose, climate datareceived from the Meteorological Station in Siirt province, located in theSoutheastern Anatolia Region of Turkey, was used as input in the analysis ofthe models. Outputs optained from models were statisticallyevaluated and theroot mean squared error (RMSE), mean absolute error (MAE), percentage of error(PE), mean ratio (MR) and determination coefficient (R2) parameterswere taken as statistical evaluation criteria. At the end of the study, thebest R2 value in the daily comparison was obtained from the EPM-Epancomparison in 2015 and 2016 with 0.8783 and 0.8062, and the RMSE valuesin this year were calculated as 1.35 and 1.32. In the monthly comparison, thesame equation showed the best performance. According to these results, Penmanequation used in this study is recommended because it gives lower RMSE valuesin semi-arid climate conditions in order to estimate evaporation from class Aevaporation vessel at daily and monthly levels., Buharlaşmanın tahmin edilmesinde gereksinimduyulan iklim parametreleri pekçok bölgedeçeşitli nedenlerle kolaylıkla elde edilememektedir. Güvenilir verilerinelde edilmesiyle, sulama planlaması ve su kaynaklarının korunması için buharlaşmatahmini daha az veri ile ve kolaylıkla yapılabilmektedir. Bu çalışmada, Asınıfı buharlaşma kaplarından olan buharlaşmanın tahmininde kullanılan ve bu amaçlageliştirilen Penman (PM) ve Kohler-Nordenson-Fox (KNF) eşitlikleri yoluylabuharlaşmanın tahmin edilerek, meteoroloji istasyonlarında ölçülen değerlerle,yarı kurak iklim koşullarında performansları karşılaştırmalı olarakdeğerlendirilmiştir. Bu amaçla; Türkiye’nin Güneydoğu Anadolu Bölgesi’nde yeralan Siirt ili Meteoroloji İstasyonu’ndan alınan iklim verileri, modellerinçözümlenmesinde girdi olarak kullanılmıştır. Elde olunan çıktılar istatistikselolarak değerlendirilmiş ve karekök ortalama hatası (RMSE), ortalama mutlak hata(MAE), hata yüzdesi (PE), ortalama oran (MR) ve determinasyon katsayısı (R2)parametreleri istatistiksel değerlendirme ölçütü olarak alınmıştır. Çalışmasonunda, günlük düzeyde yapılan karşılaştırmada en iyi R2 değeri0.8783 ve 0.8062 ile 2015 ve 2016 yılında EPM-Epankarşılaştırmasından elde edilirken, bu yıldaki RMSE değerleri 1.35 ve 1.32olarak hesaplanmıştır. Aylık düzeydeki karşılaştırmada ise, aynı eşitlik en iyiperformansı göstermiştir. Bu sonuçları göre, günlük ve aylık düzeyde A sınıfıbuharlaşma kabından olan buharlaşmayı tahmin etmek için, yarı kurak iklimkoşullarında daha düşük RMSE değerleri vermesi nedeniyle çalışmada kullanılan Penmaneşitliği önerilmektedir.

Physical human-robot interaction (pHRI) integrates the benefits of human operator and a collaborative robot in tasks involving physical interaction, with the aim of increasing the task performance. However, the design of interaction controllers that achieve safe and transparent operations is challenging, mainly due to the contradicting nature of these objectives. Knowing that attaining perfect transparency is practically unachievable, controllers that allow better compromise between these objectives are desirable. In this paper, we propose a multi-criteria optimization framework, which jointly optimizes the stability robustness and transparency of a closed-loop pHRI system for a given interaction controller. In particular, we propose a Pareto optimization framework that allows the designer to make informed decisions by thoroughly studying the trade-off between stability robustness and transparency. The proposed framework involves a search over the discretized controller parameter space to compute the Pareto front curve and a selection of controller parameters that yield maximum attainable transparency and stability robustness by studying this trade-off curve. The proposed framework not only leads to the design of an optimal controller, but also enables a fair comparison among different interaction controllers. In order to demonstrate the practical use of the proposed approach, integer and fractional order admittance controllers are studied as a case study and compared both analytically and experimentally. The experimental results validate the proposed design framework and show that the achievable transparency under fractional order admittance controller is higher than that of integer order one, when both controllers are designed to ensure the same level of stability robustness., 13 pages, 13 figures. Accepted to IEEE Transaction on Robotics

In today’s automation driven manufacturing environments, emerging technologies like cobots (collaborative robots) and augmented reality interfaces can help integrating humans into the production workflow to benefit from their adaptability and cognitive skills. In such settings, humans are expected to work with robots side by side and physically interact with them. However, the trade-off between stability and transparency is a core challenge in the presence of physical human robot interaction (pHRI). While stability is of utmost importance for safety, transparency is required for fully exploiting the precision and ability of robots in handling labor intensive tasks. In this work, we propose a new variable admittance controller based on fractional order control to handle this trade-off more effectively. We compared the performance of fractional order variable admittance controller with a classical admittance controller with fixed parameters as a baseline and an integer order variable admittance controller during a realistic drilling task. Our comparisons indicate that the proposed controller led to a more transparent interaction compared to the other controllers without sacrificing the stability. We also demonstrate a use case for an augmented reality (AR) headset which can augment human sensory capabilities for reaching a certain drilling depth otherwise not possible without changing the role of the robot as the decision maker.

Fuzzy expert systems search for a solution based on the expertise of people who are experts in a particular field. This could be described as a kind of advisory system edited on computer. The use of natural language on the basis of fuzzy logic and easier understanding of system logs provide this technique to resolve many daily and current problems. In this study, a sample expert system to estimate juice volume in pomegranate was designed, using the fuzzy logic method, which closest to the logic of the human mindset. Recording of data was performed on the private farm of the province of Siirt, Turkey. The Fuzzy Logic Interface of MATLAB Program was used in the designing phase of the system. The evaluation of the model was carried out according to coefficient of determination and coefficient of correlation. The model revealed R2 = 80% coefficient of determination, and r = 0.89 coefficient of correlation. With more informative parameters, the error rate can be decreased. Fuzzy logic seems one of the useful tools with prediction purposes in horticulture.

Reference crop evapotranspiration (ETo) is among the most important components of the hydrologic cycle. Standard FAO-Penman-Monteith method is the most frequently used equation to estimate of ETo. However, the usability of this method is limited due to its complexity Hargreaveas-Samani (HS) and Turc methods that can be operated with limited data such as temperature and solar radiation are used as an alternative to the standard method. In the present study, the reference ETo values estimated with FAO-PM as the standard method, Hargreaveas-Samani and Turc methods were compared at semi-arid climate conditions. Based on the acquired results; highest R2 value at the GAP region with semi-arid climate conditions was determined as 0.9872 from the monthly averages of ETo-PM and ETo-HS comparison, whereas the lowest RMSE value was also obtained from the same monthly comparison (0.08). ETo-Turc method yielded a monthly average comparison of 0.981 for the R2 values comparison. While ETo-CAP put forth the lowest values for all three intervals. It is suggested that HS method can be used instead of Standart Penman-Monteith method (FAO-PM) under GAP region semi arid climate conditions for reference ETo estimation if Penman-Monteith can not be calculated. The Turc method is also can be a good alternative to estimate potential evapotranspiration that can be measured by Class A pan. And that ETo estimation should be made by determining the Kp value in case CAP based ETo estimation is carried out.

WOS: 000424952600002 PubMed: 29141453 Nodular thyroid diseases are common in Turkey. Insulin resistance (IR) is considered as the most important component of metabolic syndrome (MetS), and it is thought to directly affect thyroid diseases, together with other components of MetS. The aim of this study was to evaluate potential factors associated with thyroid nodularity. This study was part of the prospective MELEN study. In total, randomly selected 2233 subjects were evaluated. A euthyroid subgroup of participants (n=1432) was selected and 421 of them had MetS. Both goitres and multinodular goitres (MNGs) were significantly more common in the MetS (+) group (p

WOS: 000337254200001 PubMed: 24869934 Background: Metabolic syndrome (MS) has become a pandemic in Turkey, as is the case globally. Increase in carotid artery intima-media thickness (CIMT) and erectile dysfunction (ED) may be evident before the clinical signs of cardiovascular disease appear. We aimed to investigate the prevalence of increased CIMT and ED as markers of atherosclerotic disease in patients with MS. Material/Methods: Thirty-two patients with MS and 29 healthy controls were included. Anthropometric and biochemical parameters, along with total testosterone (TT), high sensitive C-reactive protein (hs-CRP), were recorded. Carotid artery intima-media thickness was measured. Erectile dysfunction was assessed with International Index of Erectile Function. Results: Patients with MS had higher BMI, fasting plasma glucose, post-prandial plasma glucose, insulin, HOMA-IR, total cholesterol, triglycerides, hs-CRP, and CIMT, whereas TT levels were lower (p

Purpose: Main diagnostic method of thyroid nodules is fine needle aspiration biopsy (FNAB), but sensitivity of this method in the evaluation of follicular lesions is low. We reevaluated patients who underwent operation with FNAB reports of follicular neoplasm, Hurthle cell neoplasm and oncocytic changes. Postoperative histopathological examination and thyroid ultrasound (TUS) results, scintigraphic features of nodules were reevaluated. Material and Method: One hundred and three patients who were diagnosed with FNAB as follicular neoplasm, Hurthle cell neoplasm, oncocytic changes and who underwent thyroidectomy were reevaluated, retrospectively. FNAB and postoperative histopathological thyroidectomy specimen results were compared. Results: Comparison results of FNAB cytologic evaluation and postoperative histopathological examination of those nodules were as follows. Eight patients who were diagnosed as follicular lesion in FNAB were papillary carcinoma, 6 were follicular carcinoma. One patients who were diagnosed as Hurthle cell neoplasm in FNAB was papillary carcinoma. Six patients who were diagnosed as oncocytic changes in FNAB were papillary carcinoma. According to postoperative histopathology results, all patients’ diagnoses were as follows: 21 patients (20.4%) were diagnosed with thyroid malignancy in which 15 patients (14.6%) were papillary carcinoma, 6 patients (5.8%) were follicular carcinoma. Hypoechoic appearance of nodule in TUS was found to be the only independent risk factor in prediction of malignancy. Discussion: One fifth of the patients who were reported as follicular neoplasm, Hurthle cell neoplasm and oncocytic changes in FNAB were consistent with malignancy. Hypoechoic appearance of these nodules in TUS was found to be an independent risk factor in prediction of malignancy. Turk Jem 2014; 1: 5-12

Oral sodium phosphate (NaP) is increasingly being used for bowel preparation. There are several reports of significant serum electrolyte changes after the administration of oral NaP solution in renal failure. We report a case of postoperative hypoparathyroidism who developed severe hyperphosphatemia and associated hypocalcemia after bowel preparation with oral NaP. A 39-year old woman was admitted to the hospital because of multiple bone fractures. The diagnosis of primary hyperparathyroidism was confirmed. Further assays suggested Cushing’s disease and MRI disclosed a pituitary microadenoma. Considering the diagnostic suspect of multiple endocrine neoplasia type 1, computed tomography of abdomen was performed, showing a mass in the right adrenal. The patient underwent transsphenoidal surgery and then total parathyroidectomy. Despite total removal of the microadenoma by transsphenoidal surgery, there was no suppression in serum cortisol levels. So, an operation was scheduled for the adrenal tumor. The patient was administered 45 mL oral NaP solution for bowel cleansing before the surgery. Although her calcium and phosphorus levels were normal before NaP administration, four hours later she developed respiratory distress and tetany. Laboratory studies revealed severe hyperphosphatemia and hypocalcemia. We conclude that the use of NaP for bowel preparation should be avoided in patients with hypoparathyroidism.

The aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.

This case is presented with a pulmonary parenchymal destruction due to acquired multiple myeloma who has a history of pulmonary tuberculosis. A 55 year old male patient attempted to emergency department with complaints of shortness of breath. The final diagnose with the existing clinical and laboratory outputs were right pulmonary parenchymal destruction and pleural involvements secondary to multiple myeloma. Our prediagnose was confirmed by the overt plasma cell increase and Russell bodies in cytopathologic examination of the pleural fluid. Even though multiple myeloma leads to destruction in the pulmonary parenchyma rarely, patients should be scrutinized enough to elicit true diagnose., Multipl myeloma bağlı, pulmoner parankimal destrüksiyon gelişen, daha önceden geçirilmiş pulmoner tüberküloz öyküsü olan vaka sunulmuştur. 55 yaşında erkek hasta acil servise nefes darlığı şikayeti ile başvurdu. Hasta klinik bulguları ve labaratuar tetkikleri ile değerlendirildikten sonra, mutipl myeloma sekonder sağ pulmoner parankimal destrüksiyon ve plevral tutulum tanısı konuldu. Ön tanımız, plevral sıvının sitopatolojik incelemesinde artmış plazma hücresi ve Russell body hücreleri görülmesi ile doğrulandı. Multipl myelom nadiren pulmoner parankimal destrüksiyone yol açmasına rağmen, hastalarda ayırıcı tanı için ayrıntılı incelemek gerekmektedir

WOS: 000351702500009 PubMed: 25421155 Introduction Patients with hyperprolactinemia who require medical therapy are typically treated with dopamine agonists (DAs). In most cases, DAs normalize prolactin levels, control symptoms, and substantially decrease tumor size. Here, we aimed to compare the efficacy of cabergoline (CAB) and bromocriptine (BRC) in patients with hyperprolactinemia at a single center. Methods Retrospective analysis of the clinical records of 498 patients with hyperprolactinemia [mean age 33.3 +/- 10.8 years (range 16-66), 450 women, and 48 men] who had received either CAB (n = 450) or BRC (n = 48) was performed. Results The mean age, gender distribution, and treatment duration were similar between the CAB and BRC groups (33.2 +/- 11 vs. 34.1 +/- 9.6 years, male/female 44/406 vs. 4/44, 18.7 +/- 12.1 vs. 17.8 +/- 6.0 months, respectively; p > 0.05 for all). Mean dosage was 1.5 +/- 1.6 mg/week for CAB and 3.8 +/- 2.7 mg/day for BRC. Baseline prolactin levels, frequency of galactorrhea, amenorrhea, oligomenorrhea, erectile dysfunction, infertility, and visual impairment were similar between the two groups, whereas the baseline tumor volume was higher in the CAB group. The prolactin normalization rate (87.4 vs. 41.4 %, p = 0.029) and tumor volume shrinkage (79.8 +/- 39.1 vs. 54.1 +/- 55.3 %, p = 0.015) were significantly higher in the CAB-treated patients than in the BRC-treated patients, while the tumor cure rates were similar. Symptom relief was higher in the CAB group than in the BRC group. More side effects were recorded in patients who took BRC (29.1 vs. 5.3 %, p < 0.001). Conclusion Our data revealed that CAB was more effective than BRC in controlling symptoms associated with hormone excess, normalizing serum prolactin levels, and shrinking prolactinomas.

YILMAZ, Engin/0000-0001-8873-7645 WOS: 000331638200020 PubMed: 23673869 Von Hippel Lindau (VHL) syndrome is an autosomal dominant disorder characterized by benign and malignant tumors. This study presents the clinical and genetic features of VHL syndrome in a Turkish family. For the diagnosis of pheochromocytoma-related diseases, 49 family members from three generations were evaluated between March 2008 and January 2013. Family members were examined to identify components of pheochromocytoma- related genetic syndromes through physical examination, laboratory tests, and imaging methods. For the causative mutation, sequence analysis of VHL gene was performed. Nine patients were diagnosed with pheochromocytoma. Lumbal spinal hemangioblastoma and pancreatic neuroendocrine tumor without pheochromocytoma were detected in one patient. In patients with pheochromocytoma, additional tumors, such as retinal angioma, renal cell carcinoma, pancreatic serous cystadenoma, and pancreatic neuroendocrine tumors were detected. All patients were diagnosed as VHL syndrome type 2B. Sequence analysis of VHL gene revealed heterozygous p.A149S mutation in all symptomatic patients and in seven of the asymptomatic family members. This is the first study that identified VHL p.A149S mutation in a Turkish family with VHL syndrome. However, VHL p.A149S mutation was identified in an American family by Atuk et al. (J Clin Endocrinol Metab, 83:117-120, 14) and the family was defined as VHL type 2A. In our study, the family was identified as VHL type 2B. This variability in the phenotypic features suggests that further studies are required to beter assess the genotype-phenotype correlation in such cases.

Karabulut, Ismail/0000-0002-1339-5385 WOS: 000327592600026 PubMed: 25558576 Aim: This study was designed to investigate the function of outer hair cells and medial olivocochlear efferents in type II diabetes mellitus (DM). Materials and methods: There were 50 patients with type II DM and 51 age-and sex-matched healthy controls included in the study. Both groups were compared in terms of transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), and contralateral suppression of TEOAE. Results: Pure tone thresholds of the patients with type II DM were significantly higher than in the controls (P < 0.05). The TEOAE amplitudes at 1 kHz and at 1.5, 2, 3, 4, and 6 kHz signal-to-noise ratio amplitudes on DPOAE testing were significantly lower in the patients than controls (P < 0.05). There was no significant difference between the type II DM and control groups regarding contralateral suppression test results of TEOAEs. Conclusion: Type II DM seems to impact the auditory system at the cochlear level by affecting the functions of outer hair cells, and it results in elevation of the thresholds on audiometry and a decrease in the amplitudes of otoacoustic emissions.

et al. The effects of gonadotropin treatment on the immu- nological features of male patients with idiopathic hypogo- nadotropic hypogonadism. J Clin Endocrinol Metab 2000;85: 66-70. [CrossRef]

BACKGROUND Potassium permanganate is used clinically as an antiseptic and antifungal agent. Ingestion of potassium permanganate may result in damage to the upper gastrointestinal tract. Burns and ulceration of the mouth, esophagus and stomach occur due to its action. Emergency endoscopy is useful to assess the severity of damage and also to guide management. METHODS We reported a patient presenting to the emergency department after suicidal ingestion of potassium permanganate. RESULTS After treatment, the patient was discharged home on the 7th day after admission. CONCLUSION Early emergency endoscopy should be considered to determine the extent of upper gastrointestinal damage in the emergency department.

WOS: 000298148800028 PubMed: 22153539 Background: Transforming growth factor-beta 1 (TGF-beta 1) contributes to tissue repair by promoting tissue fibrosis, and elevations have been reported in patients with bone marrow fibrosis. The aim of this study was to evaluate the relationship between TGF-beta 1 levels and vitamin D deficiency. Methods: All patients presenting to the outpatient Endocrinology and Metabolic Diseases clinic between June and September of 2008 were approached, and consenting patients who were deemed suitable candidates were enrolled. Hematological parameters were measured, along with serum levels of total and ionized calcium, phosphorus, parathyroid hormone, iron, folic acid vitamin B12 levels, 25 OH vitamin D3 (25OHD(3)) and TGF-beta 1. Results: A total of 132 patients were included in the study. Patients were divided into 4 groups based on levels of 25OHD(3) [group 1 (< 5 ng/ml), 20 patients; group 2 (5-15 ng/ml), 38 patients; group 3 (16-30 ng/ml); and group 4 (> 30 ng/ml), 28 patients]. TGF-beta 1 levels were higher in patients in group 1 compared to the other groups. Transforming growth factor-beta levels correlated negatively with vitamin D3 and positively with leukocyte count, platelet count, of MCV and MCH. Multiple regression analyses revealed TGF-beta 1 levels to be associated with 25OHD(3) as well as with platelet count. Conclusions: Results of this study are suggestive of the presence of a significant relationship between TGF-beta and vitamin D deficiency. Increased TGF-beta 1 and platelet count may be an early indicator of bone marrow fibrosis in patients with vitamin D deficiency. Crown Copyright (C) 2011 Published by Elsevier B. V. on behalf of European Federation of Internal Medicine. All rights reserved.

WOS: 000295101200010 PubMed: 21949584 Epistaxis, active bleeding from the nose, is a common ear nose and throat emergency, and can be severe or even fatal. We report a severe life threatening recurrent massive nasal bleeding caused by intranasal heroin use that has not hitherto been reported in the English literature. A 24-year-old male who took heroin several times nasally presented with massive nasal bleeding. A blood transfusion and an operation to halt nasal bleeding were required. The patient did not experience a bleeding attack 2 months following cessation of nasal heroin use.

This experimental study was carried out between the years of 1997 and 2008 to determine the best pistachio rootstock-cultivar combinations for irrigated conditions in Sanliurfa in Turkey. Four different Pistacia species (Pistacia khinjuk Stocks, Pistacia atlantica Desf., Pistacia vera L. and Pistacia terebinthus L.) were used as rootstocks and five standard pistachio cultivars (Siirt, Ohadi, Kellekoci, Kerman and Selection 14) were grafted on them. Experimental orchard was established by 4x6 m in spacing in 1997. According to selected criteria, such as, tree vigor, bearing, yield and some quality characteristics, the best highlighted combinations were determined. P. khinjuk × Siirt cultivar and P. atlantica × Siirt combinations gave the best results for irrigated conditions in Sanliurfa.

Address for Correspondence/Yaz›flma Adresi: Dr. Talha Dumlu, Duzce Universitesi T›p Fakultesi, Go¤us Hastal›klar› Anabilim Dal›, Duzce, Turkiye Gsm: +90 505 312 82 72 E-mail: talhadumlu@yahoo.com Received/Gelifl tarihi: 09.06.2010 Accepted/Kabul tarihi: 23.09.2010 © Archives of Neuropsychiatry, published by Galenos Publishing. / © Noropsikiyatri Arflivi Dergisi, Galenos Yay›nevi taraf›ndan bas›lm›flt›r. OZET Mirtazapin, major depresyon tedavisinde onay alm›fl, noradrenerjik ve spesifik serotonerjik bir antidepresand›r. Sersemlik, afl›r› sedasyon, ifltahta artma, kilo al›m› ve a¤›z kurulu¤u gibi yan etkileri olabilmesine karfl›n genellikle iyi tolere edilir. Burada, 23 yafl›nda depresif kad›n hastada, mirtazapin tedavisi s›ras›nda geliflen kar›n a¤r›s› ve karaci¤er enzimlerinde yukselme olmas› ve mirtazapin kullan›m› durdurulduktan sonra bulgular›n normale donmesi tart›fl›lm›flt›r. (Noropsikiyatri Arflivi 2011; 48: 162-3) Anahtar kelimeler: Hepatotoksisite, major depresyon, mirtazapin ABSTRACT Mirtazapine is a noradrenergic and specific serotonergic antidepressant that is approved for use in the treatment of major depression. It is generally well tolerated with some mild side effects such as drowsiness, excessive sedation, increased appetite, weight gain, and dry mouth. We present a case of 23 years old female depressive patient who developed abdominal pain and elevation of liver enzymes during treatment with mirtazapine and returned to normal after stopping the mirtazapine use. (Archives of Neuropsychiatry 2011; 48: 162-3)