Murat Duman

Dokuz Eylul University, Ismir, İzmir, Turkey

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Publications (72)102.2 Total impact

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    ABSTRACT: Objective: The aim of this study was to define the epidemiological, clinical, and laboratory manifestations of scorpion envenomation and to identify factors that are predictive of severe cases. Methods: The medical files of 41 scorpion envenomation cases were reviewed retrospectively. The cases were classified as mild-moderate or severe. The epidemiological, clinical, and laboratory findings of patients were recorded. Results: There were 27 patients (65.9%) in the mild-moderate group and 14 patients (34.1%) in the severe group. The median age of all patients was 48 months. The most common systemic finding was cold extremities (41.5%). In all patients, the most commonly observed dysrhythmia was sinus tachycardia (34.1%). Two patients (4.9%) had pulseless ventricular tachycardia and died. Pulmonary edema and myocarditis were observed in 9 patients (22%). Median values of leukocyte and glucose levels were markedly increased in the severe group. Additionally, the mean thrombocyte level (540,857 ± 115,261 cells/mm(3)) in the severe group was significantly increased compared with the mild-moderate group (391,365 ± 150,017 cells/mm(3)). Thrombocyte levels exhibited a positive correlation with leukocyte and glucose values and a negative correlation with patient left ventricular ejection fraction. Multivariate analysis of laboratory parameters indicated that the most predictive factor for clinical severity is thrombocytosis (odds ratio 23.9; 95% CI: 1.6-353.5, P = .021). Conclusions: Although our results share some similarities with those of other reports, thrombocytosis was markedly increased in the severe group and served as the most predictive laboratory factor of clinical severity.
    Wilderness and Environmental Medicine 10/2015; DOI:10.1016/j.wem.2015.04.005 · 1.20 Impact Factor
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    ABSTRACT: Fecal calprotectin is used as a good indicator of intestinal mucosal inflammation. The aim of this study is to evaluate the diagnostic value of fecal calprotectin (f-CP) for the etiology of acute gastroenteritis in children. All patients presenting with acute diarrhea (<18 years) who had 3 or more soft or watery stools per day were enrolled in this study. Stool microscopic examination and cultures for bacteria and parasites were performed. Polymerase chain reaction test was also applied to stool samples for viruses (Rotavirus, Adenovirus, Norwalk, and Astrovirus). The level of f-CP was carried out by using enzyme-linked immunosorbent assay test. Eighty-four patients with diarrhea were enrolled. The f-CP level was higher in patients with microscopic examination positive (n = 17) (median with interquartile range, 1610.0 [908.8-2100] mg/L) than in patients with microscopic examination negative (n = 67) (123.8 [25.0-406.3] mg/L) (P < .001). Concentrations of f-CP in patients with stool culture positive (1870.0 [822.5-2100] mg/L) were significantly elevated compared with the concentrations of the patient with virus detected in stool (95.0 [21.3-240.9] mg/L) (P < .001). In the diagnosis for bacterial acute gastroenteritis, the area under the receiver operating characteristic curve for f-CP was 0.867 (95% confidence interval, 0.763-0.971), sensitivity was 88.9%, and specificity was 76.0% if the threshold was taken as 710 mg/L. We conclude that f-CP, which is useful, valuable, noninvasive, easily and rapidly measured laboratory test along with simple microscopic examination of stool, can be used as an indicator of intestinal inflammation and to distinguish the bacterial gastroenteritis from the viral gastroenteritis. Copyright © 2015. Published by Elsevier Inc.
    The American journal of emergency medicine 07/2015; 33(10). DOI:10.1016/j.ajem.2015.07.007 · 1.27 Impact Factor

  • American Journal of Emergency Medicine 05/2015; DOI:10.1016/j.ajem.2015.05.029 · 1.27 Impact Factor

  • Turkish Journal of Haematology 04/2015; DOI:10.4274/tjh.2015.0046 · 0.36 Impact Factor

  • 01/2015; 2(2):55-60. DOI:10.5505/cayb.2015.25744

  • 01/2015; 2(2):77-82. DOI:10.5505/cayb.2015.53825
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    Aykut Çağlar · Anıl Er · Cenk Demirdöver · Murat Duman ·

    01/2015; 2(1):45-48. DOI:10.5505/cayb.2015.47966

  • Rheumatology International 08/2014; 34(9). DOI:10.1007/s00296-014-3098-8 · 1.52 Impact Factor

  • Rheumatology International 05/2014; 34(9). DOI:10.1007/s00296-014-3049-4 · 1.52 Impact Factor
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    ABSTRACT: Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis of childhood. Gastrointestinal (GI) bleeding is one of the major complications of HSP. The blood neutrophil-to-lymphocyte ratio (NLR) is identified as a potentially useful marker of clinical outcome in inflammatory diseases. NLR may be a useful biomarker of GI bleeding in children with HSP, which has a neutrophil-dominated inflammation. The aim of this study was to evaluate NLR in patients with HSP and to investigate the relationship with GI bleeding. The study consisted of 63 HSP patients and 38 age- and sex-matched healthy children. C-reactive protein, white blood cell count, platelet count, mean platelet volume (MPV), hemoglobin level, and NLR were evaluated. Logistic regression analysis and receiver operating characteristic (ROC) analysis were used to determine the variables associated with GI bleeding. NLR and MPV were the only two indicators associated with GI bleeding in HSP in logistic regression analysis. The area under the ROC curve analysis indicated that NLR could be a more efficient potential predictor of GI bleeding in HSP when compared to MPV. This study suggested that higher NLR might predict GI bleeding in HSP.
    Rheumatology International 03/2014; 34(9). DOI:10.1007/s00296-014-2986-2 · 1.52 Impact Factor
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    ABSTRACT: Dehydration caused by acute rotavirus gastroenteritis is a frequent finding in pediatric patients. The most important treatment modality in these patients is recognising and treating dehydration, electrolyte imbalance and acute kidney injury. Neutrophil gelatinase-asssociated lipocalin (NGAL) is used widely as a biomarker for the diagnosis of acute or chronic renal injury in numerous clinical studies. It is recognized as an early marker of acute renal failure before the elevation of routine biochemical tests such as creatinine. The aim of this study is to investigate the plasma and urine NGAL concentrations in mildly or moderately dehydrated patients with acute rotavirus gastroenteritis. A total of 30 patients (13 girls, mean age 62.5 +/- 46.2 months) with diarrhea and mild/moderate dehydration and 35 healthy controls (17 girls, mean age 81.1 +/- 41.8 months) were enrolled in the study. Plasma and urine NGAL levels of the two groups were compared. The mean age, gender and serum creatinine levels of the patients and healthy controls were similar. The mean plasma and urine NGAL levels of the patients were significantly higher than controls (plasma: 118.6 +/- 81.2 vs. 66.5 +/- 11.3, p = 0.001 and urine: 17.7 +/- 17.5 vs. 10.6 +/- 7.9, p = 0.035, respectively). Mildly or moderately dehydrated children have higher plasma and urine NGAL levels compared to control subjects. Plasma and/or urine NGAL levels can be used for the early prediction of renal impairment in children with mild or moderate dehydration.
    Italian Journal of Pediatrics 09/2013; 39(1):52. DOI:10.1186/1824-7288-39-52 · 1.52 Impact Factor
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    ABSTRACT: Objective: Pandemic H1N1 influenza is the predominant influenza virus circulating in Turkey in 2009. Because of the clinical manifestations of influenza overlap with those attributable to other common respiratory illnesses of childhood, establishing a diagnosis of influenza requires confirmatory testing. The aim of our study was to define the predictive value of rapid influenza antigen detection test in children presenting to a pediatric emergency care department with influenza-like illness and to compare with clinical signs and symptoms. Methods: From October to November 2009, 3646 patients presented with influenza-like illness to the pediatric emergency department. Influenza-like illness is defined as fever with cough or sore throat in the absence of a known cause other than influenza. Enrollment criteria included fever and at least one of the following symptoms: coryza, cough, headache, sore throat, or myalgia. All 322 enrolled patients received a nasal wash for rapid influenza diagnostic tests, and the results were compared with clinical signs. Results: Rapid influenza detection test result was found positive in 167 (51.9%) of 322 patients. Clinical findings included fever as the presenting complaint (100%), fever (≥38 °C) (93.4%), cough (91.3%), rhinorrhea (66.1%), sore throat (35.1%), vomiting-diarrhea (22.4%), myalgia (20.2%), headache (18%) and shortness of breath (12.1%). There were 211 patients (65.5%) at high risk for the development of complications of pandemic H1N1 influenza A such as chronic lung disease (asthma) (n = 103, 48.8%), age younger than 2 years (n = 78, 37%), and neurologic disease (n = 10, 4.7%). The positivity rate and sensitivity of the test increase up to 70% in patients, who had the high body temperature (≥39 °C). The rapid test achieved the highest sensitivity in patients, who have high fever (≥39 °C), myalgia, vomiting, and diarrhea. Conclusions: We found that if the patients have high fever (≥39 °C), myalgia, and vomiting-diarrhea together, the likelihood of rapid antigen test positivity rate increases in patients, who presented with influenza-like illness.
    Pediatric emergency care 04/2013; 29(5). DOI:10.1097/PEC.0b013e31828e9b69 · 1.05 Impact Factor
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    ABSTRACT: Objective: The purpose of this study was to investigate the cases with a tick bite in Dokuz Eylül University Pediatric Hospital Department of Pediatric Emergency between 2006 and 2010. We aimed to determine the types of the tick, distribution of the cases according to months and years, personal characteristics and clinical and laboratory findings. Material and Methods: This study included all cases presenting to the Dokuz Eylül University Hospital, Department of Pediatric Emergency with a tick bite between 2006 and 2010. Demographic characteristics including residential areas of the patients and symptoms related to tick-borne diseases were investigated. Results: The total number of cases with tick bite during this period was 399; 182 (45. 6%) were female and 217 (54.4%) were male. The median and mean age was 6.0 (1.0-17.0) and 6.8±4.1, respectively and 75.6% of cases were aged 1-10 years. The majority of cases (n=359, 89.9%) had presented from April to September. The most common (31.2%) body site for tick bite was head and neck. The head and neck involvement was more common at younger ages; in contrast, lower limb and foot involvement were seen more frequently with increasing age. The laboratory findings of the patients with tick bite were assessed at baseline, 3 and 5-7 days. Overall, 27.3% (n=109) of all patients had at least one abnormal laboratory examination such as elevation of creatine kinase (15.8% n=63) and liver transaminases (11.5% n=45), elongation of activated partial tromboplastin time (4.8% n=19) and prothrombin time (1.8% n=7), and thrombocytopenia (1% n=4). The dominant tick species was Hyalomma spp (55.9% n=166) especially at nymph stage. Tick-associated disease did not develop in any patient. Conclusion: Tick-transmitted disease was not endemic in the region of our hospital. Especially head and neck areas are important for the examination of tick attachment in children. Close clinical monitoring of the patient seems to be adequate for the management of tick-bite.
    Turkiye Klinikleri Journal of Medical Sciences 01/2013; 33(1):164-171. DOI:10.5336/medsci.2012-29801 · 0.10 Impact Factor
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    ABSTRACT: Chlamydia trachomatis is a common cause of subacute, afebrile pneumonia with onset from 1 to 3 months of age. On physical examination, crepitant inspiratory rales are commonly heard. Infiltration is usually bilateral and interstitial; reticulonodular pattern and atelectasis have also been described, which distinct the disease from miliary tuberculosis. We report an infant who had a disseminated miliary pattern in the chest radiograph and computed tomographic scan of the thorax that was diagnosed as Chlamydia pneumonia with serologic investigations. We emphasized that Chlamydia trachomatis can cause a miliary reticulonodular pattern in radiological examinations of infants who were admitted with respiratory symptoms. We suggest that pneumonia due to C. trachomatis should be kept in mind in the differential diagnosis of infants examined because of a diffuse miliary pattern.
    Pediatric emergency care 09/2009; 25(9):597-8. DOI:10.1097/PEC.0b013e3181b922e3 · 1.05 Impact Factor
  • Balahan Makay · Zeynep Türkyilmaz · Murat Duman · Erbil Unsal ·
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    ABSTRACT: Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children. Gastrointestinal (GI) bleeding is one of the major complications affecting one third of the cases which may cause serious morbidity. Platelet volume directly correlates with the platelet function and activation. Small platelets have lower functional capabilities than larger ones. The aim of this retrospective study was to evaluate levels of mean platelet volume (MPV) in patients with HSP compared with healthy controls and to investigate the relationship between MPV and gastrointestinal bleeding. The study consisted of 43 HSP patients (male/female = 25/18, mean age = 6.2 +/- 2.6 years) and 27 age-matched healthy children (male/female = 14/13, mean age = 6.9 +/- 2 years) as control group. HSP patients had significantly lower MPV levels than healthy controls (7.5 +/- 0.8 vs. 7.9 +/- 0.5, p = 0.027). Thirteen of 43 patients had gastrointestinal bleeding. MPV was significantly lower in patients with GI bleeding than patients without bleeding (7.0 +/- 0.8 vs. 7.7 +/- 0.6, p = 0.01). Platelet counts, white blood cell counts, and C-reactive protein levels were significantly higher in patients with GI bleeding when compared to patients without GI bleeding (p = 0.03, p = 0.004, and p = 0.03, respectively). This study suggests that low MPV may contribute to GI bleeding in HSP.
    Clinical Rheumatology 07/2009; 28(10):1225-8. DOI:10.1007/s10067-009-1219-7 · 1.77 Impact Factor
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    B Makay · F Demirciooglu · M Duman · E Ünsal ·

    Pediatric Rheumatology 09/2008; 6:1-1. DOI:10.1186/1546-0096-6-S1-P201 · 1.61 Impact Factor
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    Tolga F Köroğlu · Seçkin Atasever · Murat Duman ·
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    ABSTRACT: The aim of this study was to describe and assess the structure, organization, and staffing of pediatric intensive care services in Turkey. A survey was sent to major university and government hospitals. Out of the 40 hospitals stating to provide pediatric intensive care, 34 responded to the survey (85% response rate). In the majority (81.2%) of hospitals, pediatric intensive care was provided in single room units or within the pediatric ward. Unit size ranged from 1-16 beds with an average of 6.8 +/- 4.2 operational beds per unit. Much of the equipment and a sufficient number of specialists for pediatric intensive care unit (PICU) care were present in the surveyed hospitals. However, only 12 units had a pediatric intensivist on staff and few had special PICU nurses. Many hospitals in Turkey already have various equipment and specialists needed to support pediatric intensive care. Expansion of services and improved care could be achieved if more pediatric intensivists and nurses could be provided and services concentrated in fully equipped tertiary centers.
    The Turkish journal of pediatrics 01/2008; 50(1):12-7. · 0.43 Impact Factor
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    ABSTRACT: The aim of this study was to assess the distribution of human leukocyte antigen (HLA) groups in Turkish children with celiac disease (CD) and to investigate the association of HLA types and clinical manifestations of CD. Seventy-five children with CD were evaluated in two groups: Group I consisted of 45 classical celiac patients (15 males, 6.7+/-3.8 years); Group II consisted of 30 atypical celiac patients (9 males, 9.3+/-4.3 years). The control group consisted of 100 healthy renal transplantation donors. HLA typing was made serologically using standard lymphocytotoxicity techniques. HLA A29, B51, CW5, DR14, DR16, and DQ1 were the most common antigens in the control group. Frequency of HLA B13, CW7, B8, DR7, DR17 and DQ2 was higher in CD patients than in the control group (p<0.005, <0.05, <0.001, <0.001 and <0.001, respectively). The relative risks for HLA DQ2, B8, DR17 and B13 were 14.9, 13.6, 7.1 and 3.6, respectively. Frequency of HLA B35, DR11 and DQ7 was higher in classical CD than atypical CD, while a positive association was found between HLA B8 and atypical CD. A positive association was found between HLA B13, CW7 and DR17 in Turkish celiac patients in addition to HLA B8, DR7 and DQ2. This study also suggested that a correlation may exist between genotype and clinical manifestations.
    The Turkish journal of pediatrics 01/2008; 50(6):515-20. · 0.43 Impact Factor
  • N. Ozdemir · A. Tuncel · M. Duman · D. Engin · E. B. Denkbas ·
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    ABSTRACT: In this study; poly(n-isopropylacrylamide) P(NIPA) based nanoparticles were prepared by dispersion polymerization technique. Prepared nanoparticles were characterized by their morphology and chemical point of view using different techniques. Morphological evaluations of the nanoparticles were taken by using an atomic force microscope (AFM). Zeta potential and the particle size of NIPA based nanoparticles in aqueous solutions were determined with DLS (Dynamic Light Scattering) technique at different pHs and different temperatures. MTT studies were carried out to confirm the non-toxic character of the nanoparticles. In the transfection and expression studies; the plasmid DNA for Green Fluorescence Protein (GFP) expressing was used as a model plasmid DNA and the HeLa cells were used as the model cell line.
    12/2007: pages 325-330;
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    ABSTRACT: Matrix metalloproteinase-3 (MMP-3) production increases in rheumatoid arthritis (RA) and has been proposed as a marker of disease activity and joint damage. The aim of this cross-sectional study is to examine the usefulness of serum proMMP-3 as an indicator of disease activity and severity in comparison with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Serum proMMP-3 was measured by a quantitative ELISA in 85 RA patients and 70 healthy subjects. Clinical and laboratory measures of disease activity and severity were obtained. Radiological joint damage was assessed by the method of Larsen. Serum proMMP-3 was significantly higher in RA patients than that in the healthy subjects. The active RA patients had significantly higher serum proMMP-3 than the inactive patients. Serum proMMP-3 was significantly correlated with some parameters of disease activity including swollen joints count, proximal interphalangeal joint score, morning stiffness, and Health Assessment Questionnaire; however, ESR and serum CRP were better correlated with all indicators of the disease activity than proMMP-3. The analysis of receiver operating characteristic supported that ESR and CRP had higher performance for reflection of activity compared to proMMP-3. There were no significant associations among Larsen score and proMMP-3, ESR, and CRP. Our results suggest that the cross-sectional measurement of serum proMMP-3 could not give additional information about RA disease activity compared to ESR and CRP, and could not give any information about joint damage.
    Rheumatology International 06/2007; 27(8):715-22. DOI:10.1007/s00296-007-0338-1 · 1.52 Impact Factor

Publication Stats

705 Citations
102.20 Total Impact Points


  • 2001-2015
    • Dokuz Eylul University
      • • Faculty of Medicine
      • • Department of Pediatrics
      • • Department of Pediatric Hematology
      Ismir, İzmir, Turkey
  • 2007
    • Hacettepe University
      • Department of Chemical Engineering and Bioengineering Division
      Engüri, Ankara, Turkey
  • 1993-2006
    • Ankara University
      • • Department of Rheumatology
      • • Faculty of Medicine
      • • Department of Immunology and Allergy
      Engüri, Ankara, Turkey
  • 2000
    • Sina Hospital
      Mashad, Razavi Khorasan, Iran
  • 1996
    • Ibn Sina Hospital Dhanmondi
      Baghdād, Mayorality of Baghdad, Iraq