Changes in Serum TSH and T4 Levels after Switching the Levothyroxine Administration Time from before Breakfast to before Dinner.

Background. Levothyroxine is commonly used in the treatment of patients with hypothyroidism. Levothyroxine is most often administered in the morning, on an empty stomach, in order to increase its oral absorption. However, many patients have difficulties taking levothyroxine in the morning. Aim. The aim of this study was evaluating the effect of changing levothyroxine administration time from before breakfast to before dinner on the serum levels of TSH and T4. Subjects and Methods. Fifty patients between 18 and 75 years old with hypothyroidism were included in the study and were randomly divided into two groups. Each group received two tablets per day (one levothyroxine tablet and one placebo tablet) 30 minutes before breakfast and 1 hour before dinner. After two months, the administration time for the tablets was changed for each group, and the new schedule was continued for a further two-month period. The serum TSH and T4 levels were measured before and after treatment in each group. Results. Changing the levothyroxine administration time resulted in 1.47 ± 0.51 µIU/mL increase in TSH level (p = 0.001) and 0.35 ± 1.05 µg/dL decrease in T4 level (p = 0.3). Conclusions. Changing the levothyroxine administration time from before breakfast to before dinner reduced the therapeutic efficacy of levothyroxine.

16(th) IHIW: global distribution of extended HLA haplotypes.

This report describes the project to identify the global distribution of extended HLA haplotypes, a component of 16th International HLA and Immunogenetics Workshop (IHIW), and summarizes the initial analyses of data collected. The project aims to investigate extended HLA haplotypes, compare their distribution among different populations, assess their frequency in hematopoietic stem cell unrelated donor registries and initiate an international family studies database and DNA repository to be made publicly available. HLA haplotypes compiled in immunogenetics laboratories during the evaluation of transplant candidates and related potential donors were analysed. Haplotypes were determined using the pedigree analysis tool publicly available from the National Marrow Donor Program (NMDP) website. Nineteen laboratories from 10 countries (11 laboratories from North America, five from Asia, two from Latin America and one from Australia) contributed data on a total of 1719 families comprised of 7474 individuals. We identified 10393 HLA haplotypes, of which 1682 haplotypes included high-resolution typing at HLA-A, B, C, DRB1 and DQB1 loci. We also present haplotypes containing MICA and other HLA loci and haplotypes containing rare alleles seen in these families. The project will be extended through the 17th IHIW, and investigators interested in joining the project may communicate with the first author.

Frequency of lipodystrophy induced by recombinant human insulin.

BACKGROUND AND OBJECTIVE: Lipodystrophy is a potential clinical complication induced by insulin therapy, and it is believed that its frequency has been reduced by using recombinant human insulin. Aim of this study was to determine the frequency of recombinant human insulin induced lipodystrophy in diabetic patients. MATERIALS AND METHODS: This cross sectional study was done on 220 diabetics referring to Imam Educational Hospital of Sari Township in 2007-2008 who had been under treatment with recombinant human insulin at least three months before. First, the anthropologic and clinical features of the patients were recorded in questionnaire, then all of the patients were examined clinically for lipodystrophy. In all patients, glycosylated hemoglobin (HbA1C) was measured for control of the blood glucose. The obtained data were analyzed by the descriptive statistical methods, t-test and 2 test. RESULTS: From the total 220 diabetics under study, 35 (15.9%) had insulin induced lipodystrophy, of them 32 (14.5%) had lipohypertrophy and 3 (1.4%) with lipoatrophy. Factors such as age, sex, level of education, body mass index (BMI), type of diabetes, period of using insulin and injection site had significant influence in development of insulin induced lipodystrophy (p<0.05). CONCLUSIONS: Findings of this study revealed that despite using a recombinant human insulin, the frequency of the lipodystrophy particularly of lipohypertrophy still remained high level. Therefore, a regular examination of the diabetic patients for this complication is necessary, specially in the individuals who have a defective control on their blood glucose level.

Identification of the novel HLA-C allele Cw*0751.

We report the novel HLA-Cw allele HLA-Cw*0751. The allele was identified during routine sequence-based typing in our laboratory. The novel allele is identical to Cw*07020101 except for a single nucleotide change in codon 90.2 in position 268. HLA-Cw*0751 allele possesses an adenine at position 268 in exon 2, while HLA-Cw*07020101 has a cytosine at this position. Although this substitution does not change serologic reactivity of HLA-Cw7 molecule, it changes the amino acid at codon 90 from an aspartic acid to an alanine. Aspartic acid is polar and acidic, while alanine is non-polar and neutral.