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    Impaired immunity against tetanus in Type 2 Diabetes
    (Int Scientific Information, Inc, 2005) Tamer, A; Karabay, O; Ekerbicer, H; Tahtaci, M; Selam, B; Celebi, H
    Background: The aim of this study was to compare serum levels of tetanus antibody in diabetic patients over 50 years of age with those of age-and sex-matched non-diabetic controls. Material/Methods: The study population consisted of 115 type 2 diabetic patients and 115 age-and sex-matched nondiabetic patients. Serum levels of tetanus IgG were measured by a commercial ELISA kit, and levels over 0.1 IU/ml were considered protective. Results: Mean serum levels of tetanus antibody in the diabetic and control groups were 0.164 +/- 0.140 IU/ml vs. 0.374 +/- 0.534 IU/ml, respectively (p < 0.001). Mean serum levels of tetanus antibody in the diabetics vs. controls aged 50-64 years were 0.172 +/- 0.141 IU/ml vs. 0.568 +/- 0.653 IU/ml and in those >= 65 years 0.151 +/- 0.139 IU/ml vs. 0.154 +/- 0.193 IU/ml, respectively (p < 0.001, p=1.000). Among patients aged 50-64 years, 38 (55.9%) cases in the diabetic and 45 (73.8%) in the control group demonstrated protective levels of tetanus antibodies (p=0.034). Of patients >= 65 years, 24 (51.1%) cases in the diabetic and 22 (40.7%) in the control group had protective levels of tetanus antibodies (p=0.298). Conclusions: Serum levels of tetanus antibody decreased in diabetic patients older than 50 years of age, whereas this period of time is prolonged to 65 years in healthy individuals. All individuals over 65 years should be vaccinated against tetanus; however, vaccination over 50 years of age might be considered for diabetic patients.
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    Tissue Doppler echocardiography in evaluation of cardiac effects of subclinical hypothyroidism
    (Springer, 2006) Arinc, H; Gunduz, H; Tamer, A; Seyfeli, E; Kanat, M; Ozhan, H; Akdemir, R
    Objective: Subclinical hypothyroidism (SH) is a mild form of thyroid failure, associated with initial signs of cardiovascular hypothyroidism. Tissue Doppler echocardiography (TDE) is a new and powerful method in evaluation of both regional and global systolic or diastolic ventricular function. We aimed to investigate the use of TDE in evaluation of cardiac effects of SH and affect of thyroid hormone replacement therapy (TRT) on tissue Doppler parameters of SH patients. Methods: Twenty-two patients who were diagnosed as SH and 22 healthy, age and sex-matched cases were included in the study. Conventional echocardiography and TDE were performed in all individuals. TRT was started in SH group. On the achievement of euthyroid state echocardiography were repeated. Results: Septal annulus relaxation time was significantly higher in SH group (82 +/- 21, 98 +/- 11 ms, p=0.024). Lateral annulus and myocardial relaxation times, precontraction/contraction ratios and precontraction times were also slightly higher. Septal lateral annulus and lateral myocardial relaxation times were decreased after TRT (98 +/- 11 vs. 81 +/- 12, p < 0.001, 89 +/- 14 vs. 78 +/- 11, p=0.022, 90 +/- 16 vs. 80 +/- 14 ms, p=0.008, respectively). Precontraction times and precontraction/contraction ratios decreased after TRT but did not reach the significance level. There was a positive correlation between TSH and TDE relaxation times. Conclusions: TDE is a powerful tool in diagnosis and follow-up of SH patients and TRT inhibits adverse affects of SH on myocardium. Septal myocardium is the most affected region of left ventricle in SH. The relaxation time is the best criteria of cardiac involvement and monitoring the effect of TRT.