Hashimoto's thyroiditis and renal transplant rejection.

PURPOSE: Hashimoto's thyroiditis (HT) is a common autoimmune thyroid disorder that can disrupt thyroid function and homeostasis. As HT results from a dysregulated immune system, we hypothesized that these patients might be more susceptible to transplant failure; however, literature on this association is limited. The purpose of this study is to examine the association of HT with the risk of renal transplant failure. METHODS: We utilized the United States Renal Database System dataset collected from 2005 to 2014 and compared the time from first renal transplant to transplant failure in end-stage renal disease (ESRD) patients with a HT diagnosis to ESRD patients without a HT diagnosis that underwent renal transplant. RESULTS: A total of 144 ESRD patients had International Classification of Disease-9 claim codes for HT prior to renal transplant, amongst a total cohort of 90,301 renal transplant patients aged 18-100 and meeting criteria. Patients with HT were significantly more likely to be female, white, and to have a diagnosis of cytomegalovirus compared to patients without. ESRD patients with a HT diagnosis that underwent renal transplant had a significantly increased risk of renal transplant failure compared to those ESRD renal transplant patients without an HT diagnosis. There was a significantly increased adjusted hazard ratio for graft failure in patients with a HT diagnosis compared to those without. CONCLUSION: Thyroid health and HT may play a significant role in the development of the increased risk of renal transplant failure observed in this study. Additional studies are needed to investigate the underlying mechanisms for this association.

Orthopedic disorders in patients with Down's syndrome.

We have contrasted 161 patients with Down's syndrome admitted to three acute care centers with 107 patients in an institutional setting, outlining their major orthopedic problems and suggesting methods of management based on acute care experience. Severe hallux valgus, metatarsus primus varus, subluxation an dislocation of the patella, severe pes planus, atlantoaxial subluxation, femoral head epiphysiolysis, and dislocation or subluxation of the hips remain the most critical problems against a background of other less common orthopedic abnormalities.

The value of the California Psychological Inventory in predicting medical students' career choice.

Much of the research in medical education has focused on the prediction of medical students' future career choices. This longitudinal study evaluates the effectiveness of the California Psychological Inventory (CPI) in predicting career choices of students attending the University of Maryland School of Medicine. While results did reveal some significant and consistent differences between career choice groups, these differences were not of the magnitude to allow discrimination among all specialty groups. There is no evidence to support the hypothesis that career choice can be predicted from CPI data. It was concluded that future research into career choice prediction should focus on variables other than personality characteristics as measured by the CPI or similar tests.