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In 2005, three independent research groups described the presence of a specific mutation in the JAK2 gene, JAK2V617F, in patients with a Philadelphia chromosome-negative myeloproliferative neoplasm (MPN). The percentage of patients with the mutation varied according to specific disease with >98 % of polycythemia vera (PV) patients having the mutation. In 2008, the World Health Organization issued new diagnostic criteria for PV including use of the JAK2V617F test as a major diagnostic criterion. The goal of the present study is to determine the accuracy of diagnosing PV in a community practice and reporting of PV to cancer registries, as well as assessing the integration of molecular testing into diagnostic paradigms. Using Geisinger Medical Center's electronic medical records (EMR), patients with a PV diagnosis being seen by a hematologist/oncologist during 2004-2009 were identified. Records were reviewed by a single hematologist/oncologist to determine accuracy of the treating physician's diagnosis and use of the molecular test for the JAK2V617F mutation. There was a diagnosis of PV from the treating physicians in 121 of the 204 evaluable patients (59 %) and another MPN in 21 (10 %). However, we confirmed a PV diagnosis in only 90 patients (44 %). Of the 90 confirmed PV patients, 64 were JAK2V617F-mutation positive while 24 were not tested. While JAK2V617F testing has made a major impact in facilitating the successful delineation of the type of polycythemia (PV versus secondary polycythemia) in patients evaluated in a large, community-based Hematology/Oncology practice, physician usage of other critical tests is inconsistent leading to errors in diagnosis. JAK2V617F mutation testing in combination with other diagnostic criteria may help reduce diagnostic errors.

Background: In India, anemia is a common and serious health disorder among both sexes and all age groups, with anemia of chronic disease (ACD) being the second most prevalent anemia. Periodontitis is an inflammatory disease of the supporting tissues of the tooth caused by specific microorganisms. An immune response to bacteria and their products induces a major vascular response, offering explanatory mechanisms for the interactions between periodontal infection and a variety of systemic disorders. Therefore, periodontitis results in low-grade systemic inflammation, which may cause lower number of erythrocytes and, consequently, lower hemoglobin concentration., Materials and Methods: A total of 100 systemically healthy male patients visiting the outpatient department participated in the study. Of these, 50 patients had healthy periodontium and 50 patients had chronic periodontitis. Clinical parameters and red blood cell parameters of all the patients were assessed at baseline and 6 months after non-surgical periodontal therapy. Statistical analysis using Student's t-test was performed., Results: Data analysis revealed that patients with chronic periodontitis showed an improvement in both clinical and red blood cell parameters from baseline to 6 months after non-surgical periodontal therapy., Conclusion: From the present study, it can be concluded that like any other chronic condition, chronic periodontitis can lead to ACD. It also provides evidence that non-surgical periodontal therapy can improve the anemic status of patients with chronic periodontitis.

Purpose: To develop a simple and practical formula for quantifying breast cancer-related lymphedema, accounting for both the asymmetry of upper extremities' volumes and their temporal changes., Methods and Materials: We analyzed bilateral perometer measurements of the upper extremity in a series of 677 women who prospectively underwent lymphedema screening during treatment for unilateral breast cancer at Massachusetts General Hospital between August 2005 and November 2008. Four sources of variation were analyzed: between repeated measurements on the same arm at the same session; between both arms at baseline (preoperative) visit; in follow-up measurements; and between patients. Effects of hand dominance, time since diagnosis and surgery, age, weight, and body mass index were also analyzed., Results: The statistical distribution of variation of measurements suggests that the ratio of volume ratios is most appropriate for quantification of both asymmetry and temporal changes. Therefore, we present the formula for relative volume change (RVC): RVC = (A(2)U(1))/(U(2)A(1)) - 1, where A(1), A(2) are arm volumes on the side of the treated breast at two different time points, and U(1), U(2) are volumes on the contralateral side. Relative volume change is not significantly associated with hand dominance, age, or time since diagnosis. Baseline weight correlates (p = 0.0074) with higher RVC; however, baseline body mass index or weight changes over time do not., Conclusions: We propose the use of the RVC formula to assess the presence and course of breast cancer-related lymphedema in clinical practice and research., (Copyright © 2011 Elsevier Inc. All rights reserved.)

A few novel 1,3-dioxane carboxylic acid derivatives were designed and synthesized to aid in the characterization of PPAR alpha/gamma dual agonists. Structural requirements for PPARalpha/gamma dual agonism of 1,3-dioxane carboxylic acid derivatives included the structural similarity with potent glitazones in fibric acid chemotype. The compounds with this pharmacophore and substituted oxazole as a lipophilic heterocyclic tail were synthesized and evaluated for their in vitro PPAR agonistic potential and in vivo hypoglycemic and hypolipidemic efficacy in animal models. Lead compound 2-methyl-c-5-[4-(5-methyl-2-(4-methylphenyl)-oxazol-4-ylmethoxy)-benzyl]-1,3-dioxane-r-2-carboxylic acid 13b exhibited potent hypoglycemic, hypolipidemic and insulin sensitizing effects in db/db mice and Zucker fa/fa rats.