Lead study investigator and Johns Hopkins infectious disease specialist Petros Karakousis, M.D., says the new animal model should hasten development of a badly needed, early diagnostic test for the condition.  Symptoms of ocular TB — vision loss, and redness and pain in the eye — are often indistinguishable from symptoms of other chronic infections and inflammatory conditions, including toxoplasmosis and sarcoidosis, which can often lead to selecting the wrong therapy. 

“TB infection can be active in the eyes even in the absence of lung symptoms,” says Karakousis, an assistant professor at the Johns Hopkins University School of Medicine. “So, there are usually long delays in diagnosis, and by this time, it’s too late for tens of thousands of people who are already going blind due to permanent inflammatory damage to the inner lining of the eyes.”

The scenario, he noted, is especially true in the United States and Europe, where TB is far less common than in developing countries, where most of the 9 million new infections occur each year.  Most new cases in the United States occur in people whose immune systems are already depressed from co-infection with HIV and who lack access to antibiotic treatments.  Some 20 percent of people with the potentially deadly lung infection, caused by Mycobacterium tuberculosis, develop inflammation in other organs, including in the inner tissue linings of the eye or linings surrounding the brain.

The Johns Hopkins team’s description of the animal model for ocular TB appeared in the Public Library of Science One online last week.

Karakousis says a clear and rapid test for ocular TB would not only prevent treatment delays, but also reduce the rate of misdiagnosis.  Suspected inflammatory disease, such as sarcoidosis and lupus in the eye, are treated with steroids, which can promote bacterial spread across other body organs, making the infection worse. 

Current diagnostic methods for ocular TB involve a lot of guesswork, says Karakousis.  Underlying signs of active TB in the lungs, such as positive chest X-rays and sputum samples, are helpful in making a diagnosis but often not present.  Tissue biopsy of the affected part of the eye offers more reliable confirmation of infection, but the procedure involves painful needle extraction that carries the risk of permanent eye damage, even blindness.  Physicians are often deciding to treat based on a high suspicion of TB infection, and then taking a “wait and see” approach for several weeks or months to determine if people are getting well or not.

Karakousis and his team used small, aerosolized doses of about 200 bacteria to infect each animal’s lungs, a procedure closely replicating human TB infection, which is spread when uninfected people inhale small numbers of the organisms coughed up by people already infected. Karakousis says all previous animal models for studying TB infection, in mice and in rabbits, used more than 10 times larger doses of injected tubercle organisms to eventually infect the eyes, which is not really how the disease spreads to the eyes. 

Microscopic testing of eye tissue samples showed all guinea pigs were infected with TB after two months, and that the disease spread through the bloodstream, as it does in humans.

Moreover, small, grainy nodules, a telltale sign of active TB infection, were observed in both the lungs and in the inner choroid tissue layer lining the eyes.  Some choroidal tissue death and thickening, as well as bleeding from blood vessels, were also seen — all known indicators of active TB infection in humans.

Further tissue analysis of lung and eye granulomas revealed increased production of vascular endothelial growth factor, or VEGF, a signaling protein linked to irregular blood vessel formation and known to play a role in other vascular-related vision problems, such as blindness due to diabetes and age-related macular degeneration.

Karakousis says ophthalmologists have already had some success with VEGF antibody treatments, used in combination with standard antibiotics, to treat TB infection in the eyes and the lungs. He adds that anti-VEGF drugs could represent new therapies for ocular-TB-related disease and that VEGF levels in the eye could signal active TB infection in the eye.  the Johns Hopkins team next plans to test VEGF and other protein levels in eye fluid as possible diagnostic test markers for ocular TB.

“having a verifiable diagnostic test for ocular TB is key to picking up on active infections early and providing treatment that stands the best chance of preventing long-term damage, with our without any signs or symptoms of lung infection,” says Karakousis.  “until then, physicians will have to be aware to test for ocular TB, especially in regions like Africa and Southeast Asia where the disease remains endemic, and to listen for clues in the patient’s life history that might alert them to earlier possible TB exposure.”

TB is the leading cause of death among people co-infected with HIV, the virus that causes AIDS, and is responsible for an estimated 2 million deaths annually, including a half-million in those infected with both organisms.

Provided by Johns Hopkins University (news : web)

LinkedIn is one of the most familiar, and most highly visible networking sites on the Internet today, so it’s not surprising that it is now the third largest social networking site. The platform is mainly used as a networking area for those looking for work, marketers looking to extend their business reach and established companies that are looking to recruit highly skilled individuals. But how many of you have truly understood its potential when it comes to marketing your business? Let’s take a brief look through how you can utilize LinkedIn to your advantage and use it to take your marketing strategy to a new level:

1. Interact with well respected, well established LinkedIn groups: LinkedIn plays host to tens of thousands of groups in every niche imaginable: marketing; mentoring; idea sharing; you name it and you will without doubt find a related group. by taking advantage of these established groups you can find a whole new audience to advertise and market to. If you are planning an event or product launch, don’t be afraid to let these groups know; if just one group member takes notice, then it’s been a worthwhile exercise. not only will your message be seen by that group, but to their extended connections. The more people view your profile on LinkedIn, the more your online visibility will start to soar.

2. Use LinkedIn for research purposes: perhaps you have a product or service that you are looking to improve or upgrade, or a new product that has yet to be launched? This is where LinkedIn comes into it’s own. by using the questions and answers section on LinkedIn, you can easily ascertain what it is your customer wants. LinkedIn users are a very interactive bunch, and you will find that the professionals here will be more than happy to showcase their skills by helping to answer your questions and providing you with invaluable feedback on your ideas.

3. Status updates and Tweeting to promote your company: Don’t underestimate the extremely useful status updates and tweets apps. Send out regular yet focused messages. Don’t waste time with too much irrelevant information. Keep your messages short and sweet. let people know of any changes you are making. But remember also to give helpful and timely advice as well.

You could give advice to people seeking work or for those working in similar niche markets as yourself. Wouldn’t you like to read something useful about a topic you are interested in? LinkedIn users are the same; they are always on the lookout for something helpful that they can use to endorse themselves or add to their knowledge base. LinkedIn is all about putting yourself out there in the marketplace, increasing your visibility and promoting your professionalism.

4. Direct advertising: Take full advantage of the recent advertising services LinkedIn have incorporated into the site and use them to promote your service or product. a LinkedIn advertising campaign can help you to effortlessly reach a worldwide audience. Having read over the LinkedIn Ts and Cs they appear to be offering reasonably affordable and flexible terms. definitely worth a small investment for a month or two and take it from there then.

5. Looking for investment? your ideal investor could be using LinkedIn: If you are in a situation where your business, idea, product development or service needs investment then you couldn’t have come to a better place. by using LinkedIn as a marketing tool, you are ensuring that your company is commanding great visibility in all the search engines.

Use your profile to it’s fullest by explaining your venture in detail and encouraging potential investors to get in contact. everything of note can be detailed on you profile: portfolio; video; product documents; achievements; education and much, much more.

As you can see LinkedIn is not just a great place to meet new people, but is a proven way to promote your business and brand. Once you start taking full advantage of LinkedIn I can assure you that you won’t be disappointed by the results.

Scott is a prolific networker – online and offline!  He is a director of an SEO Agency and also writes travel blogs for one of his clients – no.1 Traveller, operators of airport lounges across London airports.

Health officials said that the victim had been in Haiti and lived in the Dominican city of Higuey, where the first case of cholera was registered in November.

A health ministry statement said Renauld Francois, 53, died on Thursday, and that an autopsy would be performed to learn the exact cause of death but that his symptoms were “consistent with the disease.”

The Dominican Republic has reported 152 cases of cholera since the outbreak in Haiti last year.

In Haiti, officials say 3,889 people have died since the discovery of the epidemic in mid-October through January 16, out of 194,000 infected.

The two countries share the island of Hispaniola.

The Dominican Republic’s government has said it will step up its prevention system around Higuey, a popular tourist destination in the far east of the country.

The country has tried to tighten border controls to stop the disease spreading from Haiti, but tens of thousands of Haitians regularly travel to the country for work.