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Linda Cox

Publications and source records attributed to Linda Cox.

7 recordsLinked to original sources
PubMed2006

Accelerated immunotherapy schedules: review of efficacy and safety.

OBJECTIVE: To provide a comprehensive evaluation of accelerated immunotherapy build-up schedules in terms of adverse reactions and clinical efficacy. DATA SOURCES: Peer-reviewed studies and review articles were selected from the PubMed database for articles published in the years 1976 to 2006 using the following keywords: rush, cluster immunotherapy in combination with allergic rhinitis, asthma, Hymenoptera, and imported fire ant. STUDY SELECTION: Studies were selected if they provided safety and efficacy information on accelerated allergen immunotherapy schedules. Most of the studies reviewed were double-blind, placebo controlled, but some open-observational studies were included if they provided immunotherapy safety or other information the author thought was relevant. RESULTS: A wide range of systemic reactions were reported in the literature with inhalant allergens: ranging from 27% to 100% of the patients in rush immunotherapy studies and 0% to 79% of patients in the cluster studies. Predictors of systemic reactions with rush immunotherapy were forced expiratory volume in 1 second less than 80% of predicted and a high degree of skin test reactivity. Premedication clearly reduces the risk of systemic reactions with rush immunotherapy, but the effect on cluster schedules was not as clear. CONCLUSION: Accelerated immunotherapy build-up schedules in selected patients may provide a rapid alternative to conventional build-up schedules without a significant increase in risk.

Allergens↗
PubMed2005

Comparison of test devices for skin prick testing.

BACKGROUND: Allergy skin testing guides developing avoidance plans and writing an immunotherapy prescription. The goal for the allergist is to apply allergen skin testing to the appropriate patient population by using a device that minimizes both false-negative and false-positive findings while minimizing patient discomfort. New skin testing devices continue to be developed with a trend toward production of multiheaded devices. Data on the performance of these devices in a head-to-head prospective fashion are limited. OBJECTIVE: Our goal was to study 8 commonly used devices to compare their performance in a head-to-head fashion. METHODS: In a prospective, double-blind fashion, the performance of 8 skin test devices was evaluated. Devices were tested with histamine and saline on both the arms and back of each subject. Devices were rotated over 4 testing sessions, at least a week apart, so each device was tested in each anatomic testing location. Performance elements examined included wheal, flare, pain, sensitivity, specificity, and intradevice variability. RESULTS: We found significant differences in all areas of device performance among all devices examined. Multiheaded devices also demonstrated significant intradevice variability and were more painful than single devices. Furthermore, multiheaded devices had larger reactions on the back, whereas single devices had larger reactions on the arms. CONCLUSION: Statistically significant differences exist among all devices tested. Providers should consider this data when choosing a device that suits their practice setting and ensure that technicians are sufficiently trained on the correct use of that device.

Adult↗
PubMed2003

SNF2-related CBP activator protein (SRCAP) functions as a coactivator of steroid receptor-mediated transcription through synergistic interactions with CARM-1 and GRIP-1.

SRCAP (SNF2-related CBP activator protein) is a 350-kDa protein that shares homology with the SNF2 family of proteins whose members function in various aspects of transcriptional regulation. In various cell types, SRCAP is found in distinct multiprotein complexes that include proteins found in SWI/SNF chromatin remodeling complexes. SRCAP was identified by its ability to bind to CBP and was found to potentiate the ability of CBP to activate transcription. Studies in our laboratory have demonstrated that SRCAP functions as a coactivator for CREB-mediated transcription of a number of promoters, including that of the phosphoenolpyruvate carboxykinase gene. Our current studies demonstrate that SRCAP enhances phosphoenolpyruvate carboxykinase promoter transcription induced by glucocorticoids. SRCAP also enhances glucocorticoid receptor-mediated transcription of a simple promoter containing only two glucocorticoid response elements, indicating that SRCAP functions as a glucocorticoid receptor coactivator. In similar studies, SRCAP was also found to serve as a coactivator for the androgen receptor. SRCAP exhibits synergistic activation with nuclear receptor coactivators and functionally interacts in vivo with glucocorticoid receptor-interacting protein-1 and coactivator-associated arginine methyltransferase-1. We propose that SRCAP, by virtue of its ability to interact with CBP, functions as a coactivator to regulate transcription initiated by several signaling pathways.

Adenosine Triphosphatases↗
PubMed2002

Immunohistochemical demonstration of Francisella tularensis in lesions of cats with tularemia.

An immunohistochemical test was developed and validated for detection of Francisella tularensis antigen in tissues of cats with fatal tularemia. Ten cases of naturally occurring tularemia in cats were positive both by isolation of F. tularensis and immunohistochemical identification of F. tularensis antigen. Nine additional cases with lesions typical of tularemia were positive for F. tularensis antigen, although bacterial cultures were not performed. Immunohistochemical identification of F. tularensis in formalin-fixed tissue is valuable for establishing a rapid etiologic diagnosis under circumstances where fresh tissues may not be available for isolation and identification of the organism.

Animals↗
PubMedDate not supplied

Better documentation through standardized forms: what progress have we made since the 1800s?

It has been over a century since allergy skin testing and immunotherapy were first utilized. Both have withstood the test of time and numerous challenges such as cromolyn, antihistamines, and leukotriene modifiers that have threatened to make them obsolete, to continue to play a prominent role in the diagnosis and treatment of the allergic patient. Considerable advances in the understanding of immunotherapy mechanisms and effective allergen dosing as well as improved extract quality have been made in recent years. However, there appears to be a lag in the widespread implementation of these advances into clinical practice, where a broad wide range of practice patterns exists. The wide diversity of allergy practice patterns is likely because of the absence of a uniform curriculum in allergy and immunology training programs. Recently, practice parameters have been developed by the American Academy of Allergy, Asthma and Immunology' Immunotherapy Committee and the Joint Task Force on Practice Parameters, an organization that represents the American Academy of Allergy, Asthma, and Immunology and American College of Allergy, Asthma, and Immunology, aimed at promoting a consistent, objective scientific approach to allergy skin testing and immunotherapy. Standardized allergy skin test and immunotherapy forms were designed to incorporate these guidelines. The following article summarizes the recommendations of the practice parameters and reviews some of the clinical evidence that lends support to these guidelines, which are intended to enhance the safety and efficacy of allergy skin testing and immunotherapy.

Allergens↗