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Biomedical subjects

R E McCue

Publications and source records attributed to R E McCue.

22 records · Page 2Linked to original sources

The effect of cortisone on the accumulation, activation, and necrosis of macrophages in tuberculous lesions.

Rabbits were injected intramuscularly with cortisone acetate (2 mg/kg) on alternate days. Six days after the first injection these rabbits and controls were injected intradermally in multiple sites with BCG (the vaccine strain of tubercle bacillus). Periodically, over the next 2 months, the resulting lesions were measured and surgically biopsied, and the animals were tuberculin-tested. Macrophage activation in the BCG lesions was evaluated histochemically by staining for beta-galactosidase activity. Both BCG lesions (and tuberculin reactions) in the cortisone-treated group were considerably smaller than those in the control group. Cortisone was highly effective in reducing the number of infiltrating mononuclear cells (MN), the amount of caseous necrosis and ulceration, and the percent of NM that were beta-galactosidase-positive. The decreased activation and reduced number of macrophages readily explains the increased susceptibility to tuberculosis found amoung patients receiving glucocorticosteroids. In the BCG lesions, the local decrease in the number and function of leukocytes probably explains the decreased tissue necrosis. Such antiinflammatory effects of corticosteroids may offset, in selected antimicrobial-treated cases, the hormone's detrimental effect on host resistance to infectious agents.

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The relationship of the dexamethasone suppression test to subtypes of depression and to symptomatic severity in the elderly.

Dexamethasone Suppression Tests (DSTs) were performed on 91 subjects consisting of 66 elderly outpatients diagnosed as having major depression according to RDC and 25 age- and sex-matched healthy controls. Postdexamethasone plasma cortisol levels were significantly higher in depressed patients than in normals. The depressed patients were subdivided into endogenous and nonendogenous groups by alternately, RDC and Newcastle Diagnostic Scale (NDS). A significant difference in postdexamethasone plasma cortisol levels between endogenous and nonendogenous groups was noted only when NDS was used, but this difference was found to be related to a significant difference in severity of depression.

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The usefulness of DST in predicting response to antidepressants: a placebo-controlled study.

Seventy-two out-patients, 55 years or older, suffering from major depression were treated with either nortriptyline or phenelzine for seven weeks under placebo-controlled double-blind conditions. The dexamethasone suppression test (DST) was administered at baseline and at weeks 3 and 7 of treatment, and its usefulness in predicting and/or paralleling clinical response was examined. No correlation was found between baseline DST results and treatment response with antidepressants. Of 13 patients whose abnormal baseline DSTs normalized during treatment, six were responders and seven were nonresponders (P = 0.24). However, all (seven) patients whose DSTs persisted to be abnormal throughout the seven weeks did not respond. The authors conclude that the DST has not been shown to have practical value as an indicator of impending recovery from major depression in the elderly, but its failure to normalize may have ominous prognostic significance.

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Relapse of depressed patients after effective continuation therapy.

Forty-one elderly depressed patients who had responded to either nortriptyline or phenelzine were given continuation treatment for approximately 4 months (mean = 16.5 weeks) after which 19 were switched under double-blind conditions to placebo. At the end of 8 weeks, three (15.8%) of the placebo patients had relapsed and three (13.6%) of the patients kept on antidepressants had relapsed. Patients who had more prior episodes of depression had a greater risk of relapsing. The implications of these findings for continuation pharmacologic treatment in the elderly depressed are discussed.

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