Physicians and clergy in dialogue

The goals and ends of contemporary medicine are often unclear. An explicit inquiry into the religious dimensions of healing offers an important perspective from which to evaluate the potential capabilities of the medical profession. This paper describes a course in which medical students joined divinity students to explore areas of mutual intellectual, professional, and personal interest. Students and faculty examined in depth three broad areas in which medicine and religion share common ground: concepts of health and illness from the religious perspective, approaches to the understanding of suffering and meaning, and the shared professional stresses of physician and clergy.This paper comes from the Department of Medicine, Beth Israel Hospital, and the Division on Aging and the Program for the Analysis of Clinical Strategies, Harvard Medical School, and the West Roxbury-Brockton Veterans Administration Geriatric Research, Education and Clinical Center, Boston.     

Personality, stress, smoking, and genetic predisposition as synergistic risk factors for cancer and coronary heart disease.

Risk factors for cancer have been found in the past to act synergistically in a number of studies. However, these studies were not always designed to test the hypothesis of synergism, and have sometimes failed to equate for important variables, which might influence the results. The present study tests the hypothesis that psychosocial variables and physical ones (personality/stress, smoking, and genetic predisposition) interact in a synergistic fashion in the causation of lung cancer and coronary heart disease (CHD).     

Personality,stress, smoking,and genetic predisposition as synergistic risk factors for cancer and coronary heart disease

Risk factors for cancer have been found in the past to act synergistically in a number of studies. However, these studies were not always designed to test the hypothesis of synergism, and have sometimes failed to equate for important variables, which might influence the results. The present study tests the hypothesis that psychosocial variables and physical ones (personality/stress, smoking, and genetic predisposition) interact in a synergistic fashion in the causation of lung cancer and coronary heart disease (CHD).     

Interaction of the Dopaminergic System With Mechanisms of Associative Learning and Cognition:Implications for Drug Abuse

The possible role of mechanisms of associative learning in drug abuse and addiction is considered with respect to psychomotor stimulant drugs such as cocaine and amphetamine. Although the initial sites of the reinforcing effects of these drugs are associated with the mesolimbic dopamine projection to the nucleus accumbens, other important neuromodulatory influences are identified. These include the amygdala, which appears to mediate the associative processes by which environmental stimuli come to control drug-seeking behavior. Possible parallel mechanisms by which stimulant drugs enhance effects of aversive as well as rewarding stimuli are discussed. The importance of attribution and context in determining relative rewarding and aversive effects is pointed out. These attributional and contextual factors may be a function of cortical regions that may themselves be impaired by chronic drug abuse, leading to further dysexecutive control over cognition and behavior.     

Role of monoamines in the control by hormones of sexual receptivity in the female rat.

The involvement of indole- and catecholamines in the hormonal regulation of sexual receptivity has been investigated in ovariectomized female rats. Drugs that reduce 5-hydroxytryptamine, dopamine, and adrenaline or increase noradrenaline neurotransmission tended to facilitate the occurrence of estrous behavior in estrogen-treated females, and drugs having opposite effects tended to inhibit receptivity induced by estrogen and progesterone. Estrogen decreased noradrenaline turnover in cortex and brain stem; progesterone enhanced this effect in brain stem but prevented it in cortex. Both hormones tended to block noradrenaline uptake in hypothalamus in vitro. In a schedule used to induce receptivity, estrogen accelerated serotonin turnover, an effect prevented by progesterone. Thus a number of monoamines may be involved in the control by hormones of estrous behavior. Furthermore, hormones affect both amine turnover and uptake mechanisms.     

Appetitive memory reconsolidation depends upon NMDA receptor-mediated neurotransmission

Memory persistence is a dynamic process involving the reconsolidation of memories after their reactivation. Reconsolidation impairments have been demonstrated for many types of memories in rats, and signaling at N-methyl-d-aspartate (NMDA) receptors appears often to be a critical pharmacological mechanism. Here we investigated the reconsolidation of appetitive pavlovian memories reinforced by natural rewards. In male Lister Hooded rats, systemic administration of the NMDA receptor antagonist (+)-5-methyl-10,11-dihydro-SH-dibenzo{a,d}cyclohepten-5,10-imine maleate (MK-801, 0.1 mg/kg i.p.) either before or immediately following a brief memory reactivation session abolished the subsequent acquisition of a new instrumental response with sucrose conditioned reinforcement. However, only when injected prior to memory reactivation was MK-801 effective in disrupting the maintenance of a previously-acquired instrumental response with conditioned reinforcement. These results demonstrate that NMDA receptor-mediated signaling is required for appetitive pavlovian memory reconsolidation.     

Dorsal and ventral striatal protein synthesis inhibition affect reinforcer valuation but not the consolidation of instrumental learning

The evidence for a role of the striatum in the acquisition of uncued instrumental responding is ambiguous. It has been shown that post-session infusions of anisomycin into the core of the nucleus accumbens (NAcc) impaired instrumental acquisition, but pre-training lesions of the NAcc suggest that it is not necessary. Recently, we demonstrated that the infusion of anisomycin into the anterior cingulate cortex impaired instrumental acquisition indirectly through a taste aversion. Thus, we hypothesized that post-session anisomycin infusions into the NAcc affected instrumental acquisition through an effect on reinforcer valuation. For the dorsal striatum, both post-session infusions of anisomycin and pre-training lesion studies suggest that neither the dorsolateral nor the dorsomedial striatum is necessary for the acquisition of instrumental responding. However, it has not been attempted to block plasticity in both regions concurrently, and we hypothesized that both regions independently contribute to acquisition through goal-directed and habitual learning. In the current experiments, we first replicated the effect of unprotected post-session anisomycin infusions into the NAcc on instrumental acquisition. Subsequently, we investigated the effect of protein synthesis inhibition in the NAcc and dorsomedial and dorsolateral striatum concurrently on instrumental acquisition, critically controlling for effects on reinforcer valuation. The anisomycin infusions induced an aversive state, but did not affect instrumental acquisition.     

Books reviews

Journal of Medical Humanities -