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Biomedical subjects

William M Greenberg

Publications and source records attributed to William M Greenberg.

5 recordsLinked to original sources
PubMed2003

Therapeutic implications of HPA axis abnormalities in Alzheimer's disease: review and update.

The adaptive and maladaptive roles of the hypothalamic-pituitary-adrenal (HPA) axis in stressful conditions and in disorders such as major depression, posttraumatic stress disorder, and Cushing's syndrome, have been the subject of substantial, ongoing study. In particular, HPA disturbances have been associated with memory impairments, and hypercortisolemic conditions with atrophy of the hippocampus, a limbic structure closely associated with declarative memory. Recent discoveries support a more complicated picture of HPA axis function and pathology in acquiring, retrieving, and consolidating new memories. These findings include: the existence of an 'inverted U-shaped relationship" between stimulation of brain glucocorticoid receptors and memory performance; that distinct areas of the hippocampus have been found to respond differently to cortisol stimulation; and that hippocampal atrophy has been found to be potentially reversible in some conditions, although whether such atrophy is a cause or effect of these pathological conditions is currently unclear. More longitudinal studies of HPA axis function in aging normal individuals, those with mild cognitive impairment,and individuals with Alzheimer' disease, examining pertinent variables such as APOEe-4 status, are needed to help clarify these new findings. Antiglucocorticoid agents appear to have therapeutic value in particular conditions. These results are relevant for understanding and treating memory dysfunction in individuals with Alzheimer's disease, a disorder prominently and invariably characterized by early hippocampal lesions and memory impairment. Given the burden of this disease, we feel it timely to encourage controlled trials of antiglucocorticoid agents in the treatment of mild cognitive impairment and Alzheimers disease.

Adrenal Cortex Hormones↗
PubMed2002

A survey of addiction training programming in psychiatry residencies.

The authors surveyed 50 psychiatry residency training programs to examine the current status of addiction training and the impact of the new Residency Review Committee addiction training criteria for general psychiatry residencies. Only 5 programs did not already meet the new 1-month full-time equivalent addiction training requirement, and those programs anticipated only modest changes. The modal full-time equivalent addiction experience was actually 2 months, with great diversity in timing and settings. Respondents, however, often felt that their programs relied on one key addiction supervisor and that affiliated PGY-5 addiction residents usually had only limited roles in teaching and supervising the general psychiatry residents.

Journal Article↗
PubMedDate not supplied

A survey of addiction training in child and adolescent psychiatry residency programs.

OBJECTIVE: Childhood and adolescence represent a critical period for the potential initiation of substance use, and thus it is important that child and adolescent psychiatry (CAP) residents learn to screen, assess, refer, and/or treat children and adolescents who have substance abuse diagnoses. METHOD: The authors conducted a survey by mail of directors from all accredited U.S. CAP residency programs in order to describe addiction training in their respective programs. RESULTS: Seventy percent of program directors responded and indicated diverse addiction training experiences for their residents. Findings indicate that the majority of CAP residents are treating patients with substance use disorders in both years of training and in multiple treatment settings. CONCLUSION: The survey provides preliminary data for system-level constraints that merit additional consideration in order to potentially advance addiction training in CAP residencies.

Adolescent Psychiatry↗