We report a case of visceral leishmaniasis (VL) with cutaneous lesions in a patient infected with human immunodeficiency virus (HIV). The cutaneous lesions consisted of erythematous papules on the legs. Biopsy of one lesion showed abundant Leishmania amastigotes within epithelial cells of an eccrine sweat gland in the dermis. Leishmania organisms were also found in a blood smear. Rapid and complete clearance of the cutaneous lesions was achieved after antimony therapy. Cutaneous lesions in VL are being reported increasingly frequently in patients with HIV infection and their significance remains in discussion.

In A History of God, Karen Armstrong describes a division, made by fourth century Christians, between kerygma and dogma: 'religious truth … capable of being expressed and defined clearly and logically,' versus 'religious insights [that] had an inner resonance that could only be apprehended by each individual in his own time during … contemplation' (Armstrong, 1993, p.114). This early dual-process theory had its roots in Plato and Aristotle, who suggested a division between 'philosophy,' which could be 'expressed in terms of reason and thus capable of proof,' and knowledge contained in myths, 'which eluded scientific demonstration' (Armstrong, 1993, 113-14). This division-between what can be known and reasoned logically versus what can only be experienced and apprehended-continued to influence Western culture through the centuries, and arguably underlies our current dual-process theories of reasoning. In psychology, the division between these two forms of understanding have been described in many different ways. The underlying theme of 'overtly reasoned' versus 'perceived, intuited' often ties these dual process theories together. In Western culture, the latter form of thinking has often been maligned (Dijksterhuis and Nordgren, 2006; Gladwell, 2005; Lieberman, 2000). Recently, cultural psychologists have suggested that although the distinction itself-between reasoned and intuited knowledge-may have precedents in the intellectual traditions of other cultures, the privileging of the former rather than the latter may be peculiar to Western cultures (e.g. Lloyd, 1996; Nakamura, 1960/1988; Nisbett, 2003). The Chinese philosophical tradition illustrates this difference of emphasis. Instead of an epistemology that was guided by abstract rules, 'the Chinese in esteeming what was immediately perceptible-especially visually perceptible-sought intuitive instantaneous understanding through direct perception' (Nakamura, 1960/1988, p.171). Taoism-the great Chinese philosophical school besides Confucianism-developed an epistemology that was particularly oriented towards concrete perception and direct experience (Fung, 1922; Nakamura, 1960/1988). Moreover, whereas the Greeks were concerned with definitions and devising rules for the purposes of classification, for many influential Taoist philosophers, such as Chuang Tzu, '… the problem of … how terms and attributes are to be delimited, leads one in precisely the wrong direction. Classifying or limiting knowledge fractures the greater knowledge' (Mote, 1971, p.102).

Binge-eating disorder (BED) is the most common eating disorder, characterized by rapid, recurrent overconsumption of highly palatable food in a short time frame. BED shares an overlapping behavioral phenotype with obesity, which is also linked to the overconsumption of highly palatable foods. The reinforcing properties of highly palatable foods are mediated by the nucleus accumbens (NAc) and the ventral tegmental area (VTA), which have been implicated in the overconsumption behavior observed in BED and obesity. A potential regulator of binge-type eating behavior is the G protein-coupled receptor neuromedin U receptor 2 (NMUR2). Previous research demonstrated that NMUR2 knockdown potentiates binge-type consumption of high-fat food. We correlated binge-type consumption across a spectrum of fat and carbohydrate mixtures with synaptosomal NMUR2 protein expression in the NAc and VTA of rats. Synaptosomal NMUR2 protein in the NAc demonstrated a strong positive correlation with binge intake of a “lower”-fat (higher carbohydrate) mixture, whereas synaptosomal NMUR2 protein in the VTA demonstrated a strong negative correlation with binge intake of an “extreme” high-fat (0% carbohydrate) mixture. Taken together, these data suggest that NMUR2 may differentially regulate binge-type eating within the NAc and the VTA.

No abstract

A diet of energy-dense food, characterized mainly as a high-fat diet, leads to a persistent excessive consumption defined as overeating. According to the National Institute of Health, more than 2 in 3 adults in the United States are overweight or obese, straining our healthcare system with epidemic proportions. Diets that include abstaining from high-fat foods, ironically, result in an increase in motivation and craving for said high-fat foods, defined as an incubation effect because the behavior aids in developing overeating. Previously, we have shown that modulation of neuromedin U receptor 2 (NMUR2) in the paraventricular nucleus of the hypothalamus (PVN) results in increased food intake and motivation for energy-dense foods. Here, we continue our focus on NMUR2 in the PVN, but in relation to the incubation effect on craving for high-fat food. We employed a model for incubation of craving by having rats abstain from high-fat foods for 30 days before undergoing intake of fatty food on fixed ratio and progressive ratio schedules of reinforcement, and then assess their response to reactivity to cues. Using this model, we compared the feeding behaviors of rats that underwent an mRNA knockdown of the NMUR2 in the PVN to controls after both underwent a 30-day abstinence from high-fat foods. Our results show knockdown of NMUR2 in the PVN blocks the incubation of feeding behavior for food-related cues and high-fat foods.