The Potential Role of Naltrexone in Borderline Personality Disorder

Objective: Management of borderline personality disorder (BPD) is a difficult challenge due to the complex features of this disorder. This article reviews the use of naltrexone in the treatment of BPD. Methods: Published articles and clinical trials were searched in Google Scholar, MedLine, ELSEVIER, and Cochrane database of systematic reviews abstracts in English language between 1990 and 2017. Results: Naltrexone (NTX), a nonspecific competitive opiate antagonist, has been noted to be helpful in controlling self-injurious behavior (SIB) and dissociative symptoms in patients with BPD. Conclusions: Further studies should be conducted on the effects of naltrexone to confirm the role of this medication in the treatment of BPD

A comprehensive screening protocol to identify incidence of lower back pain in military office workers

Military workers experience different types of lower back pain (LBP), but there is little evidence concerning the incidence of LBP in this group, especially in Asian countries. One of the most common forms of LBP is discogenic low back pain (DLBP) which is a consequence of internal disc disruption accounting for approximately 40% of LBP cases. This cross-sectional study aimed to determine the incidence of non-specific low back pain (LBP), discogenic LBP, and other forms of LBP in military office workers in Iran. 564 military office workers (303 men and 261 women, age: 20-50 years), who had worked in this setting for at least two years, were randomly selected from one military office. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was used as the primary screening tool. Participants who reported severe and mild LBP (graded low, mild, and severe) received a detailed physical examination including radiological magnetic resonance imaging. Based on the results of the physical examination, in conjunction with individual history, and medical opinion, mild-to-severe LBP was evident in 39% (n = 220) of the participants. Of these, non-specific LBP accounted for 60%, discogenic LBP accounted for 31%, and other forms of LBP accounted for the remaining 9% of the sample. We found that LBP is highly incident in military office workers, with non-specific LBP being the most incident form. Considering these high incidence rates, a strategy for preventive health screening and exercise intervention should be considered in this population to help reduce absenteeism and increase workforce productivity

"Familial" versus "sporadic" intellectual disability: contribution of subtelomeric rearrangements

<p>Abstract</p> <p>Background</p> <p>Cryptic subtelomeric rearrangements have been proposed as a significant cause of sporadic intellectual disability (ID) but the role of such aberrations in familial ID has not yet been studied. As positive family history of ID had been proposed as an important and significant predicting factor of subtelomeric rearrangements, it was assumed that the contribution of subtelomeric aberrations in familial ID would be much more than the sporadic ones. Three hundred and twenty two patients from 102 unrelated families with more than two ID patients in the first degree relatives have been investigated. Assessment of subtelomeric rearrangements were carried out using Multiplex Ligation-Dependent Probe Amplification (MLPA) technique. Detected aberrations were then confirmed by Fluorescence in Situ Hybridization (FISH) method.</p> <p>Results</p> <p>Among the families studied, 27.4% had 4-12, 36.3% had 3 and 36.3% had 2 affected individuals in the first degree relatives. One unbalanced translocation and 4 polymorphic changes were detected. The prevalence of clinically significant subtelomeric rearrangements was 0.98%.</p> <p>Conclusion</p> <p>This is the first investigation of subtelomeric aberrations in a large sample set of familial ID patients. Our results show that the contribution of subtelomeric rearrangements to familial ID is not as much as what had been determined for sporadic ones in the literature. Moreover, this study shows that the positive family history by alone, cannot be the most important and determining indicator of subtelomeric aberrations while it would be a good predicting factor when associated with dysmorphism or congenital malformations. These findings propose that other cryptic chromosomal abnormalities or even single gene disorders may be the main cause of familial ID rather than subtelomeric aberrations.</p

"Familial" versus "Sporadic" intellectual disability: contribution of common microdeletion and microduplication syndromes

<p>Abstract</p> <p>Background</p> <p>Interstitial Microdeletion and Microduplication syndromes have been proposed as a significant cause of sporadic intellectual disability (ID) but the role of such aberrations in familial ID has not yet been investigated. As the balanced chromosomal abnormalities commonly lead to the recurrent ID or multiple congenital anomalies, this study was designed to evaluate whether it was justified to investigate such aberrations in familial ID patients. Three hundred and twenty eight patients from 101 unrelated Iranian families with more than two ID patients in the first-degree relatives, have been investigated. Assessment of a panel of 21 common Microdeletion and Microduplication syndromes (CMMS) was carried out using Multiplex Ligation-Dependent Probe Amplification (MLPA) technique.</p> <p>Results</p> <p>Among the families studied, 27.7% had 4-12, 35.6% had 3 and 36.6% had 2 affected individuals in the first-degree relatives. An autosomal dominant inheritance of Williams-Beuren syndrome (WBS) was detected in a family with no clinical suspicion of WBS. The prevalence of CMMS was therefore,0.99%.</p> <p>Conclusion</p> <p>This is the first investigation of a panel of CMMS in a large sample set of "familial ID patients". The findings of this study showed the low prevalence of CMMSs in "familial ID" patients in spite of the significant contribution of such aberrations in "sporadic ID" which has a very useful practical impact by avoiding unnecessary diagnostic tests in "familial ID" patients.</p

Evaluating assumptions of scales for subjective assessment of thermal environments – Do laypersons perceive them the way, we researchers believe?

International audienc

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Stigma and psychological help-seeking of veterans

Because of the increasing rates of suicide and underutilization of mental health services among veterans diagnosed with posttraumatic stress disorder (PTSD), this study examines help-seeking attitudes of veterans that screen positive for PTSD. I used multiple regression to test a model for understanding psychological help-seeking. Specifically, four potential moderating hypotheses were tested that examined the relationships between PTSD, posttraumatic growth (PTG), stigma, and psychological help-seeking. Vogel, Wade, and Hackler’s (2007) model of help-seeking was adapted in this study. Veterans ( N = 152) recruited via VA mental health centers as well as from a college campus in a Midwestern state completed the following questionnaires: (a) demographic questionnaire; (b) PTSD Checklist-Military Version (PCL-M; Weathers, Litz, Herman, Huska, & Keane, 1993); (c) Posttraumatic Growth Inventory (PTGI; Tedeschi, & Calhoun, 1996); (d) Stigma Scale for Receiving Psychological Help (SSRPH; Komiya et al., 2000); (e) Self-Stigma of Seeking Help (SSOSH; Vogel et al., 2006); and (f); Attitudes Toward Seeking Professional Psychological Help Scale – Short Form (ATSPPHS-SF, Fischer & Farina, 1995). This study provides psychologists with a better understanding of veteran’s help-seeking attitudes and an intervention for decreasing stigma. Specifically, the results indicated significant group differences between: (a) individuals meeting criteria for a PTSD diagnosis (n = 73) versus individuals who did not meet criteria for PTSD (n = 79), (b) participants who indicated they had previously participated in mental health counseling (n = 93) versus individuals who had not (n = 58), and (c) individuals who had participated previously in mental health counseling who indicated (n = 53) or did not indicate ( n = 32) concerns that such participation would negatively affect their employment status. Furthermore, two of the four tested hypotheses revealed moderating relationships: (a) public stigma was found to moderate the relationship between PTSD and PTG, and (b) PTG was found to moderate the relationship between self-stigma and help-seeking attitudes. Recommendations and implications for practice are provided. Limitations of the study and implications for future research are discussed

Investigating the influence of work environment factors on employees' job satisfaction and determining the most important ones at Mahan Air Company

The purpose of this empirical research is to investigate the influence of work environment factors on employees' job satisfaction at Mahan Air Company in Iran and determine the most important work environment factors for Mahan air employees. Today all the managers know how important job satisfaction is for all the employees of the organizations. Several factors influence employees' job satisfaction such as external environment factors, technical environment factors and also work environment. This research focus on investigating the influence of work environment factors on employees' job satisfaction. This survey conducted in seven departments of Mahan Air Company. Findings of the research indicate that all the work environment factors have significant influence on employees' job satisfaction at Mahan Air but employee participation has the greatest influence on employees' job satisfaction and performance feedback has the least influence. In conclusion, the research helps the managers of Mahan Air Company to obtain a better comprehension of various components of the work environment and the influence of these factors on employees' job satisfaction

The effectiveness of ibuprofen and lorazepam combination therapy in treating the symptoms of acute Migraine: A randomized clinical trial

Background: Migraine is a common, episodic and debilitating disease. The migraineur not only suffers from pain, but also lives with a diminished to poor quality of life. Several medicinal therapies are used to abate the debilitating symptoms of this disease. Objective: The present study was conducted to determine the effectiveness of Ibuprofen and Lorazepam combination therapy in treating the symptoms of acute migraine. Methods: The present randomized clinical trial study used the pretest-posttest design with three comparison treatments, to examine 90 patients with an average of two to six attacks per month and an initial diagnosis of migraine based on the International Headache Society (HIS) criteria. The study was conducted on patients during the first half of 2014 with a diagnosis of acute migraine attack who were referred to Babol Ayatollah Rouhani Hospital in Iran. The patients were randomly divided into three groups of 30. The first group was administered 200 mg Ibuprofen capsules, the second group 400 mg Ibuprofen capsules and the third group a combination of 200 mg Ibuprofen capsules and 1 mg Lorazepam tablets. The medications were taken in the presence of the researcher. A checklist was used to assess the severity of headache and other migraine symptoms such as nausea, vomiting, photophobia and phonophobia in the patients, before and two hours after the intervention. Data were analyzed in SPSS-18 using the Mann-Whitney test, the McNemar test, Wilcoxon’s test, the NOVA and the Chi- squared test at the significance level of p<0.05, and power analysis with 30 patients in each group to perform this study was 0.8(1-β). Results: The mean age of participants was reported as 52±8 years and the condition was more frequent in women (56%). All three treatment regimens reduced the severity of headache significantly in the patients (p<0.001); nevertheless, the combination therapy used, produced the lowest mean severity of headache (p<0.001). The highest reduction in nausea and vomiting was (3.3%). None of the patients in either of the three groups reported phonophobia after the intervention, but only the patients in the combination therapy group reported no instance of photophobia. Conclusions: Given the greater effectiveness of combination therapy with Ibuprofen and Lorazepam in alleviating the symptoms of acute migraine compared to single-drug treatments with Ibuprofen, Lorazepam is recommended to be used as a first line treatment for acute migraine. Clinical trial registration: The trial was registered at the Thai Clinical Trials Registry (TCTR) (http://www.clinicaltrials.in.th/) with the ID: TCTR20160927003. Funding: The authors received no financial support for the research, authorship, and/or publication of this articl