The Prevalence and Outlook of Doping in Electronic Sports (Esports): An Original Study and Review of the Overlooked Medical Challenges.

Background The first electronic sports (esports) tournament was recorded in 1972, and since then, gaming leagues and tournaments with prizes have been established. Nowadays, the commercialization of competitive gaming may drive players to cheat their way to success and neglect their physical and mental well-being. The issue is all the more vital, as it is often overlooked by classically educated doctors, including sports medicine specialists. The aim of this study was to investigate the current situation of doping in esports and the future of anti-doping actions in this field, as well as to present a more generalised approach and to point out and discuss other possible health risks associated with the rising popularity of esports. Methods A standardised online survey was published in a social media group for Polish fans and people associated with esports. Two hundred and forty-one responses were collected and subjected to a statistical analysis. Only filled-out forms containing answers to all of the questionnaire's questions from people considering themselves regular players of either League of Legends (LoL) and/or Counter-Strike: Global Offensive (CS:GO) were considered viable. The study group was divided into amateur and professional players. The calculation of test power was done post hoc to determine whether the data collected were of sufficient quality to be used further. The normal distribution was assessed using the Shapiro-Wilk test. Then, between-group differences comparing the data results from the questionnaire were analysed with Mann-Whitney U tests and Chi-square tests. The significance level was set at p <0.05. Then, the literature was screened for relevant articles. Results The majority of gamers (85.5%), despite most of them being amateurs, strive to achieve the best results when playing. Borderline legal substances are commonly used, including energy drinks (97.8%), coffee (81.6%), beer (29.7%), herbs (15.7%), and available medicines (15.1%), while more than half the participants have heard about situations during tournaments involving the use of substances forbidden by the World Anti-Doping Agency (WADA). In most answers, there were no significant differences between professionals and amateurs. Statistically significant differences were observed in the following areas: the usage of legal stimulants in the responders' environments; outlooks on implementing more strict anti-doping regulations; and the perceived usage of forbidden doping substances in a tournament setting. Conclusions E-competitors suffer from a plethora of both physical and mental health problems. These issues may be more prevalent than generally thought and include repetitive strain injuries, sleep disorders, anxiety, and depression. The largest esports organisations have started to implement measures to provide a holistic approach to esports healthcare; however, it remains a distant dream for most amateurs and aspiring e-athletes.

What do medical students think about medical doctors with mental health issues?

Medical professionals tend to stigmatise people with mental issues. The study aimed to examine the attitude of medical students towards doctors with mental disorders. An anonymous online survey was created. Eleven psychiatric conditions were included and graded on a 0-4 scale to assess perceived security of working as a Medical Doctor (MD) with them. Based on the gradation the numeric variable called discriminative attitude was calculated. Five hundred answers were collected. The majority of the participants understood the need of consultancy by psychiatrist while suffering from mental disorders (70%). Students answered more harshly when assessing each of the eleven disorders separately, than for the general questions. There is a significant need for special anti-stigmatisation classes during university education.

Stimulation-induced side effects after deep brain stimulation - a systematic review.

OBJECTIVE: Deep brain stimulation (DBS) was approved by Food and Drug Administration for Parkinson's disease, essential tremor, primary generalised or segmental dystonia and obsessive-compulsive disorder (OCD) treatment. The exact mechanism of DBS remains unclear which causes side effects. The aim of this review was to assess variables causing stimulation-induced chronic psychiatric/personality-changing side effects. METHODS: The analysis of scientific database (PubMed, Cochrane Library, EMBASE) was conducted. The included articles had to be research study or case report and DBS to be conducted in therapeutic purposes. The researches with mental disorders in patients' medical histories were excluded. RESULTS: Seventeen articles were used in the review. In the group of movement disorders the characteristic of side effects was strongly related to the placement of the electrode implantation. Tiredness/fatigue was correlated with DBS in thalamus. Implantations in subthalamic nucleus were mostly followed by affective side effects such as depression or suicide. The higher voltage of electrode was connected with more severe depression after implantation. The analysis of affective disorder contained only three articles - two about OCD and one about depression. Forgetfulness and word-finding problems as activities connected with cognition may be an inevitable side effect if obsessive thoughts are to be inhibited. CONCLUSION: DBS of subthalamic nucleus should be seen as the most hazardous place of implantation. As a result there is a strong need of 'gold standards' based on the connectivity research and closer cooperation of scientists and clinicians.

Virtual reality in the diagnostics and therapy of neurological diseases.

Introduction: The use of Virtual Reality (VR) in neurology mainly concerns motor solutions. Such an approach is cost-effective and resource-effective. The aim of this work is to review and assess the effectiveness of proposed VR systems in order to diagnose and rehabilitate neurological patients with cognitive disorders.Areas covered: The existing analog neuropsychological tests lack ecological validity. The literature review revealed that VR solutions' biggest advantage is the possibility of assessing patients in everyday situations. Specific tasks (e.g. spatial, verbal, adaptive) could be focused on examining the exact types of memory disabilities in the heterogeneous group of cognitive impairments. There is a visible promise for further development in this area and a good basis for personalized and remote use. While different methodology is set in the analyzed articles the improvement in neurological functions is seen in all of them.Expert opinion: VR is still a relatively new and understudied solution, but there is a visible progress in its research. This trend could lead to more specific and tailored methods for therapy and diagnostics.

[Specific markers of neuropsychiatric systemic lupus erythematosus with mental disorders - review of the literature].

Systemic lupus erythematosus (SLE) is a chronic multiorgan autoimmune disease belonging to spectrum of interest of many medical specialties. Wide range of patients 14-75% with SLE suffers from neuropsychiatric disorders. The problematic diagnosis of neuropsychiatric SLE has generated many studies focusing on etiology of the disease with the presence of specific autoantibodies, abnormalities which can be detected by imaging examinations or correlation with catecholamine levels. The aim of this review paper is to discuss the frequency of neuropsychiatric disturbances in patients with SLE and their potential association with immunological abnormalities and specific disease markers. So far published literature regarding this topic indicates the usefulness of autoantibodies specificity. The use of the specific antibodies may be helpful in targeting diagnostics towards psychiatric disorders, especially depressive ones. Imaging scanning techniques such as computed tomography (CT) have limited value in psychiatric disorders diagnosis but can be useful in neurological symptoms and complains. Therapeutic use of systemic glucocorticosteroids due to anti-inflammatory properties with multidirectional action, may also significantly influence the course of neuropsychiatric diseases, especially in patients with SLE. Awareness of the morbidity of neuropsychiatric disorders and the possibilities of their diagnosis are important in the management of patients with systemic lupus erythematosus, which significantly affects the quality of life of patients, treatment efficacy and psyche.