Tech Gaming Designs, Neurodevelopmental Vulnerabilities, and Risks for Internet Gaming Disorder: What Clinicians Need to Know.

Importance: Digital gaming has surged in recent decades and is widely available to individuals of all ages. Although the construct of play and games is anthropologically linked to human development, the central question remains: Does the exponential technological advancement target vulnerabilities linked to the risk of addiction? A growing burden of individuals who blur the lines between use, misuse, and addiction adds to the list of many confounders linked to mental health crises. The growing body of literature led to the addition of internet gaming disorder (IGD) to the conditions that need further research section of the DSM-5-TR.Observations: Results indicate that IGD has similar neurobiological changes to those of nicotine addiction and underscores how tech game designs are linked to gaming addiction. Additionally, a history of psychiatric diagnoses further increases the risk of developing IGD.Conclusion and Relevance: With the rapidly evolving technological landscape, using broader terminologies and definitions would aid in understanding the scope of IGD. Besides more education on IGD, a readily accessible screening tool could assist with early detection and referral to experts. While there is a dearth of specific evidence-based interventions, applying the principles of motivational interventions and harm reduction models has shown some promise. The establishment of a standardized screening and treatment approach for IGD is necessary. Clinicians must address the neurobiological aspects of IGD for effective interventions. Awareness of risk factors is key for early identification and intervention.Prim Care Companion CNS Disord 2024;26(4):24nr03712. Author affiliations are listed at the end of this article.

Outcomes of combined pyloric botulinum toxin injection and balloon dilation in dyspepsia with and without delayed gastric emptying.

Background: Pyloric botulinum toxin injection has improved symptoms in children with delayed gastric emptying. We aimed to determine the clinical response to combined endoscopic intra-pyloric botulinum toxin injection and pyloric balloon dilation (IPBT-BD) in patients with dyspepsia. Methods: Electronic medical records were reviewed to gather demographic data, symptoms, and follow-up on patients with dyspepsia. Cases were defined as those who underwent IPBT-BD in addition to their ongoing management. Controls received pharmacotherapy, behavioral intervention, or dietary management alone. Clinical response was defined as no change, partial, or complete improvement in symptoms within 12 months. Propensity score matching based on age, gender, and symptom duration was used to pair cases and controls. Results: In total, 79 cases and 83 controls were identified. After propensity matching, 63 patients were included in each group. The mean age for cases was 14.5 ± 3.9y; 62% were females and 98% were Caucasian. Further, 83% of 46 cases and 94% of 49 controls who had scintigraphy scans showed delayed gastric emptying. After matching, 76% of cases showed partial or complete improvement compared with 49% controls within 12 months (P = 0.004). Younger children tended to respond more favorably to the procedure (P = 0.08). Conclusions: In our propensity-matched analysis, combined IPBT-BD in addition to pharmacotherapy, behavioral, or dietary management clearly showed a benefit over these modalities alone. This favorable response lasted up to 12 months.