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Friday, September 20, 2013

Psychological Harm Caused by Alcohol Abuse

Alcohol abuse doesn’t just lead to the physical dangers that many are well versed on, but it can also lead to many psychological dangers that are just as frightening, if not more so. Bankole Johnson knows the psychological dangers of alcohol addiction all too well.

He currently heads the psychiatry department at the University of Maryland Medical Center.

These types of dangers can lead to actual physical problems as well, so it’s best to identify what they are and avoid them to ensure that you have a bright future laid out ahead of you. So what are these psychological dangers?

Every emotion you have is exaggerated


Sure, there are people that act out happily and show affection when they drink, but it can be to the point where it is too much to bear and makes for awkward situations. Every emotion you feel at the time of drinking is blown up like a picture into a poster.

People that decide to drink when they are angry are more likely to lash out in violent behavior once they have abused alcohol. If you are feeling down or depressed, drinking is only going to make it that much worse and can lead to an emotional breakdown.

It’s normal to have emotions, it is what makes us human. Unless you want those emotions on display for everyone to see, though, then drinking would be a bad idea.

Addiction is a psychological danger

When you become addicted to alcohol, it can be all you think about. How to get your next drink seems more important than remembering birthdays, going to work or going out for a jog. That type of crippling thinking and feeling is addiction.

When nothing else seems as important to you as opening the next bottle, it’s a serious problem. Many associate addiction as physically ailing for a substance, but it is just as much psychological.

Judgment impairment can be dangerous


People are more daring after a few drinks, but not always in a good way. There is a large difference between the person that has one drink with dinner and the person that can put away an entire case.

The worst decision of the night for the person that had just the one drink with food might be a dessert that doesn’t set well. The other person though opens themselves up to a multitude of possibly devastating decisions.

Whether you decide to drive your car, pick a fight with someone at the bar or any other dangerous decision, it can be fatal. Alcohol abuse and impaired judgment go hand in hand, and the consequences are never good.

Long term effects

The person that goes over their limit a bit just once and the person that does it with regularity will both face short term effects, but the latter is much more likely to experience the long term psychological effects.

The list of long term effects is not pretty to look at, either. Depression, loss of relationships with others and alcohol dependence are all crippling psychological dangers.

The more you abuse alcohol, the more likely that these types of dangers are to come to fruition. That sounds like a list of problems that anyone would want to avoid.

Violence

Alcohol is a depressant, so it is known to cause erratic mood swings. It is also known that physical violence is tops on the list of something you can do to someone. Loved ones, friends, complete strangers, anyone.
This isn’t limited to just typical physical violence as well, but sexual violence. The person that abuses alcohol is more likely to lash out with these types of behaviors, which is a frightening thought.

The above entry is a guest blog entry.

Tuesday, September 17, 2013

Plastic Surgery: MedFriendly's Newest Entry

On 9/17/13, MedFriendly, LLC, published a comprehensive online review on plastic surgery. Plastic surgery is a medical specialty that fixes the form and function of some part of the body involving the skin. Detailed information is provided on various plastic surgery techniques, the history of plastic surgery, and the shocking case of Hang Mioku.

The plastic surgery entry is the latest in hundreds of easy to understand entries available for free at MedFriendly.com. All entries on MedFriendly are written in an easy to understand format, with all complex terms defined within the same entry. This prevents the reader from needing to do extra research to understand what the writer is trying to convey. All entries are written on a single page, exposing the reader to fewer ads. Please share this link with others, bookmark MedFriendly and the MedFriendly Blog, and follow us on the MedFriendly Facebook and Twitter pages.

Saturday, September 14, 2013

Egg Donor Agencies: Options After Ovary Removal

In 2013, Angelina Jolie announced that she’s had a double mastectomy as a preventative measure, based on the results of the BRAC Analysis test. Ms. Jolie’s decision not only put the BRCA1 gene, and the BRAC Analysis test, in the spotlight; it also opened a dialogue about other forms of preventative surgery.

In fact, Ms. Jolie, who has a strong family history of breast cancer and ovarian cancer, is even considering having her ovaries removed as a preventative measure.

Removing the Ovaries

Removing the ovaries, or an oophorectomy, is not a new procedure in the prevention and treatment of cancer. The ovaries produce estrogen and other female hormones, and certain types of breast cancer are highly reactive to estrogen. In women who have these types of breast cancer, the oophorectomy is often used as a means of slowing down the growth and spread of the cancerous cells.

In women who do not have breast cancer, but have the BRCA1 and BRCA2 mutations, removing the ovaries not only prevents the onset of ovarian cancer, it could prevent the onset of certain types of breast cancer.

The doctor could remove the ovaries and the fallopian tubes—the tubes that carry the eggs to the uterus--but leave the uterus intact. Or, he could remove the uterus, fallopian tubes, and ovaries in what is called a total hysterectomy.

Oophorectomy Considerations

Unfortunately, once you remove your ovaries, you can no longer have children. Not only will you no longer produce eggs, you won’t produce all of the hormones you need to support a pregnancy. If you have already had all the children you want, that might not be an issue; but for a woman, of child-bearing age, who has never had children, removing the ovaries closes that door forever.

Luckily, thanks to advances in egg collection and storage, as well as hormone replacement therapy, a woman who needs to have an oophorectomy could still have children. Her two best options for having children after the oophorectomy are donor eggs and fertility preservation.

Organizations like My Egg Bank act as egg donor agencies and fertility preservation centers.

Egg Donor Agencies

As egg donor agencies, these organizations harvest eggs from healthy donors. The agencies thoroughly screen the donors, including genetic counseling, family health histories, and testing for genetic diseases.

Once the donor clears the screening, the agency then has the donor take a series of medications designed to stimulate egg production, then harvests and freezes the eggs for future use.

The recipient would receive the eggs by applying to the donor agency to become a patient. After the application process, the bank will provide the recipient with basic information about the donor eggs that are available. This information includes genetic and race information about the donor, and even photos of the donor from early childhood.

The photos give the recipient an idea of what the donor, and by extension the child, might look like without compromising the identity of the donor. This way, the recipient can choose a donor who closely resembles herself, so that the child will be more likely to share similar traits with her family.

If the recipient has a uterus, and the hormones necessary to support a pregnancy, she could opt to have the eggs fertilized by her partner and implanted into her own uterus. If she does not have a uterus, or does not have the hormonal support, she would use a surrogate to carry the fetus.

Fertility Preservation Centers

As a fertility preservation center, the agency would collect the eggs from the recipient before she undergoes an oophorectomy. As with the egg donors, the recipient might need to take medication to stimulate egg production. However, if she has a hormone-sensitive breast cancer, the agency may opt to avoid using hormone-based medications and simply collect whatever eggs they can without them.

Chemotherapy and radiation therapy can damage the ovaries. In the case of the preexisting cancer, the agency would also need to harvest the eggs before the patient begins treatment, or as soon as possible after.

Once the agency has harvested the eggs, they freeze the eggs and store them until the recipient is ready to use them. 

Cost

The cost varies by facility, and depends on a variety of factors. In-vitro fertilization (IVF) with a donor egg could cost as much as $25,000, not including the cost of medications. It could cost as much as $500 per year to store an egg in an egg bank. Some egg storage facilities, like My Egg Bank, require a non-refundable deposit, and offer financing for the remainder of the cost.

If you are faced with the decision to have an oophorectomy, either as a preventative measure or to treat an existing condition--and you want to have children in the future--IVF with donor eggs, and fertility preservation could be well worth the cost.

The above entry is a guest blog entry.

Friday, September 13, 2013

Does Your Child Need Braces? 3 Ways To Find Out

Determining that your child needs braces or can do without them can be difficult. Children commonly develop teeth at varying rates and primary teeth don’t always help in locating the adult teeth.

A report shows that around 3 million in Canada and U.S. wear braces. While there’s no exact period for when the child may require braces, there are some ways that indicate the time is near.

Identifying the need for braces

1.  Bad/incorrect bites
Ask your child if he/she has any difficulty in chewing. You can also check for cavities as they are also a sign of bad bites. Some types of bad bites include deep overbite, underbite and open bite.

You can start by comparing the position of upper front teeth to the lower teeth. If the front teeth overlap the lower, it is a sign of a deep overbite. Another indication is that the upper teeth’s biting edges will be touching the gum tissue of lower front.

On the other hand, if the jaws are not in the appropriate position and the lower teeth are overlapping the upper, it is an underbite. Open bite is when the lower and upper front teeth aren’t meeting when the child is biting, and it can also cause problem in the child’s speech. According to Dr. Ron Markey, an orthodontist from Vancouver, delaying braces can lead to risks if the teeth are left unattended, even though the risks may take several years to become prominent.

2.  Spacing/crowding problems

The child may have small teeth in a normal jaw or missing teeth. This can lead to uneven spaces because some teeth lead into vacant areas. Uneven spaces shouldn’t be taken lightly as they have a chance of becoming a periodontal disease later on as the gums stay unprotected. Other problems they can lead to is incorrect functioning and an unattractive smile.

People also confuse spacing and crowding as the same problem, but they are entirely different. Crowing occurs when there is no space left for the teeth to go out of the gum. Other causes of crowding are incorrect eruption from the gum or the teeth are larger than the allotted space. Crowding can lead to an improper pattern of the bite, dental decay and an unattractive smile.

Braces can effectively correct crowding and spacing problems. However, Dr. David Morrow orthodontist at York Mills reveals that the first few weeks with braces require some adjustments, and sometimes additional appointments may be needed. This is the reason why appointments should be made at a time when the child has enough free time (from school and other commitments) to adjust.

3.  Cleft lip or cleft palate

Cleft palate stands for a split in the mouth’s roof, while the clef lip means an upper lift split. This problem is very rare and occurs in 1 or 2 children out of 1,000 born. This condition can be inherited by the child if any member of the family has it.

This condition can result in dental problems such as extra teeth, crooked teeth and small teeth. Children with cleft lip or palate require braces because it helps the teeth to grow in a straight position.

If left unattended, it can result in speech and eating problems.

Parents who can identify the need for braces shouldn’t make any delays to make sure that child doesn’t suffer from any complications in the long run.

The above entry is a guest blog entry.

Thursday, September 05, 2013

Do Electronic Cigarettes Reduce your Risk?

The National Cancer Institute indicates that traditional cigarette smoke contains more than 69 toxic chemicals and known carcinogens, including benzene, formaldehyde, and arsenic. Cigarette smoke also contains tar, and carbon monoxide which can damage the lungs and cardiovascular system.

If you smoke, stopping now can greatly decrease your risk of cancer and respiratory disease, relieve the symptoms of sleep apnea, and potentially improve your quality of life.

Unfortunately, quitting is often easier said than done because cigarettes are highly addictive.

One way to decrease your traditional cigarette intake, and reduce your disease risk, is by substituting electronic cigarettes for traditional cigarettes.

About Electronic Cigarettes

Electronic cigarettes are battery-operated devices that contain the nicotine that you would find in a traditional cigarette, but without the smoke, tar and most of the chemicals. Electronic cigarettes have cartridges that contain a nicotine “juice.” A battery heat’s the juice, creating a vapor, that the smoker inhales just like cigarette smoke.

Electronic cigarettes are available in both disposable and reusable varieties.

Where to Buy Electronic Cigarettes

You can buy brands like Victory Electronic Cigarettes from online retailers. Some brands also sell their products in the smoking section of drug stores, grocery stores, and convenience stores.

The Cost of Electronic Cigarettes

Electronic cigarettes are also comparatively cheaper than traditional cigarettes.

A single pack of name-brand cigarettes, such as Camel or Marlboro, can cost between $5 and $8, depending on where you buy them, due to taxes and other factors.

Specialty cigarettes, such as American Spirits or Nat Sherman, can cost upwards of $10.

Conversely, a single disposable electronic cigarette costs $8 to $10 and is equal to roughly two packs of traditional cigarettes.

The base cost of a reusable electronic cigarette is $20 for a rechargeable battery and two disposable cartridges equal to two packs of cigarettes each.

Refill cartridges generally retail for $10 to $15 for packs of three to five cartridges.

The Risks of Electronic Cigarettes

Currently, electronic cigarettes are still under investigation as to their safety.

The “juice” in the cartridge usually contains a mixture of liquid nicotine, diethylene glycol, and chemicals called nitrosamines, which are also found in cigarettes. Harvard University indicates that diethylene glycol is a highly toxic substance, and nitrosamines are known carcinogens. Electronic cigarettes can also contain other toxic chemicals.

However, the researchers at Harvard also indicate that they are uncertain about the levels of these chemicals, or exactly how toxic or dangerous they are to smokers.

The Benefits of Electronic Cigarettes

Although electronic cigarettes can contain toxic chemicals, they are at a much lower concentration than their traditional counterparts.

The Consumer Advocates for Smokefree Alternatives Association (CASAA), Consumer Advocates for Smokefree Alternatives Association (CASAA), reports that a study conducted by Professor Igor Burstyn, of the Drexel University School of Public Health, indicates that the chemicals in electronic cigarettes pose little-to-no risk to smokers.

Additionally, the chemicals in electronic cigarette vapor also pose little-to-no health risks from exposure through second-hand smoke.

Although the CASAA report is promising, and electronic cigarettes do have far fewer chemicals, smokers should use caution, just as they would when ingesting any other chemical substance.

The above entry is a guest blog entry.

Tuesday, September 03, 2013

Types of Medical Malpractice Involving Kids

When your kids undergo treatment whether it’s for a common cold or a serious injury, the medical professional is required to follow certain protocols. However, negligence and failure to do so can have serious repercussions in the form of injury or damage to the child’s health.

Dauphin Country-based Dr. Andrew Shapiro advised surgery to insert ear tubes and remove tonsils and adenoids on his patient Keonte Graham. Graham was 11 months when the surgery took place.
The patient however required brain surgery following the original surgery which was for sleep apnea. After the operation, Graham was said to suffer from breathing problems and was kept in the recovery room for 5 hours while his blood level oxygen was low.

Dr. Shapiro faced a lawsuit later on, which revealed that he failed to carry out proper physical examination after the operation and neglected to instruct the medical staff for monitoring the level of oxygen in the patient’s blood.

You should keep in mind that even minor mistakes from doctors and other healthcare professionals can have life-altering effects on your kids, and some can even resulted in death. Your child can be the victim of negligence in any healthcare environment.

Types of Malpractice Children Can Suffer From

1.  Use of defective medical devices

The FDA recently asked parents to report medical device defects used for children. Despite the strict testing procedures that medical devices have to go through, some defective ones still manage to get through. Medical devices that have resulted in medical claims during the last few years include implants, defibrillators, prosthetic devices and diagnostic testing tools.

The injuries and damage caused to the child’s health as a result of a defective device can be considered for a product liability lawsuit. All states have certain procedures for filing such cases, which is why legal resources are important for parents seeking compensation. Professionals can also help in determining whether the defective use of a device is subject to a product liability lawsuit or a medical malpractice lawsuit.

2.  Negligence of the healthcare professional


Negligence is one of the common types of medical malpractices in U.S. and other countries. Some of the negligence can be in the form of failure to monitor the health of the child before recommending the treatment, delays in diagnosing of congenital issues and failure to provide special care to the child during recovery at the medical workplace or hospital.

The claims can be filed for any types of injury due to negligence. Some of the common negligence claims involving children include Cerebral Palsy and Erb’s Palsy. In case serious injures where the child requires assistance over the long term, the defendant can be taken to court and asked to compensate for ongoing needs of the child.

3.  Lack of practitioner experience

It can also happen that a doctor with inadequate experience performs treatment on the child, which can result in undesirable outcomes because they may fail to follow the standard procedures.
In this case, the lawsuit should be filed on the basis that the practitioner breached the applicable standard protocols which resulted in injury to the child. The practitioner will be asked to provide proper documentation and evidence of his applicable method in the past, and there’s a high chance those with lack of skills and poor experience will fail to do so.

It’s wise to stay proactive about complications that can arise when your child undergoes medical treatment. Doing so will allow you to take instant action in case your child falls victim to medical malpractice.

The above entry is a guest blog entry.

Monday, September 02, 2013

Nintendo and the Wii: Interactions with Health and Science

Media stories often focus on the negative effects that violent video games have on society, but it is important to also point out that video games have a positive impact in treating numerous health care conditions and in advancing science.

The most well known video game system that does this the Nintendo Wii, which utilizes numerous motion sensitive devices (e.g., balance board, handheld motion controller, skateboards, exercise bikes), to detect motion in three dimensions, allowing the player to interface with the game more realistically. Because of this role that the Wii has in motor feedback, it plays an important part in physical rehabilitation. For this reason, it is sometimes referred to as “Wii-hab”.

FEATURED BOOK: The Ultimate History of Video Games

The main settings and ways that the Wii has been helpful can be broken down into the following areas: a) neurological disorders in adults, b) developmental disorders and disabilities, c) non-neurological disorders, d) the elderly and fall prevention, e) exercise, measurement, and scientific testing, and f) surgical training. Information about each of these sections from the scientific literature is described below. The article ends with a discussion of medical problems (some of which may surprise you) that have resulted from using the Nintendo Wii and other Nintendo-based systems.

NEUROLOGICAL DISORDERS IN ADULTS:


As an example of the Wii’s rehabilitation benefits, use of the system has been shown to improve short-term motor abilities, postural stability, quality of life, and non-motor skills in Parkinson’s disease (PD) (Herz et. al, 2013; Holmes et al., 2013) although beneficial effects of the Wii Fit have not been found in all Parkinson’s patients (Pompeu et al, 2012).  PD is a type of brain disorder that leads to serious difficulties with muscle movements.  The Wii has also been used a home assessment device to measure motor abnormalities in PD such as tremor and motor slowness (Synnott et al., 2012).

The Wii has been shown to build confidence in abilities, achieve goals in leisure activities, and remove barriers from exercising in patients with multiple sclerosis (MS) (Huurnin et al., 2013). Multiple sclerosis is a condition in which people develop multiple areas of abnormal patches (also known as plaques or sclerosis) in the brain and/or spinal cord (depending on the stage of the illness). Others have found that the Wii improves balance in patients with MS (Brichetto et al., 2013). Both the Wii and PlayStation 2 have been used in stroke rehabilitation to improve motor movements, with use of games with the PlayStation 2 video camera improving movement and movement intensity (Neil et al., 2013).

The Wii Balance Board provides visual and balance feedback which has been found to be helpful in reducing hospital stays, improving sensory organization, dizziness, balance and vertigo in patients with acute vestibular neuritis. Acute vestibular neuritis refers to attacks of dizziness and spinning sensations that decrease over three to six weeks (Sparrer et al, 2013). The Wii Fit (Plus) has also been shown to be a useful balance treatment in patients with other vestibular and neurological diseases (Meldrum et al., 2012).

DEVELOPMENTAL DISORDERS & DISABILITIES:


In children, Wii Fit training has been shown to improve motor performance in those with developmental coordination disorder (Ferguson et al, 2013). It has been hypothesized that the Wii would be beneficial in improving the motor functions of children with cerebral palsy (Gordon et al., 2012). However, when this topic has been studied, children with spastic cerebral palsy preferred the Wii Fit over conventional physical therapy but it did not improve their motor functioning (Jelsma et al., 2013). Cerebral palsy is a type of brain damage that occurs during pregnancy, during birth, during infancy, or during early childhood that causes the child to have difficulties with movement and posture.

Researchers have shown that the Wii remote control can be turned into a high performance 3D object orientation detector and used with children with disabilities to improve their ability to perform a designated occupational task (i.e., rotating a 3D cube to make a requested pattern) (Shih et al, 2012a; Shih and Chang, 2012) and other occupational activities (Shih et al, 2012b) and physical activities (Shih, 2011; Shih et al., 2011a, Shih et al., 2012c), including limb action (Shih et al., 2010a) and standing posture (Shih et al., 2010b). Playing Wii games was found to improve highly practiced motor skills and postural control in a child with Down syndrome (Berg et al, 2012). Down syndrome is an abnormality that is present from birth that results in mental impairments and a characteristic physical appearance (small facial features, large tongue that sticks out, a flat back area of the head, and hands that are short and broad).

The Wii remote controller has helped people with disabilities keep their head in an upright position to obtain desired environmental stimulation during a head position correction program (Shih, Shih, and Shih, 2011). Use of the Wii remote has also helped reduce hyperactive limb behavior in children with attention deficit hyperactivity disorder (Shih et al, 2011b).

NON-NEUROLOGICAL DISORDERS:


In non-neurological disorders, the Wii balance board has been used in research on improving postural control impairments in people who undergo reconstruction of the ACL (anterior cruciate ligament) which is in the knee(Howells et al, 2013). However, one study did not find that the Wii Fit provided additional benefit compared to conventional physical therapy in patients who have undergone ACL reconstruction (Baltaci et al., 2013). The Wii balance board has been found to be a potentially acceptable rehabilitation adjunct to physical therapy in patients who have undergone total knee replacement (Fung et al., 2012). There have been indications that use of the Wii may help with improving pain, anxiety, active range of motion, function, and enjoyment in patients undergoing acute burn rehabilitation although this has not been scientifically proven (Yohannan et al., 2012). Residents of long-term care facilities using the Wii bowling game in addition to standard physical therapy for arm dysfunction enjoyed the therapy more and tended to report more improvements than a physical therapy program without the Wii bowling game, but not significantly so (Hsu et al., 2011).

THE ELDERLY AND FALL PREVENTION:

Elderly people playing the popular Wii Sports game in residential care centers have had fun using it, feel a sense of empowerment and achievement, and feel that it allows for greater socialization (Keough et al, 2013; Williams et al., 2010). Use of the Wii has been shown to increase exercise capacity, energy expenditure, motivation to exercise, and decreased barriers to exercising in the elderly , such as an elderly man who suffered heart failure (Griffin et al., 2012; Klompstra et al, 2013). Staff at health care centers where the Wii was used for at least three months believes that Wii activities promote physical (mobility, range of motion, dexterity, coordination, distraction from pain) and psychological benefits (social engagement, self-esteem, mastery, ability to pacify challenging behaviors) with aged (and disabled) clients (Higgins et al., 2010).

Use of the Wii has been found to improve leg strength in the elderly, which can help decrease falls in a safe, adaptable, and low cost manner (Clark and Kraemer, 2009; Jorgensen et al., 2013; Young et al., 2011). It is thus used to prevent falls in numerous rehabilitation programs (Taylor et al,. 2012) and to improve balance in other settings with the elderly (Williams et al., 2011) . Although the elderly enjoy the Wii Fit, not all studies have shown that it improves their balance (Franco et al, 2012). However, in older patients who have needed to wear a prosthesis for leg amputation, the Wii Fit it has been shown to improve balance confidence, to decrease reliance on assistive devices, and to increase energy efficiency when walking with the prosthesis (Miller at al, 2012). Importantly, the elderly, including those in long-term care facilities, enjoy playing the Wii for exercising, socializing, nostalgia, and competition, which enhances adherence to continuing its use (Brandt and Paniaqua, 2011) although some elderly prefer traditional therapy techniques (Laver et al., 2011). Although an initial attempt was made to use cognitive games on the Wii as a form of neuropsychological testing for the elderly, this idea never materialized into clinical practice, perhaps due to difficulties encountered by requiring physical interactions (Gamberini, et al., 2010).

EXERCISE, MEASUREMENT, AND SCIENTIFIC TESTING:

In times where it has become increasingly costly to cut medical costs, the Wii has been shown to provide a low cost, objective, valid, and reproducible way to measure standing and postural balance in adults (Clark et al., 2009 Jorgensen et al, 2013). The Nintendo Wii hand controllers have also been shown to be a portable and valid measure of running velocity (Clark et al, 2011a). The Wii remote controllers have also been used for the measurement of the angle of head posture (Kim et. al, 2012). Use of multiple Wii balance boards has been shown to be a reliable measure of weight bearing (Clark et al., 2011) and to improve weight bearing in athletes (McGough et al, 2012). The Wii remote has been used in functional magnetic resonance imaging (MRI) studies to track one or more moving points that can correspond to limbs, fingers or any other object whose position needs to be known (Modrono et al., 2011b).

The Wii Sports boxing game has been found to provide moderate to vigorous aerobic activity for exercise (Bosch et al., 2012). The Wii boxing game has been shown to involve more non-dominant upper extremity movement, energy expenditure, and heart rate than the Wii tennis or bowling games (Graves et al., 2008).

The Wii Fit has been shown to be an acceptable alternative to traditional moderately intense aerobic exercise in sedentary young adults (Douris et al., 2012). One problem with the Wii Fit is that the balance board scores it produces have been found to have poor reliability (consistency) within and between sessions and not to match up well with similar measures from other more established balance measurement systems (Wikstrom, 2012). However, others have found the Wii balance board to be reliable in measuring bodily sway in the elderly (Koslucher et al., 2012).

The handheld Nintendo DS system has been shown to be capable of integrating healthcare monitoring functions (e.g., heart monitoring signals, fall detection)  and transmit the information wirelessly to a separate location, allowing it to be used in an ambulance, nursing home, or general hospital (Lee et al., 2009; Lee et al., 2011). The Wii has also been used to show that men perform best at hunting games (navigation and shooting) but that men and women perform the same on gathering games (fine motor and visual search) (Cherney and Poss, 2008).

SURGICAL TRAINING:

Use of the Wii has also shown promise in predicting and improving basic laproscopic surgical skills in students and surgical trainees, particularly with the non-dominant hand (Badurdeen et al. 2010; Bokhari et al., 2010; Boyle et al., 2011; Middleton, et al, 2013). These benefits in enhancing laproscopic surgery skills have been replicated by others (Giannotti et al, 2013) and have also been shown for the PlayStation 2 when playing a gun arcade game (Time Crisis II) (Ju et al, 2012).

NINTENDO BASED INJURIES AND HAZARDS:


While the Nintendo Wii has had many positive benefits as it relates to healthcare, some negative impacts have been reported in the scientific literature. This includes a hand tendon rupture suffered by a community doctor after playing tennis on the Wii and striking a wall with her wrist and thumb while attempting a backhand motion (Bhangu et al, 2009). Even more dangerous was the case of a 55-year-old woman who sustained a large hemothorax (chest bleed) when playing tennis on the Nintendo Wii because she swung around too fast (Peek et al., 2008). A chest drain was inserted to drain out the blood and she was discharged home 5 days later.

Injuries while playing Nintendo are not unique to the Wii. In 2001, Dr. Johanna Wood documented the case of an 8-year-old child and his two friends who developed a blister in the middle of one of their hands due to overplaying the game, Mario Party, when rotating the central joystick with the palm of the hand.  Back in 1992, Bright and Bringhurst coined the term, “Nintendo elbow” in a 12-year-old boy with several days of right elbow pain, presumably from playing Nintendo alot. The problem resolved 9 days after stopping Nintendo play and use of ibuprofen. It was recommended that children support the elbow on a firm surface during Nintendo play. Nintendo elbow was preceded by “Nintendo neck” which was described in the scientific literature one year prior by Dr. David Miller. The term was coined after the author observed his son develop neck pain after 30 minutes of playing the hand-held Game Boy system. This was presumably caused by the position held while playing the game (hunched over, chin on the  chest, elbows bent, screen close to the face, while staring intently).

In 1990, the term “Nintendinitis” was used by Brasington  to describe thumb pain in a 35-year-old who pushed the Nintendo button repeatedly while playing. The term, “Nintendo epilepsy” was used the same year by Hart due to seizures that occurred in a 13-year-old girl after playing Super Mario Brothers for three hours with only a 10 minute break. The presumed cause was the shifting pattern of the video game image. Nintendo has also been associated with urinary accidents (Schink, 1991) and fecal accidents (Corkery et a., 1992) in children because they try to hold in bodily waste longer than they can due to not pausing the game.

REFERENCES:

Badurdeen S, Abdul-Samad O, Story G, Wilson C, Down S, Harris A. (2010). Nintendo Wii video-gaming ability predicts laparoscopic skill. Surg Endosc. 24(8):1824-8.

Baltaci G, Harput G, Haksever B, Ulusoy B, Ozer H. (2013). Comparison between Nintendo Wii Fit and conventional rehabilitation on functional performance outcomes after hamstring anterior cruciate ligament reconstruction: prospective, randomized, controlled, double-blind clinical trial. Knee Surg Sports Traumatol Arthrosc. 21(4):880-7.

Berg P, Becker T, Martian A, Primrose KD, Wingen J. (2012). Motor control outcomes following Nintendo Wii use by a child with Down syndrome. Pediatr Phys Ther. 2012 Spring;24(1):78-84.

Bhangu A, Lwin M, Dias R. (2009). Wimbledon or bust: Nintendo Wii related rupture of the extensor pollicis longus tendon. J Hand Surg Eur Vol. 34(3):399-400.

Bokhari R, Bollman-McGregor J, Kahoi K, Smith M, Feinstein A, Ferrara J. (2010). Am Surg. Design, development, and validation of a take-home simulator for fundamental laparoscopic skills: using Nintendo Wii for surgical training.76(6):583-6.

Bosch PR, Poloni J, Thornton A, Lynskey JV. (2012). The heart rate response to nintendo wii boxing in young adults. Cardiopulm Phys Ther J. 23(2):13-29.

Boyle E, Kennedy AM, Traynor O, Hill AD. (2011). Training surgical skills using nonsurgical tasks--can Nintendo Wii™ improve surgical performance? J Surg Educ. 68(2):148-54.

Brandt K, Paniagua MA. (2011). The use of Nintendo Wii with long-term care residents. J Am Geriatr Soc. 2011 Dec;59(12):2393-5.

Brasington, R. Nintendinitis. N Engl J Med 1990; 322:1473-1474.

Brichetto G, Spallarossa P, de Carvalho ML, Battaglia MA. (2013).The effect of Nintendo(R) Wii(R) on balance in people with multiple sclerosis: a pilot randomized control study. Mult Scler. 19(9):1219-21.

Bright DA, Bringhurst DC. (1992). Nintendo elbow. West J Med. 156(6):667-8.

Cherney ID, Poss JL. (2008). Sex differences in Nintendo Wii performance as expected from hunter-gatherer selection. Psychol Rep. 102(3):745-54.

Clark R, Kraemer T. (2009). Clinical use of Nintendo Wii bowling simulation to decrease fall risk in an elderly resident of a nursing home: a case report. J Geriatr Phys Ther. 32(4):174-80.

Clark RA, Bryant AL, Pua Y, McCrory P, Bennell K, Hunt M. (2010). Validity and reliability of the Nintendo Wii Balance Board for assessment of standing balance.Gait Posture. 31(3):307-10.

Clark RA, Paterson K, Ritchie C, Blundell S, Bryant AL. (2011). Design and validation of a portable, inexpensive and multi-beam timing light system using the Nintendo Wii hand controllers. J Sci Med Sport. 14(2):177-82.

Clark RA, McGough R, Paterson K. (2011b). Reliability of an inexpensive and portable dynamic weight bearing asymmetry assessment system incorporating dual Nintendo Wii Balance Boards. Gait Posture. 2011 Jun;34(2):288-91.

Douris PC, McDonald B, Vespi F, Kelley NC, Herman L. Comparison between Nintendo Wii Fit aerobics and traditional aerobic exercise in sedentary young adults. J Strength Cond Res. 2012 Apr;26(4):1052-7.

Ferguson GD, Jelsma D, Jelsma J, Smits-Engelsman BC (2013). The efficacy of two task-orientated interventions for children with Developmental Coordination Disorder: Neuromotor Task Training and Nintendo Wii Fit training. Res Dev Disabil. 34(9):2449-61.

Franco JR, Jacobs K, Inzerillo C, Kluzik J. (2012). The effect of the Nintendo Wii Fit and exercise in improving balance and quality of life in community dwelling elders.Technol Health Care. 2012;20(2):95-115.

Fung V, Ho A, Shaffer J, Chung E, Gomez M. (2012). Use of Nintendo Wii Fit™ in the rehabilitation of outpatients following total knee replacement: a preliminary randomised controlled trial. Physiotherapy. 2012 Sep;98(3):183-8.

Gamberini L, Cardullo S, Seraglia B, Bordin A. (2010). Neuropsychological testing through a Nintendo Wii console. Stud Health Technol Inform. 154:29-33.

Giannotti D, Patrizi G, Di Rocco G, Vestri AR, Semproni CP, Fiengo L, Pontone S, Palazzini G, Redler A. (2013). Play to become a surgeon: impact of Nintendo Wii training on laparoscopic skills. PLoS One. 8(2):e57372.

Gordon C, Roopchand-Martin S, Gregg A. (2012). Potential of the Nintendo Wii™ as a rehabilitation tool for children with cerebral palsy in a developing country: a pilot study. Physiotherapy. 98(3):238-42.

Graves LE, Ridgers ND, Stratton G. (2008). The contribution of upper limb and total body movement to adolescents' energy expenditure whilst playing Nintendo Wii. Eur J Appl Physiol. 104(4):617-23.

Griffin M, McCormick D, Taylor MJ, Shawis T, Impson R. (2012). Using the Nintendo Wii as an intervention in a falls prevention group. J Am Geriatr Soc. 2012 Feb;60(2):385-7.

Hart, EJ. Nintendo epilepsy. N Engl J Med. 1990 May 17;322(20):1473.

Herz NB, Mehta SH, Sethi KD, Jackson P, Hall P, Morgan JC. (2013, in press). Nintendo Wii rehabilitation ("Wii-hab") provides benefits in Parkinson's disease. Parkinsonism Relat Disord.

Higgins HC, Horton JK, Hodgkinson BC, Muggleton SB. (2010). Lessons learned: Staff perceptions of the Nintendo Wii as a health promotion tool within an aged-care and disability service. Health Promot J Austr. 21(3):189-95.

Holmes JD, Jenkins ME, Johnson AM, Hunt MA, Clark RA. (2013). Validity of the Nintendo Wii® balance board for the assessment of standing balance in Parkinson's disease. Clin Rehabil. 2013 Apr;27(4):361-6.

Howells BE, Clark RA, Ardern CL, Bryant AL, Feller JA, Whitehead TS, Webster KE. (2013). The assessment of postural control and the influence of a secondary task in people with anterior cruciate ligament reconstructed knees using a Nintendo Wii Balance Board. Br J Sports Med. 47(14):914-9.

Hsu JK, Thibodeau R, Wong SJ, Zukiwsky D, Cecile S, Walton DM. (2011). A "Wii" bit of fun: the effects of adding Nintendo Wii(®) Bowling to a standard exercise regimen for residents of long-term care with upper extremity dysfunction. Physiother Theory Pract. 27(3):185-93.

Huurnink A, Fransz DP, Kingma I, van Dieën JH. (2013). Comparison of a laboratory grade force platform with a Nintendo Wii Balance Board on measurement of postural control in single-leg stance balance tasks. J Biomech. 46(7):1392-5.

Koslucher F, Wade MG, Nelson B, Lim K, Chen FC, Stoffregen TA. (2012). Nintendo Wii Balance Board is sensitive to effects of visual tasks on standing sway in healthy elderly adults. Gait Posture. 36(3):605-8.

Jelsma J, Pronk M, Ferguson G, Jelsma-Smit D. (2013). The effect of the Nintendo Wii Fit on balance control and gross motor function of children with spastic hemiplegic cerebral palsy. Dev Neurorehabil. 16(1):27-37.

Jorgensen MG, Laessoe U, Hendriksen C, Nielsen OB, Aagaard P. (2013). Efficacy of Nintendo Wii training on mechanical leg muscle function and postural balance in community-dwelling older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 68(7):845-52.

Jørgensen MG, Laessoe U, Hendriksen C, Nielsen O BF, Aagaard P. (2013, in press). Intra-Rater Reproducibility and Validity of Nintendo Wii Balance Testing in Community-Dwelling Older Adults. J Aging Phys Act.

Ju R, Chang PL, Buckley AP, Wang KC. (2012). Comparison of Nintendo Wii and PlayStation2 for enhancing laparoscopic skills. JSLS.  16(4):612-8.

Keogh J WL, Power N, Wooller L, Lucas P, Whatman C.(2013, in press). Physical and Psychosocial Function in Residential Aged Care Elders: Effect of Nintendo Wii Sports Games. J Aging Phys Act.

Kim J, Nam KW, Jang IG, Yang HK, Kim KG, Hwang JM. (2012). Nintendo Wii remote controllers for head posture measurement: accuracy, validity, and reliability of the infrared optical head tracker. Invest Ophthalmol Vis Sci. 2012 Mar 15;53(3):1388-96.

Klompstra LV, Jaarsma T, Strömberg A. (2013). An in-depth, longitudinal examination of the daily physical activity of a patient with heart failure using a Nintendo Wii at home: a case report. J Rehabil Med. 45(6):599-602.

Laver K, Ratcliffe J, George S, Burgess L, Crotty M. (2011). Is the Nintendo Wii Fit really acceptable to older people? A discrete choice experiment. BMC Geriatr. 11:64.

Lee S, Kim J, Kim J, Lee M. (2009). A design of the u-health monitoring system using a Nintendo DS game machine. Conf Proc IEEE Eng Med Biol Soc. 2009:1695-8.

Lee S, Kim J, Lee M. (2011). The design of the m-health service application using a Nintendo DS game console. Telemed J E Health. 17(2):124-30.

McGough R, Paterson K, Bradshaw EJ, Bryant AL, Clark RA. (2012). Improving lower limb weight distribution asymmetry during the squat using Nintendo Wii Balance Boards and real-time feedback. J Strength Cond Res. 2012 Jan;26(1):47-52.

Meldrum D, Glennon A, Herdman S, Murray D, McConn-Walsh R. Virtual reality rehabilitation of balance: assessment of the usability of the Nintendo Wii(®) Fit Plus. Disabil Rehabil Assist Technol. 2012 May;7(3):205-10.

Middleton KK, Hamilton T, Tsai PC, Middleton DB, Falcone JL, Hamad G. (2013, in press).Improved nondominant hand performance on a laparoscopic virtual reality simulator after playing the Nintendo Wii. Surg Endosc.

Miller CA, Hayes DM, Dye K, Johnson C, Meyers J. Using the Nintendo Wii Fit and body weight support to improve aerobic capacity, balance, gait ability, and fear of falling: two case reports. J Geriatr Phys Ther. 2012 Apr-Jun;35(2):95-104.

Miller DL. (1991). Nintendo neck. CMAJ. 145(10):1202.

Modroño C, Rodríguez-Hernández AF, Marcano F, Navarrete G, Burunat E, Ferrer M, Monserrat R, González-Mora JL. (2011). A low cost fMRI-compatible tracking system using the Nintendo Wii remote. J Neurosci Methods. 202(2):173-81.

Neil A, Ens S, Pelletier R, Jarus T, Rand D. (2013). Sony PlayStation EyeToy elicits higher levels of movement than the Nintendo Wii: implications for stroke rehabilitation. Eur J Phys Rehabil Med. 49(1):13-21.

Peek AC, Ibrahim T, Abunasra H, Waller D, Natarajan R. (2008). White-out from a Wii: traumatic haemothorax sustained playing Nintendo Wii. Ann R Coll Surg Engl. 90(6):W9-10.

Pompeu JE, Mendes FA, Silva KG, Lobo AM, Oliveira Tde P, Zomignani AP, Piemonte ME. (2012). Effect of Nintendo Wii™-based motor and cognitive training on activities of daily living in patients with Parkinson's disease: a randomised clinical trial. Physiotherapy. 98(3):196-204.

Schink JC. (1991). Nintendo enuresis. Am J Dis Child. 145(10):1094.

Shih CH, Chang ML, Shih CT. (2010a). A limb action detector enabling people with multiple disabilities to control environmental stimulation through limb action with a Nintendo Wii Remote Controller.Res Dev Disabil. 31(5):1047-53.

Shih CH, Shih CT, Chu CL. (2010b). Assisting people with multiple disabilities actively correct abnormal standing posture with a Nintendo Wii balance board through controlling environmental stimulation.  Res Dev Disabil. 31(4):936-42.

Shih CH. (2011). A standing location detector enabling people with developmental disabilities to control environmental stimulation through simple physical activities with Nintendo Wii Balance Boards. Res Dev Disabil. 32(2):699-704.

Shih CH, Chung CC, Shih CT, Chen LC. (2011). Enabling people with developmental disabilities to actively follow simple instructions and perform designated physical activities according to simple instructions with Nintendo Wii Balance Boards by controlling environmental stimulation. Res Dev Disabil 32(6):2780-4.

Shih CH, Chang ML.(2012). A wireless object location detector enabling people with developmental disabilities to control environmental stimulation through simple occupational activities with Nintendo Wii Balance Boards. Res Dev Disabil. 33(4):983-9.

Shih CH, Wang SH, Chang ML, Shih CH. (2012a). Enabling people with developmental disabilities to actively perform designated occupational activities according to simple instructions with a Nintendo Wii Remote Controller by controlling environmental stimulation. Res Dev Disabil. 33(4):1194-9.

Shih CH, Chang ML, Mohua Z. (2012b). A three-dimensional object orientation detector assisting people with developmental disabilities to control their environmental stimulation through simple occupational activities with a Nintendo Wii Remote Controller. Res Dev Disabil. 2012 Mar-Apr;33(2):484-9.

Shih CH, Chen LC, Shih CT. (2012c). Assisting people with disabilities to actively improve their collaborative physical activities with Nintendo Wii Balance Boards by controlling environmental stimulation. Res Dev Disabil. 33(1):39-44.

Shih CH, Shih CJ, Shih CT. (2011a). Assisting people with multiple disabilities by actively keeping the head in an upright position with a Nintendo Wii Remote Controller through the control of an environmental stimulation. Res Dev Disabil. 2011 Sep-Oct;32(5):2005-10.

Shih CH, Yeh JC, Shih CT, Chang ML. (2011b). Assisting children with Attention Deficit Hyperactivity Disorder actively reduces limb hyperactive behavior with a Nintendo Wii Remote Controller through controlling environmental stimulation. Res Dev Disabil. 32(5):1631-7.

Sparrer I, Duong Dinh TA, Ilgner J, Westhofen M. (2013). Vestibular rehabilitation using the Nintendo® Wii Balance Board -- a user-friendly alternative for central nervous compensation. Acta Otolaryngol. 133(3):239-45.

Synnott J, Chen L, Nugent C, Moore G. (2012). WiiPD - Objective Home Assessment of Parkinson's Disease using the Nintendo Wii Remote. IEEE Trans Inf Technol Biomed.

Taylor MJ, Shawis T, Impson R, Ewins K, McCormick D, Griffin M. (2012). Nintendo Wii as a training tool in falls prevention rehabilitation: case studies. J Am Geriatr Soc. 60(9):1781-3.

Wikstrom EA.(2012). Validity and reliability of Nintendo Wii Fit balance scores. J Athl Train. 47(3):306-13.

Williams MA, Soiza RL, Jenkinson AM, Stewart A. (2010). EXercising with Computers in Later Life (EXCELL) - pilot and feasibility study of the acceptability of the Nintendo® WiiFit in community-dwelling fallers. BMC Res Notes. 3:238.

Williams B, Doherty NL, Bender A, Mattox H, Tibbs JR. (2011). The effect of nintendo wii on balance: a pilot study supporting the use of the wii in occupational therapy for the well elderly. Occup Ther Health Care. 25(2-3):131-9.

Wood DJ. (2001). The "How!" sign--a central palmar blister induced by overplaying on a Nintendo console. Arch Dis Child. 84(4):288.

Yohannan SK, Tufaro PA, Hunter H, Orleman L, Palmatier S, Sang C, Gorga DI, Yurt RW. (2012). The utilization of Nintendo® Wii™ during burn rehabilitation: a pilot study. J Burn Care Res. 2012 Jan-Feb;33(1):36-45.

Young W, Ferguson S, Brault S, Craig C. Assessing and training standing balance in older adults: a novel approach using the 'Nintendo Wii' Balance Board. Gait Posture. 33(2):303-5.