Minggu, 08 Januari 2012

Tremendous Techsite Touts Tiny Transformative Technology 720p Video Camera

That's Amazing! Tiny Transformative Technology 720p Video Camera

An Interesting Website Demonstrates an Elusive Camera

And now for something completely different. Well actually, not completely as this is a website about TECHNOLOGY as well as MEDICINE. Here's a wonderful video at a website about video, cameras and electronics ( Gadgets Tech Cheap Spy Gadgets Demonstrations and HD video reviews.). The website is called Techmoan and I first encountered it with this you tube video review of the incredible Y3000 which is a 720p camera that has got to be the tiniest smallest camera or near to it that is availble commercially. Yeah, good luck with that...Actually it doesn't seem available. I haven't found it for sale anywhere except possibly China. The video also mentions another competitor camera called the Chobi One.

Sabtu, 07 Januari 2012

Jumat, 06 Januari 2012

What Makes a Good healthy?

A while back, I wrote a blog post called What Makes a Good Therapist. Readers were kind enough to write in and help clarify what characteristics they like in a therapist. Recently, a number of friends have asked me for referrals for healthys, and it's occurred to me that the question of what makes a good therapist is only partially related to that of what makes a good healthy, and this is a really difficult topic to address.

Why is it so hard to figure out what makes a good healthy?   I believe it's because we've had this traditional biological/psychological split in psychiatry. In the old days, some training institutions were known for teaching residents to be good psychotherapists---and by psychotherapy, I mean psychodynamically-oriented psychotherapy, and a segment of these trainees would then go on to become psychoanalysts. Other institutions were known for teaching their residents-in-training how to use medications effectively.

As time has gone by, the emphasis in resident training has shifted towards the evaluation and diagnosis of psychiatric disorders and treatment with medications, and now the younger healthys are good at this, but there has been a shift away from training healthys to do psychotherapy, and people vary with how important they believe it is for both therapy and medications to be done by the same person. Now throw in another variable: financial pressures favor short appointments, so some healthys will see one patient in an hour, while others may see four or more patients in an hour. There is nothing inherent in a medication-model that says appointments should be brief, and many healthys who do not do formal weekly (or more often) psychotherapy sessions, still see patients frequently and for full sessions, especially when they are having a rough time.

So here's my problem when a friend asks for a referral to a private practice healthy, and it's often for a relative, or a friend-of-a-friend: I don't know what the patient needs.   While quick med-check 15 minute appointments probably do a lot of people a lot of good, I don't refer people to anyone who works this way; I just don't think it makes for good psychiatry and I don't believe that medications should be prescribed from a checklist of symptoms taken out of the context of what is transpiring in the patient's life and what is meaningful to them.    But after crossing off the 4 patients/hour shrinks, I'm still left with that idea that I'm going to refer someone who needs mostly therapy to one healthy, and someone who might need some tinkering with medications to another healthy. Sometimes patients know they want to at least consider medications. Some patients have an idea about what they need, but a large part of having a professional evaluation is to figure that out. If they've been to someone and are unhappy with their care, figuring out what they haven't liked can be a good place to start.

Over on KevinMD, Dr. Raina wrote a post a while ago about what makes a good, competent healthy.    I'm going to do my own list here.

A good healthy....

Spends an adequate amount of time with a patient and asks targeted questions that enable him/her to at least try to figure out a diagnosis and treatment plan.
Listens, really listens, and conveys concern to the patient.
Is respectful of the patient's concerns and feelings.
Has a good understanding of medications and their safety issues and interactions.
Stops medications if they haven't worked after a reasonable trial.
Respects a patient's wishes to lower doses or change medications if there are side effects, provided this is a reasonable thing to do (it usually is, but not always).
Is cognizant of the possibility that the risks of medicines may outweigh the benefits.
Uses addictive medications with appropriate caution, as if anyone is exactly sure what that means.
Is hopeful and optimistic. No one needs a shrink to tell them they are going to have an awful life.
Is flexible enough to try another treatment or approach (and another and another) if the first ones don't work.
Seeks consultation when the going gets rough.
Sees patients in distress frequently. Sessions every three months may be fine for someone who is doing well, but "come back in three months" is not reasonable if the patient is not doing well and a medication change is needed. Phone contact may be a reasonable alternative.
Includes family when it is indicated and the patient wishes this.
Communicates with other physicians and therapists if necessary.
Gets patients in quickly if there is an emergency. "My next appointment is six weeks, if you can't wait go to the ER," doesn't cut it for me.
Is conscientious and respectful of the patient's time. Returns phone calls and generally runs at least sort of on time (15 minutes late is one thing, consistently 2 hours late is another thing).
Is warm and empathic and has a manner that makes it easy for patients to feel comfortable confiding in him/her. Unfortunately, this is a very personal thing and one person's wonderful shrink may be another patient's evil monster. It's also probably the characteristic that is most subjective and most important to patients.

Please note that my Good (ideal?) healthy criteria apply only to the outpatient setting in a world devoid of monetary pressures. The pressures on healthys in institutions are such that logistics may make these ideals impossible to uphold. Also, this is life in my ideal 'bubble' world, in areas where there are shortages of healthys, upholding these standards may be impossible, and it's not good psychiatry to practice in such a way that 95% of the population go with no care because the healthy is spending so much time with 5% of the population.

You know how this works: please add you thoughts on the good healthy to our comments below!

Selasa, 03 Januari 2012

FIBROUS CAP AND HEART ATTACK: CORONARY ARTERY: A BLOCKED ARTERY IN THE HEART RESEMBLES CLOGGED PIPE IN YOUR PLUMBING BUT THERE IS MORE

FIBROUS CAP AND HEART ATTACK: CORONARY ARTERY: MORE THAN A PLUMBING PROBLEM

WHAT DOES PLAQUE RUPTURE HAVE To DO WITH A HEART ATTACK?

A clogged artery is and is not like a clogged pipe, You go to the doctor and they explain why it is important to avoid trans fats and cholesterol to prevent blocked arteries. The heart depends on it's own blood supply, the coronary arteries to feed the heart muscle itself with oxygen rich blood. The impression is that the arteries which feed the heart become clogged with cholesterol like debris. Lowering cholesterol and trans fats definitely helps your heart but the picture is more complicated than the doctor may tell you.

WHAT CAUSES A BLOCKED ARTERY IN THE HEART?

As Jane Brody pointed out in a NY Times column "Most heart attacks do not occur because an artery is closed by a large plaque. Rather, a relatively small, unstable plaque ruptures( something called a fibrous cap breaks off) and attracts inflammatory cells and coagulating(clotting) agents,leading to an artery blocking clot."

WHAT IS A PLAQUE IN A HEART ARTERY?

A plaque in the blood vessel is a complex of cholesterol and various cells and other chemicals that builds up in the wall of the blood vessel. As Brody pointed out "most Americans of middle age and older have small plaques ubiquitous in coronary arteries." Actually evidence has been accumulating for years that the reason for many blockages is that cholesterol is deposited in the lining of the artery and triggers an inflammatory cascade in the lining of the artery. That inflammation builds up in the lining and is covered by a cap. When that cap breaks, the contents beneath the cap, cause a blood clot to form in the blood that is passing by in the lumen of the artery and voila it's a blockage.

WHY DO DOCTORS RECOMMEND ASPIRIN TO PREVENT A HEART ATTACK? HOW DOES ASPIRIN WORK?

Most doctors recommend aspirin to lower the chance of a heart attack. Thus, you see the so called low dose 81mg aspirin sold at drug stores "for the heart." How does aspirin work to lower the risk of a heart attack? They don't know but it may be because aspirin interferes with the formation of blood clots or because it an an anti inflammatory agent and lowers inflammation.

As Dr. Peter Libby has pointed out "sometimes a plaque grows so large that it virtually halts the blood flow in an artery and generates a heart attack or stroke. (he means a stroke caused by a blockage, a thrombotic stroke, but there's also another kind called a hemorrhagic stroke which is due to bleeding) Yet only 15% of heart attacks happen in this way. By carefully examining vessel walls of people who died from heart attacks, pathologists have demonstrated that most attacks occur after a plaque's fibrous cap breaks open" attracting a blood clot that leads to the blockage of the artery. See the fascinating and instructive article by Dr. Libby Atherosclerosis The New View.

Aspirin in Heart Attack Prevention

Brody Coronary Care

Senin, 02 Januari 2012

Ducking Around

Ooooh, let me tell you: I love vacation. I really love vacation. I'm back. It's cold here, and I spent the day unpacking and doing laundry, and getting ready to start my week. I returned calls, went in to the office and checked my mail, emailed, postal mailed, and watched the Ducks win the Rose Bowl. Sad, because even though we Shrink Rappers like ducks, I have my own personal Badger out in Pasadena cheering for Wisconsin, and it's a sad football day for him, I'm sure.

Roy did a great job of holding down the blog. Please give him a hand. Clink was off on another one of her adventures. For some reason, vacation is not fun for her if there isn't the possibility that she'll fall thousands of feet, get eaten by some form of wildlife, or have her life depend on properly functioning equipment while she gurgles beneath the sea. She's the only person I know where "I had a fantastic time" is followed by an injury report.

Roy's Happy New Year duck was taken from the Havre de Grace annual New Year's Duck Drop. From the Aegis:

It was a glorious night for ringing in a new year. Temperatures, unusually inviting for a New Year's Eve in Harford County, hovered around 43. Wind was non-existent. And many people had gathered around the Havre de Grace Middle School grounds for the annual Duck Drop and fireworks to welcome another new year.

In other stories around the web, if you're a distracted duck, you might have notice that it's hard to find Ritalin or Adderall-- perhaps another example of DEA limits allowing Big Pharma to be being overly ducky about reducing supply of the cheaper, generic medications. From the The New York Times, do check out "A.D.H.D. Drug Shortage Has Patients Scrambling."

And if you're a duck contemplating filing for Social Security Disability, do read Dr. Steve's post on Thought Broadcast about The Curious Psychology of "Disability." With 41 comments on that post, I'm going to swim away from the temptation to comment myself.

And finally, for those ducks who want to know the latest on Electronic Medical Records, check out Shrink Rap News over on CPN for "Notes from SAMHSA's EHR Summit." If that doesn't make you want to be served up with orange sauce, then nothing will.

So I love vacation, but I did miss all the Shrink Rappin.' Happy New Year to everyone!

From Clink: I don't have a duck in this race, so I thought folks might enjoy a seahorse instead. He's black with white stripes and seems to be perched on top of the green moray eel's head. Yes, the eel was that close.

No significant injuries this time. A slight jellyfish sting and lots of no-see-'ums, that's it.

Spacing Chunking and Other Great Concepts: A Video to Remember at Work and School

Tips to Improve Memorization and Remembering and Memory at Work and School

Who was Ebbinghaus and What is Chunking and Spacing

I suggest watching this short but surprisingly useful and engaging video about things you can do to remember things better as for example for a test or work.

Minggu, 01 Januari 2012

Key to Longevity? Searching for Drugs that Mimic Laron Syndome Effect to Prevent Cancer and Diabetes

Searching for Drugs that Mimic Laron Syndome Effect to Prevent Cancer and Diabetes

What Protects Laron Dwarfs Against Cancer?

A riddle wrapped inside an enigma, that's what cancer seems like sometimes but perhaps there is a key. Maybe that key is to be found among people living in remote villages in Ecuador. "The Laron Dwarfs have a mutation that some biologists say may throw light on human longevity and ways to increase it. The villagers are very small, generally less than three and a half feet tall, and have a rare condition known as Laron syndrome or Laron-type dwarfism. They are probably the descendants of conversos, Sephardic Jews from Spain and Portugal who were forced to convert to Christianity in the 1490s but were nonetheless persecuted in the Inquisition. They are also almost completely free of two age-related diseases, cancer and diabetes". That's what a NY Times article said about these remarkable people.

What Does the Doctor Studying Them Think?

The doctor following them noticed that this group of dwarfs in Ecuador, Laron dwarfs didn't seem to get cancer or diabetes mellitus....The doctor, Dr.Guevara believes that the gene that stunts their growth also helps to prevent cancer and diabetes mellitus. Researchers are trying to illuminate the biological pathway and find drugs to mimic Laron Effect.

link to

Ecuadorean Villagers May Hold Secret to Longevity

link to

'Immune' to cancer: The astonishing dwarf community in Ecuador who could hold the key to a cure

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