I tweeted this today. It captures the problem with the current post modern approach to science. What do I mean by that? All of the self proclaimed experts who claim they "did their own research" and came to ideological conclusions about climate change, vaccinations, the origins of the COVID-19 pandemic virus, fluoride in the water supply, chronic illnesses, "food as medicine", and just about all "health and wellness" interventions. You will notice in my post the expectation seems to b...| Real Psychiatry Technical Blog
Retirement dreams 02.18.2025 (one day after a retirement| Real Psychiatry Technical Blog
I posted this on X (formerly known as Twitter) today in response to an observations that psychiatry is not all good or bad. It is a fairly standard technique that is rarely commented on....| Real Psychiatry Technical Blog
Interesting brief story in Science this week. The International Committee on Taxonomy of Viruses (ICTV) renamed thousands of viruses according to standard Linnaean nomenclature. The two most famous of those changes were for the viruses causing COVID-19 and HIV. Those proposed changes were as follows:| Real Psychiatry Technical Blog
After a typical unproductive exchange with a critic suggesting that there is widespread dissatisfaction with psychiatry I decide I would start out next year by pointing out the levels of physician accountability that currently exist in most states. They have existed for some time - but things have become more intense as more physicians are employees. | Real Psychiatry Technical Blog
I am currently working on a post on malaise for my main blog. I have an interest in this syndrome because of its importance in psychiatry for the study of inflammation and how those underlying mechanisms are important in the pathophysiology of psychiatric disorders and the implications for treatment. One problem is that there is no clear definition of malaise that seems specific enough to study. Michel Rutter developed a Malaise Inventory. It was adapted from the| Real Psychiatry Technical Blog
For some reason I got out of the habit of posting the technical stuff that I use on my main blog on this one. Just yesterday I found a graphic so compelling it will start me doing this again. NCBI is the National Center for Biotechnology Information. It is part of the US governments collection of medical, chemical, genetic, and biological databases. I routinely use many of their sites including PubMed, PubChem, and toxicology databases. One of my current projects is taking a close l...| Real Psychiatry Technical Blog
It has been a while since I sifted through the chaff in| Real Psychiatry Technical Blog
I had a chance to get a recent anesthesia record for a procedure that I had done on August 30, 2023. A few years ago I had another procedure done through the same healthcare systems and electronic health record and the anesthesia record was in graphic form showing exact details of what was done and when. The current record showed more of a typical EHR printout these days with line by line interventions and times listed for the overall intervention. It seemed like a much less information...| Real Psychiatry Technical Blog
This issue comes up periodically with claims of diagnostic proliferation and attempts to discredit the diagnostic systems in the DSM. The numbers that are quoted vary considerably and there are no explicit rules that I can find for how the diagnoses are counted. I finally decided to count them myself today in the DSM-5. I don't have a DSM-5 TR. As a backdrop, here is a list of the DSMs and the total diagnoses and pages.| Real Psychiatry Technical Blog
Over the past several years I have made many timelines trying to get the development of American psychiatry correct. The limiting factor on my graphics have been the software (Excel, Visio, PowerPoint, Timeline app) and the amount of detail I wanted to include. Somewhere along the line I saw a highly detailed graphic in a journal that used Wondershare EDraw Max (1). I used that to make the following timeline for a presentation this Friday. I had to eliminate 40% of the detail but hope t...| Real Psychiatry Technical Blog
Tried this metabolism drawing with Visio. I also subscribed to EDRAW but could not figure out a better way to do it with that software. Key problem here is the enzyme labels on the circle. The circle is easy enough but if you want to segment it - that is a problem. When it is not segmented you can move it to the back but that means the product boxes in this case need to be non-transparent or the line will show. Overall I don't think it looks too bad - just a question of what kind of...| Real Psychiatry Technical Blog
Really like the St. Louis Federal Reserve web site for their financial information and graph generating ability. I made this graph there today to illustrate the myth that any President has the power to change gasoline and oil prices beyond the trivial. I have no idea why any President or administration would be interested in increasing fuel prices, especially in an election year. Not an expert but my guess is that the price volatility reflects a combination speculation on oil futures in the...| Real Psychiatry Technical Blog
Doing a deep dive back into the mitochondria and redox chemistry lately. The reason will be evident on my main blog. For now there is a lot of inconsistency in the nomenclature of some of the components but I have pieced it together diagrammatically in the slide that I modified from a VisiScience slide. This system of molecular engines is responsible for energy production in cells and heat production in intact organisms. It is also thought to be responsible for most of the production of re...| Real Psychiatry Technical Blog
Currently working on a flow diagram to illustrate how involuntary treatment occurs, who is involved, and the oversight for this process. This is the step-by-step process that occurs when a patient is taken to a community hospital. Not all community hospitals accept patients on psychiatric holds because they have no appropriate treatment environments and the treatment is very costly and poorly reimbursed. These details are typically left out in discussions of involuntary treatment. It ha...| Real Psychiatry Technical Blog
I have tinkered with this concept over the course of the pandemic. Just before getting my Moderna booster this afternoon I had the thought: "You have come too far to get knocked off by a brainless particle." I followed up with the graphic below that I think would make a good bumper sticker. Our energies need to be focused on the real problem to resolve this pandemic and the ones in the future. Political grandstanding on unrelated issues won't do. Decide whether you want a future for h...| Real Psychiatry Technical Blog
As previously noted - I typically use Visio for timelines and graphics. Visio does seem to have a major constraint when it comes to timelines in that it does not extend back before 1899. I decided to try Excel on that basis and found this video on YouTube about how to do it. The instruction are very clear and effective - if somewhat rapid for an Excel user who has not used it much recently. The advantage to Excel is that your graphic is linked to the spreadsheet and that allows rapid modifi...| Real Psychiatry Technical Blog
As research efforts have tried to connect coffee to human disease - the evidence is becoming clearer and clearer that all forms of coffee (including decaff) are probably good for your health. The following graphic shows the compounds that the authors of this article consider as protecting the liver as they investigate the possible protective effect of coffee against liver disease. Slide was made by downloading the 2D chemical structure from PubChem and arranging and captioning them in P...| Real Psychiatry Technical Blog
I drew these graphics to show how business management has adversely affected the practice environment and the physician patient relationship over the past 40 years. The diagrams were made with Microsoft Visio. It took me quite a while to figure out how to draw the curved graphic going from the blue zone (reasonable practice environment) to the red zone (deteriorated practice environment in each case. I am posting the succession of drawings over the past month with increasing drawing sop...| Real Psychiatry Technical Blog
This is a link to the NIH/NLM repository for information on the coronavirus and COVID-19 - LitCovid. I have tried it and find it is a much more specific search engine than the current versions of PubMed. It will take you back there for reference formatting and other links. This is a great free resource.| Real Psychiatry Technical Blog
If "worse" is measured in terms of mortality, this excellent graphic from the CDC illustrates why that statement is inaccurate. As I am typing this the total number of deaths due to SARS-CoV-2 in the USA is at 194,000 from 6.57 million cases and 387,616 hospitalizations in that past 7 months. The slide shows the total cases, hospitalizations, and deaths for the past 8 seasons (click to enlarge).| Real Psychiatry Technical Blog
I put this Labor Day graphic together to illustrate how the work of psychiatry has changed over the years. Colleagues trained in the past 20 years may not realize that all of the clerical work they are doing did not exist at one point. When I use the terms (to scale) I mean there is a 40% increase in this unreimbursed work courtesy of the federal government and the healthcare businesses that they invented and support. Put another way - there have been hundreds of articles on physician b...| Real Psychiatry Technical Blog
The takeover of medicine by managed care over the past 40 years is an ignored and poorly understood process. Patients generally don't realize why their care is rationed and why they are suddenly paying large out of pocket fees and not receiving quality services. They are paying more for less. In the meantime physicians have been disenfranchised and are told how to practice medicine by business managers who don't have the slightest bit of medical knowledge. Here is a basic graphic of how...| Real Psychiatry Technical Blog
I included a couple of tables in my latest main blog post on non-benzodiazepine sleep medications. The first is a table looking at the Ki's or inhibitory constant of the drug. It is defined as the concentrations of drug that reduces the reaction rate to half the maximum rate/effect. In the case of receptor medicated mechanisms that means the binding of the active drug to the receptor to create the effect.| Real Psychiatry Technical Blog
