Shift work has previously been linked to an increased risk of developing MS, presumably due to the resulting sleep deprivation and circadian desynchrony. The current study compared sleeping 7–9 hours/night during adolescence, with less than 7 hours/night and found a 40% increase in risk for developing MS in the short-sleep cohort. The authors conclude that “insufficient sleep and low sleep quality during adolescence seem to increase the risk of subsequently developing MS.”

This physician sounds the alarm on CDC’s ill-founded mandates for mandatory masking, citing the recent Cochrane Review.

Christen Fuller, MD, describes her approach to the often-conflicted situation. One of her keys? “Know your own limitations.” Another? Don’t let the frequency of the patient coming in for pain management lead you into defensiveness and minimizing their pain.

The number and quality of available studies on ketamine plus psychotherapy are limited because of the newness of the therapy. However, in the 4 studies deemed eligible for review, ketamine plus psychotherapy—regardless of protocol—was associated with significant symptom reduction.

As originally reported in the Journal of Addiction Medicine, use of the animal tranquilizer xylazine has now been seen in more than 23 states in the US. Finding the drug in a patient sample should prompt the physician to look for early signs of tissue infection and other symptoms.

Factors evaluated were diet, exercise, social integration, cognitive activity, smoking history, and alcohol use. Participants were categorized as favorable (4-6 positive factors), average (2–3 positive factors), and unfavorable (0–1 positive factor). The “favorable” group had a a slower decline in cognition even if they were APOE e4 carriers.