In a recently published prospective cohort study, a third dose of the BioNTech Pfizer vaccine yielded a sustained immunologic response. But response to a fourth was much smaller and was gone completely by 13 weeks, providing only a short-term benefit over the third dose. A fourth dose should therefore be timed based on disease waves or be provided seasonally, like the influenza vaccine.

Around 82% of residency programs in the US subsist on federal funding. The Balanced Budget Act of 1997 capped the number of federally funded residency spots at 100,000 and the only adjustment since then has been a 1% increase. At least eight bills to address the issue have been put forward in Congress but none have passed.

MDLinx compiled a reading list of captivating books that have nothing to do with medicine—but might just help physicians realize some things about their work — and life.

Gantenerumab treatment generated a slowing of clinical decline from baseline score on the Clinical Dementia Rating-Sum of Boxes (CDR-SB), but at levels that did not reach statistical significance. The relative reduction in clinical decline was 8% in GRADUATE I and 6% in GRADUATE II compared with placebo.

Many drugs of abuse increase orexin production in both animal and human brains. Blocking the orexin system reverses addiction in animals. Orexin levels normally cycle in a circadian rhythm, with additional activation when under stress. Opioids, cocaine, alcohol, and other substances activate the cells that produce orexin, but don’t deactivate them. They stay on constantly, producing high levels of orexin that drive the desire for another hit. Anti-orexin insomnia medications might be of benefit in treating addiction.

In this case report, two Massachusetts psychiatrists, together with a radiologist and gerontologist, walk through the diagnosis and management of new onset neuropsychiatric symptoms following COVID infection.