decline

health

Atlas push to ‘slow the testing down’ tracks with dramatic decline in one key state

Atlas, a neuroradiologist, not an infectious disease expert, strongly supported a decision in August to revise federal guidelines to de-emphasize the need to test people without symptoms, according to two sources familiar with the process. He shared his view with state officials, including Republican Gov. Ron DeSantis and several others in Florida, according to transcripts of public events and accounts from private meetings in that state.

“The purpose of testing is to stop people from dying,” Atlas said during one stop, captured on video. “When you start introducing closure of schools because people have positive, asymptomatic tests, that’s sort of not the purpose of testing.”   

“I think, Dr. Atlas, we’re in agreement on focusing strategies in school on people who are symptomatic,” DeSantis said in another joint news conference that day. 

Their push to de-emphasize tests coincided with a dramatic drop in testing across Florida, even as the country was careening toward a fall coronavirus surge. A CNN analysis of the Florida state official numbers, aggregated by the Covid Tracking Project, shows that testing dropped off at the end of July and early August, with a peak seven-day average over 90,000 tests per day on July 18. Six weeks later, in early September, the seven-day average dropped by nearly half, with fewer than 48,000 tests per day, and hovered between there and 60,000 during the fall.

If Atlas and DeSantis’ advocacy in Florida is, in fact, responsible for the state’s testing decrease, that would be in keeping with the wishes of Trump, who for months has falsely suggested that the US has so many coronavirus cases only because it conducts so many tests. In June, Trump even said publicly that he wanted to “slow the testing down, please.”   

Though both Atlas and DeSantis declined to discuss their views with CNN for this story, they have articulated them in public. Some state and local officials believe the pair was influential in taking Trump’s anti-testing pronouncements and helping to turn them into public policy. And the drop-off in testing is of deep concern to some. It took place as positivity rates remained high, in the range that the Centers for Disease Control and Prevention considers indicative of high community spread.

Asymptomatic Covid-19 carriers are still contagious, experts say. A lack of widespread testing makes it harder to map the disease as it spreads and to warn those at risk of illness.    

“There’s no question more people are going to die,” says Miami Beach Mayor Dan Gelber, a critic of DeSantis’ approach to testing and other matters of the governor’s pandemic management. “We are flying blind without tests.”    

At the moment, the nation is experiencing another surge of illness. Daily case numbers are reaching levels not seen since late July, and Florida is starting to see its numbers go up as well. Experts say that widespread testing, including of asymptomatic carriers, is critical to limiting the spread of the virus.    

A White House spokesman claimed Atlas had never advocated reducing testing, despite the

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health

Measuring brain tissue damage accurately identifies cognitive decline, researchers say

Oct. 27 (UPI) — By analyzing brain tissue damage using a new MRI evaluation tool, researchers accurately identified people with early signs of cognitive decline up to 70% of the time, a study published Tuesday by the journal Academic Radiology found.

The approach uses magnetic resonance imaging to identify — and measure the number and size — of bright spots on the mostly gray images of the brain called white matter hyperintensities, or lesions, the researchers said.

These spots have long been linked to memory loss and emotional problems, especially as people age. Now, newly available MRI technologies could make it possible for them to be used for diagnosis of dementia, the researchers said.

“White matter lesion captured by MRI scans may reveal cognitive decline much earlier than behavioral symptoms,” study co-author Jingyun “Josh” Chen told UPI.

“Amounts of white matter lesions above the normal range should serve as an early warning sign for patients and physicians,” said Chen, a research assistant professor of neurology at New York University Langone Health.

Roughly 6 million adults in the United States have dementia, according to the Alzheimer’s Association.

Although the condition is common, it remains challenging to accurately diagnose, and no effective treatments exist, according to Chen and his colleagues.

The bright spots seen on MRI scans represent fluid-filled holes in the brain — lesions that are believed to develop from the breakdown of blood vessels that nourish nerve cells.

Earlier research has shown that increased numbers of spots and their presence in the center of the brain is linked with worsening dementia and other brain-damaging conditions, such as stroke and depression.

Current methods for grading white matter lesions, however, rely on little more than the “trained eye” using an imprecise three-point scale, according to the researchers.

The new tool, called the white matter hyperintensities toolbox and developed by Chen and his colleagues at NYU Grossman School of Medicine, is intended to provide neurologists with a uniform, objective method for calculating the spots’ volume and location in the brain.

For this study, Chen and his colleagues randomly selected 72 MRI scans from a national database of adults age 70 and older who participated in the Alzheimer’s Disease Neuroimaging Initiative, a research project seeking to identify clinical, imaging, genetic and biochemical biomarkers for the early detection and tracking of Alzheimer’s disease.

Using MRI techniques to map the brain’s surface, the researchers then used the new tool to calculate the precise position and volume measurements for all observed white matter spots or lesions.

When researchers cross-checked their measurements, they found that seven out of 10 calculations correctly matched the patient’s actual diagnosis.

With the standardized tracking and measuring tool, physicians could monitor the growth of white matter lesions in patients with suspected dementia, the researchers said.

White matter brain measures alone are not sufficient to diagnose early dementia, Chen said, but should be considered along with other factors. This includes a history of brain injury, memory loss and hypertension, as well as clear symptoms

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