Italy quarantines whole towns, closes schools and cancels sports fixtures as infections increase.

The patients caught the virus on the Diamond Princess cruise liner, bringing the total UK cases to 13.

Virtual assistants like Alexa and Siri are little help for people seeking information about how to quit drinking, smoking, vaping or taking opioids, a new study finds.

“Alexa can already fart on demand, why can’t it and other intelligent virtual assistants also provide lifesaving substance use treatment referrals for those desperately seeking help? Many of these same people likely have no one else to turn to except the smart device in their pocket,” said study co-leader John Ayers. He’s an associate adjunct professor of medicine at the University of California, San Diego’s Qualcomm Institute.

About half of US adults use virtual assistants, and some manufacturers plan to introduce health care advice, including personalised recommendations.

The new study – published online in the journal NPJ Digital Medicine – investigated whether virtual assistants already provide useful information about substance use.

Few ‘actionable responses’

“One of the dominant health issues of the decade is the nation’s ongoing addiction crisis, notably opioids, alcohol and vaping. As a result, it is an ideal case study to begin exploring the ability of intelligent virtual assistants to provide actionable answers for obvious health questions,” Ayers said in a journal news release.

For the study, the researchers asked Amazon Alexa, Apple Siri, Google Assistant, Microsoft Cortana and Samsung Bixby to “help me quit” various substances, including alcohol, tobacco, marijuana and opioids.

In response to 70 different help-seeking queries, the virtual assistants offered “actionable responses” only four times. The most common response was confusion, the investigators found.

Of the queries that yielded a response: “Help me quit drugs” on Alexa returned a definition for drugs; “Help me quit smoking” and “Help me quit tobacco” on Google Assistant returned the smoking cessation app QuitNow; and “Help me quit pot” on Siri returned a promotion for a marijuana retailer.

Disseminating resources to the public

Despite their findings, the study authors said that virtual assistants have the potential to provide meaningful help to people seeking help for addiction.

Study co-leader Alicia Nobles, a postdoctoral scholar at the institute, said, “Thanks to free federally managed remote substance-misuse treatment or treatment referral services, like 1-800-662-HELP for alcohol or drugs and 1-800-QUIT-NOW for smoking or vaping, we can encourage people to take the first step towards treatment by having intelligent virtual assistants promote 1-800 helplines.”

She noted that only 10% of Americans who need treatment for substance misuse receive it.

“Because intelligent virtual assistants return the optimal answer to a query, they can provide a huge advantage in disseminating resources to the public,” Nobles said. “Updating intelligent virtual assistants to accommodate help-seeking for substance misuse could become a core and immensely successful mission for how tech companies address health in the future.”

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When someone close to you dies, grief can literally break your heart, but two common medicines may help prevent a heart attack.

“While almost everyone loses someone they love during their lifetime and grief is a natural reaction, this stressful time can be associated with an increased risk of heart attack,” said Dr Geoffrey Tofler, a professor of preventive cardiology at the University of Sydney in Australia.

Tofler led a ground-breaking clinical trial that found the use of two common medicines – low-dose aspirin and the blood pressure-lowering beta-blocker metoprolol (Lopressor) – may reduce survivors’ risk of a fatal or nonfatal heart attack.

“A medical check-up for the bereaved is helpful. While most people gradually adjust, doctors can consider this treatment combination as an option,” Tofler said.

No side effects

The risk of heart attack and death is highest in the first days of bereavement – particularly for those who have lost a spouse or child. For a month afterwards, the risk of heart attack is four times higher than usual, and an increased risk persists for up to six months, Tofler said.

“The bereaved should not neglect their health or ignore symptoms that may be heart-related,” he said, adding that family and friends should be extra-supportive at this time.

The combo treatment is a new idea that needs more testing to find out who would benefit most from the therapy, Tofler said. Patients had no side effects from the drugs, he added.

“These findings provide encouragement for family doctors and other health care professionals to consider this preventive approach among people they consider to be at high risk associated with bereavement,” he said.

For the study, Tofler’s team randomly assigned 85 spouses or parents to a combination of low-dose aspirin and beta-blocker, or a placebo, within two weeks of a family member’s death.

After six weeks, the researchers monitored participants’ heart rate, blood pressure and changes in blood clotting. Those taking the medications experienced fewer spikes in blood pressure and heart rate, the study found. They also had a better blood-clotting profile.

Emotional stress of grief

In addition, people who were taking the medications were less anxious and depressed, Tofler said. To his surprise, lower anxiety and blood pressure levels remained even after the drugs were stopped.

“Our finding on the potentially protective benefit of this treatment is a good reminder for doctors to consider the well-being of the bereaved, and for the bereaved to have a health check-up with their doctor,” Tofler said.

Dr Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, reviewed the findings.

He noted that earlier studies have indicated that the emotional stress of grief can cause physical changes, including increases in heart rate, blood pressure, as well as in inflammatory and clotting factors.

This study suggests that aspirin and metoprolol may help reduce the adverse physiologic effects of bereavement, Fonarow said.

“However, larger trials will be needed to test whether or not this approach can lower the risk of fatal and nonfatal cardiovascular events in these vulnerable individuals,” he added.

The findings were published in the American Heart Journal.

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When a child has strep throat, an antibiotic like penicillin usually has them back at school 24 hours later.

But a new study warns that strains of bacteria that cause strep throat and “flesh-eating disease” appear close to becoming resistant to penicillin and other antibiotics known as beta-lactams.

“If this germ becomes truly resistant to these antibiotics, it would have a very serious impact on millions of children around the world,” said study lead author Dr James Musser, chair of pathology and genomic medicine at Houston Methodist Hospital.

“That is a very concerning but plausible notion based on our findings,” Musser said in a hospital news release.

Decreased susceptibility to antibiotics

The international team of researchers analysed more than 7 000 group A streptococcus strains collected over several decades from around the world. They found that about 2% had gene mutations of interest.

Tests confirmed that those strains have decreased susceptibility to beta-lactam antibiotics. That suggests these antibiotics may eventually become less effective or completely ineffective against these strains, according to the researchers.

The study findings highlight the urgency of developing a vaccine against group A streptococcus, the researchers said.

“We could be looking at a worldwide public health infectious disease problem,” Musser said. “When strep throat doesn’t respond to frontline antibiotics such as penicillin, physicians must start prescribing second-line therapies, which may not be as effective against this organism.”

How mutations arise

Group A streptococcus causes 20%–30% of sore throats in children and 5%–15% of sore throats in adults, according to the US Centers for Disease Control and Prevention.

According to the CDC, that same strain is considered the most common cause of the flesh-eating disease necrotising fasciitis. The bacteria usually enter the body through a break in the skin, and rapid antibiotic treatment is essential.

The study was published online in the Journal of Clinical Microbiology.

Musser and his colleagues plan further research to learn how group A streptococcus mutations arise in people, how they may affect health, and how they may alter the virulence of the bacteria.

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UK nationals evacuated from a cruise ship arrive at Arrowe Park, where they will spend the next 14 days.

Concerns that cholesterol-lowering statin drugs can impair brain health appear to be unfounded, according to new research.

“Statins won’t make you stupid or cause memory loss,” said lead researcher Dr Katherine Samaras, a professor of medicine at St. Vincent’s Clinical School of Medicine in Darlinghurst, Australia.

Black box warning

And for some people at risk of dementia, statins like Lipitor (atorvastatin) and Crestor (rosuvastatin) may improve memory and mental functioning, her team found.

Many millions of people take statins because of heart disease or high cholesterol. But reports that the drugs could cause memory loss led the US Food and Drug Administration in 2012 to require a black box warning on all statin medications, she said.

However, “we could find no overall impact on memory or any other aspect of cognitive function over six years in a large population of older people, who had extensive testing every two years,” Samaras said.

The observational nature of this study means the research can’t be considered conclusive, only that a strong link exists, the researchers noted.

“Any person who takes statins and is concerned about their memory and cognition should discuss this with their doctor. However, overall, we should be greatly reassured by the study findings,” Samaras said.

For the study, she and her colleagues collected data on more than 1 000 people aged 70 to 90 who took part in the Sydney Memory and Aging Study. About 600 took statins and had done so for an average of nine years.

Slower rate of memory loss

All of the participants had their memory and cognitive skills – such as processing speed and language – tested at the start of the study. No difference was seen between statin users and nonusers, according to the report.

Some people also had MRI scans to assess their brain volume. The MRIs showed no significant difference in brain volume among statin users and nonusers over two years.

And over six years, the researchers found no significant difference between memory and mental ability among those who did and didn’t take the drugs.

Among 99 people who started taking statins during the study, however, Samaras and colleagues found statins were linked to a slower rate of memory loss.

As expected, statins did protect people with heart disease from heart attacks. Within this group, the drug also resulted in a slower rate of a decline in memory, compared with people who didn’t take statins.

Moreover, in people with heart disease, diabetes or other risk factors for dementia, statin use slowed down mental decline in comparison with nonusers who had the same conditions.

Many effects on the brain

Looking at people who had the APOE-4 gene mutation, which puts them at high risk for Alzheimer’s disease, the researchers found statins appeared to significantly slow the rate of mental decline.

However, among participants without heart disease who took statins, the rate of memory decline was similar to those who didn’t take the drug, the findings showed.

The report was published online in the Journal of the American College of Cardiology.

Dr Costantino Iadecola, a professor of neurology and neuroscience at Weill Cornell Medicine in New York City, co-authored an editorial accompanying the study. He said, “Statins have many effects on the brain.”

The brain is 80% fat and has the most cholesterol of any organ in the body, and is very sensitive to any changes in fat, said Iadecola.

“So it’s not surprising that modulating cholesterol affects the brain,” he said.

Reducing cholesterol in the brain may reduce two changes linked to Alzheimer’s, namely beta-amyloid plaques and tau tangles, he noted.

But whether statins have a positive effect on preserving cognitive function requires more study, Iadecola said.

In the meantime, he doesn’t advise taking statins for the sole purpose of maintaining your mental abilities, since these drugs can have side effects.

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Could hot chocolate deliver relief to those suffering from the painful condition known as peripheral artery disease (PAD)?

A small, new study says it’s entirely possible.

Though you may be picturing a steaming cup of hot milk chocolate with tiny marshmallows bobbing on the top, the concoction the study volunteers drank was made from dark chocolate, and had a less sweet taste.

“A food-derived, nutritional therapy that is accessible, inexpensive and safe may meaningfully improve walking ability in people with peripheral artery disease,” said study author Dr Mary McDermott. She’s a professor in the departments of medicine and preventive medicine at Northwestern University Feinberg School of Medicine, in Chicago.

Pain, cramping and weakness

“Peripheral artery disease is common and underdiagnosed,” she said, adding that it’s a major cause of disability in people over 55. PAD causes narrowing in the blood vessels that supply blood to the legs from the heart. Common symptoms include pain, particularly when walking, cramping and weakness in the leg muscles.

McDermott noted that “these findings are particularly important because currently few therapies have been identified to help patients with PAD”.

However, the study was a preliminary effort and only 44 people were enrolled, so further research is needed to confirm these findings, she said.

The study was published in the journal Circulation Research. Funding for the research was provided by the US National Institute on Aging and the Office of Dietary Supplements at the US National Institutes of Health. The Hershey Company provided the chocolate beverage and the placebo. Mars Inc. measured the amount of cocoa flavanols through blood tests to ensure that the study participants were drinking the prescribed amount of hot chocolate.

Flavanols are a compound found in many plant-based foods. They can help improve blood flow and lower blood pressure, according to information from Harvard Medical School.

McDermott said the researchers were interested in studying cocoa in PAD because cocoa is known to contain flavanols that “have favourable effects on blood flow and on skeletal muscle.”

No meaningful weight change

The chocolate used in the study is commonly available natural, unsweetened cocoa powder. This type of cocoa powder is rich in the flavanol epicatechin. This flavanol is found in larger quantities in dark chocolate containing more than 85% cacao. McDermott said that dark chocolate that isn’t “alkalized” (a process to improve taste that removes some flavanols) would likely offer similar benefits. Regular chocolate wouldn’t be expected to have a similar effect.

Study volunteers drank a warm mixture of milk or water and a powder packet containing cocoa and epicatechin, or a placebo three times a day for six months.

The average age of the study volunteers was 72. All had PAD.

McDermott said those drinking the cocoa powder mixture drank an extra 180 calories a day. She said the researchers warned people about the extra calories. There was no meaningful change in weights during the study.

Hot chocolate drinkers had 20% improved blood flow to their calves and improved muscle health and function, the researchers said.

McDermott noted that hot chocolate drinkers were also able to walk further in a six-minute test. She said the benefit seen in hot chocolate drinkers was similar to what would be expected from a supervised treadmill exercise intervention.

Better to eat the whole food

Cardiologist Dr Nieca Goldberg, a spokesperson for the American Heart Association, said this study falls under the category of what she calls “pleasurable prevention”.

“Flavonoids have been shown to relax blood vessels. And, there are many healthy things that give you flavonoids, like green vegetables, berries, apples and tea,” Goldberg said. (Flavanols are a type of flavonoid.)

“Dark chocolate, too, has been shown to help relax blood vessels and helps lower blood pressure. But, like with anything we eat, it has to be eaten in moderation. You need to put any dark chocolate you eat in the context of the rest of your diet,” Goldberg explained. She noted that being overweight or having diabetes are common risk factors for PAD, so keeping tabs on calories may be even more important for people with PAD.

While the flavanol epicatechin is available in a pill, according to the researchers, Goldberg said when foods have certain benefits, it’s often difficult to replicate in a pill. She said it seems that there’s often something more beneficial when you eat a whole food.

Goldberg also said that hot chocolate isn’t a substitute for any current PAD treatments.

But McDermott noted that since hot chocolate is safe and doesn’t have side effects (except for extra calories), it could be used in addition to other treatments.

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Pregnant women who smoke cigarettes and drink alcohol may put their babies at higher odds for Sudden Infant Death Syndrome (SIDS), a new government study finds.

After the first trimester of pregnancy, women who both smoked and drank increased the risk for SIDS nearly 12 times. For those who continued to smoke, SIDS risk rose fivefold, and for those who continued to drink, the risk was four times higher, researchers found.

The risks are compared with women who didn’t use tobacco or alcohol before getting pregnant or who stopped by the end of the first trimester.

“Our findings suggest that combined exposures to alcohol and tobacco have a synergistic effect on SIDS risk, given that dual exposure was associated with substantially higher risk than either exposure alone,” said study co-author Amy Elliott. She is chief clinical research officer at Avera Health Center for Pediatric and Community Research in Sioux Falls, South Dacota.

Dangers of dual exposure

For the study, researchers followed nearly 12 000 pregnancies in five US sites, including two American Indian reservations in the Dakotas, and in Cape Town, South Africa. These sites were selected because they have high rates of alcohol use and SIDS.

Between 2007 and 2015, 66 infants died, including 28 from SIDS and 38 from other causes.

The study was supported by the National Institute on Alcohol Abuse and Alcoholism, part of the US National Institutes of Health.

“Our findings support the current recommendation of the US Centers for Disease Control and Prevention, the US Surgeon General, and the World Health Organization that women not drink or smoke during pregnancy, and emphasises the significance of dual exposure, which provides the greatest risk for infant mortality,” co-author Dr Hannah Kinney said in an NIH news release. Kinney is a neuropathologist at Boston Children’s Hospital.

The report was published online recently in the journal EclinicalMedicine.

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