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WCVB(BOSTON) -- Riding a bike for most kids is a rite of passage, but for kids with special needs attending the bike camp at Emerson Hospital, it’s like a dream come true.

For 8-year-old Chloe, who has a form of cerebral palsy, it can be a bit overwhelming, she told ABC Boston affiliate WCVB.

“Scared because not used to ride without training wheels, you might fall ..." she said.

For Chloe’s mom, Jenn Smagula, it’s exhilarating. “We live in a neighborhood, there's kids riding bikes all the time, and she hasn't been able to. I'm just so appreciative and thrilled,” she told WCVB.

The camp at Emerson Hospital runs about a week. Kids with special needs are paired up with coaches and special bikes, working to progressively get them on two wheels.

The camp is not just about learning to ride bikes; it also gives kids courage and determination to tackle many other things, Emerson Hospital spokesperson Mary Evans said.

“This changes lives, every parent will tell you, once their child learns to do something that they've never been able to do and thought 'I just can't do that' and they're like, 'I can DO THAT,'” said Evans.

For Molly, who has Down syndrome, learning to ride the bike, is an opportunity to do something together with her family.

“We're gonna ride together," said Molly, together with her mother Brenda Cassella.



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iStock/Thinkstock (NEW YORK) -- A new study in Australia looked at how much junk food advertising kids were exposed to and the numbers were staggering.

Food advertising can directly affect the types of foods that children actually eat, The World Health Organization has said.

To establish just how much food advertising children may be exposed to, researchers in this study examined the advertising content of a single TV network in Australia for the year 2016. Researchers sorted through 30,000 hours of TV and over 800,000 advertisements, paying special attention to the times in which children were most likely to be watching: before school (7 to 9 am) and after school (4 to 10 pm).

During these times, there were twice the amount of unhealthy foods advertisements, compared to the amount of healthy food advertisements. These unhealthy ads aired 1.7 times per hour. The most commonly advertised foods included snack foods like chips and popcorn, fried food and fast food. The least commonly advertised foods included vegetables, low sugar cereals and fruit.

The study calculated that an average school-aged child watched approximately 827 unhealthy food advertisements, amounting to 4 hours, in a single year.

The researchers made these calculations under the assumption that children watch 80 minutes of TV per day. But data from the American Academy of Pediatrics states that the average American child consumes more than 120 minutes of screen time per day so that estimate could be low for kids in the U.S.

Because of the long hours and the impact advertising can have on children, the authors of this study discuss the potential benefit of regulating unhealthy advertising on media children consume.

“Australian health, nutrition and policy experts agree that reducing children’s exposure to junk food ads is an important part of tackling obesity and there is broad public support for stronger regulation of advertising to protect children,” Professor Lisa Smithers, the article’s lead author, said in a statement.

Childhood obesity -- defined as a body mass index (BMI) greater than or equal to the 95th percentile, meaning the child weighs far more than what is ideal for their height -- is an epidemic on both a national and international scale.

In 2014, 17.4 percent of American children and teenagers were obese according to the U.S. Centers for Disease Control and Prevention. Children are obese for the same reasons adults are obese, the agency says, meaning too much bad food and too little activity are the main culprits -- although certain medications, poor sleep and lack of community support also play a role.

People who are obese as children are more likely to be obese as adults, the agency added. Obesity leads to a host of well-known medical issues including heart disease, diabetes, high blood pressure, sleep apnea, arthritis, liver disease, and gall bladder disease.

To combat this rising problem, the American Academy of Pediatrics recommends a diet high in vegetables, fruits, whole grains, low-fat dairy, and lean protein. They also recommend limiting sweetened beverages like soda or juice drinks, in addition to limiting all forms of sedentary entertainment like TV and video games.

When that entertainment includes advertisements for junk food, the study authors believe there may need to be limits set on how many can run, which could even include government policy.

"The first step in establishing whether to regulate is knowing what advertising children might be exposed to," she added. "Our work has done that more comprehensively than before."

More research would be needed to determine how much impact, and at what frequency, advertisements might have on children's food choices or their parents'.

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Courtesy Rebecca Hiles(NEW YORK) -- A woman who alleges that she was misdiagnosed by doctors because of her weight is sharing her story.

Rebecca Hiles, 28, said she was told by doctors that her health problems were related to her weight. But it turns out that Hiles was suffering from cancer.

"It was very scary to sort of exists in a body that I thought was failing me and have medical professionals who didn't seem to take me seriously," Hiles said on "Good Morning America.

Hiles credits the medical team for setting her health on the right path, which ultimately lead to the shocking cancer diagnosis.

In 2012, doctors found a tumor in Hiles’ bronchial tube. Less than two weeks later, she had surgery to remove her entire left lung.

"It was the first time in my life that I remember having a doctor take me seriously," Hiles said. "The first moment that I saw my surgeon who said, 'You have carcinoid cancer' and the time that I had to surgery was two weeks."

Carcinoid tumors are a type of slow-growing cancer that can develop in several places throughout a person's body, according to the Mayo Clinic.

Six years after her surgery, Hiles said she's speaking out to enourage women to be their own health advocates.

"Had the diagnosis been made two years prior, had it been made when I was 20, maybe things would have been different," she said.

ABC News chief medical correspondent Dr. Jennifer Ashton said patients who feel they may be facing weight bias can take action.

"From the patient's side, it's really important to understand, we make a medical assessment first, visually -- what does a patient look like?" said Ashton, who is board-certified in obesity and medicine. "It is a fact being overweight or obese does carry certain risks of other things. It is also a fact that you can have more than one thing going on at the same time. So you can be overweight or obese, have a cough, have an infection and you can have lung cancer."

Ashton said that training more doctors in obesity medicine would be useful.

"Making a diagnosis is a very involved, complex process," she said. "But [patients] also need to hold their healthcare provider accountable and if they are being made to feel, 'You're not hearing me,' express your feelings. That can totally turn the table and give the patient more power."



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Sussex Police Department(LONDON) -- A British man has been jailed for life after being found guilty of deliberately trying to infect 10 men with HIV.

Prosecutors alleged that Daryll Rowe, 27, infected five men through unprotected sex, and attempted to infect several others by intentionally damaging condoms.

Rowe, who was diagnosed with HIV in 2015, met men on the gay dating app Grindr, prosecutors said.

After having sex with his partners, he would message some of the victims saying, “I have HIV. Lol. Whoops,” according to The Guardian.

Christine Henson, the judge at his sentencing, said, “The messages you sent make it crystal clear you knew exactly what you were doing. As well as the physical offenses, it is clear for the victims the psychological effects are immense."

"Many of those men were young men in their 20s at the time they had the misfortune to meet you," she said, adding, “I cannot see how and when you will no longer be a danger to gay men.”

One of Rower's victims testified during the six-week trial that he felt “pressured” into having sex with Rowe; another branded him as “grotesque” and a “sociopath.”

A third victim said Rowe had “destroyed my life. I would rather he had murdered me than left me to live my life like this.”

Rowe's lawyer pleaded with the judge for a lighter sentence, arguing that a life term would stigmatize HIV sufferers.

Henson said the sentence would not be about "stigmatizing anyone with HIV," but about the "immense" psychological effects Rowe caused his victims.

Rowe, who is 27, will serve at least 12 years of his sentence in prison. It is the first sentencing of its kind in the U.K., where a person is imprisoned for “grievous bodily harm” by intentionally infecting others with HIV.

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iStock/Thinkstock(NEW YORK) -- The key to crushing your fitness goals may come down to something as simple as changing the time of your workout.

If you want to run faster and lift heavier, research shows you should hit that snooze button and workout in the afternoon, according to Daniel Pink, author of When: The Scientific Secrets of Perfect Timing.

Morning workout benefits

If you want to lose weight, set your alarm for an early-morning workout, according to Pink, who analyzed decades of research for the book.

“There really isn't a perfect time to exercise,” he told ABC News. “It really depends on what you're trying to achieve.”

People who hit the gym for their mental health are better off exercising in the morning, according to Pink.

"One of the greatest benefits of morning exercise, at least in my view, is that exercise gives us a mood boost," he said. "We feel better."

Pink added, "That can last a long time, and if you exercise in the morning, you get that mood boost and it lasts a big chunk of the day."

Perks of an afternoon workout

On the other hand, if you want to set personal records, working out in the afternoon or early evening can help you reach your peak performance.

"Afternoon exercise seems to be better for performance overall," he said. "Lung performance is higher at that time of day, and eye-hand coordination is better that time of day. And also, speed is better."

Pink attributes that quality to the fact that our bodies are more warmed up by the middle to end of the day.

For that same reason, afternoon and evening exercise is preferred to avoid injury because, according to Pink, "you're literally more warmed up."

What an evening workout is good for

If you want to actually enjoy exercise -- and not dread it -- you can also sleep in and schedule an evening workout instead.

"Late afternoon, early-evening exercise -- people report enjoying it more at that time of day. Particularly, finding it less effortful," Pink said. "I think the reason for that is body temperature."

He continued, "We're more warmed up, and so people seem to enjoy it more and find it less of a strain."

When by Pink explains the best time to do anything, from running a marathon to asking for a raise.

No matter your goal, Pink found that motivation for exercise also comes when you are facing a life milestone, such as the end of a decade.

"Twenty-nine-year-olds are twice as likely to run a first marathon as 28-year-olds and 30-year-olds," he said. "Another age at which people are disproportionately likely to run a first marathon is 39 and also 49. It all has to do with endings."

"When we get to the end of something, even something as arbitrary as a life decade, it tends to energize us," Pink said. "We kick a little bit harder."

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Paul Morigi/Getty Images(NEW YORK) -- “Someone told me daddy is gross. He isn’t gross. He is a hero,” said the oldest daughter of Michael Verardo, a wounded veteran who is missing a limb.

Verardo lost his leg in 2010 serving as an infantryman in Afghanistan. Since then, he has undergone over 100 surgeries and years of physical and occupational therapy, according to a press release.

After hearing their daughter’s words, the Verardo family realized the need for a children’s book that could explain the wounds sustained by many veterans.

“There are many military families who struggle with explaining the complex injuries to their own children, and even more so with children who are not exposed to this life on a daily basis,” said Michael’s wife and caregiver, Sarah Verardo.

She's now the author and publisher of "Hero At Home," a children’s book that aims to normalize interactions with injured veterans, especially those with amputations.

“Our goal with this book is to be able to describe this in a way that allows these children to understand the sacrifices made by our nation’s wounded veterans and to see that they are truly heroes,” she said.

The mother of three is also the executive director of the Independence Fund, an advocacy organization for severely wounded Veterans.

One of the pillars of the Independence Fund is the mobility program, which provides all-terrain wheelchairs and adaptive bicycles to veterans “of all eras.”

The cover of "Hero at Home" features an illustration of a veteran in one of those all-terrain wheelchairs. While the book may be for children, a spokesperson says that it's educational for people of all ages.

"Hero at Home" is currently available on Amazon. The proceeds from the sale of the book will go towards the Independence Fund, according to a spokesperson.

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ABCNews.com(NEW YORK) -- A new study shows that even a mild head injury, commonly called a concussion, makes veterans more likely to get Parkinson's disease later on in life. This is the same type of injury suffered by many Americans on the sports field or in a motor vehicle crash each year.

A group of 165,000 veterans with a history of traumatic brain injury (TBI) were found to have a higher risk of Parkinson's disease, compared to other veterans of the same age.

The link between severe head injury and Parkinson's disease was already known, but the most important finding was that even mild head injuries can increase this risk. Half of the veterans in the study had only a mild head injury, and this group was 56 percent more likely to receive a Parkinson’s diagnosis than those with no TBI. The risk increased more in those with a head injury classified as severe.

"This is the highest level of evidence so far to establish that this association is a real one and something to be taken seriously," Dr. Raquel Gardner, the study’s lead author and an assistant professor of neurology at University of California, San Francisco (UCSF) and the San Francisco VA Medical Center, told ABC News.

Overall, Parkinson’s is still very rare.

"Even in our study, the vast majority of veterans who had a traumatic brain injury [more than 99 percent] did not get Parkinson’s disease. So the risk is low on the individual level," Gardner explained.

What is the link?

It may be explained by the release of a protein called “alpha-synuclein” by injured brain cells into the fluid surrounding the brain. Abnormal accumulation of this protein inside cells is a hallmark of Parkinson's disease. But there is a lot more research needed to better understand the effects of the brain injury.

“The TBI might directly trigger changes in the brain that weren’t there before. The other possibility is that maybe there was a process already happening in the brain and the person might have gotten Parkinson’s disease [anyway] many years later. But the brain injury made the symptoms come on sooner and the diagnosis come sooner,” Gardner explained. “We need more studies to unravel the biology behind what’s going on here.”

The study was published on Wednesday in the online edition of the Journal of Neurology. This study is a part of the large-scale Chronic Effects of Neurotrauma Consortium research initiative. One of the investigators is senior author Kristine Yaffe, professor in the UCSF departments of neurology, psychiatry, medicine, and epidemiology and biostatistics. The goal of the study is to understand the chronic effects of TBI -- particularly mild TBI -- in veterans, and it's a response to the high rates of mild TBI in young veterans.

“While the participants had all served in the active military, many if not most of the traumatic brain injuries had been acquired during civilian life,” Yaffe said in a press release. “As such, we believe it has important implications for the general population.”

About Parkinson's disease

Parkinson’s is a chronic, progressive brain disorder that leads to problems with balance and movement. People often develop tremors or very slow, stiff movements which eventually lead to difficulty walking or completing simple tasks. Symptoms usually develop gradually.

Researchers are still working to understand what causes Parkinson’s. It is likely a combination of genetics and changes in the brain throughout one's lifespan. Parkinson’s usually develops in adults over the age of 60. There is no cure for the disease, but therapies can slow the progression of movement symptoms. Currently available treatments are medications which affect brain signaling and a procedure called deep-brain stimulation, which involves electrodes implanted in the brain.

You can find out more about Parkinson's disease at the American Parkinson Disease Association website.

About TBI

The Centers for Disease Control and Prevention (CDC) describes a TBI as “a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury.”

TBI is gaining attention as a public health problem in the United States. They contribute to about 50,000 deaths per year, but there are also concerns for people who survive their head injury.

After a TBI, people may experience impaired memory and reasoning, abnormal sight or hearing, balance problems, or difficulty communicating. They may also have emotional changes like anxiety, depressed mood, aggression, or even social inappropriateness. When the injury is a concussion, symptoms usually disappear within six weeks. Some people experience post-concussive syndrome, which is a prolonged period of difficulty performing daily tasks due to symptoms such as headaches, dizziness, irritability, difficulty concentrating and slowed thinking.

Having more than one head injury in a short time span can be highly dangerous. Chronic Traumatic Encephalopathy (CTE), made famous in the film "Concussion," is a specific type of brain condition which may result after TBI or after many repeated minor hits to the head.

Long-term problems related to concussion are very rare, but TBI has been shown to increase a person’s risk for Alzheimer’s disease, ALS (or Lou Gehrig's disease), depression, and bipolar disorder. In most of these cases, the brain injury is probably not the only cause for the condition but is one of many factors, like genes, lifestyle habits, and age, which all act to make a person more susceptible to the associated brain changes.

Athletes and military personnel are at high risk for TBI. There is growing awareness that very young children and the elderly are frequently affected by TBI as a result of accidental falls. Motor vehicle crashes are also a leading cause of TBI.

Protecting you and your loved one from TBI

The best way to avoid the consequences of TBI is to minimize the risk of head injury in the first place.

Wear a properly fitted helmet every time you are involved in a high-risk activity. This includes riding a bike, scooter, skateboard, or all-terrain vehicle, playing a contact sport such as football or ice hockey, or any activity with the possibility of high speed falls, like skiing, rock climbing, or riding a horse.

Buckle your seat belt every time you ride in a vehicle. If you have young children, make sure their car seats are properly installed.

Family members can help senior citizens have a fall-safe home by making sure there's good lighting in hallways and stairways, using non-slip mats in the shower and bathroom, and removing potential trip hazards like rugs or electrical cords from the floor.

If you have young children around, install trip gates at the top and bottom of every stairway and make sure their playground surfaces are made of soft material.

For more information on these safety tips, see the CDC website.

And if you or a loved one does suffer a concussion, the best thing you can do for recovery is rest, rest, and more rest.

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Jennifer Williams(RED OAK, Texas) -- One selfless 6-year-old has cut his long hair for kids in need.

Daniel Williams grew his hair out for two years so another child who's experiencing hair loss due to cancer, alopecia and other disorders, can have a wig. Daniel and his family recently donated his hair to Wigs For Kids in Ohio, his mother Jenny Williams told ABC News.

Daniel, a kindergarten student, was inspired by his sister Rachel, 7, who donated nearly 18 inches of her own hair last year. Both children had their hair cut at the cosmetology department at Red Oak High School in Texas where their mom is a teacher.

"I'm really proud of them," Williams said. "Of course I have some bias as a mom, but I think they really have kind hearts and a love for people."

Marti Weimar, the cosmetology instructor at Red Oaks, was the one to cut Daniel's hair.

"When you have children who think of others before they think of themselves it makes you proud as a teacher and a mom," Weimar told ABC News.

Michael Goddard, Ph.D., superintendent of Red Oaks School District, said Daniel exemplifies the model student.

"I saw him this morning as we were walking in [to school] and we talked about what he did," Goddard said. "He's already a hero in his class."



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Christopher Furlong/Getty Images(LONDON) -- The father of a terminally-ill British baby who has been denied further treatment had a private audience with Pope Francis on Tuesday, during which he asked for help to save the child.

In a tweet by an Italian newspaper, Pope Francis is reported to have said in the meeting with Alfie Evans' father, Tom Evans, that the "only master of life is God. Our duty is to do everything to protect life."

Alfie, who is just under 2 years old, has a rare neurological condition that will continue to progress. Doctors have not been able to diagnose it.

The boy's parents, Evans and Kate James, have appealed on numerous occasions against legal decisions preventing the baby from being taken to Italy for treatment.

After hearings in London and Liverpool in February, a judge ruled that doctors at Alder Hey Children's Hospital in Liverpool, where the baby is being treated, could end life support against the wishes of his parents.

The judge, Justice Hayden, endorsed a plan submitted by doctors for withdrawing his treatment.

The Pope has previously called for the two sides to work together toward a solution to help Alfie, in the wake of protests about the decision.

The Papal audience comes two days after the Court of Appeal in London refused to overturn a decision that would allow Alfie to leave Alder Hey, where he has been treated since December 2016, and receive treatment in Rome.

Alfie's parents have lost legal battles in the Court of Appeal and the High Court, and their appeals have also been rejected by the Supreme Court and the European Court of Human Rights.

Alfie has been compared to baby Charlie Gard, who died last year in London at the age of 11 months old from a terminal mitochondrial disorder after doctors ended treatment that he had been receiving since birth.

His parents also fought a legal battle to allow Charlie to receive experimental treatment abroad, but were defeated in the courts. The case garnered widespread international attention and statements of support by both Pope Francis and U.S. President Donald Trump.

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iStock/Thinkstock(NEW YORK) -- Checking your blood pressure is a mainstay of every medical checkup. Now, there's some new medical advice on this seemingly mundane part of a wellness visit to the doctor.

So, what's the new medical advice?

Get your blood pressure checked twice, a new study advises.

Patients who had their blood pressure (BP) checked a second time at their primary care doctor’s office often have a lower number, according to a study published by the Journal of the American Medical Association this week.

The truest blood pressure reading is taken after sitting quietly for at least five minutes, and that rarely happens in a doctor’s office. Usually, a blood pressure reading is the first thing done, along with a heart rate reading.

From nervousness and stress to arm positioning and the wrong cuff size, there are several reasons for a blood pressure reading to be high initially.

If its high, here's why you should ask your doctor to check your blood pressure a second time

In the study, checking the blood pressure again, even just one minute after the initial reading, showed a drop in the systolic (top number) blood pressure of up to 17 mmHg, which is enough to change a diagnosis from hypertension to healthy. Researchers found that the higher the initial reading, the steeper the drop for the second try.

The study, which was done in a large healthcare system, MetroHealth in Cleveland, Ohio, looked at 38,000 patients who had high blood pressure and were seen approximately 80,000 times over the course of 2016 by their primary care doctors. A simple alert was placed on their chart to remind the staff or doctor to take a second blood pressure reading if the first one was high -- over 140/90 mmHg, which is the number doctors are told is the threshold to treat high blood pressure.

The second blood pressure reading, however, took 36 percent of people in the study out of the “high blood pressure” category and put them within the normal range.

One out three adults have high blood pressure in the United States

Uncontrolled high blood pressure can lead to heart attacks, strokes and kidney disease. Almost half of people seen by a primary care doctor do not have their high blood pressure controlled -- to a reading less than 130/90 mmHg -- based on the new 2017 American Heart Association and American College of Cardiology Guidelines.

A primary care office visit usually takes 15 to 20 minutes and checking a patient's blood pressure -- one of the most common reasons people see a primary care physician -- takes less than a minute. While a second check will take up another minute in an already short doctor’s visit, it's a minute well spent.

The lower reading avoids unneeded medication, decreases secondary fatal effects of hypertension and will likely decrease overall healthcare costs. When it comes to blood pressure control, getting it checked once is not enough.

This article was written by Dr. Roshini Malaney, a Cardiology Fellow at Stony Brook University Hospital who works with the ABC News Medical Unit.

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iStock/Thinkstock(HUNTINGTON, W.V.) -- More than a dozen people, including two major distributors, were arrested in a major crackdown on the opioid drug trade Tuesday in West Virginia and Michigan involving hundreds of federal, state and local law enforcement officers, officials said.

Officials targeted almost 100 people for arrest and said they believe that the takedown, dubbed Operation Saigon Sunset, will dismantle what is known as the Peterson Drug Trafficking Organization, a heroin and fentanyl distribution network based out of Huntington, W.Va., and Detroit, Mich.

“Our great country has never seen drug deaths like we’re seeing today,” Attorney General Jeff Sessions said in a statement. “Today’s charges against at least 90 defendants will help make the people of West Virginia and Michigan safer from the threat of dangerous drugs – and they bring us one step closer to ending the opioid epidemic.”

Investigators said they discovered that the Peterson organization had been in operation for almost 15 years, trafficking large quantities of heroin, fentanyl and cocaine from suppliers in Detroit to street dealers in Huntington. Leader Willie Peterson was arrested in Detroit, while his brother, Manget Peterson, was arrested in Huntington, officials said.

The other suspects targeted for arrest, which include Peterson associates and others operating within its distribution network in West Virginia and Michigan, face a myriad of narcotics, violent crime and weapons charges at the state and federal level.

Officials estimated that the amount of suspected fentanyl seized in the investigation prior to Tuesday's operation, about 450 grams, could have killed more than 250,000 people. Fentanyl is a powerful synthetic opioid sometimes mixed with cocaine or heroin for illicit use, according to the Centers for Disease Control and Prevention.

Operation Saigon Sunset, part of a broader U.S. government opioid enforcement initiative, comes as West Virginia continues to lead the U.S. in the rate of deaths due to drug overdose: 52 out of every 100,000, according to the most recent publicly-available data from the CDC. In Nebraska, the state with the lowest rate, about six people out of every 100,000 die from drug overdoses.

Mike Stuart, U.S. Attorney for the Southern District of Virginia, said Tuesday’s action is a sign that the U.S. government’s efforts against the opioid epidemic are working.

“Today is a turning point for the City of Huntington and in the war against the opiate nightmare,” he said. “We still have to do but the days of havoc, chaos and misery caused by the peddlers of illicit poisons are soon to be over.”

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Mark Wilson/Getty Images(NEW YORK) -- On Monday, the office of Senator John McCain released a statement saying he was admitted to the Mayo Clinic in Phoenix, Arizona and underwent surgery for diverticulitis.

The condition is very common in the United States and has many variations and treatment options, depending on the individual situation. The statement from McCain's medical team does not elaborate on the circumstances that led his physicians to recommend surgery, how it was performed or whether it was an emergency situation.

The treatment may be simple and uncomplicated, requiring 10 to 14 days of oral antibiotics, or it may require an extremely complex surgery with extensive rehabilitation.

Below are some answers to some common questions about diverticulitis:

What is diverticulitis?

The colon is meant to be smooth-walled. Diverticulitis is an inflammatory condition attacking a sac-like pouch protruding from the colon wall, called a diverticuli. Some believe fecal matter and bacteria can become stuck in these outpouchings, triggering an inflammatory response from the body to fight it. Others believe the inflammation and distress is caused by slow erosion of the colon wall because of the increased pressure in the diverticuli.

What causes it?

There is not a single “cause” of diverticular disease, but diet plays a large role. The low fiber, high fat, red meat diets more commonly found in the West are often the culprit. Among Western populations, approximately 50 percent of people over the age of 60 and 70 percent over the age of 80 develop diverticular disease.

In less developed countries, diverticular disease is rare -- the theory is that their diets have more fiber, which works as a preventative mechanism. Studies have shown when immigrants settle in the West and adopt Western diets, they develop diverticular disease at the same rate as others in the West. There is a rising incidence of diverticulitis in countries where there is increasing popularity of Western food.

Smoking, obesity, physical inactivity and certain medications are also risk factors for developing diverticular disease. Fortunately, only 20 percent of patients with diverticular disease will develop symptoms that needs medical treatment.

The symptoms of diverticulitis

The classic patient who has diverticulitis has acute, sudden abdominal pain, most commonly in the left lower quadrant of their belly, with nausea and/or vomiting. Fever may or may not be present. Patients may or may not have changes in bowel movements, either constipation or diarrhea.

One of the challenges with diverticulitis is that it often does not appear to be what it is. A known variant called cecal diverticulitis, which is more common in younger patients and in the developing countries, has all the symptoms of appendicitis. The pain starts and is most severe on the right, lower quadrant of the abdomen with associated nausea and/or vomiting. The inflammation may irritate the membrane that surrounds the entire gut, which results in pain that spreads all over the abdomen. If the patient develops a perforation or an abscess on the gut wall, the patient may have chills, rigors, weakness, headaches, dizziness, etc.

Diagnosing diverticulitis

For people who are younger, relatively healthy, a doctor often make the diagnosis by taking a history and performing a physical exam. They may start with antibiotics to fight the bacterial infection and see if there is improvement. Alternatively, the diagnosis can be made with imaging, most commonly a CT scan. Blood tests can suggest diverticulitis, but are not definitive in making the diagnosis.

How serious is diverticulitis?

Diverticulitis can have severe complications, most notably peritonitis, or inflammation of the organ membranes, that can progress to severe sepsis, or bacterial contamination in the rest of the body. Fortunately, this is rare.

Most patients have symptoms severe enough that they head to a doctor and the diagnosis is common enough that it is usually made on a first or subsequent visit. Diverticulitis has a wide spectrum and there are staging classification systems that health care providers may use to determine the level of severity.

Hospitalization is not always necessary. A first-time, uncomplicated case of diverticulitis usually does not require an admission to the hospital and can be treated with outpatient antibiotics, along with close follow-up with a doctor. This depends on age, other medical conditions, access to follow up, if there are complications present and an evaluation of the treating physician of whether the patient will improve as an outpatient.

Not all cases of diverticulitis need surgery, either. Depending on age, risk factors, severity of symptoms, presence of complications, and overall clinical evaluation by a health care provider, a patient may be admitted to the hospital for IV antibiotics or possibly surgery. For those who have had multiple courses of diverticulitis or had a particularly complicated course, physicians may discuss possible elective surgery as an outpatient after weighing risk and benefits.

What are the complications of diverticulitis?

The most serious complication is a large perforation of the colon wall. That would mean the inflammatory response is so severe or persistent that the colon splits, forms a hole and spills bacteria and fecal matter into the abdomen. Patients with a large perforation are usually severely ill, require an emergency surgery and often need intensive care. A large perforation is very rare.

To a much smaller degree, there can be microperforations, which may wall off into an abscess. Depending on size and severity, doctors may recommend surgery or a radiology procedure to drain the abscess and heal the colon wall. They may elect to treat with IV antibiotics if the hole is very small.

For patients who have multiple bouts of diverticulitis, chronic diverticulitis, or diverticulitis that went untreated for a long time, they may develop strictures in the colon –- a physical obstruction can cause uncontrolled vomiting and an inability to pass gas. These patients usually need a surgical procedure and a possible bowel resection.

Can diverticulitis come back?

Unfortunately, yes. It varies based on person to person, but the likelihood is high. Repeat episodes of diverticulitis are more likely to be admitted to the hospital and more likely to need surgery; however, every patient is different, and every case needs to be evaluated by a health care provider with benefits and risks weighed to determine appropriate course of treatment.

This article was written by David J. Kim, MD, a final year Emergency Medicine resident at the University of California, Los Angeles, working with the ABC News Medical Unit in New York.

Copyright © 2018, ABC Radio. All rights reserved.

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ABC(NEW YORK) -- Celebrity chef Marcus Samuelsson shared an original, seasonal salad recipe on "Good Morning America" today.

This recipe from the head chef of Red Rooster in New York City's Harlem neighborhood features deliciously complex flavors, and makes for the perfect healthy springtime lunch or dinner.

It's also one of the dishes that will be served at the fourth annual Harlem EatUp Festival, organized by Samuelsson. The festival, which takes place in May, is a celebration of Harlem's culinary, culture and art communities.

Here is his step-by-step guide for how to make the salad and its dressing at home.


Marcus Samuelsson's lemony spring chicken salad recipe

Ingredients:

2 head Raddicchio lettuce, cut in half
2 heart romaine, cut in half
Grilled Herb Chicken (recipe below)
4 spring onions, grilled and roughly chopped
4 carrots, grilled and roughly chopped
2 tbsp bulgar, cooked and drained
2 fresh radishes, quartered
1/2 avocado, roughly chopped
4 tbsp cilantro, chopped
4 tbsp parsley, chopped
3 oz lemon dressing (recipe below)

Method:

1. In a large bowl, combine raddicchio lettuce, romaine lettuce, bulgur, radishes and toss with lemon dressing to coat.
2. Add avocado and top with grilled herb chicken, spring onions, and carrots.


Grilled herb chicken recipe

Ingredients:

1 whole chicken, cut into eighths
1/4 cup parsley, chopped
2 tbsp cilantro, chopped
2 tbsp green onion, sliced
1 tsp garlic, chopped
2/3 cup olive oil
2 tbsp lemon juice
1 tsp of salt
1 tsp black pepper
1 tsp chili flake

To toss chicken after it’s cooked:
2 cups mole verde (recipe below)

Method:

Combine all marinade ingredients and place in a one-gallon freezer bag.

Add the chicken pieces and massage the marinade into the pieces. Place the bag in a bowl or on a plate in the fridge and let marinade at least two hours and up to overnight.

Heat a grill or grill pan over moderate high heat. Cook thighs for 5 to 10 minutes per side, and the legs, breast, and wings for 5-7 min per side until completely cooked through.

Allow chicken to rest for 10 minutes.

In a large bowl, add mole verde sauce and grilled chicken. Toss to coat.


Mole verde recipe

Ingredients:

1/4 cup sesame seeds
1/4 cup pumpkin seeds
2 teaspoon Cumin seeds
1 teaspoon dried oregano
1/2 cup olive oil
3 poblano peppers (or green bell peppers if cannot find)
6 cloves of garlic
1 red onion
2 jalapeno peppers
1 cup chicken stock
1 bunch Mint
1 bunch Watercress
2 bunches Cilantro
1 bunch Spinach
1 avocado
2 limes, juiced
2 teaspoon salt

Method:

Blister poblano peppers, onions, and jalapeno peppers on a hot grill (or grill pan) until blackened.

Place in a bowl and cover with plastic wrap for five minutes. Peel off the skin and roughly chop.

Add the herbs and spinach to the grill pan and char for 1-2 minutes until wilted and charred. Remove from heat and roughly chop.

In a medium pan, toast cumin, oregano, sesame seeds and pumpkin seeds for 3 minutes. Remove from heat.

In a large saucepan, heat chicken stock until just beginning to simmer.

Add to a high powered blender with the charred peppers, garlic, and toasted spice mixture. Puree until smooth.

Add herbs and greens, avocado, and olive oil and puree again until smooth.

Finish with lime juice and salt to taste


Lemon Caesar dressing recipe

Ingredients:


2 egg yolks
1 cloves garlic, minced
1 tsp anchovy paste
2 tsp parmesan cheese, grated
2 tsp Dijon mustard
1 tsp Worcestershire sauce
1 tbsp lemon juice
1 tsp course black pepper
2/3 cup canola oil
1/3 cup olive oil

Method:

Puree all ingredients except for the oils in a blender. With the motor running, slowly drizzle in the oils until incorporated.


Bulgar recipe

Ingredients:


1 cup bulgar wheat
2 cups water
1/2 tsp salt

Method:

Bring water to a boil.

Add bulgar and salt.

Cover and turn the heat down.

Simmer for 10 minutes, or until all water is absorbed.

Remove from heat and serve.

Recipe courtesy of Marcus Samuelsson.
Copyright © 2018, ABC Radio. All rights reserved.

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iStock/Thinkstock(NEW YORK) --Dr. Whitney Bowe, the author of "The Beauty of Dirty Skin," shared with "Good Morning America" her top tips for clear skin from her new book. Here, the medical director of integrative dermatology, aesthetics and wellness at Advanced Dermatology, P.C., breaks down how you might be washing your skin wrong, and gives her expert recommendations for what you can do to revamp your skincare routine.

Too much of a good thing? Yep, the adage applies to beauty, too.

Over-cleansing, believe it or not, is the No. 1 skin care mistake people make on a regular basis. Our antiseptic-style hygiene practices -- extreme cleansing, sanitizing and scrubbing to feel squeaky clean -- harm skin by stripping away its natural oils, confusing its equilibrium and upsetting its sensitive microbial balance. And all of this contributes to the many skin disorders that are so prevalent today.

We rarely think about this, so brace yourself, but our skin serves as a veritable petri dish for a wide range of microorganisms -- which I like to call a rainforest of bugs -- with upward of 1 million of these bugs occupying a single square centimeter. The vast majority of these microbes are either innocuous or advantageous. Some benefit us simply by taking up space and making it impossible for bad guys to move in. Others release antimicrobial substances to kill off pathogens. And then there are those that produce anti-inflammatory compounds to protect and preserve the skin’s barrier and microbiome.

Our skin’s good bugs face a steady barrage of daily threats -- ultraviolet rays, pollution, antibiotic overuse and yes, seemingly benign skin care products. All of these things can breed inflammation, and endanger both the skin’s bacterial inhabitants—their integral diversity and abundance, in particular—and the skin’s protective barrier.

Studies show that even frequent hand-washing can disturb the skin barrier, sparking irritation and unwanted changes in the local microflora. The bottom line? Gentle cleansing is an imperative part of safeguarding your skin’s barrier, microbiome and the special relationship they share.

Here are my top three tips on how to get it right every time:

1. Do choose a biome-friendly cleanser

Leading microbiome researchers use the term “impoverished” to describe microbial communities that lack healthy numbers and diversity. And repeatedly using the wrong cleanser can contribute to this bacterial bankruptcy by dissolving the natural oils fat-friendly bacteria rely on for nourishment and wiping out good bugs altogether. On the heels of such an assault, the skin’s microbiome snaps into survival mode to restore itself. During this hours-long process, the microbiome is essentially absent, leaving skin vulnerable to colonization by undesirable bugs -- E. coli from stairwell banisters or Staphylococcus aureus from elevator buttons. To keep your community vibrant and varied, choose a gentle, low-foam, pH-balanced, soap-free cleanser that leaves skin hydrated, not taut.

2. Don't sanitize your skin


Your washing machine likely has a “sanitize” cycle designed to kill germs by agitating them in sudsy 150-degree water. Please don’t apply this logic to your face. While we don’t yet know the exact water temperature our skin bugs like best, err on the cool side to conserve the microbiome, as excessive heat may cause bad bacteria to proliferate.

3. Don't enlist cleansing aids


Loofahs, Buf-Pufs, washcloths, gritty scrubs, scratchy mitts, cleansing brushes -- dump them all. Your own two hands are the only tools you need to emulsify, massage in and splash off a gentle cleanser. Use anything else, and you run the risk of damaging your barrier and modifying your microbiome in deleterious ways.

I know that this is such a new way of thinking in our culture, which has been obsessed with sanitizing and squeaky-clean cleansing. But, if you want healthy, glowing skin, it’s time to make these changes. You will see results and your skin will thank you!

For more tips from Dr. Bowe, visit her Facebook or Instagram.Copyright © 2018, ABC Radio. All rights reserved.

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iStock/Thinkstock(NEW YORK) -- How do you take your caffeine? Caffeine is a stimulant that has been linked to improving how your brain functions. No wonder it is one of the most widely used drugs on the planet. The most common forms of caffeinated beverages include coffee, tea and energy drinks. New research in the Journal of the American College of Cardiology suggests that caffeine is not harmful to the heart, as it has previously been suggested, and may actually be good for it.

Caffeine works by adding more energy to the inside of your cells. Because caffeine is known to make the heart beat faster, many people believe that it can be damaging to the heart’s electrical system. In fact, greater than 80 percent of doctors in the U.S. recommend against caffeine consumption in patients with known abnormal heart rhythms. Many feel the faster heart rate makes your heart more vulnerable to entry into life-threatening rhythms.

On the other hand, caffeine has also been described as an antioxidant. Antioxidants neutralize the negative waste products of your cells’ day-to-day activities and are believed to preserve the long-term health of your cells and tissues. Some scientists believe that caffeine protects the longevity of the heart muscle itself.

Heart doctors do not have great evidence that caffeine causes abnormal heart rhythms. The current recommendations against caffeine are conservative and mostly based on assumptions of how the body works. A new article in the Journal of the American College of Cardiology compiles the data from multiple studies to add scientific data to the debate on caffeine.

On to the results: Multiple studies associate regular coffee drinkers with lower amounts of new-onset atrial fibrillation, commonly known as “a. fib.” Atrial fibrillation is a very common, irregular heart rhythm that increases your risk of stroke. Approximately 9 percent of Americans older than 65 years old have this abnormal rhythm, according to the U.S. Centers for Disease Control and Prevention. Treatment typically includes medications to control your heart rate and potentially blood thinners.

Researchers in this article discuss other types of abnormal rhythms including supraventricular tachycardia (SVT) and ventricular fibrillation (“v. fib”). There were no studies that found an association between caffeine and these rhythms, even in patients who already had sick hearts from heart attacks or heart failure.

While this information may be exciting to our “low fat, half sugar, extra hot” regulars, it is very important to note that some patients with atrial fibrillation have a negative relationship with caffeine. In 25 percent of people who already have the diagnosis of atrial fibrillation, caffeine can actually a trigger an episode of the abnormal rhythm. As always, it’s important to consult your doctor before making any changes.

So here’s the good news.

The authors do not think caffeine causes most abnormal heart rhythms. In fact, they suggest that regular coffee use actually protects patients from atrial fibrillation. Based on data in some animal trials, however, they do recommend a maximum of 300 mg of caffeine per day. This is the equivalent of about three cups of coffee.

If coffee or tea is your drug of choice, you are in luck. If it’s an energy drink, not so much. While coffee and tea seem to be fairly safe, the research suggests that most energy drinks are slightly more risky. Unfortunately for some of our readers, multiple studies recommend against energy drink consumption. Researchers suggest that these drinks may cause life-threatening rhythms and even blood clots. On top of high amounts of caffeine, they often have other ingredients like guarana, sugar and ginseng. These additives seem to amplify the body’s response to the stimulant, causing more harmful side effects including abnormal heart rhythms.

This article was written by Laura Shopp, MD, a third-year pediatrics resident affiliated with Indiana University. Shopp works in the ABC News Medical Unit.

Copyright © 2018, ABC Radio. All rights reserved.

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