Page 16 - Boca Club News - September '24

Page 16, Boca Club News
Medical Matters: Viral Hepatitis

By Richard Nagler, M.D., a member The virus is often contracted by individuals traveling raw shellfish polluted with sewage, sharing of needles and
of Broken Sound Club and retired to areas where there is poor sanitation, particularly in syringes, medical instruments not properly sterilized, and
physician. After graduating from Mexico, Central America and South America. It is seen IV drug paraphernalia, exposure to human blood and travel
the University of Pennsylvania frequently in the gay community and among drug addicts. to areas with high infection rates such as Asia, Africa and
and New York University’s School Interestingly, persons infected with hepatitis A cannot be eastern Europe. Pregnant women who are infected often
of Medicine, Dr. Nagler served infected again as they become immune to the virus. pass the virus to their babies during childbirth.
his internship and residency at In mild cases there may be no symptoms. However, in People who have chronic hepatitis B who are
Baltimore City Hospital and Johns more severe cases fatigue, nausea and vomiting, pain on immunocompromised from corticosteroids or
Hopkins. He followed that with a the right side of the abdomen, anorexia, itching, fever, dark chemotherapy are prone to reactivation of the virus, which
Fellowship in Gastroenterology at Yale University School urine, clay-colored stools and jaundice all may occur. – By can cause severe liver damage and liver failure.
of Medicine, and was then Chief of Gastroenterology the end of six months these symptoms will spontaneously Some people, especially children, may have no
at Fitzimmons General Army Hospital in Denver. He abate and there will be no evidence of chronic liver disease. symptoms of the disease. Or symptoms can appear from
returned to the Yale Medical School for one year as an The diagnosis is made by a blood test for hepatitis 1 to 4 months after exposure and may be mild to severe.
Assistant Professor of Medicine before opening his own A antibodies and abnormal liver enzymes. There is no Fever, weakness, abdominal pain, dark urine, joint pain,
successful private practice in Internal Medicine and specific treatment indicated. Alcohol should be avoided, anorexia, nausea and vomiting and jaundice are typical.
Gastroenterology. During that time, he also served for and adequate hydration maintained. Antibiotics are useless. Diagnosis is made with a triple panel blood test
ten years as Chief of Medicine at Huntington Hospital in Preventive measures are strongly advised: washing including HBsAg, anti -HBs and anti -HBc, a liver
Huntington, N.Y. hands thoroughly with soap and water, avoiding drinking ultrasound, CT scan and a needle liver biopsy. Screening
There are three important different strains of hepatitis untreated water and eating raw or undercooked shellfish, for hepatitis B should be performed in pregnant women,
viruses—A, B and C—which cause inflammation of the especially clams and oysters. people with many sexual partners, those who have had
liver. In this column I will discuss both A and B, and in a There is an effective vaccine for hepatitis A. It should sex with someone known to have the disease, have HIV
subsequent column hepatitis C. be administered to anyone who is at risk of exposure to the or hepatitis C, are on kidney dialysis, use illegal injected
Hepatitis A is a commonly transmitted food- and water- hepatitis A virus. Two doses are required six months apart. drugs, or are in prison.
borne illness caused by fecal contamination. It is highly In addition, injections of immune globulin are indicated There is no cure for acute hepatitis B infection, but most
contagious, spreading from person to person. It is most and effective in preventing disease upon known exposure, infected people will recover fully with no complications
often mild and highly unlikely to cause any long-term but provide no lasting benefit. after six months. However, an injection of immunoglobulin
damage to the liver. Hepatitis B. This is an infection of the liver caused within 24 hours of exposure can prevent many of the
by the hepatitis B virus. Like hepatitis A it can be a mild symptoms of the disease; but this offers only short-term
disease with complete recovery within six months, but protection. Rest, good nutrition and adequate hydration are
in some cases, especially when contracted in children, it useful measures. Anti-viral medications are recommended
may lead to chronic infection with severe liver damage for severe symptoms and can help prevent complications.
and even liver failure, cirrhosis and liver cancer. There is a very effective hepatitis vaccine available
Chronic infection may exist for many years without that is administered in three doses–the second shot after
detection, being discovered only when the person infected one month and the third four months later which is good
becomes seriously ill. There are 2.4 million people in the for life. It is recommended for all newborns, children up
U.S. who have the disease, but only 25% are diagnosed. to age 18, adults 19 to 59 years of age and adults over 60
There are 20,000 new cases annually, but it is estimated who are at risk for infection.
that a million people are living with the disease and there For chronic hepatitis B, treatment is strongly advised.
are thousands of deaths each year. Antivirals can fight the virus and slow down liver damage.
The virus is passed through exposure to blood, semen Adding interferon can be helpful. If advanced cirrhosis and
or other bodily fluids as a result of: unprotected sex with liver failure ensues, the only option is to perform a liver
an infected person, food washed in contaminated water, transplant.
Legal: New Residential

Real Estate Commission Rules

By Michael J Posner, Esq., is a now means that Buyers will have to spend an additional
partner in Ward Damon a mid- $7,500 to buy that same house based on a Buyer’s Agent
sized real estate and business- commission of 2.5 percent. This will further stress many
oriented law firm serving all of Buyers who struggle to even come up with the 3 percent
South Florida, with offices in Palm down payment minimum (let alone the traditional 20
Beach County. They can be reached percent down payment).
at (561)594-1452, or at mjposner@ Alternatively, the Seller could simply price the real
warddamon.com. estate at $292,308 to net the same $285,000. This lower
As a result of various cases price may attract more Buyers and may also be the
Captain’s was established in 1980 servicing against the National Association of Realtors and several difference between a Buyer qualifying for a mortgage or
Palm Beach County and is a privately large real estate companies, the industry is facing a not qualifying. Sellers will always retain the right to pay
owned and managed company. widespread change in how residential Sellers, Buyers and the Cooperating Agent, but many will choose not to do
Captain’s is committed to providing Realtors will interact and get paid. This process started in so, so as to maximize the net proceeds on sale.
dependable, reliable and professional August and will change the real estate sales landscape. Buyers will have bargaining power to avoid paying
ground transportation to and from all
South Florida Airports and Seaports. PBCVH212 Traditionally, a Seller would hire a real estate agent, a high real estate commission to a Cooperating Agent.
To reserve your vehicle: commonly referred to as the Listing Agent, to market and Buyers will have to shop around and choose the best
561-798-2180 or 800-634-7890 www.captainsairport.com sell their property in exchange for a commission (usually Realtor for the lowest price. This could result in
5 – 6 % of the sales price). To entice other real estate agents commissions falling from 2.5 – 3 percent to 1 to 2 percent
from other real estate brokerage firms to bring Buyers to based on what level of service is provided. Some agents
Southern Exposure Technologies purchase the real estate, the listing agent would list the with savvy clients may simply offer a flat fee service,
Computer Install/Setup/Repair real estate in the local multiple listing service database providing Buyers with certain purchase tools, but having
the Buyer do far more of the leg work when house shopping
and offer to pay the Buyer’s agent, commonly referred to
(561) 315-0144 as the Cooperating Agent, a commission equal to one-half and touring. Conversely, it is expected that Sellers will
getsetgo.annie@gmail.com the commission being paid by the Seller. also expect lower commission rates with many in the
* DSL, Broadband,Wireless Install The end result is that traditionally the Seller paid both industry expecting the listing agent commission to fall to
* Networking, Troubleshooting their own agent and the agent helping the Buyer purchase two percent.
* Instruction the real estate. This meant that the Buyer did not pay One result of these changes is that mediocre agents
* Hardware/Software Installation anything for the services of the Cooperating Agent who who made only a few sales a year at 2.5 – 3 percent will
* Virus/Spyware/Adware Fix presented the real estate to the Buyer and assisted the most likely quit the business when they can only make
* Cleanup/Maintenance/Backup
* Business Consult/Startup/Move Buyer with the Contract through the closing. 1 – 2 percent on each sale. Another change will be the
* Website Design/Maintenance Under the new rules, the commission structure will be relationship between Buyers and the Cooperating Agent.
Call S.E.T. to install your “new computer, printer changed, with the Seller and Buyer each making their own For the first time Buyers will enter into commission
and wireless network”! deals with the agents that they hire. Sellers will likely pay agreements with the Cooperating Agent, setting forth the
GET S.E.T. GO! a 2 – 3% commission to the listing agent. Buyers will now agreed commission to be paid to the Agent at closing,
REASONABLE HOURLY, WEEKLY, MONTHLY RATES have to pay the Cooperating Agent, who will no longer be agreements that will have to be signed before the first
FOR SMALL BUSINESSES FOR AS LOW AS $50.00 AN HOUR, paid by the Seller through the Listing Agent. This means house is toured.
WITH A MINIMUM OF 6 HOURS A MONTH, the cost to buy a home for Buyers will increase unless These new rules must be properly explained to Sellers
OR 2 HOURS A WEEK, OR ON AN AS-NEEDED
BASIS RATE OF $75.00 P/HOUR. Sellers agree to reduce the sale price as a result of the and Buyers so as to educate them on their options. Agents
START YOUR NEW YEAR WITH SECURE BACKUPS, reduced commission payment. who fail to comply could face disciplinary issues or
QUALITY MAINTENANCE, ATTENTION TO DETAIL AND For example, a home traditionally listed at $300,000 lawsuits from disgruntled customers. It will be interesting
PERSONABLE ON-SITE SUPPORT! with a 5 percent commission would net the Seller how the market and the Sellers and Buyers of real estate
(561) 315-0144
CALL S.E.T. TODAY FOR YOUR COMPUTER NEEDS! $285,000. With a reduced commission of 2.5 percent, respond to these changes and the fallout from the new
a Seller would now net $292,500 or $7,500 more. This commission regimen.