Archive | July 2016

Aren’t dogs amazing!

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Dogs are more than great pets, they aid in our health!

Goldsmiths College released a study that showed more dogs will approach someone who’s crying or in distress than someone who is not. This shows that dogs are empathetic and are eager to help comfort humans in pain.

Their sense of smell can do even more than we think; dogs can also detect low blood sugar in their master. They will either alert the person that the sugar has dropped or, if a diabetic attack has already occurred, will bark and bark and bark in an attempt to alert somebody to come help, thus working to save the diabetic’s life.

Some dogs are also able to detect seizures in humans. Recent research has shown certain dogs are able to warn seizure patients that they’re going to experience an attack, sometimes hours before it happens. Nobody yet knows how they do it, or why only certain dogs can do it. They also can’t be trained to do it, so if you feel you need a seizure-sniffing dog, you need to make sure you have yourself a natural.

Due to their incredible sense of smell, dogs have shown anywhere from 70 to 99% accuracy (depending on the study) when tasked with detecting lung cancer in a nearby patient.

Fibromyalgia is a debilitating disease that can leave its victim in constant pain. Studies have shown that the Xolo dog’s body temperature can be used as a kind of therapeutic heating pad, due to it being a hairless species. Of course, unlike heating pads, a Xolo will bond with you, snuggle with you and keep you warm as long as you need, leading to both external comfort and internal happiness.

In a surprising twist, it might actually be beneficial to get a dog for your baby, even if they’re allergic. Studies have shown that children under the age of one who live with a dog are much less likely to develop the chronic, and annoying, skin condition called eczema.

Dogs can highly make humans more social. The British Medical Journal has concluded that dogs act as “social catalysts,” who help people get out more, approach others more easily, and overall reduce isolation. This is actually just as important as the basic companionship that dogs provide, as human social support is beneficial to human health and the dog.

Simply by being themselves, dogs have been shown to help reduce PTSD among soldiers. In addition to providing the usual doggie companionship, they have been shown to help sufferers come out of their shells, be less numb and angry, and improve their social life as well.

A dog kissing you obviously feels wonderful, but it might actually have physical benefits too. Studies have shown that saliva, both the human and doggie variety, can help stimulate nerves and muscles, and get oxygen moving again, which is the secret ingredient in helping wounds to heal. In short, “licking your wounds” is not just a cliché after all.

Almost certainly due to the positive vibes and good feelings that dogs bring out of their masters, even in the worst of times, studies have found that older people who own dogs average at least one less doctor appointment per year than those who do not.

Not that they are the cure but preliminary studies by the American Heart Association are revealing that dog owners have less risk of heart disease than those without dogs. The reasons given are the exercise that owners get when walking their dogs, plus the presence of the dog helps the owner deal with stress better. The evidence is mostly anecdotal right now, but dog owners know that it’s all true.

Day-to-day depression, or even more serious chronic depression, is easier to handle with the love of a dog, studies show. Simply by having them around, and knowing that even at our worst, somebody loves us unconditionally and is eager to see us happy again, we’re given a reason to get up and keep going.

Autistic children often find the world very stressful, in ways that the non-autistic can’t understand. Luckily, a dog can. Studies are showing that bringing a therapy dog into an autistic household helps to reduce the amount of cortisol (a stress hormone) in the autistic child’s body. This both calms the child down and shows him that he has a friend.

Bullying has been a huge problem for a long time, and people are finally doing something about it. Dogs, too. Experimental programs have been launched that bring dogs into schools to promote empathy, with the lesson that you shouldn’t treat people badly, because you wouldn’t do it to a dog. Thus far, kids have been able to make the connection, which will hopefully continue to be the case.

Dogs have shown that they can help keep dementia sufferers on schedule, reminding them when its time for medicine and when to see the doctor. In addition, when the owner experiences frustration over the state of their mind, the “dementia dog” is right there to support them, comfort them, and remind them that someone’s always there for them.

AREN’T DOGS AMAZING!!

 

QUOTE FOR FRIDAY:

Treatment for Cushing’s syndrome depends on its cause. Surgery may be needed to remove the tumor or the pituitary or adrenal glands. Other treatment may include radiation, chemotherapy, and use of certain hormone-inhibiting drugs.

John Hopkins Medicine

 

Ablation, a great resolution created for certain arrhythmias.

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Ablation is used to treat abnormal heart rhythms, or arrhythmias. The type of arrhythmia and the presence of other heart disease will determine whether ablation can be performed surgically or non-surgically.

Ablation therapy using radio frequency waves on the heart is used to cure a variety of cardiac arrhythmiae such as supraventricular tachycardia, Wolff–Parkinson–White syndrome (WPW), ventricular tachycardia, and more recently as management of atrial fibrillation (especially when its newly diagnosed when medical management can’t change it back to normal sinus rhythm, which is the normal cardiac rhythm seen on a telemetry monitor or of an EKG taken on a patient).

An arrhythmia is a change in the heart’s normal rate or rhythm, normally between 60 and 100 beats per minute. Arrhythmias are classified by their location in the heart and by their speed or rhythm. An atrial arrhythmia is an abnormality that occurs in one of the two upper chambers of the heart, the left or right atrium. Arrhythmias are associated with aging and typically happen more frequently during middle age. At least 10 to 15 percent of people older than 70 years experience arrhythmias.  We have what we call our human pacemaker of the heart that naturally sends conduction for the heart to pump, which is called the sinus node.  This is in the upper left corner of the right chamber of the heart.  That is where the name sinus rhythm derives from (the sinus node) which is the best rhythm a human can be in as long as the pulse rate stays above 60 and stays under 100. Now if that sinus node for some reason breaks down and no longer works; so than the pace site starts somewhere in the right atrium below the sinus node (the heart is compensating for whatever is the reason the sinus node is not working).  So now the rhythms are called atrial rhythms because of where the new natural pacemaker site is in the heart.  This is where ablation comes into play if the type of atrial rhythm they have is detrimental to the patient; including if that patient is a candidate for this procedure.  Between our heart chambers on the top (called atriums) and below (called the ventricles) is a AV (meaning atrioventricular valve).  Rhythms above the ventricles are also grouped as supraventricular rhythms.  Which is what ablation is used for.

Types of rhythms a patient would be considered for ablation as a possible treatment:

Atrial fibrillation. The electrical signal that circles uncoordinated through the muscles of the atria (the upper chambers of the heart), causing them to quiver (sometimes more than 400 times per minute) without contracting. The ventricles (the lower chambers of the heart) do not receive regular impulses and contract out of rhythm, and the heartbeat becomes uncontrolled and irregular. It is the most common atrial arrhythmia, and 85 percent of people who experience it are older than 65 years.

Atrial fibrillation can cause a blood clot to form, which can enter the bloodstream and trigger a stroke. Underlying heart disease or hypertension increases the risk of stroke from atrial fibrillation as does age even without heart disease or hypertension.

Premature atrial contraction (PAC or premature atrial impulses). A common and benign arrhythmia, a PAC is a heartbeat that originates away from the sinus node, which sends electrical signals through the upper chamber. It typically occurs after the sinus node has initiated one heartbeat and before the next regular sinus discharge. A PAC can cause a feeling of a skipped heartbeat. Use of caffeine, tobacco, and/or alcohol, or stress can bring on PACs or increase their frequency.

Supraventricular tachycardia (SVT). Characterized by a rapid heart rate that ranges between 100 and 240 beats per minute, SVT usually begins and ends suddenly. SVT occurs when an electrical impulse ‘re-enters’ the atrial muscles. A disorder that a person may have at birth, SVT is commonly caused by a variation in the electrical system of the heart. SVT often begins in childhood or adolescence and can be triggered by exercise, alcohol, or caffeine. SVT is rarely dangerous, but can cause a drop in blood pressure, causing lightheadedness or near-fainting episodes, and, rarely, fainting episodes.

Atrial flutter. Differentiated from atrial fibrillation by its coordinated, regular pattern, atrial flutter is a coordinated rapid beating of the atria. Most who experience atrial flutter are 60 years and older and have some heart disorder, such as heart valve problems or a thickening of the heart muscle. Atrial flutter is classified into two types, according to the pathways responsible for it. Type I normally causes the heart rate to increase to and remain at 150 beats per minute. Rarely, the rate may reach 300 beats per minute; sometimes it decreases to 75 beats per minute. Type II increases the atrial rate faster, so the ventricular rate may be 160 to 170 beats per minute. As with atrial fibrillation, atrial flutter increases the risk of stroke.

Sick sinus syndrome (SSS). Common among older people, SSS is an improper firing of electrical impulses caused by disease or scarring in the sinus or Sinoatrial node (SA node). SSS normally causes the heart rate to slow, but sometimes it alternates between abnormally slow and fast. A progressive condition, with episodes increasing in frequency and duration, SSS can be caused by:

  • Degeneration of the heart’s electrical system; or
  • Diseases of the atrial muscle.                                                                                                                                                                                                                                                                                                                                                                                         Sinus tachycardia. The sinus node emits abnormally fast electrical signals, which increases the heart rate to between 100 beats per minute to 140 beats per minute at rest, and 200 beats per minute during exercise. A normal response to exercise or stress, it can also be caused by:
  • Adrenaline;
  • Consumption of caffeine, nicotine, or alcohol; and
  • Heart conditions.                                                                                                                                                                                                                                                                                                                                                                                   Wolff-Parkinson-White syndrome (WPW). WPW syndrome occurs when electrical signals fail to pause in the atrioventricular node because an extra pathway allows the impulse to “bypass” the normal pathway; and the syndrome is sometimes called bypass tract. WPW syndrome causes heart rates approaching 240 beats per minute.
  • Occasionally, impulses can go down one extra pathway and up another, creating a “loop” or “short circuit,” (called SVT because of WPW). Patients with WPW syndrome may develop atrial fibrillation and are at increased risk for developing a dangerous ventricular arrhythmia when this occurs. *                                                                                                                                                                                                   Sinus bradycardia. Associated with impaired impulse generation in the SA node, it causes the heart rate to decrease to fewer than 60 beats per minute. Commonly caused by SSS, drugs like beta-blockers and calcium-channel blockers can also cause sinus bradycardia. Occasionally sinus bradycardia can be caused by impaired conduction of impulses to the atrial muscles.

Part II Cushing’s Syndrome Treatments

cushing's diagnosing  cushing's medical treatment

 

 Treatment of Cushings Syndrome:

 Treatment of cushings syndrome is by castigation of the under lying cause. Treatments for Cushing’s syndrome are contrived to pass your body’s cortisol production to normal. By indurate, or even distinctly lowering cortisol levels, you’ll feel evident improvements in your signs and symptoms. Left untreated, however, Cushing’s syndrome can finally induce to death. The treatment choice depend on the cause. For example:

*If a tumour in an adrenal gland is the reason, an operation to withdraw it will cure the condition.

*For adrenal hyperplasia, both adrenal glands may require to be withdraw. You will then require to take lifelong replacement therapy of several adrenal hormones.

*Other tumours in the body that produce ‘ectopic’ ACTH may be able to be removed, depending on the kind of tumour, where it is, etc.

*Medication to block the production or consequence of cortisol may be a choice.

 Ending line treatments for Cushing syndrome are designed to lower the high level of cortisol in your body. The best treatment for you depends on the cause of the syndrome. Treatment options include:

  • Reducing corticosteroid use. If the cause of Cushing syndrome is long-term use of corticosteroid medications, your doctor may be able to keep your Cushing signs and symptoms under control by reducing the dosage of the drug over a period of time, while still adequately managing your asthma, arthritis or other condition. For many of these medical problems, your doctor can prescribe noncorticosteroid drugs, which will allow him or her to reduce the dosage or eliminate the use of corticosteroids altogether.

Don’t reduce the dose of corticosteroid drugs or stop taking them on your own. Do so only under your doctor’s supervision.

Abruptly discontinuing these medications could lead to deficient cortisol levels. Slowly tapering off corticosteroid drugs allows your body to resume normal cortisol production.

  • Surgery. If the cause of Cushing syndrome is a tumor, your doctor may recommend complete surgical removal. Pituitary tumors are typically removed by a neurosurgeon, who may perform the procedure through your nose. If a tumor is present in the adrenal glands, lungs or pancreas, the surgeon can remove it through a standard operation or in some cases by using minimally invasive surgical techniques, with smaller incisions.

After the operation, you’ll need to take cortisol replacement medications to provide your body with the correct amount of cortisol. In most cases, you’ll eventually experience a return of normal adrenal hormone production, and your doctor can taper off the replacement drugs.

However, this process can take up to a year or longer. In some instances, people with Cushing syndrome never experience a resumption of normal adrenal function; they then need lifelong replacement therapy.

  • Radiation therapy. If the surgeon can’t totally remove a pituitary tumor, he or she will usually prescribe radiation therapy to be used in conjunction with the operation. Additionally, radiation may be used for people who aren’t suitable candidates for surgery.

Radiation can be given in small doses over a six-week period, or with a technique called stereotactic radiosurgery (Gamma Knife surgery). In the latter procedure, administered as a single treatment, a large dose of radiation is delivered to the tumor, and the radiation exposure to surrounding tissues is minimized.

  • Medications. Medications can be used to control cortisol production when surgery and radiation don’t work. Medications may also be used before surgery in people who have become very sick with Cushing syndrome. Doctors may recommend drug therapy before surgery to improve signs and symptoms and minimize surgical risk.

Medications to control excessive production of cortisol at the adrenal gland include ketoconazole (Nizoral), mitotane (Lysodren) and metyrapone (Metopirone).

Mifepristone (Korlym) is approved for people with Cushing syndrome who have type 2 diabetes or glucose intolerance. Mifepristone does not decrease cortisol production, but it blocks the effect of cortisol on your tissues.

Side effects from these medications may include fatigue, nausea, vomiting, headaches, muscle aches, high blood pressure, low potassium and swelling. Some have more serious side effects, such as neurological side effects and liver toxicity.

The newest medication for Cushing’s is pasireotide (Signifor), and it works by decreasing ACTH production from a pituitary tumor. This medication is given as an injection twice daily. It’s recommended if pituitary surgery is unsuccessful or cannot be done.

Side effects are fairly common, and may include diarrhea, nausea, high blood sugar, headache, abdominal pain and fatigue.

In some cases, the tumor or its treatment will cause other hormones produced by the pituitary or adrenal gland to become deficient and your doctor will recommend hormone replacement medications.

If none of these treatment options are appropriate or effective, your doctor may recommend surgical removal of your adrenal glands (bilateral adrenalectomy). This procedure will cure excess production of cortisol, but will require lifelong replacement medications.

Complications are rare but include:

Bruising on your thigh

Ear pain during the procedure

Very rarely, neurological problems

QUOTE FOR THURSDAY:

“Cushing’s syndrome is a hormonal disorder caused by prolonged exposure of the body’s tissues to high levels of the hormone cortisol.”

NIH National Institute of Diabetes and Digestive and Kidney Diseases (U.S. Department of Health and Human Services)

QUOTE FOR WEDNESDAY:

“The Centers for Disease Control and Prevention estimates that 294,000 children in the United States have been diagnosed with arthritis and other rheumatic conditions.”

CDC Centers for disease and control

July Awareness to Juvenile Arthritis

                                                

                                                JIA

 

                                               JIA

                           JIA3

Juvenile arthritis (JA) is not a disease in itself. Also known as pediatric rheumatic disease, JA is an umbrella term used to describe the many autoimmune and inflammatory conditions or pediatric rheumatic diseases that can develop in children under the age of 16. Juvenile arthritis affects nearly 300,000 children in the United States.

Although the various types of juvenile arthritis share many common symptoms, like pain, joint swelling, redness and warmth, each type of JA is distinct and has its own special concerns and symptoms

Types of Juvenile Arthritis

  • Juvenile idiopathic arthritis (JIA). Considered the most common form of arthritis, JIA includes six subtypes: oligoarthritis, polyarthritis, systemic, enthesitis-related, juvenile psoriatic arthritis or undifferentiated.
  • Juvenile dermatomyositis. An inflammatory disease, juvenile dermatomyositis causes muscle weakness and a skin rash on the eyelids and knuckles. 
  • Juvenile lupus. Lupus is an autoimmune disease. The most common form is systemic lupus erythematosus, or SLE. Lupus can affect the joints, skin, kidneys, blood and other areas of the body. 
  • Juvenile scleroderma. Scleroderma, which literally means “hard skin,” describes a group of conditions that causes the skin to tighten and harden.
  • Kawasaki disease. This disease causes blood-vessel inflammation that can lead to heart complications. 
  • Mixed connective tissue disease. This disease may include features of arthritis, lupus dermatomyositis and scleroderma, and is associated with very high levels of a particular antinuclear antibody called anti-RNP. 
  • Fibromyalgia. This chronic pain syndrome is an arthritis-related condition, which can cause stiffness and aching, along with fatigue, disrupted sleep and other symptoms. More common in girls, fibromyalgia is seldom diagnosed before puberty. No known cause has been pinpointed for most forms of juvenile arthritis, nor is there evidence to suggest that toxins, foods or allergies cause children to develop JA. Some research points toward a genetic predisposition to juvenile arthritis, which means the combination of genes a child receives from his or her parents may cause the onset of JA when triggered by other factors.pain or stiffness when moving joints Swelling in the jointsUnfortunately it is not a simple one or two tests to diagnose. The diagnostic process can be long and detailed. There is no single blood test that confirms any type of JA. In children, the key to diagnosis is a careful physical exam, along with a thorough medical history.

How Juvenile Arthritis is diagnosed:

  • In the morning or after resting Warm or tender joints Limited range of motion (your child’s ability to move his or her joints)
  • Juvenile Arthritis symptoms:
  • Causes of these arthritis illnesses:

What is Juvenile Arthritis Treatment?

Unfortunately, there is no cure for juvenile arthritis, although with early diagnosis and aggressive treatment, remission is possible. The goal of treatment is to relieve inflammation, control pain and improve the child’s quality of life. Most treatment plans involve a combination of medication, physical activity, eye care and healthy eating.

Juvenile Arthritis Self Care

An important part of JA treatment is teaching the child the importance of how to follow the treatment prescribed by the healthcare team. Self care also involves helping the child address the emotional and social effects of the disease. Self management encompasses the choices made each day to live well and stay healthy and happy.

QUOTE FOR TUESDAY:

“Hepatitis types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.”

WHO World Health Organization

 

QUOTE FOR MONDAY:

“Scientists have identified 5 unique hepatitis viruses, identified by the letters A, B, C, D, and E. While all cause liver disease, they vary in important ways.”

World Health Organization

 

Part I Awareness on Hepatitis A and B Types.

                                 Hepatitis II

                        Hepatitis_Overview

Viral hepatitis, including hepatitis A, hepatitis B, and hepatitis C, are distinct diseases that affect the liver and have different hepatitis symptoms and treatments. Other causes of hepatitis include recreational drugs and prescription medications. Hepatitis type is determined by laboratory tests.  The infection leads to inflammation of the liver with any hepatitis. The liver processes blood and filter toxins so they don’t cause damage to your body but when the organ is inflamed problems happen with the infection that caused the inflammation.

HEPATITIS A:

If you have this infection, you have inflammation in your liver that’s caused by a virus. You don’t always get symptoms, but when you do, you might have: Jaundice (yellowing of the skin), Pain in your belly, Loss of appetite, Nausea, Fever, Diarrhea, Fatigue, Loss of weight, fever, sore muscles, **Pain on the right side of the belly, under the rib cage-where your liver is located** (if not a combination of these symptoms).

Children often have the disease with few symptoms.

You can spread the Hepatitis A virus about 2 weeks before your symptoms appear and during the first week they show up, or even if you don’t have any.

How it’s transmitted:

-You can catch the disease if you drink water or food that’s been contaminated with the stool of someone with the virus.                                                                                                                                                  

You can also get infected if you:   HOW?  Well: -Eat fruits, vegetables, or other foods that were contaminated during handling.                                        

-Eat raw shellfish harvested from water that’s got the virus in it.                                                                        

-Swallow contaminated food. Exampes: Sometimes a group of people who eat at the same restaurant can get hepatitis A. This can happen when an employee with hepatitis A doesn’t wash his or her hands well after using the bathroom and then prepares food. It can also happen when a food item is contaminated by raw sewage or by an infected garden worker.                                                                                                                                                        

 -The disease can also spread in day care centers. Children, especially those in diapers, may get stool on their hands and then touch objects that other children put into their mouths. And workers can spread the virus if they don’t wash their hands well after changing a diaper.                                                                                                                                        

How Is It Diagnosed?

Blood tests allow doctors to diagnose it. **It is important to identify the type of hepatitis virus causing the infection to prevent it from spreading and to start the proper treatment. Since this Hepatitis A virus infection is spread through food or water that has been contaminated by the feces (stool) of an infected person.**

Are There Any Long-Term Effects?

Usually the virus doesn’t cause any long-term problems or complications. But according to the CDC, 10% to 15% of people with hepatitis A will have symptoms that last a long time or come back over a 6- to 9-month period. In rare situations, some people may have liver failure or need a transplant.

What’s the Treatment?

No treatments can cure the disease. Your doctor may take tests that check your liver function to be sure your body is healing.

Who is at highest risk for this?

-Live with or have sex with someone who’s -Travel to countries where hepatitis A is common

Remember the people who are also at risk:

-Men who have sex with men.                                                                                                                                       

-People who inject illegal drugs                                                                                                                                  

-Kids in child care and their teachers

-The virus can also be transmitted through close physical contact with an infectious person, although casual contact among people does not spread the virus.

HEPATITIS B

Hepatitis B is a serious disease caused by the hepatitis B virus (HBV). Infection with this virus can cause scarring of the liver, liver failure, liver cancer, and even death. What happens to most cases of Hepatitis patients is the adult cases (up to 95%), hepatitis B causes limited infection. Usually people manage to fight off the infection successfully within a few months, developing an immunity that lasts a lifetime. (This means you won’t get the infection again).  Blood tests show evidence of this immunity, but no signs of active infection. Unfortunately, this is not true in infants and young children in which 90% of infants and 30% to 50% of children will develop a chronic infection.

Symptoms of acute infection (when a person is first infected with hepatitis) include:

Jaundice (yellowing of the skin or whites of the eyes and/or a brownish or orange tint to the urine) -Unusually light colored stool  -Unexplained fatigue that persists for weeks or months    

-Flu-like symptoms such as fever, loss of appetite, nausea, and vomiting –Abdominal pain

Often, symptoms occur one to six months after exposure, with an average of three month. An estimated 30% of those infected do not have any symptoms at all.

How it’s transmitted:

Hepatitis B is spread in infected blood and other bodily fluids such as semen and vaginal secretions. It is spread in the same way that the virus that causes AIDS (HIV) is spread but hepatitis B is 50 to 100 times more infectious. Most people who are infected with hepatitis B in the U.S. do not know they have it. If you’re pregnant and you’ve got hepatitis B, you could give the disease to your unborn child. If you deliver a baby who’s got it, he needs to get treatment in the first 12 hours after birth.

How it’s diagnosed:                                                                                                              

If your doctor suspects that you may have hepatitis B, he or she will perform a complete physical exam and order blood tests to look at the function of your liver. Hepatitis B is confirmed with blood tests that detect the virus.

If your disease becomes chronic, liver biopsies (tissue samples) may be obtained to detect the severity of the disease.

Are There Any Long-Term Effects?

Liver damage if the virus is not taken care will happen with multiple organ crash from putting affect on other organs from doing their jobs.

WHAT’S THE TREATMENT:

Treatment depends on whether you:

-Have been recently infected with the virus (treating acute hepatitis B).

-Have the symptoms of an acute infection.                                                                                                                  

-Have chronic infection (Have had the hepatitis B for a chronic period of time).                                        

-Acute vs Chronic=different RX.

Acute Hep B. you should get a shot of hepatitis B immunoglobulin (HBIG) and the first of three shots of the hepatitis B vaccine(What is a PDF document?). It is important to receive this treatment within 7 days after a needle stick and within 2 weeks after sexual contact that may have exposed you to the virus. The sooner you receive treatment after exposure, the better the treatment works.

Regarding Chronic Hep B treatment depends on how active the virus is in your body and your chance of liver damage. The goal of treatment is to stop liver damage by keeping the virus from multiplying.

Antiviral medicine is used if the virus is active and you are at risk for liver damage. Medicine slows the ability of the virus to multiply.

Antiviral treatment isn’t given to everyone who has chronic hepatitis B.

Follow-up visits

Whether or not you take medicine, you will need to visit your doctor regularly. He or she will do blood tests to check your liver and the activity of the hepatitis B virus in your body.

Some of the tests can find out whether the virus is multiplying in your liver, which would increase your risk of liver damage.

Liver transplant

If you develop advanced liver damage and your condition becomes life-threatening, you may need a liver transplant. But not everyone is a good candidate for a liver transplant.

If you have not gotten a hepatitis B vaccine and think you may have been exposed to the virus, you should get a shot of hepatitis B immunoglobulin (HBIG) and the first of three shots of the hepatitis B vaccine(What is a PDF document?). It is important to receive this treatment within 7 days after a needle stick and within 2 weeks after sexual contact that may have exposed you to the virus. The sooner you receive treatment after exposure, the better the treatment works.

THOSE AT HIGHEST RISK FOR HEPATITIS B:

-Being born in, or spending more than 6 months in, parts of the world where hepatitis B is common or where a large number of people have been infected for a long time. Such areas include Southeast and Central Asia, the islands of the South Pacific, the Amazon River basin, the Middle East, Africa, Eastern Europe, and China.

-Being a man who has sex with men.

-Being sexually active. This includes having unprotected sex with someone who is infected with the virus or whose sexual history is unknown to you.

-Having more than one sex partner. (Your risk is higher if you have another sexually transmitted infection such as chlamydia.)

-Living with someone who has a chronic hepatitis B infection.

-Getting body piercings or tattoos from someone who doesn’t sterilize his or her equipment.

-Sharing needles or other equipment (such as cotton, spoons, and water) to inject illegal drugs.