All posts by Anthony Casimano

Anthony is an accomplished sales and marketing professional, with superior management and communication skills. Anthony embraced his full spectrum of talents as an entrepreneur and has accrued over two decades of expertise in sales and marketing, particularly in the healthcare arena to which he dedicated almost ten years of his career. Anthony commenced his professional journey back in the 1990s and is considered a pioneer of the digital marketing world, as well as an expert in all facets of personal & business Internet branding, marketing and positioning. An entrepreneur, thought-leader, influencer, and extraordinary marketer, Anthony enjoys the patronage of numerous clients for which he has prescribed a recipe for success over the years. Anthony Casimano is one of the Co-founders of Find A Top Doc. is a free service available to patients 24/7 to help them find doctors in their area and book appointments instantly. A valuable source of information for the patient, Find a Top Doc makes seeing the right doctor a simple, fast, and convenient task.

Women and Girls Living With HIV

More than 35 years have passed since the first diagnosis of AIDS (Acquired Immune Deficiency Syndrome) in the US. While there were a handful of women among the first cases, AIDS primarily affected gay men. However, as the years passed, women have emerged as another group hit by the HIV/AIDS epidemic. Globally, women living with HIV (HIV+) account for half of all people living with HIV and women living with HIV outnumber men living with HIV. Across the globe, transgender women are affected by HIV to a much greater degree than other groups.  It is estimated that the proportion of transwomen living with HIV is 49 times higher than in the general adult population.

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Who is at risk for HIV?

All women can get HIV, but your risk for getting HIV is higher if you:

  • Have unprotected sex
  • Have injected illegal drugs, either now or in the past
  • Had sex with someone to get money or drugs in return or with someone who has traded sex for money or drugs
  • Had sex with someone who has HIV
  • Has sex with both men and women
  • Injects drugs
  • Had a blood transfusion between 1978 and 1985

Is HIV Different for Men and Women?

Until recently, little research had been done on women and HIV. While many questions remain unanswered, available information shows that HIV affects men and women differently in some ways:

  • When women are first diagnosed, they tend to have lower amount of HIV in the blood compared to men who are newly diagnosed
  • Women generally have lower CD4 cell counts than men with similar viral loads
  • Women are more likely than men to develop bacterial pneumonia
  • Women get thrush (a yeast infection) in their throats more often than men

Women tend to be diagnosed with HIV later in their disease than men and fewer women than men are getting HIV treatment. Women may delay getting medical care and treatment and choose not to disclose their HIV status for several reasons, including:

  • Limited access to health care due to lack of insurance and/or transportation
  • Unstable housing
  • Fear of violence in the home
  • The stigma associated with HIV
  • Problems with substance abuse or addiction
  • Depression
  • Lack of financial resources and/or social supports
  • Taking care of everyone but themselves and not putting themselves first

Younger women

Young women are at risk for HIV as well. According to a 2013 survey, only half of female high school students used a condom the last time they had sex. Only one in eight female high school students in the study had ever been tested for HIV. Younger women are more likely to have a sexually transmitted infection (STI). Having an untreated STI makes HIV transmission more often. An untreated vaginal yeast or bacterial infection can also increase the risk of transmission. This is because the infection brings white blood cells into the area. This is especially true for women, because small cuts on the skin of the vagina are hard to notice but may allow HIV to pass into your body. Teen girls and younger women are at higher risk for HIV infection than adult women, because their reproductive tract is still developing.

Pregnancy and HIV

With the advances in HIV care and treatment, many women living with HIV are living longer, healthier lives. As they think about the future, some of these women are deciding to have the babies they always wanted. Women living with HIV who want to become pregnant should discuss their plans with a health care provider.

More research is needed to determine how HIV progresses in women and how HIV drugs affect women’s bodies. However, it does seem that HIV drugs benefit women as much as men. By taking advantage of good health care and treatment as soon as you can, you greatly increase your chances of living a longer and healthier life for you and your loved ones.


Reframe Your Negative Thoughts

Like everyone, your goal is to be as happy as possible, as much of the time as possible. But like most people, you probably don’t have happiness as your primary priority. Or maybe you think you do, but you find yourself consistently sabotaging yourself by slipping into sadness, despair and other unproductive negative thoughts. Without happiness as a priority, it’s very easy to slip into negativity, and suffer much more than you need to in this life. That’s why, if you want to learn how to level up the quality of your life, it’s crucial to embrace the pursuit happiness as your primary priority, and not just as a concept. Once you truly embrace the pursuit of happiness, you’ll have the right mindset for being able to recognize and reframe negativity. And the right mindset is crucial because you have thousands of negative thoughts a day. Here is how to reframe your negative thoughts and find true happiness.

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  1. Brainstorming

Writing in a journal can be very helpful. Try pinpointing in one sentence what your biggest problem is. Then, think of various solutions. You may even try mind mapping, with your problem in the middle of the page. Then, draw lines outwards with various solutions to your problem. Let your imagination roam free. If your biggest problem is finances you may write winning the lottery, getting a job or going back to school as various solutions. The most important thing this exercise does is to instill hope and open your mind to possibilities.

  1. Awareness

The first thing you need to focus on is your awareness. If happiness is your primary priority, you need to take awareness of negativity very seriously. You need to stay aware because you’re going to have thousands of negative thoughts a day, at least. It’s just a matter of catching them, recognizing you’re unhappy, and asking the right questions in order to change that.

  1. Counteract Negative Thoughts

One effective technique is to write down your negative thoughts. Then, take a closer look at them. Try to look for evidence for and against this thought. Write down the evidence and then write a more balanced thought. When people are feeling depressed they often “dampen” any positive thoughts or good things that happen in their life. For example, if they receive a large tax refund they may negate it by telling themselves that it’s still not enough money to pay off their debt. Try writing a sentence to counteract that negative thought. The person who received the check may write down that they were able to file their taxes and receive a refund this year, which helped pay down bills. Reframing and changing your point of view is the key.

  1. Asking the right questions

The right questions are all variations of:

Why am I unhappy?

What do I have to do to feel better?

You are the questions you ask yourself, so it’s very important you know how to ask the right questions.

  1. Conduct Thought & Behavior Experiments

It can be very effective to test your thoughts for validity. For instance, you can experiment to see which thought holds more validity. Try swapping negative for positive thoughts. Instead of, “I’ll stop binging on sugary foods if I chastise myself afterwards” try “I’ll eat less sugary foods if I forgive myself after overeating and tell myself it’ll be okay”. Write down your overeating results after each thought. By conducting this experiment you will collect objective data as to which thought actually results in less overeating.

  1. Use Visualization, Morning and Night

When you wake up in the morning, imagine your day going well. No matter what you have scheduled, put a positive outcome on it. Imagine your dentist telling you that you have no cavities, the bank saying yes to your mortgage application or your co-workers smiling in greeting when you arrive. Later, before you go to bed, put your imagination to use again. Replay any positive events and if anything negative happened, imagine it as thought it had gone well instead. This way, prior to sleep, you have filled your mind with positive imagery, which in turn instills hope and lets your mind entertain positive possibilities.

The point of cognitive reframing is to find a new better frame of how you look at a specific event. A frame that can be supported by constructive underlying beliefs, one that doesn’t cause negative feelings and thoughts enables you to keep all the necessary personal power in your own hands for acting and responding properly and rationally. It’s not about daydreaming and denying the seriousness of a situation. It’s about responding more wisely and rationally.

Coordinated Care

Care coordination synchronizes the delivery of a patient’s health care from multiple providers and specialists. The goals of coordinated care are to improve health outcomes by ensuring that care from disparate providers is not delivered in silos, and to help reduce health care costs by eliminating redundant tests and procedures.

Benefits of Coordinated Care

Effective population health management benefits patients, physicians, health care organizations, the entire health care system, and the nation at large. Here’s how:

  • Patients receive better coordinated care – and enjoy better health – because they are reminded of procedures needed to manage their condition or disease.
  • Physicians are better informed and their patients are more engaged, resulting in better outcomes in care. Physicians also more easily satisfy quality measures that focus on engaging patients and providing timely, appropriate, coordinated care.
  • Health care organizations are more profitable – whatever their payment model – because gaps in care are filled, patient volume increases and the cost of delivering care can be more accurately quantified.
  • The nation benefits from reduced health care costs, better management of diseases, and a generally healthier population.

Examples Of Care Coordination

  1. Primary care coordination

To care for patients with chronic diseases and conditions such as diabetes and high cholesterol, some providers have adopted a “guided primary care” approach. The Guided Care model was developed by a team of researchers at Johns Hopkins University, to respond to the challenge of caring for a rapidly aging America. A specially educated, registered nurse (RN) is responsible for patients with multiple chronic conditions. The RN performs an initial assessment with the patient, works directly with the primary care providers to develop a care plan, and coordinates specialty care with other providers to ensure that nothing is missed and the plan is followed.

  1. Acute care coordination

Patients with acute health problems like a stroke or heart attack require a more complex level of care due to the critical nature of their condition. Because emergencies like strokes and heart attacks can happen anytime, patients may first receive care by emergency medical services and by hospitals outside of their regular network. The risk for communication breakdowns, redundancies, and medical errors can increase when providers are involved, making it even more important that health care be coordinated to achieve the best clinical results. Studies show that acute care coordination focusing on communication between provider-handoffs is an important factor for success.

  1. Post-acute/long-term care coordination

Patients who reside in rehabilitation, long-term care (LTC) or post-acute care (PAC) facilities may need to move between facilities — or to different care levels within facilities — as their health changes.A majority of patients admitted to PAC are later transferred to a second PAC setting. These predominantly senior-aged patients often have mental and memory disorders in addition to physical ones. They therefore require coordinated care to manage medications transfers and update care plans. The importance of this is increasing as studies show that hospital discharges to post-acute care (PAC) facilities have increased rapidly and hospital readmission from PAC facilities is common and associated with a high mortality rate. Readmission risk factors may signify inadequate transitional care processes or a mismatch between patient needs and PAC resources.

Successes and failures in care coordination will be perceived in different ways depending on the perspective: patient/family, health care professional(s), or system representative(s). Consideration of views from these three potentially different perspectives is likely to be important for measuring care coordination comprehensively.


Color of Pee

Urine color generally ranges from a pale-yellow color to deep amber. This coloring is primarily caused by the pigment urochrome. Whether your urine is diluted by water or more concentrated determines how the pigment will appear. The more water you drink, and the more hydrated you become, the lighter the pigment in your urine. The pigments and chemical compounds in the foods you eat and the medications you take can also alter the color of your urine. These changes are fairly standard and typically don’t last for long. Certain changes in color may be a sign of an underlying medical condition.

Normal urine color varies, depending on how much water you drink. Fluids dilute the yellow pigments in urine, so the more you drink, the clearer your urine looks. When you drink less, the color becomes more concentrated. Severe dehydration can produce urine the color of amber.But urine can turn colors far beyond what’s normal, including red, blue, green, dark brown and cloudy white.

When to see a doctor
Seek medical attention if you have:

Visible blood in your urine. Bloody urine is common in urinary tract infections and kidney stones. These problems usually cause pain.

Dark or orange urine. If your urine is dark or orange — particularly if you also have pale stools and yellow skin and eyes — your liver might be malfunctioning.

What your urine can tell you
Here’s a quick lowdown for you. A little uncomfortable, but very important information that you should know.

When your urine is clear, it can indicate:

You’re drinking too many liquids. Be careful not to over-hydrate. Shoot for drinking half your body weight in ounces of water each day.

When your urine is bright or neon yellow, it can indicate:

Vitamin supplements that are being taken in excess or not being absorbed by your body. Word to the wise: take whole food-based vitamin supplements for better absorption.

When your urine is dark yellow or gold, it usually indicates one thing:

Dehydration.Get your drink on. Shoot for drinking half your body weight in ounces (i.e. if you weigh 130 pounds, shoot for 65 ounces of water per day).

When your urine is pink or red, it is usually indicative of:

Blood in the urine from a kidney or bladder infection.You’ve eaten too many pink or red foods like beets or berries or foods that are artificially colored.A side effect of some laxatives.

When your urine is orange, it usually indicates:

A side effect of a medication you’re taking. Ask your doctor about this, and bring your medication with you to the doctor’s visit.You’ve eaten too many orange or red foods like beets and berries or foods that are artificially colored.Dehydration.

If your urine is ever blue or green, it can indicate:

A side effect of certain medications; see your doc.You’ve eaten too many green foods, especially asparagus or foods that are artificially colored blue or green.

When your urine is dark brown or tea colored, it can indicate:

A liver disorder, especially if accompanied by pale stools and a yellow, jaundiced complexion.A side effect of certain medications.

If your doctor discovers that your dark-yellow urine color is due to dehydration, they will recommend that you add more fluids to your diet. The color of your urine should return to its normal yellow color within days. If an underlying medical condition is found, your doctor will pursue treatment for that condition.

If your urine takes on a dark-yellow color, it may be your body’s way of telling you to drink more water. This change in color may be caused by dehydration, so make sure to drink up. Whether you’re sitting at the office, working out at the gym, or laying out at the beach, it’s important to stay hydrated. If you’re taking any medication that causes this discoloration, it’s likely harmless. You should continue taking the medication under the supervision of your doctor, unless you’re advisedotherwise.


Top Healthcare Risks

As the New Year begins, it is important to take some time to evaluate the most important challenges in health care and determine which will require proactive and different planning. The complexity of many of these risks requires a multi-faceted approach in order to develop a comprehensive solution. Collaboration has never been more important, both in gaining a full understanding of the risk and in designing the most proactive solution. Experts, brokers and insurance providers should be consulted to assure that you optimize both risk control and risk transfer strategies. The following issues are prominent areas of discussion for risk managers, health care professionals and clinicians. Here are some of the most important healthcare risks.

  1. Cyber Risk
    The healthcare industry’s move to electronic records has created new patient privacy exposures as records are more easily accessed by consultants, vendors and other third parties for efficient operation, and targeted by cyber criminals. Moreover, healthcare organizations face exposure to cyber risks that could have significant impacts on their operations, including shutting down critical, health-related systems.
  1. Physician Contracting
    Organizations continue to pursue physician integration, and physician arrangements are increasingly complex, bringing with them much greater risk. Hospitals often must move quickly on contracts with crucial physicians, but it is extremely important for all parties to review the contracts before they finalized. A committee or attorney should review every contract for appropriate compensation based on location, specialty, and market comparability as well as potential Stark Law violations.
  1. Healthcare Infections
    Healthcare-acquired infections (HAIs) cost the U.S. healthcare system billions of dollars each year and lead to the loss of many lives.  At any given time, about 1 in 25 hospital patients has at least one such infection. Healthcare-acquired infections also come with a financial price, costing up to $10 billion a year.
  1. Quality Process Improvement
    Healthcare reform has brought an increased focus on the quality of patient care, with quality measures having a bigger impact on reimbursement. To help improve outcomes and recover the highest reimbursement possible, hospitals need to implement evidenced-based practices and reinforce the reliability of their clinical processes. Proper monitoring is essential to identifying and accurately addressing breakdowns.
  1. Ransomware
    Cyber criminals don’t even have to steal data from the computers of hospitals to be able to make easy money. Ransomware is a new data security threat that has victimized a great deal of hospitals in recent years. It also pertains to a type of malware that cyber criminals infect on a healthcare organization’s IT system, preventing the company from accessing certain files or sectors. Usually, the infected components become encrypted and the authorized user is then unable to access them. The hackers will then deliver a message containing instructions for sending payment or ransom in exchange for restored access to the affected system. What makes ransomware even more complex is that cyber criminals demand that payment be made through bitcoins. Unlike credit cards, bitcoin payments are difficult to trace which helps hackers in eluding authorities.
  1. Violent Incidents in Hospitals
    Hospitals may be places of healing, but they also have become the scene of number of violent incidents. Such incidents not only put patients at risk but also medical professionals, who are often the targets of attacks, harassment, intimidation and other disruptive behavior.

The risks facing the healthcare industry are complex and constantly evolving. Organizations need to conduct formal risk assessments to identify new and changing risks, regularly monitor identified risks, uncover gaps, and take appropriate actions to mitigate risks to an acceptable level.


Seasonal Influenza

Influenza (flu) is a contagious respiratory illness mainly caused by influenza viruses. It can cause mild to severe illness, depending on the person. Serious outcomes of flu infection can result in hospitalization or even death. Some people, such as older people, young children, and people with certain health conditions, are at a higher risk of serious flu complications. The best way to prevent the flu is by getting vaccinated each year.

People who have the flu often feel some or all of these signs and symptoms that usually start suddenly:

  • Fever or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches

The flu is caused by the influenza virus and is easily spread from person to person through respiratory droplets formed when coughing or sneezing. You can become infected if you breathe in these droplets through your nose or mouth or if the droplets come into contact with your eyes. The virus can also be spread through the sharing of food or drinks. You can also catch it by touching objects contaminated with the flu virus, then touching your mouth, eyes or nose.

Period of Contagiousness
You may be able to pass on the flu to someone else before you even know you are sick, as well as while you are sick. Although people with the flu are most contagious in the first 3-4 days after their illness begins,  people may be able to infect others beginning 1 day beforesymptoms develop and up to 5 to 7 days after becoming sick. Some people, especially young children and people with weakened immune systems, might be able to infect others with flu viruses for an even longer time.

Most simple seasonal influenza cases are managed symptomatically and are advised bedrest at home to minimize the risk for infecting others. Treatment focuses on reducing fever and relieving the symptoms. The diagnosis can be confirmed by taking specimens for laboratory analysis. It is important that patients monitor themselves to detect if their condition deteriorates and they require medical intervention.

Risk Factors
Anyone can get the flu and serious problems related to the flu can happen at any age, but some people are at high risk of developing serious flu-related complications if they get sick. This includes people 65 years and older, people of any age with certain chronic medical conditions such as asthma, diabetes, or heart disease, pregnant women, and young children.

The best way to protect yourself and your loved ones against the flu is through immunization. Many hospitals and institutions haveimmunization programs which provide free, publicly-funded vaccines to those who are eligible. There are many different strains of the flu virus. The vaccine cannot protect against all of them. Scientists monitor the global spread of flu and decide which three flu strains will likely cause the most illness during the upcoming flu season. Those three strains are put into the flu vaccine each year. So it is important to get immunized against the flu every year with no exceptions.Other precautions can be taken, including: practicing good hand hygiene, covering your nose and mouth when you cough and sneeze, and avoiding touching your eyes, nose or mouth.

The first and most important step in preventing flu is to get a flu vaccination each year. Everyday preventive actions like staying away from people who are sick, covering coughs and sneezes and frequent handwashing will help slow the spread of germs that cause respiratory illnesses, like flu.


Hearing Loss Facts

Hearing loss is a sudden or gradual decrease in how well you hear. It can be mild or severe, temporary or permanent. Congenital hearing loss means you are born without hearing. Gradual hearing loss happens over time and can affect people of all ages. If you have hearing loss, you may not be aware of it, especially if it has happened over time. Your family members or friends may notice that you’re having trouble understanding what others are saying. There are some ways you can deal with hearing loss. And hearing aids and other devices can help you hear.

Symptoms of hearing loss

The symptoms of hearing loss can vary depending on the type of hearing loss, the cause of hearing loss, and the degree of loss.In general, people who have hearing loss may experience any or all of the following:

  • Difficulty understanding everyday conversation
  • A feeling of being able to hear but not understand
  • Asking others to repeat often
  • Avoidance of social situations that were once enjoyable
  • Tinnitus, or ringing and/or buzzing sounds in the ears

Causes of hearing loss

Hearing loss can have many different causes. For example:

  • Sudden hearing loss in one ear may be due to earwax, an ear infection, a perforated (burst) eardrum or Ménière’s disease.
  • Sudden hearing loss in both ears may be due to damage from a very loud noise, or taking certain medicines that can affect hearing.
  • Gradual hearing loss in one ear may be due to something inside the ear, such as fluid (glue ear), a bony growth (otosclerosis) or a build-up of skin cells (cholesteatoma)
  • Gradual hearing loss in both ears is usually caused by ageing or exposure to loud noises over many years.

How hearing loss can occur

Causes of hearing loss include:

  • Damage to the inner ear. Aging and exposure to loud noise may cause wear and tear on the hairs or nerve cells in the cochlea that send sound signals to the brain. When these hairs or nerve cells are damaged or missing, electrical signals aren’t transmitted as efficiently, and hearing loss occurs.
  • It may become difficult for you to pick out words against background noise. Heredity may make you more prone to these changes. This type of hearing loss is known as sensorineural hearing loss, which is permanent.
  • A gradual buildup of earwax. Earwax can block the ear canal and prevent conduction of sound waves. This can be restored with earwax removal.
  • Ear infection and abnormal bone growths or tumors. In the outer or middle ear, any of these can cause hearing loss.

Hearing loss treatments

Hearing loss is a medical condition that has many tried-and-true treatment options. Finding the right treatment is a joint venture between you and your hearing care professional, and if done properly, takes into consideration the following factors:

  • Type of hearing loss
  • Severity of hearing loss
  • Cause, if known
  • Your lifestyle
  • Your budget

Some types of hearing loss, especially conductive types, can be medically or surgically corrected but others cannot. The most common treatment for sensorineural hearing loss is hearing aids. Hearing aids are widely available in a range of styles, colors, sizes, technology levels and price points.

Your doctor will do a physical exam and ask about your symptoms and past health. He or she also may look in your ears with a lighted device called an otoscope. If your doctor thinks that you have hearing loss, he or she will do hearing tests to check whether you have hearing loss and find out how severe it is. You may be referred to an audiologist to do the tests.