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Associated Press
2 hours ago
- Associated Press
WorldWide HealthStaff Solutions and Books For Africa deliver 40,000 medical books to Kenya
CHARLOTTE, N.C., July 3, 2025 /PRNewswire/ -- WorldWide HealthStaff Solutions (WWHS), a Medical Solutions company and leader in international direct hire recruitment, has partnered with Books For Africa, the largest shipper of donated books to the African continent, to help expand access to nursing education in underserved regions of Kenya. WWHS supported the shipment of 40,000 nursing textbooks to the Kenya Medical Training College (KMTC). These donations aim to strengthen healthcare education and empower future nurses in Kenya. 'It is exciting to see these donations going to such dedicated students and educators,' said Patrick Plonski, Executive Director of Books For Africa. 'This kind of collaboration is what drives lasting impact. It is our hope that they will advance medical care and medical training in Kenya for many years to come.' This donation comes at a time when many countries are experiencing a critical shortage of nurses, making investments in education and training more important than ever. 'These textbooks represent more than just academic resources; they symbolize opportunity, equity, and a renewed belief in the potential of every health student to transform lives across Kenya,' said Irene Karari, Director at the State Department of Diaspora Affairs in Kenya. Since 2022, WWHS has partnered with Books For Africa to donate more than 100,000 nursing textbooks to parts of Africa. It's a partnership that's deeply personal to WWHS President Louis Brownstone. 'I volunteered in Tanzania in 2008, and it opened my eyes to the power of community and education,' said Brownstone. 'Partnering with Books For Africa allows me to continue that work. With the right resources, I believe we can transform lives and communities.' Books For Africa has shipped over 63 million books to all 55 African countries since 1988. Its mission to end the book famine in Africa aligns with WWHS's mission to improve lives worldwide by connecting global professionals with healthcare employers for the best career opportunities. WORLDWIDE HEALTHSTAFF SOLUTIONS WorldWide HealthStaff Solutions specializes in direct hire international nurse recruitment, connecting healthcare employers with qualified RNs and healthcare professionals worldwide. From recruitment to relocation, we guide both parties through seamless processes to foster long-term, mutually beneficial relationships. With offices in the United States, United Arab Emirates, and the Philippines, we are positioned to serve global healthcare markets effectively. View original content to download multimedia: SOURCE Medical Solutions LLC
Medscape
2 hours ago
- Medscape
Endocrine Insights: Thyroid Management Tips for PCPs
This transcript has been edited for clarity. Matthew F. Watto, MD: Welcome back to The Curbsiders . I'm Dr Matthew Frank Watto, here with my great friend and America's primary care physician, Dr Paul Nelson Williams. Paul, are thyroid nodules common? I heard they're not. Is that wrong? Paul N. Williams, MD: They're very common, Matt, and they actually become more common as we age. The reassuring thing is that most of them are benign and most of them are actually found incidentally. On the episode, we discussed how thyroid nodules are becoming even more common now that low-dose lung cancer screening is more prevalent. It's wonderful that the screening is more commonplace, but we're finding many incidental things, including thyroid nodules, on these scans. One nice thing to tell patients when we're starting the initial workup is that, by and large, these are extraordinarily common and they are usually benign — though not always, and we'll get to that in a little bit. Matt, if someone were to have a thyroid nodule, what kind of symptoms would you be asking the patient about? Watto: I would not have thought of this, but one of our guests, Dr Chindris, said that she asked people about neck tightness. That can be one of the symptoms that patients will have. She also asks about compressive symptoms, voice changes, and the classic hyperthyroid or hypothyroid symptoms (eg, heat intolerance, palpitations). Dr Chindris also mentioned that she had one patient who experienced a personality change and the family thought it might be related to the thyroid. This personality change did end up getting better once the patient had their hyperthyroidism treated. This might have been anecdotal, but I thought it was a cool anecdote. Take that for what you will, audience, but I guess personality changes could be on the list of symptoms as well. Williams: I guess it's one of the things that we always check when someone is feeling different or behaving sort of "off." So, maybe this validates that to some extent. Watto: But Paul, I'm going to be real with America here: I don't know that I've ever felt someone's thyroid and been able to absolutely, confidently state that they have a dominant nodule on a certain side of the neck. I'm good at noticing if someone's thyroid is so big that I can visibly notice it without even touching them, but thyroid nodules are difficult to feel. Tell us a little bit about that, Paul. You're the physical exam guy. Williams: If I remember the episode correctly, it turns out we miss about half of thyroid nodules on physical examination, even when they are over a centimeter. They're just tough and they're really hard to feel, especially if they're less than 1 centimeter. If they're located posteriorly, your chances are really sort of slim to none. These are not typically things that we find on examination. If they're large enough, I suppose that you could feel them, but don't beat yourself up. We also discussed the various techniques used for physical exams. When we were in medical school, the technique was to "stalk" the patient from behind and wrap your hands gently around their neck. You can also have the patient drink out of a straw. Watto: I think on the episode you asked, "So, how are we doing this? Are we still sneaking up behind them and choking them?" I like the approach that Dr Susan Mandel uses. She said she examines from the front, one side at a time, using her thumb. I think that's a good way to go. Williams: The one side at a time is clutch, for sure. Watto: And it's okay to give a patient a cup of water to have them swallow so you can feel the thyroid go up and down. I had stopped doing that for a little while — probably because of laziness; there aren't many cups in my office — but I think it's a good practice. Williams: Especially if you're feeling thyroids all day. Watto: Paul, the testing for this is pretty simple. Thyroid-stimulating hormone (TSH) is still going to be the workhorse here. Then, if you find a nodule, you're determining if it's a hot nodule or if the person could have Graves disease, depending on what you're seeing or feeling on exam. You don't necessarily have to get free T4 or T3 for every single person, but sometimes you can. We also asked about calcitonin because that had come up. There's not really a role for calcitonin anymore because if you are proceeding with fine-needle aspiration (FNA), they have these molecular tests that allow you to figure out which type of thyroid cancer it might be. So, it's just a pretty basic work workup. The TSH and then ultrasound can really shine here. Paul, have you ever ordered a radionuclide thyroid scan? Williams: No, I have not. I think I've seen it on certain algorithms and thought, Boy, if I'm thinking about ordering one of those, I should probably have the patient see endocrinology anyway, as is my way. I've never pulled the trigger on one myself, and I'm not even sure I've seen one ordered by endocrinology — at least not in the past 5 years, I don't think. Watto: Dr Chindris said she might order them sometimes, like in circumstances where you may be pre-oping a patient. But nowadays, even if someone is seeing an endocrinologist, they're not necessarily getting them. In primary care, if you're practicing on your own, you're probably not going to be ordering these too often. I don't think it's necessarily the wrong thing to do; you just don't have to do it. Williams: There are often easier ways to go about it, I think. Watto: And when you get the ultrasound report, it will have a TI-RADS — much like they have a BI-RADS for mammograms — and the higher the number, the worse it is. It goes from 1 to 5, with 5 being highly suspicious. If you do a FNA, you'll receive Bethesda categories which go from 1 to 6, with 6 being malignant and 1 being nondiagnostic. It's too much to get into on this video, but if you want to hear more, definitely check out the full episode where we talk through those. Paul, let's talk about GLP-1 agonists. Tell me if this is wrong, but I believe that everyone who's on a GLP-1 agonist should have yearly or twice-yearly thyroid ultrasounds, just as standard practice. Williams: That might be a bit overaggressive. Most people watching this probably know that if a patient has either a personal or family history of multiple endocrine neoplasia (MEN), that would be a contraindication for GLP-1 agonists. I think many of us have gotten a little bit squirrely in terms of thyroid cancer, in general. If there's a history of papillary thyroid cancer, we wonder, Ooh, is this still okay? When these agents were starting to be used, we probably looked it up every time and still had a little bit of trepidation about initiating GLP-1 agonist therapy. But our guests say they have plenty of patients with history of thyroid cancer — no, not medullary, but other differentiated types — who receive GLP-1 agonists, and our guests did not have any underlying concerns about this treatment. So, I don't know if we need to be doing serial ultrasounds. But Matt, I oftentimes feel like patients come to us and they may not know what specific type of thyroid cancer they have. Do you remember the party trick we can use to differentiate that? Watto: So, what you're saying, Paul, is that I don't have to routinely order a thyroid ultrasound if someone's on a GLP with agonist, but I should ask them if they have medullary thyroid cancer in their family or if they've had MEN2A. Then, if they're not sure what type of cancer they've had, you can ask them, "Have you been treated with radiation or thyroid suppression?" If they have been treated with either of those options, it's a good signal that they were probably treated for a well-differentiated thyroid cancer. You would not treat medullary thyroid cancer with radiation or suppressive doses of levothyroxine. That's a good way to figure out what type of thyroid cancer they have. In terms of anaplastic thyroid cancer, unfortunately it has such a poor prognosis that you're probably not going to be meeting someone 10 years down the line who doesn't remember which type they had. Those patients know if they had anaplastic thyroid cancer. So, the research and the party line right now would suggest it is safe to give GLP-1 agonists to patients who have had thyroid cancer or who have thyroid nodules. The only circumstance where GLP-1 agonists are not recommended is if they have medullary thyroid cancer or MEN2A. That's good news, Paul, because a lot of doctors out there are prescribing these for patients, and thyroid cancer is relatively common.
CNN
2 hours ago
- CNN
Scores killed in Gaza as Israel intensifies strikes
More than 80 Palestinians were killed across Gaza on Thursday, according to health officials, as Israel intensified its strikes across the strip. The deaths, which authorities said included dozens of people seeking aid, come as negotiations to reach a ceasefire in the enclave ramp up. A source told CNN that Hamas officials were set to meet Thursday to prepare a response to the latest proposal, which has been accepted by Israel. At a school-turned-displacement facility in Gaza City, 15 people were killed and 25 injured in Israeli strikes that left many with severe burns, the director of Al-Shifa hospital Dr. Mohammad Abu Silmiya said. The hospital is treating those wounded in the attack. 'The scene was extremely harrowing due to the charred bodies of the martyrs and children,' said Fares Afana, who heads the Emergency and Medical Services in northern Gaza, and had teams evacuating the injured from the school. The hospital director another 12 people were killed in other strikes in Gaza City. In response to a CNN question on the school strike, the Israeli military said it struck a 'key Hamas terrorist who was operating in a Hamas command and control center' in Gaza City. The Israeli military said that prior to the attack, 'numerous steps were taken to mitigate the risk of harming civilians, including the use of precise munitions, aerial surveillance, and additional intelligence.' Earlier this morning, the Israeli army said that over the past day it struck 'approximately 150 terror targets throughout the Gaza Strip, including terrorists, underground routes, military structures, weapons, sniper posts, and additional terror infrastructure sites.' CNN has requested comment from the Israeli military on Thursday's strikes. Images taken at the scene of the attack in Gaza City showed flames inside a building and several bodies that had been severely burned. 'Every so often, the Israelis would attack the school and bomb it, forcing us to flee, then we would return when the Israeli pressure eased. Today, as you can see, the pressure was intense,' said a woman, who did not give her name. In southern Gaza, 35 bodies arrived at the Nasser Hospital on Thursday morning, according to the spokesman of Nasser hospital, Ahmad Al-Fara. The death toll includes fifteen people who were allegedly killed while waiting for aid in Khan Younis, and 20 others who died in strikes on encampments in the city, the hospital said. The aid seekers were waiting near the US-backed Gaza Humanitarian Foundation (GHF) distribution sites in the Al-Tahliya area of southwest Khan Younis when they were hit, according to the hospital. 'They said the American (GHF) is safe, is that what safety looks like?' one man, Awad Barbach, said at the funeral of one of those killed. In another incident, in central Gaza near the Netzarim Corridor, crowds gathered to receive aid from trucks when chaos ensued, a witness said. Twenty-five people were killed in the incident, according to Abu Silmiya, the Al-Shifa hospital director. 'It was a trap… people were stabbing each other for the food… (then there was an) hour and a half of (Israeli) gunfire… we are not Hamas or Fatah. I'm just a civilian who wants to eat, and instead I find death,' one eyewitness, Ahmed Khella, told CNN. 'Where are (Hamas)?… they are all dogs,' he added.
