Maria Almeida, Ph.D., is the first researcher at UAMS to receive supplemental funding through the NIAMS STAR program and hopes it will not only take her work to the next level but show other investigators a roadmap for their careers.

Almeida, an associate professor in the Department of Internal Medicine-Endocrinology in the UAMS College of Medicine, has spent the last 16 years studying the basic mechanisms of bone growth and skeletal aging.

With the $300,000 supplement from the National Institute of Arthritis and Musculoskeletal and Skin Diseases’ Supplements to Advance Research program, she hopes to springboard her laboratory findings into a pilot drug that she will test for its potential use in bone diseases like osteoporosis.

“They use the phrase ‘from projects to programs,’” Almeida said. “It will allow the opening of new possibilities within my lab. I will be able to take my work beyond one area of focus, and I will be able to be a little more creative with my approach. Most of my work has been in basic science, and this will allow me to be more translational – taking the basic science closer to potential treatments.”

Since its first cycle in 2015, the NIAMS STAR program has awarded only three to five investigators per year. Awardee institutions have included Harvard Medical School, the Mayo Clinic in Rochester, Duke University and Stanford University.

One of the perimeters of NIAMS STAR is that it looks to fund what it terms “high-risk ideas.” The thinking is that with high risk also comes the potential for high reward in terms of advances in medicine and impact on human health. In recent years, the National Institutes of Health has been looking for new ways to fund such research.

“Traditional NIH funding programs have certainly led to advances in human health, but there has always been speculation that promising discoveries can take too long to emerge from the lab to become treatments or diagnostics,” said Lawrence E. Cornett, Ph.D., vice chancellor for research at UAMS. “The idea behind NIAMS STAR and similar programs is to give investigators additional resources to pursue these high-risk, high-reward lines of research that have the potential to produce breakthroughs that can rapidly advance a field. Dr. Almeida is a talented investigator whose work has the potential to do just that.”

The STAR program also targets researchers like Almeida because they are at a vulnerable point in their careers. They have had early success with a scientific pursuit but may be running out of traditional funding options. Without funding, they might abandon even promising research for other pursuits.

Instead, NIAMS is looking to help these early- to mid-career scientists – or “early-established investigators (EEIs),” as they call them.

While announcing the program in 2014, NIAMS Director Stephen I. Katz, M.D., Ph.D., said that by not adequately supporting these EEIs, what is truly at stake is the loss of innovative advancements to human health and the underdevelopment of the next generation of scientists.

“The goal of the program … is to promote innovation and exploration of new research directions,” Katz said in the announcement. “Ultimately, we believe that the awards will assist EEIs in making the transition from work on a single research project to leadership of a comprehensive research program.”

Almeida received her first NIH Research Project Grant Program (R01) award in 2010. Through extensive research in her lab, she found that the interaction between the cellular-level functions of two proteins involved in gene transcription – forkhead box O and β-catenin – can decrease bone mass.

“We were lucky enough to get great results, which were published in high-impact journals,” Almeida said. “I was able to have the R01 renewed in 2016. Renewing an R01 is not very common and suggests the promising nature of the research. This supplemental funding will allow me to develop a pilot drug out of the principals we discovered, which I can then test to see if it behaves like we expect it to.”

The supplemental funding also opens up the project for collaboration with Kottayil Varughese, Ph.D., a professor in the College of Medicine’s Department of Physiology and Biophysics. Almeida’s lab and Varughese’s lab together will attempt to develop specific cell-penetrating peptides that will block or disrupt the interaction between forkhead box O and β-catenin in order to stimulate bone formation.

The work begins in April 2018.

Almeida notes that there was a small window when she was eligible for the program. At NIAMS, they are focusing on supporting this specific group of promising mid-career scientists, but at other institutes, there are new programs aimed at better supporting senior scientists who are well established or new ones just beginning their careers.

“Funding is critical,” Almeida said. “We all have to keep our eyes open for these new opportunities.”

The Arkansas Business Publishing Group honored two College of Medicine faculty members this week.  The awards recognize individuals, companies and organizations that are making a significant impact on the quality of health care in Arkansas.

Ron Robertson, M.D., of the Division of Trauma, Critical Care and Acute Surgery in the Department of Surgery, received the Physician of the Year award. Read more at the Arkansas Business website.

Paul J. Wendel, M.D., professor in the Department of Obstetrics and Gynecology, was awarded the Women’s Health and Wellness Hero award. Read more at the Arkansas Business Website.

Kent C. Westbrook, M.D., Distinguished Professor in the Department of Surgery in the College of Medicine at UAMS, has received the Arkansas Business Healthcare Heroes Lifetime Achievement Award.

Get more information in the article on the Arkansas Business website.

The first memory David Scott has following his traffic accident July 31, 2017, is a paramedic leaning over trying to help release him from underneath his 18-wheeler.

“I’m trying to pull my arm out and they’re telling me I can’t,” Scott said. “So I turn around and try and force it. But they stopped me.”

That’s because at that moment, Scott wasn’t fully aware how badly his arm had been damaged. When he arrived at UAMS, his surgeons were not able to save it. And not just the arm, they and had to amputate up to his chest.

“Typically if an extremity is reconstructable, we will reconstruct it,” said Mark Tait, M.D., an orthopaedic hand and upper extremity surgeon and assistant professor in the Department of Orthopaedic Surgery. “In this case, his nerves, arteries and vessels were so severely damaged we had to do an amputation.”

But Tait and John Bracey, M.D., another UAMS orthopaedic hand and upper extremity surgeon, were thinking beyond the loss of Scott’s arm. They had plans for his future.

Traditionally, Tait said, patients can receive body-powered prosthetics. But new technology allows advanced robotics to be used by amputees. Because the surgeons decided to prepare Scott to be able to use a robotic arm, the surgery took about seven hours.

Tait and Bracey identified the nerves that once flowed in his hand, wrist and elbow. They then took those nerves and plugged them into other muscles in Scott’s chest. With time, the nerve would reinnervate – supply energy to – that muscle, causing it to have a new function. So now when Scott thinks, “close hand” or “bend elbow” new muscles, operated by nerves formally in his arm, respond. That response is sensed by his robotic arm, which follows the brain’s command.

“David is very highly motivated,” Bracey said. “He understood the severity of his injury but was determined not to be limited by that. His motivation helps make this so successful.”

UAMS is one of a few institutions in the nation able to do these kinds of surgeries and Scott is among the first here in the state to receive a robotic arm. Tait and Bracey say they’re happy to bring this option to amputees in Arkansas and the region. This procedure is also remarkable, the surgeons said, because it is intuitive. With more time and practice, a patient is able to fine-tune the way the robotic arm works with his or her body. He says they’re still working on improving the functionality.

“I told my wife, I’m not going to let this get me down,” Scott said.

And he hasn’t. His doctors expected it to take six months for him to make the progress he has made since having the arm. It’s taken him only three and each day he gets a little more control. He’s able to put the arm on and take it off with little to no help and has been very active in his church and his softball team.

“It’s amazing the things doctors have been able to come up with in medicine,” Scott said. “I’m happy to be alive and plan to make the most of my life.”

Tait and Bracey say even those who have already had an amputation could be eligible for robotic technology. Because the nerves are likely still there, they would still be able to identify them and plug them into different targets.

“It can be a good option for those even 10 years past their amputation,” Bracey said.

James D. Marsh, M.D. – chairman of the Department of Internal Medicine in the College of Medicine at the University of Arkansas for Medical Sciences (UAMS) – has been honored by the American Heart Association for his three-decade career fighting cardiovascular disease and stroke.

Marsh received the Worthen-Cornett Award on March 10 at the Little Rock Heart Ball at the Statehouse Convention Center.

Named in memory of the philanthropy and dedication shown by the late George Worthen and the late James K. Cornett, M.D., the Worthen-Cornett Awarded is presented to an individual each year at the Heart Ball for excellence in volunteerism. Recipients demonstrate an outstanding commitment to working with the American Heart Association’s mission to build healthier lives, free of cardiovascular diseases and stroke.

Marsh has received numerous grants from the American Heart Association for a total of more than $500,000 during his career. It has funded research into using gene therapy to improve the function of a failing heart, stroke prevention and other topics.

“I am proud to receive this recognition,” Marsh said. “AHA research funding has touched the lives of every heart and stroke patient treated in the United States, no matter if the hospital is a research institution or not. This research has led to gold standard treatments and guidelines used by health care providers in every corner of the nation and around the world. Not only does every heart and stroke patient benefit from our research, but so do the millions of people who want to live healthier lives and prevent these diseases from every happening.

“My family, like the majority of families in Arkansas, has been affected by heart disease and stroke, with lives disrupted or ending too soon,” Marsh said. “It is a privilege to commit my career to developing preventive measures and new treatments for cardiovascular disease, and to caring for patients who are already bearing the burden of heart disease and stroke.”

A nationally prominent internist, cardiologist and cardiology researcher, Marsh served on the faculties at Harvard Medical School and Wayne State University before being recruited to UAMS in 2004 where he is also the Nolan Professor.

Marsh received his medical degree from Harvard Medical School in 1974. He trained in internal medicine at Brigham and Women’s Hospital in Boston, where he went on to complete clinical and research fellowships in cardiovascular diseases. He served on the faculty at Harvard for 13 years while also directing the cardiology fellowship program at Brigham and Women’s Hospital. In 1993 he moved to Wayne State University in Detroit, where he later was appointed director of cardiology and in 2001 became associate chair of the Department of Internal Medicine.

By Amy Widner| March 26th, 2018|

In the summer of 2016, Stuttgart native Blake Pond, 36, moved back to his home state after living in Dallas for 16 years. He, his wife, Ann, with their infant daughter, Caroline, wanted to be closer to family. So Pond accepted a position as chief of staff at the UAMS Myeloma Institute.

On Oct. 5, 2017 a day before Caroline’s first birthday, Pond scheduled an appointment with Chuck Smith, M.D., at the UAMS Rahling Road clinic to establish primary care.

“I told him I’d been having some symptoms over the past couple of years,” Pond said. “I just thought to mention it. But that piece of information along with my family history concerned Dr. Smith, who recommended to get it checked out just to be on the safe side.”

Smith referred Pond to get a diagnostic colonoscopy which revealed a polyp about the size of a golf ball. He was diagnosed with invasive adenocarcinoma of the colon, the most common type of colorectal cancer.

The news came as a surprise to Pond.

“I’d been in oncology research for 10 years, so all these thoughts were going through my head. The worst part was the unknown,” he said.

Conan Mustain, M.D., a board-certified colon and rectal surgeon and assistant professor in the Department of Surgery, talked through the next steps with Pond.

“First we got a CT scan to look at his lungs and liver,” Mustain said. “Those are the two sites most common for colon cancer to spread.”

Blake’s scan came back clear. There was no evidence that the cancer had spread.

“The decision then was whether removing just the polyp was adequate treatment or if we needed to also remove part of the colon,” Mustain said.

Mustain said there were two things to consider when it came to deciding whether to remove a part of Pond’s colon: the polyp site itself and whether cancer had spread to the regional lymph nodes. For some early cancers the risk of lymph node spread is sufficiently low that complete removal by colonoscopy is considered adequate treatment. In Pond’s case pathologists had not been able to confirm if the base of the polyp’s stalk (a piece of tissue that attaches the polyp to the intestinal wall) was completely clear of cancer. Additionally, some enlarged lymph nodes were visible on his CT. Given his young age, uncertainly about these nodes could mean years of costly surveillance and worry. Pond and Mustain ultimately decided they’d remove part of the colon and the lymph nodes.

The surgery was scheduled for Oct. 30. Mustain laparoscopically removed 10 inches of Pond’s colon containing the polyp site and 16 regional lymph nodes. The minimally invasive approach included three small incisions around the abdomen. Mustain says doing the procedure this way leads to less pain, lower narcotic use and a faster return to normal bowel function after surgery. Pond was discharged from the hospital after two days and back to work in two weeks.

“I’m grateful for the whole health care team at UAMS,” Pond said. “From Dr. Smith for having the wherewithal to refer me for a colonoscopy to my follow-ups after surgery. I really think this is a good example of the system working. My original primary care appointment was Oct. 5. By Nov. 5, I was back on my feet and on the road to the recovery.”

Pond went on a ski trip in January and performed at a level he would have prior to his diagnosis and surgery.

“No one is eager to get a colonoscopy,” Pond said. “But you have to know your body and if there are any symptoms, don’t wait to get it checked out.”

Mustain says colon cancer screening should begin at age 50 for most people. Those tests should come sooner if a patient shows symptoms or has a parent, sibling or child who was diagnosed with colorectal cancer.

Tears came in all shapes and sizes at Match Day 2018 – tears of joy, tears of relief and tears from proud families.

“I’m going to cry,” College of Medicine senior class President Grant Cagle said prophetically while welcoming the audience, made up of the 155 seniors who participated in the match, their families and mentors and staff from UAMS in a packed room March 16 at the Embassy Suites in Little Rock.

A short time later, he ripped open a sealed envelope to reveal the location and specialty for his residency: internal medicine at Rhode Island Hospital/Brown University in Providence. Almost inaudible through tears, he assured the crowd that it was his dream match, and the audience erupted to share his joy.

Student after student came to the podium, each with their own version of Cagle’s story, including the years of work, high expectations and support from others along the way. Many used their time at the mic to give thanks.

“It takes a team just for one medical student to graduate,” Cagle said.

Each year Match Day starts at 11 a.m. Central Time, with senior medical students all over the nation simultaneously opening envelopes to reveal their “match” – or where they have been accepted to continue their training in a specialty residency for the next three to seven years.

For some, the tears came later, maybe as they hugged their proud mothers and fathers waiting on the sidelines, or while hugging other members of their class – peers who can truly understand everything that has led up to this day.

Tess Coker and Alex Croft got a little misty-eyed as they looked back to that first day of school when they met. Soon after, they started dating. They had each other to lean on throughout the highs and lows of med school, and the match process for couples is especially daunting.

Match Day is conducted by the National Resident Matching Program (NRMP). Students in their fourth year apply to programs, interview and then send a ranked list to the NRMP. Residency programs also submit a list of preferred candidates, and an NRMP computer, using an algorithm, reconciles the lists as best as possible.

Couples face the additional challenge of trying to match in the same geographical area, while considering each other’s career goals with regard to specialty and the prestige of the program. There is a “couple match” option through the NRMP that tries to factor in geography, but still, it’s tough. One of the students who didn’t match this year was a member of a couple who was not looking for alternatives in order to stay close to a partner.

“We both knew on Monday that we had matched somewhere, but you don’t know exactly where, and even with couple matching you still have to list some apart, and couple matching in general just limits your options,” Croft said. “We were both super nervous coming into this.”

Coker’s envelope revealed she had matched in pediatrics; Croft matched in emergency medicine – both at Indiana University School of Medicine in Indianapolis.

“We couldn’t be more happy,” Croft said.

Cody McLeod of Arkadelphia, on the other hand, said selecting his top rank was easy. At the mic, he announced his match – orthopaedic surgery at UAMS – with a bit of punch in his voice, and the crowd cheered in response. McLeod’s father is an orthopaedic surgeon in Arkadelphia and he envisions a similar future for himself.

“I’ve had so many great mentors in the ortho department,” McLeod said. “It was a no-brainer for me to stay in that program. They’re doing exciting things right now, and I’m glad I’m going to get to be a part of it.”

McLeod said that in addition to his mentors, support from his wife has been key, and he’s glad he will have the support of some familiar faces as part of his residency. Derrick Henry, Timothy Hereford and Sean Parham also matched in the department.

Several students also matched in family medicine at the UAMS Regional Center in Pine Bluff, including Robert Ferguson of Booneville, who said he hopes the program will take him one step closer to his goal of becoming the rural Arkansas family doctor he aims to be.

“It’s what I’ve always wanted to be,” Ferguson said. “When I was growing up, the doctor you saw in the doctor’s office was the same one you saw in the hospital, it was the same person providing you with almost all of your care. That was my idea of what a doctor was.”

Similarly, Julie Sherrill, who grew up in Dumas and attended the University of Arkansas at Fayetteville for her undergraduate degree, matched in pediatrics at UAMS just as she hoped.

“I grew up in rural southeast Arkansas, where health care is limited and doctors are hard to find,” Sherrill said. “I want to be a primary care provider for children and adults in a small, rural community. Arkansas is my home state and I really would like to use my training to care for the people here.”

This year, 51 percent of the UAMS students matched in primary care – internal medicine, pediatrics, family medicine or obstetrics/gynecology. With an in-state tuition and fees for the 2017-2018 academic year of $32,378, many Arkansans pursuing careers in medicine see the value in a quality education at that price and chose to complete medical school at UAMS close to home.

One of UAMS’ goals is to inspire doctors to stay in Arkansas for their careers, particularly those in family medicine.

The program ranks third in the nation at retaining medical school and residency program graduates in the state. More than two thirds of Arkansas’ 75 counties include federally designated Primary Care Health Professional Shortage Areas. For five out of the last nine years, UAMS has ranked among the top 10 Doctor of Medicine programs in the nation for the number of graduates who chose family medicine.

Richard Wheeler, M.D., executive associate dean for academic affairs in the College of Medicine, started keeping statistics related to Match Day in 2005. Although there were many tears at this year’s Match Day, thankfully, few were related to students not matching at all. This year, five students did not match in the first round.

“One of the problems that students have now is the number of students graduating from medical school has increased,” Wheeler said. “The number of residencies that are opening have not kept up with that. Last year there were over 600 students in the United States who didn’t get anything at all … and that’s horrible.”

Wheeler said UAMS is working with other hospitals and programs in the state to open additional residency slots in an effort to address this issue, and every year the staff continues to help students find positions even if they didn’t match in the first round.

“We’d like to have everybody match,” Wheeler said.

The NRMP billed the 2018 Main Residency Match as the largest in history, exceeding the more than 43,000 applicants who registered for the 2017 Match and the more than 31,000 positions offered by residency programs across the nation last year.