First year medical students gathered on November 2 to honor the 35 individuals who, through the gift of their bodies after death, provided the first lessons in the students’ medical school education. The students recently finished the Human Structure segment, in which they get hands-on experience with human anatomy.

Class president Paula McClain opened the ceremony by saying “We are here today to honor a gift that is almost indescribable.”

Student speakers reflected on what the donations meant to them and their careers, and others played and sang music in memory of the donors. The class also presented an original artwork to the faculty. The piece will hang in the hallway outside the anatomy lab.

The class wrote these words of appreciation:

“We, the class of 2022, would like to express our deepest gratitude to the thirty-five individuals who have given their bodies to us so that we may learn. These individuals have not only given to us, but given to the world. Their contributions to the practice of medicine will serve to help others in their time of suffering. We honor them with our hearts and our minds, as we continue to live our lives to serve others.”

At the end of the ceremony, a student representative from each lab table group placed a white rose in memory of their donor. The students then observed a moment of silence.

Each year, about 100 people sign up to donate their body as a whole to science upon their deaths through the UAMS Anatomical Gift Program.
For more information, please visit https://neurobiology.uams.edu/about/anatomical-gift-program/

By Liz Caldwell

The Baptist Health – University of Arkansas for Medical Sciences (UAMS) Medical Education Program is now recruiting residents for two residency programs set to launch next summer in Internal Medicine and Family Medicine.

The three-year programs, which train up to 12 residents per year in each as part of a partnership between Baptist Health and UAMS, were granted accreditation approval in October by the Accreditation Council for Graduate Medical Education.

“This collaborative effort enriches the health care scope at Baptist Health and UAMS, providing additional opportunities for education and the ability to serve more communities,” said Troy Wells, president and CEO of Baptist Health. “Those priorities fall directly in line with our organization’s mission of providing quality health education and responding to the changing needs of Arkansas residents.”

Each residency option, mindful of the national shortage of primary care physicians, allows students to be educated by experienced, distinguished academic faculty on the Baptist Health Medical Center-North Little Rock campus. These first programs will begin resident training in July 2019.

“The Baptist Health – UAMS Medical Education Program extends our commitment to providing residents with a culture of excellence through high-quality, superior leading examples,” said Cam Patterson, M.D., M.B.A., UAMS Chancellor. “These residency training programs will be embedded in a community hospital with academic medical support that provides an environment much like the one where they will one day practice. By providing residents with a notable community training program we have a better chance of retaining them as generalists, a need prevalent in small to mid-size communities.”

Expanded teaching areas include sports medicine, women’s health, geriatrics, wound care and electives to complement each resident’s specific interest. The methods with which residents are trained will help them be life-long learners after they graduate with the skills they learn to use in residency.

Reflecting the continued vision of the Baptist Health – UAMS Accountable Care Alliance, which was announced in August 2017, the program is intended to strengthen the two institutions’ ability to improve population health and care delivery.

For more information about the Baptist Health – UAMS Medical Education Program, including the application process, visit baptisthealth-uams-gme.org or call (501) 202-4831.

By David Robinson

Oct. 26, 2018 | People with frequent and recurring pain from an amputated leg are being enrolled in a University of Arkansas for Medical Sciences (UAMS) research study of a device designed to reduce amputation pain.

Led at UAMS by Erika Petersen, M.D., a neurosurgeon and researcher, the study is part of a clinical trial being conducted at sites across the United States.

The study is testing the safety and effectiveness of an implanted device, Altius® High Frequency Nerve Block, that is designed to block nerve signals and reduce pain in an amputated limb. The investigational device sends a high-frequency electrical signal to targeted nerves to block the nerve transmission. It was developed by Neuros Medical Inc., in Cleveland, Ohio.

Called the QUEST study (High-FreQUEncy Nerve Block for PoST-Amputation Pain, ClinicalTrials.gov Identifier: NCT02221934), it is a randomized, controlled clinical study of up to 180 patients, at up to 25 clinical study sites in the U.S.

Study participants will undergo surgery to be implanted with the device. It includes a cuff electrode, which is coiled around the nerve, and a pulse generator, which is similar to a pacemaker. Together they deliver an electrical signal to the nerve when activated. Once implanted, study participants can activate a 30-minute treatment session on demand, as needed for their pain. Participants will be followed for a year and seen in clinic once a month. They will also receive modest compensation for their time and travel.

Eligibility requirements for participating in the study include:

• Having one amputated leg
• Frequent and recurring amputation pain
• 21 years of age or older

Those interested in learning if they are eligible may contact the UAMS Translational Research Institute study coordinator, 501-398-8622.

An earlier pilot study involving 10 participants demonstrated that the implant device may be safe and effective for post-amputation pain. (Soin A., Syed Shah N., Fang Z-P. 2015. High-Frequency Electrical Nerve Block for Postamputation Pain: A Pilot Study. Neuromodulation 2015; 18:197-206). DCO# 18-0030 / LB-0042 Rev. A / Effective May 23, 2018 Page 4 of 11.

The project described is supported by the Translational Research Institute (TRI), grant 1U54TR001629-01A1 through the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

By Ben Boulden

Oct. 11, 2018 | Hari Eswaran, Ph.D., and his research team are working hard to see if a new generation of technology can improve on a device developed at UAMS while lowering its cost and benefitting pregnant mothers.

In 2000, Eswaran was part of the UAMS team that developed the SARA (SQUID-Array for Reproductive Assessment) device for maternal-fetal medicine research. When the SARA is used, a pregnant woman sits against a concave shield that covers her abdomen.

More than 100 sensors obtain three-dimensional data from the fetus and the uterus – without employing needles or any other invasive instruments. Advanced techniques with the SARA allowed for the simultaneous examination of cardiac and brain activities in the fetuses.

Eswaran, Ph.D., is a professor in the College of Medicine’s Department of Obstetrics and Gynecology.

“The biggest problem with SARA is its cost and maintenance,” Eswaran said. “It requires liquid helium to sustain and run. That prevents a lot of hospitals from buying a system like this, even just for research. It costs about $8,000 a month. The positions are pretty rigid. The sensors are fixed where they are and cannot be moved.”

Along with Curtis Lowery, M.D., Heather Moody, R.N., a certified research specialist, and Diana Escalona-Vargas, Ph.D., Eswaran has been working with QuSpin, a company that has developed a new type of sensor that might be a viable replacement for the original SARA. Lowery is chair of the Department of Obstetrics and Gynecology. Moody and Escalona-Vargas work in the department’s Division of Maternal-Fetal Medicine.

“The new systems that have come along in the last few years do not require any cryogenic helium to operate,” Eswaran said. “They are more flexible and we can move the sensors to be close to the heart based on what the ultrasounds show us the position of the baby is.”

Instead of more than 100 sensors, they have been able to use a grid array of 14 sensors that can be strapped to the mother’s abdomen. Where the original SARA cost almost $2 million to construct, each sensor in what Eswaran and his team are calling ‘SARA 2.0’ costs $8,000 to $10,000, a potentially huge savings.

That savings means the new technology might one day be an affordable diagnostic tool in hospitals for use with pregnant mothers. The cost of the original SARA has meant it has primarily been a research tool, one only available at UAMS and another research facility in Germany.

In late 2017, UAMS received a two-year, $275,000 grant from the National Institutes of Health to study the effectiveness of the new technology and what might be the best position for the mother to get a good signal from the device while also improving her comfort. So far, the reviews from at least one pregnant mother have been positive.

“I find it comfortable,” said Shyanne Chisum, a first-time mother and firefighter. “It eases the belly weight. It’s definitely more comfortable than the old machine, much more comfortable.”

Chisum volunteered for the study about 28 weeks into her pregnancy. When she came to UAMS recently on a September morning for her fourth round of scans, she was at 35 weeks. By volunteering, she also was able to receive 3D and 4D ultrasound imaging of her baby, something she wanted to have.

The research team also has tried using the device while the mother is leaning back in an Adirondack chair. Next, they want to try out a specially built massage table with a cut-out for the pregnant mother’s belly that will allow her to comfortably lie flat and face down while the SARA 2.0 array is strapped in place.

Eswaran said data retrieval for the fetal heart has been strong. Even though the number of sensors has been greatly reduced, the flexibility means the SARA 2.0 sensors can be moved and more precisely targeted for data gathering. Other technologies only can capture the baby’s heart rate, but the SARA can look at the activity in the fetal heart like an electrocardiogram can in an adult.

They’ve yet to examine what kind of data can be gathered in regard to fetal brain activity when compared to the original SARA, but the study will not conclude until summer 2019.

UAMS also directly contributed some funds to the study.

By Linda Haymes

David Bumpass, M.D., an orthopaedic surgeon at the University of Arkansas for Medical Sciences (UAMS), was named one of the nation’s outstanding young spine care providers by the North American Spine Society’s SpineLine magazine in its inaugural “20 Under 40” list honoring spine professionals under the age of 40.

Bumpass, 37, is featured in the September/October 2018 issue. The list, selected by the magazine’s review team, included 21 members following a tie in application scoring.

“Dr. Bumpass is an outstanding member of our department,” said C. Lowry Barnes, M.D., chair of the Department of Orthopaedic Surgery in the UAMS College of Medicine. “He excels in the clinic and operating room and in both basic and clinical research, as well as in educating and mentoring students and residents. He is already a clinical leader and was recently named co-director of the spine clinical services. We are fortunate to have him as our partner, and our state is lucky to have him here.”

Bumpass and the 20 others spotlighted this year were recognized throughout the society’s 33rd Annual Meeting in Los Angeles, Sept. 26-29 with a poster at the magazine’s booth and several tweets throughout the week. More than 3,000 spine professionals from the organization’s 8,000-plus members attended.

In addition to treating adult and pediatric patients, he serves as director of clinical research for the Orthopaedic Surgery Department.

Bumpass also collaborates with local emergency medical services in Little Rock to improve their emergency spine trauma care in the field. The joint effort has strengthened the relationship between physicians and local EMS crews and educated first responders on how physicians treat spinal injuries after patients arrive at the hospital.

“I have been able to learn more about questions and challenges the paramedics face in the field when managing spine trauma,” he said in his “20 Under 40” feature in the magazine. “Our hospital system has worked hard to streamline and improve protocols for spinal trauma management once patients hit the door, identifying delays and improving multi-team care.”

Bumpass was earlier recognized by the society in 2014 with its Young Investigator Translational Research grant for “The Role of Myeloid-Derived Suppressor Cells and T-Lymphocytes in Human Vertebral Metastasis: A Prospective Pilot Study.”

“That enabled me to complete some exciting research in the role of the immune system in facilitating spinal metastasis,” Bumpass said. The $50,000 grant went toward research that is nearly complete.

“The results suggest that there is an under-appreciated role that the immune system plays in allowing the development of metastatic cancer in bone,” Bumpass said, adding that healthy immune cells within the bone seem to be inhibited from preventing cancerous cells from spreading into the bone.

By Linda Haymes

Frits van Rhee, M.D., Ph.D., a myeloma researcher and clinician at the University of Arkansas for Medical Sciences (UAMS), was lead author on a recently published paper that for the first time establishes treatment guidelines for patients with a form of Castleman disease, a rare disorder of the lymph nodes and related tissues.

The guidelines are designed to improve outcomes in patients with a severe form of the disease called idiopathic multicentric Castleman disease (iMCD). It affects multiple lymph node areas and can cause night sweats, fevers, weight loss, anemia and in severe cases organ failure and death.

“Treatment is challenging and outcomes can be poor since no uniform treatment guidelines exist, few systematic studies have been conducted and no agreed upon response criteria have been described, according to the paper published online Sept. 4 in Blood, the journal of American Society of Hematology.
“International, Evidence-based Consensus Treatment Guidelines for Idiopathic Multicentric Castleman Disease” includes research and input from van Rhee and 41 other specialists, researchers, and clinicians from 10 countries.

“These guidelines are important because patients are at significant risk of death,” said van Rhee, director of clinical affairs of the UAMS Myeloma Center. “Until now, physicians have not agreed on the criteria for response to treatment of the disease.”

Van Rhee is regarded as an international expert on Castleman disease. He is professor of medicine and holds the Charles and Clydene Scharlau Chair for Hematologic Malignancies Research.

iMCD has been treated with a wide variety of agents, including corticosteroids and chemotherapies. But many patients, especially those with a severe form of the disease, do not benefit from some of these treatments.

The guidelines should assist physicians with selecting therapy and evaluating the response, thereby improving patient outcomes. Most recommendations were reached by consensus of the expert panel. They based the guidelines on published literature, review of treatment effectiveness in 344 cases, and expert opinion. They gathered through coordinated meetings of the Castleman Disease Collaborative Network, which van Rhee cofounded in 2012 with his patient David Fajgenbaum, M.D.

Other UAMS researchers who helped with the project are Katie Stone, director of the Myeloma Immunotherapy Lab, and Amy Greenway, research associate with the Myeloma Immunotherapy Lab. Contributors hail from across the United States and Canada, the United Kingdom, Germany, Italy, France, Japan, Hong Kong, Norway and New Zealand.

“The average oncologist may only see one patient with Castleman disease in his career,” said van Rhee. “A lot of progress has been made in the treatment of this disease and a lot of new information is available.”
An international registry for patients with Castleman disease was established in October 2016 to collect patient outcomes to increase the evidence base for selection of future therapies.

Castleman disease occurs when an abnormal overgrowth of cells occurs in the lymph system, which serves as the main part of the body’s immune system. The disease, affecting 5,000 to 6,000 patients across the nation, was identified by Benjamin Castleman, M.D., in 1954.

Van Rhee was previously the principal investigator on a worldwide trial with siltuximab, which led to the first FDA-approved treatment for multicentric Castleman disease and led to the approval of the drug by the European Medicine Agency. Earlier this year, he released a book, Castleman Disease, as part of the Hematology/Oncology Clinics of North America series of clinics review articles published bimonthly by Elsevier Inc. Van Rhee wrote the chapter, “Treatment of Idiopathic Castleman Disease” along with Green, his research associate, and Stone, his lab director.

By Susan Van Dusen

Oct. 2, 2018 | Arkansas’ children have a healthier tomorrow before them, after the University of Arkansas for Medical Sciences (UAMS) and Arkansas Children’s today signed updated research collaborative and affiliation agreements.

The agreements, which take effect Oct. 1, continue the strategic partnership of the state’s only medical university and the state’s only children’s health system.

UAMS Chancellor Cam Patterson, MD, MBA, and Arkansas Children’s President & CEO Marcy Doderer, FACHE, called the agreements “a vital step and the next milestone” in the more than 40-year relationship of the two institutions. The two describe the agreements as enhanced strategic partnerships between UAMS and Arkansas Children’s.

The institutions agreed last year to explore a closer relationship. The agreements announced today have met the due diligence and regulatory approvals of both institutions.

“The 720,000 children of Arkansas are at the center of every decision we make at Arkansas Children’s, and never more so than today,” Doderer said. “These updated agreements empower us and our strategic partner to continue blanketing the state with pediatric services aimed at improving the health of children where they live, learn and play.”

“The affiliation between our two institutions is good for Arkansas Children’s and UAMS but most importantly for children all across our state,” said Patterson. By working together, UAMS and Arkansas Children’s are able to provide better health and health care for the youngest Arkansans who are at the heart of everything we do.”

“UAMS brings a comprehensive team of physicians to Arkansas Children’s that represent all specialties across the spectrum of medicine,” said Christopher T. Westfall, MD, FACS. “Because our physicians have an academic interest in research and education, they are teaching and providing the latest treatments and techniques.”

The updated agreements aim to provide high level care to children and young adults, integrate pediatric research activities and continue to advance leading pediatric clinical care and academic programs with national recognition, attract and retain top staff, and improve operating performance.

“We look forward to empowering the faculty, researchers and staff who serve children every day to make their highest and best contribution at every point of care,” said Arkansas Children’s Executive Vice President & Chief Operating Officer Chanda Chacon, MPH, FACHE. “The people of Arkansas have come to expect the very best for their children. We are poised to continue to deliver just that.”