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  1. University of Arkansas for Medical Sciences
  2. College of Medicine
  3. News
  4. Page 8

News

J.D. Day, M.D., Invested in Robert Watson, M.D., Chair in Neurological Surgery

By Benjamin Waldrum

J.D. Day, M.D., an internationally recognized leader in skull base surgery and specialist in Gamma Knife surgery and vascular disorders of the brain and skull base at the University of Arkansas for Medical Sciences (UAMS), was invested Oct. 10 in the Robert Watson, M.D., Chair in Neurological Surgery.

“This is probably one of the most humbling days of my life,” Day said. Referring to a map showing his many stops across his medical career, he pointed to a red line that led him to UAMS. “God willing, that red stands for stop, and I will be here for the rest of my career.”

Day is chair of the Department of Neurosurgery in the UAMS College of Medicine.

Day poses with Ebonye Green, M.N.Sc., and Analiz Rodriguez, M.D., Ph.D., at the event's reception.
Day poses with Ebonye Green, M.N.Sc., and Analiz Rodriguez, M.D., Ph.D., at the event’s reception. (Photo by Bryan Clifton)

An endowed chair is among the highest academic honors a university can bestow on a faculty member. A chair is established with gifts of at least $1 million, which are invested and the interest proceeds used to support the educational, research and clinical activities of the chair holder. Those named to a chair are among the most highly regarded scientists, physicians and professors in their fields.

“I’d like to thank J.D. Day for everything that he’s done for UAMS and the people of Arkansas, and for the entire field of neurosurgery,” said UAMS Chancellor Cam Patterson, M.D., MBA. “We are grateful for what you have done and we are grateful for what you will continue to do.”

Robert C. Watson, M.D., known as the father of neurosurgery in Arkansas, was just a teenager in Mena, Arkansas, working in the local drugstore when he discovered he wanted to become a physician. Upon graduation from the UAMS College of Medicine in 1935, he had not decided which specialty he would pursue, but that changed when he cared for a young girl with a brain injury during his internship at Detroit City Hospital. He furthered his training in Brooklyn, New York, at King’s County Hospital, where his fascination with the brain grew.

In 1944, Watson became only the 108th physician to receive accreditation from the American Board of Neurological Society. Watson returned to Arkansas to practice neurosurgery and began a 27-year volunteer career as a teacher, educating young physicians about diagnosing neurological cases.

“Dr. Watson was a pillar of the medical community and here at UAMS,” said Christopher T. Westfall, M.D., UAMS executive vice chancellor and dean of the College of Medicine. “He was truly the father of neurosurgery in Arkansas, and he had an immeasurable impact on our students, our residents, our fellows, and most importantly, to the patients they went on to serve.”

James P. Chandler, M.D., praised Day as "a neurosurgeon's neurosurgeon."
James P. Chandler, M.D., praised Day as “a neurosurgeon’s neurosurgeon.” (Photo by Bryan Clifton)

“This investiture celebrates the generosity and philanthropic spirit, and the legacy of Dr. Watson, and we are delighted to celebrate Dr. Day’s leadership and accomplishments with this chair,” he said. “Dr. Day has propelled our Department of Neurosurgery and the Neurosciences Service Line to new heights.”

Watson’s accomplishments included serving as chief of staff of Baptist Medical Center, president of both the Arkansas and Pulaski County Medical Societies, and president and founder of the Southern Neurological Society. He was a founding member and longtime chairman of the Board of Directors of the Medical Education Foundation of Arkansas. In 1980, the neurosurgeons who had joined Watson’s practice created the Robert Watson, M.D., History of Medicine Room in the UAMS Library.

“Dr. Watson truly had a remarkable career,” Day said. “He always worried about his patients like we do, and I’m sure he prayed every day, just as I do, that our patients have the best outcome possible. Some things just will never change in neurosurgery.”

Patterson and Westfall thanked the members of Watson’s family who were in attendance.

“I’ll tell you, if I ever had a neurologic or neurosurgical problem, I would fly to Arkansas, to this place, and have John as my neurosurgeon,” said James P. Chandler, M.D., vice chair of the Department of Neurological Surgery and co-director of the Lou and Jean Malnati Brain Tumor Institute of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. “He is a neurosurgeon’s neurosurgeon. Congratulations, John – this honor is very appropriate and very well deserved.”

“We worked a lifetime together and John became a brother,” said Michael L. Levy, M.D., Ph.D., chief of pediatric neurosurgery at Rady Children’s Hospital-San Diego and the University of California, San Diego School of Medicine. “I think this honor is so appropriate for him because he is everything that this honor represents. He is everything you want in somebody to be in a leadership position, to educate those surgeons – they’re going to be practicing for decades – and to make a difference in the lives of so many people. That’s what John does.”

Day was presented with a commemorative medallion by Patterson and Westfall.

Day thanked members of his family in attendance, as well as the Watson family, and reserved special praise for members of his department, including faculty, administrators, nurses and the scrub techs in the operating room.

Day thanked members of his family in attendance, including his mother Carla and daughters Erin and Carly.
Day thanked members of his family in attendance, including his mother Carla and daughters Erin and Carly. (Photo by Bryan Clifton)

“While it would seem like the pinnacle of an academic physician’s career to be invested in an endowed chair, I assure you that this, for me, represents more of a rebirth and a beginning to the next phase,” Day said. “My overall goal, when I’m finished, is that if you’re in Arkansas and you have a neurosurgical problem, you know that you will be delivered the most comprehensive, cutting-edge, up-to-date care that’s available anywhere in the country. That’s my pledge to you.”

Day became chairman of the Department of Neurosurgery in 2010. He was previously an associate professor, vice chair for academic affairs, and the associate residency program director at the University of Texas Health Science Center in San Antonio, Texas.

He earned his Bachelor of Arts in chemistry from Whitman College in Walla Walla, Washington, and his medical degree from the University of Washington in Seattle, Washington. He completed his residency at the University of Southern California LAC/USC Medical Center in 1996 and followed with a research fellowship in cranial base surgery at the University of Vienna Medical School, Neurochirurgische Universitätsklinik in Vienna, Austria. During his residency, Day received the Mahaley Award for Clinical Research from the American Association of Neurological Surgeons.

Day’s clinical interests include brain tumors, cerebrovascular surgery and skull base surgery. His research efforts include refinements of minimally invasive neurosurgical techniques in brain surgery and enhancing early recovery after brain surgery. He has authored four textbooks on skull base surgery and published over 80 chapters and articles on neurosurgical topics. He is a highly sought-after lecturer on skull base surgery techniques and has lectured and served as faculty for courses on four continents.

Filed Under: News

Research Collaboration Crosses Basic Science, Clinical Boundaries

By Susan Van Dusen

Biomedical research does not exist in a vacuum. To succeed, scientists must work together by combining resources and ideas in new and innovative ways.

Many times, these collaborations exist across institutions, where combined strengths provide the perfect combination of skills necessary to undertake complex projects successfully.

Such is the case with a partnership between the UAMS Winthrop P. Rockefeller Cancer Institute and the University of Arkansas, Fayetteville (UA) that recently resulted in a five-year, $2.03 million R01 grant from the National Cancer Institute (NCI).

It all started with grant recipient Narasimham Rajaram, Ph.D., and his mission to create a method of monitoring a cancer patient’s response to radiation and chemotherapy, allowing for timely changes to the treatment plan if necessary. Rajaram is a UA assistant professor of biomedical engineering.

With conventional treatment and monitoring methods, doctors are unable to determine how well a tumor responds to treatment until after the fact. This includes whether the patient’s tumor completely disappears, shrinks, remains the same or enlarges.

Dr. Rajaram in his lab
Grant recipient Narasimham Rajaram, Ph.D., at work in his lab at the University of Arkansas College of Engineering.
(Image credit: University of Arkansas)

“Unfortunately, there are currently no methods that can identify treatment response in the clinic during therapy, which causes patients – both responsive and resistant – to lose critical time when alternative approaches could be considered,” said Rajaram.

To complete his experiments, Rajaram, who spent four years at Duke University before arriving at UA in 2014, required unique cell lines to examine for potential new biomarkers and disease-resistance patterns.

Through his network of colleagues, Rajaram discovered a connection to Robert J. Griffin, Ph.D., professor and biologist in the UAMS College of Medicine Department of Radiation Oncology. After initial discussions, the two determined their mutual interest in the effects of radiation therapy and disease resistance could lead to a partnership.

Griffin’s colleague Ruud Dings, Ph.D., who joined UAMS during this time, also entered the discussion. Dings is assistant professor in the Department of Radiation Oncology and, like Griffin, uses his laboratory to create unique cell lines.

“Previously, scientists studied disease resistance patterns by comparing cell lines that were not related to each other or that had different backgrounds, resulting in potential false correlations,” said Dings.

The unique cell lines created in the UAMS labs are isogenically related, meaning they are engineered from a parental line, have the same genetic background and are exposed to repeated interventions that create acquired resistance to radiation or drugs.

With a set of unique cell lines he acquired from Dings’ lab in 2015, Rajaram continued his work on optical imaging technologies, with the goal of developing a method to predict a tumor’s sensitivity to treatment.

A paper highlighting findings related to this research was published in the April 17, 2019, issue of Cancer Research, a publication of the American Association for Cancer Research.

Out of Rajaram’s research came the development of a thin, chopstick-like probe. When touched to a tumor or surrounding tissue, light emitted from the probe refracts. The light is then captured back into the probe and collected for analysis.

With the probe ready to test in humans, Rajaram reached out to UAMS surgeon Mauricio Moreno, M.D., for input on how to apply this emerging technology to head and neck cancer.

From there, the idea for a clinical trial was born.

“The Holy Grail of head and neck oncology is the ability to accurately predict which patients will or will not respond to radiation therapy,” said Moreno, associate professor in the UAMS College of Medicine Department of Otolaryngology-Head and Neck Surgery.

Those patients whose tumors do not completely disappear following radiation therapy typically require surgery. And, as Moreno pointed out, patients who have recently undergone radiation therapy are a much higher risk of potential surgical complications.

“If there was a way for us to know upfront that a patient was not likely to respond to radiation, we could alter their treatment plan and prevent them from experiencing the toxicity of radiation therapy in the first place,” Moreno said.

Moreno and Rajaram determined that head and neck squamous cell carcinoma (HNSSC) of the larynx or tonsil was the best condition on which to focus their clinical trial for four reasons:

1) It is a common cancer, resulting in a large number of potential participants.

2) It is treated with radiation.

3) The tumor can be easily accessed noninvasively.

4) It is often caused by the human papilloma virus (HPV), which is typically sensitive to radiation therapy.

Their study, which has enrolled about five UAMS patients so far, is approved to enroll up to 90 subjects with Stage 3 or Stage 4 HNSCC, including those with tumors that are both HPV-positive and HPV-negative.

Trial participants undergo both a baseline test after diagnosis and a test during their course of radiation treatment. The test includes inserting the thin probe into the patient’s throat and touching the probe’s light to the tumor and surrounding tissue. Researchers hope that by examining the light patterns captured during both of these tests they can identify correlations related to tumor treatment response.

“It’s very investigational, but if we can identify a pattern either before or during the early phases of treatment where we see the tumor is not responding properly, that could potentially have significant clinical impact for future patients,” Moreno said.

All data collected by the probe goes back to Rajaram for analysis and is compared to the patients’ other imaging results, including CT scans, for potential correlations.

The fact that Rajaram’s NCI grant funds both the basic science and clinical trial associated with this research is uncommon, said Griffin, adding that “the clinical observations collected by Dr. Moreno will strengthen the basic science conducted by Dr. Rajaram, Dr. Dings and myself.”

Additional pre-clinical studies and technology development were conducted at Johns Hopkins University. Rajaram’s initial work to demonstrate the feasibility of this approach was supported by start-up funds from UA and the Arkansas Biosciences Institute.

Research collaborations such as this one bolster the Cancer Institute’s ongoing efforts to receive National Cancer Institute Designation.

To achieve designation, cancer centers undergo a highly competitive assessment process that demonstrates an outstanding depth and breadth of research in three areas: basic laboratory, patient/clinical and population-based. The designation brings with it many benefits, including expanded access to federal funding for researchers and improved access to clinical trials for patients.

Filed Under: News

Jia Liu, Ph.D., Honored as Community Champion, Receives $10,000

By Ben Boulden

It’s been a time of accolades for UAMS researcher Jia Liu, Ph.D., an assistant professor in the UAMS College of Medicine Department of Microbiology and Immunology.

In June 2019, she was awarded $10,000 in research funds by the River Valley Ovarian Cancer Alliance, an advocacy group based in Fort Smith, Arkansas that aims to raise awareness and promote education to fight ovarian cancer. On Friday, Sept. 27, she was honored as the Community Champion of the Year by the Arkansas Ovarian Cancer Coalition, the state advocacy organization for Arkansas.

“Ovarian cancer is the most deadly gynecological cancer. Sadly, about half of the diagnoses are in women in their early 60s,” said Shuk-Mei Ho, Ph.D., UAMS vice chancellor for research. “The five-year relative survival rate is less than 50%. We need new breakthrough treatments, such as the one being developed by Dr. Liu, to combat this cancer. UAMS as the only academic center in Arkansas is committed to research that improves cancer care in Arkansas and around the nation.”

Liu and her research team have taken a unique approach to fighting cancer, especially ovarian cancer. They are re-inventing the use of viruses that infect and kill cancer cells to create more effective treatments or even cures.

“Viruses can make us sick, but we can re-engineer them to benefit us,” Liu said. “In this case, we can use them to kill cancer cells. The virus we are studying can work on many cancer types, but we’re particularly interested in treating ovarian cancer. For four decades, long-term survival for patients with ovarian cancer remained low and we hope to be able to help to improve this result.”

The team’s work has produced one re-engineered virus that has shown promise in early testing. Liu said a patent is pending, and there is interest from a pharmaceutical company in further developing and testing the virus in clinical trials.

“While society often uses numbers of patients to measure the effect of a disease, we perhaps should look at ovarian cancer more closely. This disease is a silent killer for women and indeed impacts so many families or individuals,” Liu said. “Compared with other cancer types, improvement in diagnosis and treatment for ovarian cancer is urgently needed.

Liu said awareness of this deadly disease also needs to be raised, including awareness of its symptoms, risk factors, treatment options, care, and advocating for research that will improve diagnosis and treatment.

“We sincerely thank the generous support from the River Valley Ovarian Cancer Alliance,” Liu said. “This fund will allow us to conduct important studies and help us to establish a sustainable research program for ovarian cancer immunotherapy. I also want to thank our long-time collaborator on our work, Dr. Martin Cannon. Dr. Cannon is an internationally renowned immunologist at UAMS and a mentor for me on ovarian cancer immunotherapy. Only with his help we were able to test my viral vector on clinical specimens and showed exciting results.”

Filed Under: News

College of Medicine Students Get into Spirit at Academic House Olympics

By Amy Widner

Medical school isn’t always about books and biology. Sometimes it’s about Baggo and bragging rights.

Such is the case at the Academic House Olympics, an annual event where students, faculty and their families put aside the hard work of medical school for an afternoon to have a little fun. This year’s festivities were held in Murray Park beneath a bright summerlike September sky near the banks of the Arkansas River.

The Academic Houses squared off for a house spirit competition and then broke down into smaller groups to preserve house honor at volleyball, tug of war, Baggo — even Hula-Hooping. The afternoon was interspersed with food, fun, and fellowship, and participants were encouraged to bring family members and pets so that everyone could get a better sense of each other’s lives outside of med school.

Woman and baby in inflated toy
House Ish tied for second place in the spirit competition.

“This is all about fun,” said Haley Birth, a fourth-year student in Compton House, which won the spirit competition and was the overall top-scoring team for the Academic House Olympics. “We get to interact with our faculty mentors in a casual atmosphere, see their kids running around, and it all just makes school feel a little bit less academic and more of a social network that we can depend on.”

That feeling is by design. As freshmen, College of Medicine students are divided into one of seven Academic Houses for the duration of medical school. Each house includes students who are at various stages of their training, and each house is shepherded by faculty advisers. The small-group atmosphere facilitates mentorship from the advisers and also between the students. The Academic House system began in 2016 and the Olympics followed in 2017 to deepen those connections.

Student with dog, both decorated
Students were encouraged to bring family and pets to get to know each other’s lives outside of the classroom.

“We wanted to have an event that would welcome the freshmen medical students, a gathering that would involve family and friends, dogs, babies and really get everybody involved,” said Sara Tariq, M.D., associate dean for student affairs in the College of Medicine. “We also wanted to harness the spirit of competition from the medical students, something fun that would build a sense of comradery.”

Second-year student Olivia Speed of Ish House and her teammates spent about a week working on their phoenix-themed design. They tied for second place in the spirit competition with Tank House and Beall House.

“It’s been phenomenal,” Speed said. “It’s nice to get out of the library and actually spend a weekend having fun, relaxing and hanging out together in a non-school setting. I’ve gotten to know my advisers and the other students better — you find out pretty quick who’s competitive and who’s into trash talk!”

Students and professors
House Tank prepares for judging by Jeannette M. Shorey II, M.D., and Puru Thapa, M.D., Ph.D., (yellow shirt).

However, it’s not all fun and games. Many house activities focus on academic success and preparation for crucial milestone events such as national exams and the increasingly competitive National Resident Matching Program, which determines where physicians will train after graduation. The advisers and upperclassmen help younger students gear up for these challenges.

“We know that sustained professional and personal relationships between students and faculty and among peers contribute to effective learning,” Tariq said. “This is one reason about 60 medical schools across the country — about 40 percent of U.S. medical schools — have adopted academic houses or similar learning communities.”

Students hula-hooping
Activities included Hula-Hooping, Baggo, volleyball and tug of war.

UAMS’ seven academic houses were named by students in honor of successful UAMS alumni, iconic faculty members, prominent Arkansas physicians and other leaders (all deceased) who made their mark on Arkansas and medicine. For example, Neil Ernest Compton, M.D., graduated from UAMS in 1939, served the U.S. Naval Reserve as a medical officer, and practiced obstetrics and gynecology in northwest Arkansas for decades. Compton was a nationally lauded conservationist and was instrumental in having the Buffalo River of Arkansas designated as the first protected “national river” in the National Park System. Ish House is named for George William Stanley Ish, M.D., a Harvard-trained African American physician who cared for citizens in Little Rock from the 1920s through the 1960s and founded a sanatorium for treating tuberculosis patients.

Filed Under: News

Vigil Honors Groundbreaking Life, Career of Dr. Edith Irby Jones

By Spencer Watson

Dozens of UAMS faculty, staff and students gathered outside the Medical Center on a mercifully cool and clear evening for a vigil by the Edith Irby Jones, M.D., chapter of the Student National Medical Association (SNMA) to honor its namesake, who died July 15.

Dr. Cam Patterson at podium adjacent to poster collage of Dr. Jones
UAMS Chancellor Cam Patterson, M.D., MBA, speaks to the emotional impact of Jones’s loss.

Jones became the first African American to attend an all-white medical school in the South since Reconstruction when she was admitted to UAMS in 1948. She graduated in 1952 and went on to become the first African American resident at Baylor College of Medicine and the first female president of the National Medical Association.

“When I was younger, my grandfather gave me a picture of Edith Irby Jones because he knew I wanted to be a doctor,” said Tia’Asia James, current SNMA president, explaining the personal inspiration she takes from the example Jones set. “Having the opportunity to hold this event meant a lot to us as students, because a few of us are actually recipients of her scholarships, including me.”

“If it were not for her and what she stood for and her drive and accomplishments, many of us might not be here today,” said Maya Merriweather, SNMA vice president. “Tonight, we take a moment to celebrate who she was and what she meant to us as a doctor, mentor, friend and leader.”

Two medical students at podium
SNMA President Tia’Asia James and member Paige Jones lead attendees in lighting candles and observing a moment of silence.

Following a welcome and invocation at Bruce Fountain, under clear skies that had threatened rain all day long, James read a letter from Jones’ eldest daughter, Myra Jones Romain. It shared her mother’s struggle of losing her own mother and having to take care of a younger brother while still in medical school, beginning her career and finally establishing her practice, as well as becoming an advocate for civil rights.

Following the letter, SNMA member Paige Jones invited all participants to light candles and observe a moment of silence. Afterward, UAMS Chancellor Cam Patterson, M.D., MBA, addressed the gathering, sharing not the details of Jones’s life, but the emotions her death evoked.

“We are lucky to have been on this earth with someone who was so committed to making a difference… and grateful to Edith Irby Jones for being a groundbreaker,” he said. “We’re also sad because she’s departed us here at this moment. And I am sad that she did not accomplish her goal, that we do not have health care equity in the United States, that we are not all treated the same regardless of where we grew up, what day we pray on, what color we are or what language we speak.”

Person signing card
Vigil attendees signed cards to be sent to Jones’s surviving family.

Patterson encouraged determination to carry on with Jones’ “revolution” and hope that by “committing ourselves to continuing to march forward on behalf of what really matters, that we will make her proud.”

Erick Messias, M.D., Ph.D., M.P.H., noted that in her time as a student, Jones was required to dine alone at a segregated table in the cafeteria, where the kitchen staff left her fresh flowers. “Today, the chancellor is bringing a candle to celebrate her life. This is the trajectory of life that Dr. Jones created for us,” he said.

Messias also shared the impact Jones had for the College of Medicine, transforming both its student body and its faculty.

“The door that she opened is the door through which we got incredible students, incredible residents and we have had amazing faculty members in the College of Medicine,” he said. “I am grateful to her as the associate dean of faculty affairs for giving us such an incredible group of African American faculty members who have made us proud and continue to make us proud every day.”

Small group of people lighting candles
UAMS employees light candles in honor of Jones at Bruce Fountain.

In closing, Brian Gittens, Ed.D., M.P.A., vice chancellor for diversity, equity and inclusion, reminded those in attendance that with all the privileges Jones’s life made possible for those who followed her comes the responsibility to provide compassionate care and to support and be kind to others.

“That’s the price of this privilege,” he said. “That’s the price I’m hoping we all are willing to pay.”

Filed Under: News

UAMS-Sponsored Senior Expo Draws Crowds to Learn, Participate

By Ben Boulden

To the sounds of bingo numbers being called out, speakers on a main stage and the general murmur of conversations, several hundred seniors circulated through the Statehouse Convention Center in downtown Little Rock to participate in the Senior Expo.

Sponsored by UAMS and presented by the Arkansas Democrat-Gazette, the event pulled visitors from throughout central Arkansas and beyond.

Expo participants visit a booth; poster of Mediterranean Diet
A Nutrition Booth at the Senior Expo provided samples of healthy foods and demonstrations of how to make them.

About 243 seniors received free health screenings for blood glucose, blood pressure and heart rate as well as medication and vaccination education.

The UAMS Donald W. Reynolds Institute on Aging provided geriatricians to give free consultations throughout the day at the “Ask the Doctor” booths. UAMS Harvey & Bernice Jones Eye Institute staff performed 60 vision screenings.

As part of a panel discussion and question-and-answer session, Jeanne Wei, M.D., Ph.D., executive director of the UAMS Donald W. Reynolds Institute on Aging, and Johnathan Goree, M.D., director of Interventional Pain Management Services at UAMS, gave a presentation on “New Treatments for Managing Pain.”

Both Goree and Wei agreed someone experiencing pain, particularly in the joints and limbs, should not stay still for too long.

“I work with a physical therapist who says ‘movement is lubrication for the joints,’” Goree said. “One of the best things you can do to keep out of our offices is to keep moving. Pain makes you want to keep from moving. Pain can cause inactivity and inactivity can cause pain”

Wei provided three tips for treating acute pain:

  • Applying ice to an affected area is the best because it stops nerve traffic and reduces inflammation, making it easier to recover.
  • Taking over-the-counter medications like acetaminophen or ibuprofen for the first 48 hours.
  • Keeping an affected arm, leg or foot above the level of your heart, so fluids can drain and reduce swelling.
Student volunteers with expo participant
Student volunteers from the UAMS College of Pharmacy and other UAMS colleges volunteered at the Senior Expo to provide free health screenings.

“All of us know there is an epidemic of opioids and other medications that don’t really work for ongoing pain,” Wei said. “We don’t want anybody to get hurt by continuing to take those medicines long term. Research has shown that you only need between three days to seven days of a prescription of opioid medication after a surgery or procedure or injury.”

For anyone, but especially for patients older than 60, use of opioids to treat chronic pain can lead to negative side effects like nausea, constipation, respiratory changes, falls, walking difficulty and bladder issues.

Beyond just a few days of opioid use, patients should try to use mindfulness, meditation and even hypnosis to cope with the mental and emotional stress of chronic pain.

Among the UAMS services and medical specialties represented at the Expo with booths were geriatrics, orthopaedics, caregiver training, ARresearch, stroke, vascular, cancer and nutrition services.

Other presentations made by UAMS physicians included: “Retinal Diseases— Seeing into Your Senior Years,” ophthalmologist Ahmed Sallam, M.D.; “Colon Cancer Screening: Why It’s More Important Than Ever,” colorectal surgeon W. Conan Mustain, M.D.; “Protecting Our Hands and Wrists,” orthopaedic surgeon Theresa Wyrick-Glover, M.D.

Filed Under: News

Symposium focuses on Past, Present, Future of Sickle Cell Disease Treatment

By Ben Boulden

One patient with sickle cell disease can experience severe pain and other symptoms while another with the same disease type only has moderate or even mild pain crises, said UAMS’ Issam Makhoul, M.D.

“What makes that disease so severe in one individual over another one?” he asked. “That’s what we need to learn more about. By participating in clinical trials, we will gain more knowledge about that.”

Audience at symposium
Sixty-one people attended the symposium, including adults with sickle cell disease, their families and clinicians.

Adult Sickle Cell Clinical Program and director of the Division of Hematology/Oncology in the UAMS College of Medicine’s Department of Internal Medicine.

He was one of three presenters Sept. 17 at the Sickle Cell Symposium at UAMS. Sixty-one attended the gathering, sponsored by the UAMS Adult Sickle Cell Clinical Program.

Suzanne Saccente, M.D., is a pediatric hematologist and medical director of the Sickle Cell Program and Apheresis Program at Arkansas Children’s Hospital. She discussed the past of sickle cell disease research and treatment; Makhoul, the present; and Shelley Crary, M.D., the future. Crary is a pediatric hematologist at Arkansas Children’s and an associate professor in the UAMS College of Medicine’s Department of Pediatrics. Saccente also is an assistant professor in the same department.

Sickle cell disease is a group of inherited red blood cell disorders. Healthy red blood cells are round and travel through small blood vessels to carry oxygen throughout the body. With sickle cell disease, the red blood cells become hard and sticky, and result in a C-shape or “sickle.” When sickle cells travel to small blood vessels, they get trapped and block blood flow to the area. This results in pain and may lead to other problems such as infection, acute chest syndrome and stroke.

Both Makhoul and Crary discussed the challenges of using gene therapy and its future promise as well as other possible cures like bone marrow transplants.

Makhoul described the two approaches to gene therapy being developed. One uses a modified virus to insert a gene segment into a patient’s cells to correct the genetic disorder that causes sickle cell disease.

“What’s wrong with this scenario? It’s so hard to do,” Makhoul said. “Our body is designed to fight any kind of infection. The cell is going to try to destroy that virus. It also might try to silence that new gene segment because it’s coming from an outside source.”

Suzanne Saccente, M.D., at podium
Suzanne Saccente, M.D., talked at the symposium about the history of sickle cell disease treatment and research.

Another technology makes the same genetic correction to a patient’s cells in the lab so they can be injected into patients to replace the cells that cause sickle cell disease.

The cost per patient is estimated to be $500,000 to $700,000.

Bone marrow transplants are one of the procedures used to restore stem cells and cure sickle cell disease. Recent advances in ‘half-matched’ bone marrow transplantation have allowed for a much broader range of donors.

Transplantation comes with risks of chronic complications and even death, although the risk is less than 10 percent with a matched sibling donor, Crary said.

“But, for some people, it’s worth the risk to cure their child’s sickle cell,” Crary said. “We present it to families and they have to choose what is right for them.”

Apart from treatments and potential cures, the presenters discussed drug therapies like hydroxurea and L-glutamine for treating symptoms and pain crises, as well as pain medications like opioids.

“We shouldn’t just treat pain crises with pain medications,” Makhoul said. “Oxygenation, hydration and transfusion also are important. All those measures can lessen the pain because it’s a symptom of an acute inflammatory process, sometimes infectious and sometimes not. You need to target all those factors. Low-oxygen levels are the trigger.”

Filed Under: News

DFPM-RED’s TIPS team releases public Annual Report

The DFPM-RED TIPS team just finished their public-facing annual report today and are excited to share both the results and their new look!

Two years into executing their new evaluation framework, TIPS is seeing impressive survey results and app use statistics that are providing evidence for TIPS’ effectiveness as well as opportunities for growth.

Read the 2018-2019 report here.

About TIPS:

TIPS is a new, innovative parenting education program for parents of children ages birth to 5 years. With the TIPS training and toolkit, people working with parents can

  • Share recent research through brief, family-friendly messages.
  • Educate parents without parenting classes.
  • Respond to parents’ concerns and tailor parenting information to individual families.

TIPS also hosts Naptime Academy, free online professional development for childcare professionals.

Filed Under: News

WISE receives strongest recommendation from SNAP-ED

You can now find DFPM-RED’s  WISE listed as a SNAP-Ed approved intervention on the SNAP-Ed website.

WISE is listed as “research-tested” which is SNAP-ED’s strongest recommendation.

See the WISE SNAP-Ed Toolkit page here.

About the SNAP-Ed Toolkit:

The Interventions component of the SNAP-Ed Toolkit helps state SNAP-Ed administrative and implementing agencies identify and implement evidence-based obesity prevention and policy, systems, and environmental change (PSE) interventions to include in SNAP-Ed Plans. These interventions help agencies comply with the requirement that state SNAP-Ed Plans must include multi-level interventions or public health approaches that reach low-income households most impacted by health disparities.

Identification of interventions appropriate for SNAP-Ed Plans has involved the USDA Food and Nutrition Service, the National Collaborative on Childhood Obesity Research, the Association of SNAP-Ed Nutrition Networks and Other Implementing Agencies, and the Center for Training and Research Translation. The interventions included span the continuum of scientific evidence from research-tested interventions to practice-tested interventions to emerging interventions. A peer-review process was used to examine the evidence and assess evaluation findings, reach, and the potential for scaling up the interventions.

Filed Under: News

Study Co-authored by UAMS Doctor Shows Benefit of Facebook Patient Support Groups in Rare Cancer Research

By Susan Van Dusen

An article co-authored by Jerad Gardner, M.D., at the University of Arkansas for Medical Sciences (UAMS) demonstrates the ability to use international Facebook patient support groups to rapidly reach large numbers of rare cancer survivors.

The study titled “Perspectives of Patients with Dermatofibrosarcoma Protuberans on Diagnostic Delays, Surgical Outcomes, and Nonprotuberance” was published online Aug. 30 in the open-access journal JAMA Network Open.

The study reports international disease-relevant statistics from 214 survivors of dermatofibrosarcoma protuberans (DFSP). Researchers believe this to represent the largest-ever survey of patients with DFSP, a very rare soft tissue sarcoma that occurs in the deep layers of skin. Soft tissue sarcomas are a diverse group of rare cancers arising from connective tissues such as fat, tendon, muscle, blood vessels or nerves.

Gardner, a dermatopathologist and bone/soft tissue sarcoma pathologist, developed the idea for the study in 2014 after connecting with DFSP survivors on a Facebook patient support group. Dermatopathology is a medical subspecialty that focuses on the microscopic diagnosis of skin disease.

“I collaborated with several UAMS colleagues and an international group of DFSP survivors I met on Facebook to develop a formal research study about their experiences with delays in diagnosis, risk of disease recurrence and how their disease presented itself,” said Gardner, who also serves as associate professor of pathology and dermatology in the UAMS College of Medicine.

Marjorie David, M.D., director of the Molecular Diagnostic Laboratory at UT Health San Antonio and former UAMS pathology resident, serves as the article’s lead author and worked closely with Gardner throughout the research process.

“Patients with rare diseases like DFSP can feel neglected by the medical community because the rarity of their tumor makes it difficult to find enough patients to put together a study. By working with previously established social media support groups, we were able to connect with hundreds of survivors and managed to overcome that hurdle,” David said.

According to the National Institutes of Health, DFSP is estimated to occur in somewhere between 1 in 100,000 to 1 in 1 million people per year.

The study includes results of 214 surveys administered to patients and family members, who answered on behalf of patients, from international DFSP Facebook patient support groups and a database provided by the nonprofit organization Sarcoma Foundation of America.

The survey questions, which were developed by a team of medical practitioners and patients with DFSP, were designed to determine risk of disease recurrence and spread, surgical outcomes, sources of delay in diagnosis, symptoms and number of recurrences, scar size, and number of medical professionals seen before a biopsy was performed.

The classic textbook description of DFSP is a large irregular mass protruding out of the skin. However, in this study, 44.8% of cases first appeared as a flat plaque rather than a raised bump or mass. Because of this, the authors propose to re-name the tumor dermatofibrosarcoma, often protuberant.

This rare malignancy is often confused with more common benign skin conditions, resulting in misdiagnosis or delay in diagnosis. A total of 52.3% of respondents believe they were initially misdiagnosed, and 19.6% made five or more visits to a clinician before undergoing a biopsy.

Additional findings are available here.

In addition to Gardner and David, five DFSP survivors served on a Patient Advisory Board, participated in research-related training and are listed as co-authors of the article, including Pip M. Caliskan of the United Kingdom and Gayle Dicker of Chicago.

As founder of the Facebook patient support group titled DFSP-Dermatofibrosarcoma Protuberans, Caliskan welcomed Gardner’s participation with its members and played a key role in development of the research study.

Caliskan’s group was created in 2008 and includes more than 1,800 members worldwide. As a closed group, interested persons must request to join, and information posted on the group’s site is not available to nonmembers.

“Pip changed my life by showing me that when pathologists and other doctors volunteer in rare cancer Facebook patient support groups, it can lead to amazing benefits for everyone. Without her, I never would have thought to do this type of research,” Gardner said.

Dicker said she hopes the study will spread awareness of DFSP and inform doctors about the disease and how it presents itself in different patients.

“DFSP is commonly left untreated for years, resulting in more aggressive surgery and a higher risk of disfigurement. Being part of this research project is important to me because it’s all about raising awareness among health care providers. All lumps and bumps deserve attention,” Dicker said.

This study was supported by a research grant from the Patient-Centered Outcomes Research Institute (PCORI) to Gardner and Pam Williams, Ph.D., formerly of the UAMS College of Nursing.

Williams, Ashley Funderburg of the UAMS Office of Sponsored Programs Administrative Network and Leah Fisher, formerly of the UAMS College of Nursing, worked directly with patient partners designing and implementing the survey. James Selig, Ph.D., associate professor in the UAMS Department of Biostatistics, assisted with data analysis.

Filed Under: News

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