• Skip to primary navigation
  • Skip to main content
  • Skip to primary navigation
  • Skip to main content
Choose which site to search.
University of Arkansas for Medical Sciences Logo University of Arkansas for Medical Sciences
College of Medicine: Department of Family and Preventive Medicine
  • UAMS Health
  • Jobs
  • Giving
  • About Us
    • The DFPM Chair
    • Department News
    • Verification of Residency Training
    • Available Positions
  • Residency Programs
  • Community Health and Education
    • Upcoming Events
    • CME/CE for Family Medicine
    • Partnerships in Colorectal Cancer Screening for Arkansas
      • Who We Are
      • Providers’ Resources for Colorectal Cancer Screening
      • Patient Resources
      • PiCS-AR! Raises the Bar
  • Research and Scholarly Activity
    • Clinical Research
    • Community Research
      • Research & Evaluation
        • Arkansas Early Childhood Care & Education Financing: Cost Modeling & Market Price Analysis
        • Arkansas Workforce Studies
        • Child & Youth Mental Health
        • Healthy Families America (HFA)
        • Home-Visiting Support for Low-Birth-Weight Preterm Infants
        • Parents as Teachers (PAT) Arkansas
      • Research-Based Early Childhood Professional Development
        • Engage Continuum
        • FIRST:ECE
        • TIPS
        • WOW
        • Family Map
        • Project PLAY
        • REACH
        • WISE
        • Strengthening Families
      • Research and Evaluation Division Faculty
        • Nikki Edge, Ph.D.
        • Lorraine McKelvey, Ph.D.
        • Taren M. Swindle, Ph.D.
        • Kanna Lewis, Ph.D.
      • Contact RED
    • Publications
  • Medical Student Education
    • Junior Clerkship
      • Clerkship FAQs
      • Clerkship Syllabus
      • Contacts
      • Community and Housing
    • Senior Students
      • Residency Resources and Timeline
      • Post Match Survey
      • Student Alumni Sign-up Form
    • Scholarships and Loan Repayment
      • Harold H. Hedges III, M.D., Endowed Scholarship in Family Medicine
    • Student Conferences
  • DFPM Offices
    • Communication and Departmental Relations
    • Digital Health
    • Leadership and Professional Development
      • DFPM Chair’s Awards for Recognition of Excellence (CARE)
        • Chair’s Awards for Recognition of Excellence Nomination Form
    • Wellness
  1. University of Arkansas for Medical Sciences
  2. College of Medicine
  3. Department of Family and Preventive Medicine
  4. Department News

Department News

Family Medicine Conference Warns of Trend for Early-Onset Colorectal Cancer and Highlights Topics Important to Family Medicine

Family medicine providers gathered for UAMS’ virtual 2025 Family Medicine Spring Review April 23 -25 and learned that the colorectal cancer death rate in people younger than 55 is climbing one percent each year since the mid-2000s, but that this group is more open to a yearly stool-based screening test such as the fecal immunochemical test (FIT) or Cologuard than other age groups.

The colorectal cancer screenings updates from Whitney Jones, M.D., a gastroenterologist from Kentucky, and Francis Colangelo, M.D., a primary care physician with Allegheny Health Care in Pittsburgh, were part of the first day of the three-day conference.

Francis Colangelo, M.D. talking with Family Medicine Spring Review logo on the side.
Francis Colangelo, M.D., primary care physician, speaking on early-onset colorectal cancer.

“Around 41 percent of these (younger patients) had symptoms for at least six months before visiting a provider,” said Colangelo. “And if you see rectal bleeding, always assume it is colorectal cancer in the younger patient.”

The conference was presented by the Department of Family and Preventive Medicine’s Community Health and Education division, which has produced continuing medical education for 47 years.

Amanda Deel, D.O., associate dean of the New York Institute of Technology’s College of Osteopathic Medicine, spoke on compassion in healthcare.

“Following a compassion-centered script with patients may feel artificial, but in a study, patients didn’t sense that. Physicians miss opportunities to practice compassion 70 percent of the time and interrupt patients on average in the first 11 seconds,” said Deel.

Angela Driskill, M.D.
Angela Driskill, M.D.

Angela Driskill, M.D., is a wound care specialist practicing at Baptist Health. She said there must be a distinction between pressure injuries and skin that fails because pressure injuries imply failure of care or harm.

“If you don’t document a wound 12 to 24 hours after admission, it will throw up a red flag to CMS. Say it’s been 24 hours before anyone does a skin assessment, they are classified as ‘unwounded’ when they came in. Then we document there’s a stage 3 or 4 wound of the sacrum, and CMS begins to recoup the cost of that care, which can be $50,000 to $70,000,” said Driskill.

Sleep medicine physician Caris Fitzgerald, M.D., offered trouble-shooting tips for patients who wear a CPAP, a machine that treats sleep apnea with continuous positive airway pressure. CPAP manufacturers estimate that more than eight million people wear a CPAP each night. One common complaint is dry mouth.

Picture of Caris Fitzgerald, MD
Caris Fitzgerald, M.D.

“A leak makes or breaks the experience with a CPAP,” said Fitzgerald, who sees patients at the Central Arkansas Veterans Healthcare System. “If a patient complains of dryness, fix the leak, don’t just increase the humidity. The nose is a humidifier. If your pressure system is sealed well and the patient is nasal breathing, they will not need a humidifier.”

My goal with patients is 10LPM unintended leak. 10LPM is generally a good goal for 95% Unintended Leak. Most under 10LPM can do without a humidifier which means a lot less cleaning and expense. And those with co-occurring good use have almost always resolved the complaints associated with OSA.

In his talk on metabolic issues, James Tucker, M.D., bariatric surgeon with Arkansas Heart Hospital, said bariatric surgery is not a cure for disease of obesity but a treatment. Sleeve gastrectomy is the more common surgery where 50 to 70 percent of the stomach is removed.

“With insulin-dependent patients who’ve had the surgery, 60 percent to 80 percent experience remission from the disease,” said Tucker.

On the third day of the conference, Amy Grooms, M.D., with the UAMS Department of Psychiatry, spoke about using transcranial magnetic stimulation for patients with treatment-resistant depression. She said transcranial magnetic stimulation uses a magnetic pulse that stimulates the dorsolateral prefrontal cortex and rebalances it with the subgenual anterior cingulate cortex. Around 30 percent of patients who use this treatment have a standard response, but 18 percent of patients report that their depression is gone.

Bill Fantegrossi, M.D.
Bill Fantegrossi, M.D.


Bill Fantegrossi, Ph.D, who works in the UAMS Department of Pharmacology and Toxicology, ended the conference with a talk on emerging drugs of abuse. He said new synthetic opioids grip more tightly to the opioid receptors in the brain. With such a strong bond, reversing an overdose is difficult with standard treatments such as naloxone (Narcan). Naloxone knocks opioids from brain receptors, but it struggles to unbind new synthetic opioids from receptors. This means it can only partially reverse an overdose or may fail.

Synthetics - fentanyls. Lethal doses of heroin, fentanyl and the ultra-potent analog carfentanyl.

Other conference topics included an update on the HPV vaccine with Portia Knowlton, who works with St. Jude’s HPV prevention program, renal cysts and masses with UAMS’ Marcelo Bigarella, M.D., and long-term effects after curative cancer treatments with Viriginia Laliberte, APRN. Ashley Acheson, Ph.D., and Jami Jones, who work with the National Center for Opioid Research & Clinical Effectiveness at Arkansas Children’s Hospital, spoke on the research they are conducting on children and adolescents who have been affected by the opioid crisis and other drug addictions.

Filed Under: Community Health and Education Tagged With: bariatric surgery, cancer, CME virtual conference, colon, CPAP, emerging drugs of abuse, screening, skin failure

Are you taking a Spring Break?  It’s Time to Unplug

If so, have you considered taking a break from your phone as well?  Can you really disconnect from work while on vacation?

According to a 2024 JAMA study of 3024 physicians, 70% of doctors work during a typical vacation day and around a third spend at least 30 minutes per vacation day on work-related correspondence.

If this feels familiar, take a moment to reference this article from Medscape for tips to help you unplug.  

And….its not just not just for physicians!  Everyone can benefit from a break from our phones and social media.   According to the Mayo Clinic, slimming screen time frees up more time to connect with family and friends – which can help ward off symptoms of stress, depression and anxiety. 

Links

  • Always On Call: Why You Can’t Unplug and How You Finally Can
  • 5 ways slimming screen time is good for your health
Inscription Don't touch, on a paper reminder on smartphone on a yellow background, digital detox, dependency on tech, no gadget and devices, don't touch personal things.

Filed Under: Wellness News

Case Report by Dr. Viridiana Saenz (PGY-3) Featured in the AMSSM

Viridiana Saenz

“Recurrent Forearm Pain in a High-Level Tennis Player” is the name of a case report written by Viridiana Saenz, M.D., (PGY-3, Little Rock) and published online by the American Medical Society for Sports Medicine.

Access the case report. Congratulations to Dr. Saenz!

Filed Under: Residency

Dr. Shashank Kraleti Wins Chancellor’s Award

Chancellor Cam Patterson presented the 2024 Chancellor’s Award of Excellence for Clinical Innovation to Dr. Shashank Kraleti during the Town Hall on November 19.

Dr. Kraleti was honored for his collaborative work with the UAMS Office of Patient Experience in creating Patient and Family Advisory Councils (PFACs) in 16 of our clinics across the state. Chancellor Patterson congratulated Dr. Kraleti for being a strong advocate for Arkansas patients and for the team that serves them.

Dr. Patterson presents award to Dr. Kraleti
Winners of Chancellor's Awards 2024
Stephanie Gardner, far left, and Chancellor Cam Patterson, far right, congratulate four of the awardees of the Chancellor’s Awards of Excellence. Left to right, the awardees are Judith Weber, Stephen Bowman, Shashank Kraleti, and Stacie Jones. Image by Evan Lewis

Filed Under: Department-Wide News, Residency

Gratitude

As we approach this holiday season, let’s take a moment to reflect on the importance of Gratitude in Life.

Gratitude is strongly related to wellbeing.  

Some benefits of gratitude can be better sleep, better immunity, decreased stress, lower blood pressure, stronger relationships and greater life satisfaction.

Practicing gratitude places a focus on the present, thus helping to magnify positive emotions.

And Gratitude can have a domino effect -If a person experiences gratitude, they are more likely to reciprocate in the future.

Here are some ideas, ways to practice gratitude.    

  • Observe the moment      
  • Create Gratitude Rituals
  • Write it down 
  • Give Thanks
  • Savor the Moment

What are you grateful for this year?

Filed Under: Wellness News

Virtual Family Medicine Update Set for Oct. 23 – 25 with First Day on Opioids

Family Medicine Update, Fueling the Front Line, Oct. 23 - 25

The 28th Annual Family Medicine Update: Fueling the Front Line will offer up to 14 hours of online CME/CE Oct. 23–25 for primary care physicians, doctors of osteopathic medicine, advanced practice registered nurses, registered nurses, pharmacists, physician assistants, physical therapists, certified health educators, social workers and substance abuse counselors.

To register, visit https://cvent.me/4X75nd or call 501-686-6626 by Oct. 21.

The annual conference provides an opportunity for health care professionals to learn about the latest advances and information impacting family medicine.

The conference is completely virtual. The first day – All About Opioids – offers six hours of content for only $25. Thursday and Friday sessions are $20 each.

Don Teater, M.D., MPH
Don Teater, M.D., MPH

The first day is All About Opioids with talks from local and national experts on opioids, kicking off with Don Teater, M.D. He is a family physician from Denver who has focused on the intersection of pain, opioids and addiction and was medical advisor for the National Safety Council. Another nationally known speaker, Aaron Weiner, Ph.D., will offer ways providers can help those with substance use disorders when abstinence isn’t an option. A team from Boston Mountain Rural Health will give a behind-the-scenes look at how they integrated behavioral health into their clinics to help those with addiction and co-occurring mental disorders. Other speakers include Karen Burks, M.D., a family physician with the UAMS/Baptist Health family medicine residency program, and UAMS’ Bill Fantegrossi, Ph.D., who researches new psychoactive substances such as “bath salts” psychostimulants to amphetamine-like dietary supplements. Kristin Martin, D.O., founder of River Valley Medical Wellness, is bringing her team to talk about their mobile opioid recovery unit which treats patients with substance use disorder in areas where help is scarce.

Sheena Colclough, APRN
Sheena Colclough, APRN

Talks on the second day will feature topics from UAMS providers on non-alcoholic fatty liver disease with Sheena Colclough, APRN, a syphilis update with Mitchell Jenkins, M.D., chronic kidney disease with Paige Beck, M.D., Ph.D., and Cassandra Fritz, M.D., an assistant professor with Washington University Medicine’s division of gastroenterology, who will speak on early onset colorectal cancer.

The third day of the virtual conference will focus on weight loss medications, presented by Bri Morris, Pharm.D., executive director of the Arkansas Community Pharmacy Enhanced Services Network, and UAMS’ Christopher Johnson, Pharm.D. Patty Harper, CEO of InQuiseek Consulting, will update attendees on Medicare news. The two afternoon sessions will feature pulmonary and cardiology updates with Steven Deas, M.D., a physician with the Central Arkansas Veterans Healthcare System, and UAMS’ Srikanth Vallurupalli, M.D.

Pharmacists Christopher Johnson and Bri Morris
Pharmacists Christopher Johnson and Bri Morris

Participants who attend the entire conference and complete all surveys will be eligible to attend the Family Medicine Spring Review in April at no cost.

Filed Under: Community Health and Education, News Tagged With: 14 CME/CE, CME virtual conference, CME/CE, Family Medicine Update, October 23 - 25

Take it outside!

Now that the weather is cooling down, let’s take a quick moment to enjoy the benefits of nature.

Did you know that exposure to nature can help to regulate our sympathetic nervous system? 

Even a quick 5-minute walk or work break outside can improve our mental focus and moods.

Take a walk today, eat lunch outside, enjoy a quick break in the sunshine.  Try a new outdoor activity like cycling, pickle ball, go for a hike in our amazing state parks.  It really can make a difference!

Try it!

Learn more about how nature can help to reduce stress and increase happiness:

  • The mental health benefits of nature: Spending time outdoors to refresh your mind
  • Nurtured by nature
  • A 20-minute nature break relieves stress
Early-50s healthy hiker sets off for a bit of backpacking in the Ozark Mountains of Arkansas, USA.
Happy African American woman playing pickleball on an outdoor court and looking at camera. Copy space.
Cycling on a bridge

Filed Under: Wellness News

New Article in “Family Medicine” from DFPM Faculty

Dr. Kraleti, Dr. Gibson-Oliver, and Dr. Jarrett are the authors of a brand new article in the journal Family Medicine.

Titled “The Importance of a Champion in Leading Major Improvements in Residency Programs,” the article addresses improvements in the numbers of pediatrics patients and procedures performed in the FMC.

It’s online ahead of print now, and it will be included in a monthly issue of the journal later this year.

Filed Under: Department-Wide News, Residency

Dr. Wayne Bryant Jr. Appears on TV

Dr Wayne Bryant

Dr. Wayne Bryant Jr., Associate Director of the UAMS Little Rock Family Medicine residency program, recently appeared on KATV Channel 7 to discuss how to make sure kids are healthy and ready to return to school.

The video is available at this link.

Dr. Bryant is sought after by the local TV stations because he always does such a good job. We look forward to seeing him again soon.

Filed Under: Department-Wide News, Residency

Hidradenitis Suppurativa: Three Questions to Diagnose and Five Layers of Treatment

Hidradenitis suppurativa (HS) is a skin disorder that starts with blocked hair follicles, leading to painful nodules, abscesses and scarring. Front-line providers can work with dermatologists to diagnose and treat this often debilitating condition by asking three questions and following a five-tiered approach to treatment.

Dr. Vivian Shi, former UAMS dermatologist and director of the hidradenitis suppurativa clinic, offered tips to family medicine providers at the UAMS 2024 Family Medicine Spring Review last April. She said, “It requires a multidisciplinary approach. An HS team including all of these specialists and dermatology providers are the principal providers, but we really lean on front-line providers … to detect, treat, refer and to collaboratively manage.”

Picture of Vivian Shi, MD
Vivian Shi, M.D.

Most of her HS patients have had it more than 10 years after having seen their providers at least five times, and around 15% are disabled or unable to work because of HS pain. Girls typically show signs in their early teens, and boys start in their mid to late teens. If the teen has severe acne, have the patient lift the arms to check for HS signs. The typical onset is between puberty and age 40, with women being three times more likely to be affected.

Three key diagnostic questions every provider must ask the patient:

1. In the last 12 months, did you repeatedly have big, painful nodules and boils in the armpits or groin?

2. Have you had outbreaks of boils in the last six months?

3. Do you repeatedly have outbreaks of big sores, painful nodules or boils that heal with scars in any of these locations?

If the answer is “yes,” there is a 90 percent chance of HS.

“There’s no reason healthcare providers should be missing this if they ask these questions,” said Dr. Shi.

HS can show up anywhere on the body – behind the ears, outer arms or legs – not just the skin folds and areas with sweat glands. The two exceptions are the palms and soles of the feet. It’s chronic, inflammatory and very painful. Initially, the patient will have inflamed nodules, abscesses, white heads and black heads. The more advanced stage includes draining sinus tracts (narrow channels) and severe scarring, which are especially true in Blacks. Often it is misdiagnosed as cellulitis.

pictures of 3 Hurley stages

HS is divided into three Hurley Stages. The mildest is Hurley Stage 1: Abscesses that resolve without any trace of scarring, but this is rare.  As soon as the patient has any sign of a scar, it’s labeled Hurley Stage 2. This stage includes recurrent abscesses, sinus tracts and scarring, but normal-looking skin will appear between them. The most advanced stage is Hurley 3, characterized by multiple connected sinus tracts and abscesses across the entire area with little to no normal-looking skin between. She describes it as an “over-exaggerated inflammatory response where, over time, the hair follicles connect with each other and form sinus tracts and extensive scarring.”

Dr. Shi recommended a pyramid of treatment. The front-line provider can manage all the treatments except for biologics, the top tier. In early moderate to severe patients (late Hurley 1 to early Hurley 2), Dr. Shi suggested preparing patients for biologic therapy by prescribing oral antibiotics because payors typically require patients to fail 90-plus days of systemic antibiotics to qualify. Regardless of disease stage, providers should refer the patient to a dermatologist for advanced therapy, while collaboratively managing the patient.  

The 5 Tiers of Treatment:
Top layer - Biologics
Second layer - Hormonal Treatments
Third layer - Oral Antibiotics
Fourth layer - Topicals
Bottom Layer - Lifestyle Modification

Lifestyle Modification

The first tier of the pyramid is lifestyle modifications where the provider would screen for comorbidities and start treatments. In a recent JAMA Dermatology report, patients with HS said diet changes were the most used non-prescription treatment with the Mediterranean diet and intermittent fasting both being effective. The two exercises that HS patients can tolerate are Pilates and swimming. Weight loss surgery is also a strong consideration if the patient is greater than 35 BMI, and if the patient smokes, encourage them to quit since cigarette smoke has dioxin-like compounds that can cause acne and scarring. Loose-fitting clothing and anti-chaffing products applied in skin folds can reduce friction and pain.

If the patient has draining sinus tracts, bathing helps to rinse out the tunnels. Dr. Shi recommends alternating daily with 10-minute baths of Epsom salt, CBD oil and ¼ cup 6% commercial bleach which help with pain, itch, relaxation and decrease biofilm.

Topicals

The next level is topical treatments. She typically uses clindamycin 1%; however, resorcinol 15% elicits a better response in mild to moderate HS. Resorcinol is especially helpful because it breaks down the outer layers of the skin and unplugs the hair follicles. There are also washes such as benzoyl peroxide, chlorhexidine or dapsone. Dr. Shi cautioned against benzoyl peroxide wash used together with topical dapsone because they’ll have reversible yellowing of the hair follicles.

Oral Antibiotics

Dr. Shi’s office typically starts with the tetracycline family because it’s better at reducing inflammation in the hair follicle and less costly. She recommends 100 milligrams of doxycycline or minocycline twice daily or extended release minocycline at a weight-adjusted dose once a day for eight to 12 weeks. Dr. Shi cautioned that dosage may need to exceed 100 milligrams for it to work, so ensure the patient doesn’t have anemia. She uses this for flare-ups or to bridge to biologic therapy.

Rotating through combined systemic antibiotics also works, being careful not to extend beyond three months. One combination is clindamycin with rifampin. A second choice is rifampin with moxifloxacin and metronidazole, which is especially helpful for drainage. And one thing providers want to consider is to stop the metronidazole after six weeks because longer use can cause reversible peripheral neuropathy.

Certain supplements also should be considered. Persons with HS typically have lower serum zinc levels. Prescribing 100 – 200 milligrams of daily zinc (with copper included after two months) has shown to reduce HS severity in 80% of patients. Another supplement to consider is Vitamin D since most patients with HS are deficient. Vitamin D regulates hair cycle and skin cell activity.  

Hormonal Treatments

Dr. Shi recommends these hormonal / metabolic therapies:

Hormonal and Metabolic Therapies
For Women - Spironolactone 50 - 150 mg daily. Monophasic OCP (with increased estrogen and with anti-androgenic progestin such as drospirenone)
For Men – Finasteride 5-10 mg daily
For Both - Metformin 500 mg - 1500 mg daily (for patients who are obese or have diabetes). Also Metformin XR.

Biologics
Biologics is the last step of treatment. Dr. Shi said providers should learn the basics of biologics so they can explain how it works before they refer to a dermatologist.  The patient must be on at least 90 days of an oral antibiotic before most insurance will allow biologics.

Dr. Shi’s takeaways:

  • Ask the three questions to have a high confidence of diagnosing HS.
  • Refer to dermatology once diagnosed.
  • Screen for metabolic syndromes, inflammatory bowel disease, hormonal and mental health abnormalities.
  • Reverse screen for HS if the patient has Down syndrome.
  • Start antibiotics if the patient has any scarring because biologics is the next step. Most insurance requires 90 days to four months of oral antibiotic to be eligible for biologic treatment, so this is the referral window.
  • More information on HS can be found at hs-foundation.org

    If you’re interested in more of UAMS’ primary care CME/CE, check out our list of upcoming CME/CE here.

Filed Under: Community Health and Education Tagged With: diagnosis and treatment of hidradenitis suppurativa, family medicine approach to hidradenitis suppurativa, hidradenitis suppurativa

  • Page 1
  • Page 2
  • Page 3
  • Interim pages omitted …
  • Page 14
  • Next Page»
UAMS College of Medicine LogoUAMS College of MedicineUniversity of Arkansas for Medical Sciences
Mailing Address: 4301 West Markham Street, Little Rock, AR 72205
Phone: (501) 686-7000
  • Facebook
  • X
  • Instagram
  • YouTube
  • LinkedIn
  • Pinterest
  • Disclaimer
  • Terms of Use
  • Privacy Statement

© 2025 University of Arkansas for Medical Sciences