Grand Rounds October on Arkansas Medical News Inc.

Grand Rounds October

Arkansas Health Care Access Foundation Celebrates 20 Years of Providing Donated Medical Care to Low-income, Uninsured Arkansans

AHCAF exists to help those who have fallen between the cracks of the health care system. Today, the basic AHCAF program provides services to approximately 1,800 Arkansans a year, but with the failing economy and increasing number of people losing benefits, we expect this number to increase.

AHCAF was established in 1989 by the Arkansas Medical Society with the bulk of volunteers coming from their physician membership. AHCAF, a non-profit organization, is a statewide health care program for Arkansans citizens who have incomes below the current level of 100%, do not have Medicaid, Medicare Part B, VA Medical or private health insurance.

AHCAF was initially funded with a two-year start-up grant through the Lt. Governor's Task Force on Indigent Care, and continuation of the services beyond that was going to be impossible without additional funding; so Keller approached the Arkansas Department of Human Services (DHS) for possible solutions. Due to the success of the program, they agreed to contract with the program for two more years, and as years passed, they continued to see the value of this service to the people of Arkansas.

Originally, prescriptions were filled for the clients at a discount, but it was soon obvious that the clients could still not afford them. Due to the great need for prescription drugs, pharmaceutical manufacturers Pfizer, Inc., Johnson & Johnson, and Blansett Pharmacal were recruited to participate and agreed to provide a formulary of prescription medications that the prescribers could choose to write from, which would be filled through the pharmacy volunteers. These companies have remained a part of AHCAF for approximately 17 years.

After receiving many pleas for dental pain relief, AHCAF consulted with the Arkansas State Dental Association (ASDA) regarding the recruitment of dentists to provide dental pain relief to AHCAF eligible clients. A number of their membership volunteered to provide dental pain relief at no charge to AHCAF clients.

Nearly 12 years ago, an additional dental service was added to help the elderly, disabled and medically compromised to receive a comprehensive dental treatment. The National Foundation of Dentistry for the Handicapped, a program out of Denver, Colorado, relies upon volunteer dentists to donate a comprehensive treatment plan to qualified applicants. Again, with participation from the ASDA membership, along with other Arkansas dentists, the Arkansas Donated Dental Services program (DDS), was established and now operates as a licensee of the National Foundation of Dentistry for the Handicapped. The DDS volunteer dentists rely heavily upon Arkansas dental laboratories to also volunteer and donate their skills in the manufacturing of dentist prescribed prosthetics such as dentures.

We are having a fundraiser Nov. 12, 2009, to raise funds to help pay for certain medical costs that are not donated under the current program. If there are any businesses interested in making a cash or in-kind donation to us for the fundraiser, please contact us for details.

For more information about the Arkansas Health Care Access programs, you can visit our website at www.ahcaf.org, call them at 501-221-3033, 800-950-8233, or info@ahcaf.org.

Northwest Physician Opens New Senior Wellness Practice

SPRINGDALE — Springdale native Mary Frances Daut, M.D., a board-certified Physical Medicine/Rehabilitation physician, is establishing a new, one-of-a-kind specialty clinic for Northwest Health System at the Schmieding Center on Aging in Springdale – the Northwest Senior Wellness Clinic.

The new clinic is designed to provide senior patients with a comprehensive outpatient rehab treatment program, combining closely monitored trials of medication, physical therapy and needed assistive devices. The clinic provides evaluation of acute or chronic pain issues, generalized deconditioning (a decline in fitness often caused by illness and/or inactivity) and balance deficits.

In practice since 2004, Dr. Daut received her medical education at the University of Arkansas for Medical Sciences (UAMS) in Little Rock and then completed an internship at at the Alton Ochsner Medical Foundation Hospital in New Orleans and a residency in Physical Medicine/Rehabilitation at Louisiana State University Health Sciences Center, also in New Orleans. She has been a member of the Northwest Health System medical staff since 2005, previously serving as Medical Director of Inpatient Rehabilitation at Northwest Medical Center in Springdale. Dr. Daut also has published scholarly works in several professional publications.

UAMS Researcher Receives $2.3 Million in Nanomedicine Grants to Treat and Prevent Lethal Cancer Metastasis

LITTLE ROCK – A University of Arkansas for Medical Sciences (UAMS) researcher on the cutting edge of nanotechnology has been awarded $2.3 million in three grants to further groundbreaking developments in the prevention of lethal cancer metastasis and take his team's findings to the first clinical trial of its kind.

The three new grants recently awarded to Vladimir Zharov, Ph.D., director of the Phillips Classic Laser and Nanomedicine Laboratories at UAMS, are in addition to a $1.5 million National Cancer Institute grant he received in May.

Zharov said nanomedicine may eventually lead to breakthroughs in the early diagnosis and effective treatment of cancers, stroke, heart attack and infections, which remain the leading causes of death in the world.

The first grant from the National Institute of Biomedical Imaging and Bioengineering is $1.2 million over four years and will support comprehensive preclinical studies and a first-of-its-kind clinical trial using nanoparticles at the UAMS Winthrop P. Rockefeller Cancer Institute. It will help the Institute's world-renowned cancer experts explore a way to diagnose deadly breast cancer metastasis in its earliest stages.

Zharov and his team have developed hybrid multicolor gold and magnetic nanoparticles with a special biological coating that can target metastatic cells within the body once they have spread through the blood and lymph system. A laser is used to heat up those nanoparticles attached to metastatic cells without harmful effect on the body's healthy cells. Rapid expansion of nanoparticles in metastatic cells causes ultrasound waves, which travel through the tissue and are captured by a small ultrasound transducer held near the skin. In a preliminary study the technique was so sensitive that it was able to detect and count rare metastatic cells before they form distant metastases.

Laura Hutchins, M.D., a professor and director of the Division of Hematology/Oncology in the UAMS College of Medicine will be participating in the trial.

The second grant, a nearly $400,000 offering over two years from the National Cancer Institute, will focus on the role of stem cells in cancer development. Ekaterina Galanzha, Ph.D., an assistant professor collaborating with Zharov, said the challenges of current cancer treatment may be explained by a small subset of therapy-resistant and highly aggressive metastatic cancer cells called cancer stem cells. UAMS researchers hope to develop a method using nanoparticles for molecular identification of circulating cancer stem cells. If successful, Zharov hopes to create a new therapy for the targeted eradication of those cancer stem cells.

The third grant awarded to Zharov is for $700,000 over four years from the National Science Foundation to develop high resolution laser nano-imaging of tiny structures in live single cells that can be used for both basic and clinical studies with a focus on the early diagnosis of abnormal processes responsible for cancer and aging.

Collaborating with Zharov in the final two grants are Robert Reis, Ph.D., professor in the UAMS Departments of Geriatrics; Thomas Kelly, Ph.D., associate professor in the UAMS Department of Pathology; and Evgeny Shashkov, Ph.D., a visiting scholar.

Nanomedicine research and advances are gaining steam worldwide with a recent Global Industry Analysts report revealing that the nanotechnology market will surpass $160 billion in the next six years.

Experienced Infectious Disease Physician Joins Northwest

BENTONVILLE — Mark Lee Stillwell, M.D., F.A.C.P., a board-certified Internal Medicine and Infectious Disease physician, has joined the medical staff of Northwest Health System at Northwest Center for Infectious Diseases.

Dr. Stillwell graduated from the University of Oklahoma in Norman, received his medical education at University of Maryland School of Medicine in Baltimore, and then completed an internship in Internal Medicine and Internal Medicine residency at University of Maryland Hospital and Baltimore VA Medical Center, where he served as chief resident. He completed his fellowship in Infectious Disease at UMH, BVAMC, and Maryland Institute for Emergency Medical Services System (MIEMSS) in Baltimore.

In practice since 1988, Dr. Stillwell comes to Northwest from Fort Smith, where he has been in practice at Sparks Regional Medical Center for the past 21 years. He has been a Clinical Assistant Professor of Medicine at the University of Arkansas for the Medical Sciences for the past 20 years. He is a member of the American Medical Association, American Society for Microbiology, Arkansas Medical Society, Infectious Disease Society of America, and a fellow of the American College of Physicians.

Thoracic Surgeon, Lung Cancer Specialist Matthew Steliga, M.D., Joins UAMS

LITTLE ROCK – Thoracic surgeon and lung cancer specialist Matthew A. Steliga, M.D., has joined the staff of the University of Arkansas for Medical Sciences (UAMS) as assistant professor in the Division of Cardiothoracic Surgery.

Steliga specializes in thoracic oncology with an emphasis on lung cancer, esophageal cancer and other tumors of the chest and is experienced in minimally invasive thoracic surgery. He previously served as an instructor in the Department of Thoracic and Cardiovascular Surgery at M. D. Anderson Cancer Center in Houston.

A graduate of the Medical College of Wisconsin in Milwaukee, Steliga completed his internship and residency in general surgery at the University of Tennessee Health Sciences Center in Memphis, Tenn. He also served as a resident in cardiothoracic surgery at the Texas Heart Institute in Houston.

He is board certified by both the American Board of Surgery and the American Board of Thoracic Surgery, an associate fellow of the American College of Surgeons, a member of the International Society for Minimally Invasive Cardiothoracic Surgery and a member of the Society of Thoracic Surgeons.

Pulmonary/Critical Care Doctor Joins Mercy Clinic

Pulmonary/Critical Care physician Dr. Saurin Patel joined St. Edward Mercy Clinic in July. He also is the medical director for the St. Edward Mercy Intensive Care Unit.

Patel completed his residency in Internal Medicine/Pediatrics and fellowship in Pulmonary/Critical Care Medicine at the University of Kansas Medical Center in Kansas City. He received his undergraduate degree in biology/chemistry from Georgia State University in Atlanta.

Hoffman Returns to Cooper Clinic

Dr. John Hoffman has returned to Cooper Clinic to practice Gynecology. Dr. Hoffman was a 20-year veteran in the Clinic's Department of Obstetrics and Gynecology before serving St. Edward Mercy Medical Center in Administration. A board certified physician, he is a graduate of the University of Illinois College of Medicine and completed his residency at Grady Memorial Hospital in Atlanta. Dr. Hoffman will see patients at two offices: the Cooper Clinic main location at 6801 Rogers Avenue, Fort Smith, and at the Booneville Community Hospital. Cooper Clinic is a physician-owned multi-specialty group with doctors in 25 specialties/subspecialties at 17 locations.

Baptist Health Bariatric Center Of Excellence

LITTLE ROCK — BAPTIST HEALTH Bariatric Center of Excellence's co-director, Dr. John W. Baker, has recently been named as the new president of the American Society for Metabolic and Bariatric Surgery (ASMBS), the largest association in the world dedicated to this particular specialty.

Dr. Baker is a leading expert in the surgical treatment of obesity. He has performed more than 2,500 surgical weight loss procedures during his career. He is also a board member and president of the ASMBS Foundation and the medical director of the BAPTIST HEALTH Weight Loss Center in Little Rock.

Dr. Baker is an active member of several other professional associations and societies including the American College of Surgeons, the International Federation for the Surgery of Obesity and Metabolism, the American Society for Parenteral and Enteral Nutrition, and the American Medical Association.

Morbid obesity is closely correlated with a number of serious conditions that severely undermine the health of overweight patients, including heart disease, high blood pressure and diabetes. Bariatric surgery can help obese patients manage these conditions and the Bariatric Surgery Center of Excellence staff and its surgeons with ASBS COE designations are committed to provide the highest level of bariatric care ensuring efficacy of the procedure with each patient.

Head and Neck Surgeon Mauricio Moreno, M.D., Joins UAMS

LITTLE ROCK – Mauricio Moreno, M.D., a surgeon specializing in cancer and other conditions of the head and neck, has joined the staff of the Head and Neck Oncology Clinic at the University of Arkansas for Medical Sciences (UAMS).

Moreno comes to UAMS from the University of Texas MD Anderson Cancer Center in Houston where he completed fellowships in head and neck surgical oncology and microvascular reconstructive surgery, followed by a fellowship in head and neck surgical endocrinology.

In May 2009, he received the MD Anderson Research Award for clinical/patient-oriented research with the project titled "Ultrasound for Long-term Assessment of Lateral Neck in Thyroid Cancer."

Moreno received his medical degree at Pontificia Universidad Católica de Chile School of Medicine in Santiago, Chile. He completed a residency in general surgery at the University of Valparaíso in Chile and a residency in otolaryngology-head and neck surgery at the University of Chile.

Shoppers Receive 20 Percent Discount At Almost 200 Arkansas Shops with the UAMS Winthrop P. Rockefeller Cancer Institute Partners Card

LITTLE ROCK — Almost 200 shops and boutiques in central and northwest Arkansas will offer discounts on their merchandise Oct. 30 through Nov. 8 as part of Partners Card, a fundraising project of the volunteer auxiliary of the Winthrop P. Rockefeller Cancer Institute at the University of Arkansas for Medical Sciences (UAMS).

To purchase the auxiliary's Partners Card, or for more information, call (501) 686-8286 or visit www.cancer.uams.edu/partnerscard. Cards also may be purchased in Room 150 on the first floor of the Cancer Institute. Many participating retailers will be selling Partners Cards in their stores.

For 10 days, shoppers who purchase the $50 cards will receive a 20 percent discount at dozens of area stores. All proceeds from the sale of the Partners Cards will go to the Cancer Institute's volunteer auxiliary to fund projects that directly benefit cancer patients. The auxiliary provides information, services, compassion and hope to those touched by cancer.

UAMS Receives $10 Million Grant to Continue Successful Center for Translational Neuroscience

LITTLE ROCK – A more than $10 million grant from the National Institutes of Health (NIH) will support a research program at the University of Arkansas for Medical Sciences (UAMS) that has already produced new medical treatments, yielded basic science discoveries and improved the campus' research capabilities.

The UAMS Center for Translational Neuroscience recently received a five-year, $10.3 million grant to continue its work. The grant, through the Center of Biomedical Research Excellence (COBRE) program at the NIH's National Center for Research Resources, is intended to provide the infrastructure to develop nationally recognized centers of research excellence.

The UAMS center is led by Edgar Garcia-Rill, Ph.D., professor in the Department of Neurobiology and Developmental Sciences of the UAMS College of Medicine. It is designed to help clinician and basic scientists become more competitive for federal research grants. Since 2004 when $7.5 million was awarded to develop the center, it has generated more than $13 million in new research grants for UAMS scientists, helped recruit five new faculty members, produced more than 130 research articles in scientific journals and established six new research facilities at UAMS.

Projects supported during the past five years produced a novel treatment for tinnitus – or ringing in the ears – that relieves the symptoms in a majority of patients; a new use for an existing drug that relieves the excessive reflexes induced by spinal cord injury; and an effective new treatment for a common side effect of a stroke, spatial neglect.

Also original funding for the UAMS center allowed creation of "cores" or facilities for research administration, human and animal electrophysiology, imaging analysis, transcranial magnetic stimulation, and molecular biology. The center also established a Community Based Research and Education Core Facility that supports the neonatal program "PedsPLACE," which links 15 neonatal intensive care units around Arkansas for telemedicine and distance health.

Additionally, the center has recently received two supplemental grants totaling more than $560,000 from the federal stimulus program. One supplement will upgrade research facilities and the other will help establish a telemedicine program for emergency departments throughout the state.

The new research projects supported by the grant renewal include a potential new treatment for Alzheimer's Disease, a new strategy for dealing with relapse to methamphetamine abuse, a study on the long-term effects of neonatal pain due to low birth weight, research on the role of leptin – a protein hormone – in obesity and sleep and a new therapy for tobacco dependence.

Risk Management Event Scheduled In Arkansas

LAMMICO will host its first Risk Management "live lecture" in Arkansas next month as the company continues to expand its reach into the Natural State.

"This will be the first time LAMMICO will offer RM credit for a live event in Arkansas," said Thomas H. Grimstad, M.D., LAMMICO's President / Chief Executive Officer. "Our seasoned team of experts will offer this service to help reduce risk and mitigate claims."

The LAMMICO Risk Management panel discussion is entitled, "You've Been Served: Managing Litigation Stress and Surviving Depositions." It is scheduled for Wednesday, October 7, 2009 at the Embassy Suites Conference Center, 11301 Financial Center Parkway in Little Rock from 6:00 p.m. until 8:00 p.m. Speakers include F. Jeff White, III, M.D., an Arkansas native and LAMMICO's Senior Vice President of Risk Management; Laura Smith, J.D.; Partner at the Little Rock law firm of Friday, Eldridge & Clark and Ron Kennedy, LAMMICO Vice President of Risk Management. The seminar's goal will be to address how to best manage litigation stress, advice on discovery and giving depositions.

Inquiries & those interested in attending should contact the LAMMICO Risk Management Department at 800/452.2120. Attendees are eligible for both CME and AAFP credit. Two Risk Management Premium Discount credits are also available for LAMMICO policyholders.

LAMMICO currently offers on-line RM services. This event follows the company's recent extension of its coverage territory into Arkansas. LAMMICO, the state of Louisiana's largest medical malpractice insurer, began serving medical practitioners in Arkansas in 2007. Existing LAMMICO policyholders, particularly those in the northern sections of Louisiana, now have the option to expand their practices to the border state. The move also means LAMMICO now serves medical practitioners in Arkansas as the company has done in Louisiana since 1982. To establish a local presence and assure exceptional service to Arkansas' health care practitioners, the company partnered with Ramsey, Krug, Farrell & Lensing, the premier agency and claims-handling service in Arkansas.