Clinical highlights

Clinical milestones

First in state to offer life-changing therapy for Duchenne muscular dystrophy

In August, a 5-year-old boy at UC Davis Medical Center became the first child in California to receive a groundbreaking, potentially lifesaving infusion treatment — the first-ever gene therapy for treating Duchenne muscular dystrophy (DMD) in pediatric patients. He was the fourth child in the nation to receive the treatment outside clinical trials.

Years in the making and recently approved by the FDA, the treatment brings hope to as many as 12,000 people in the U.S. who live with DMD, one of the most severe types of muscular dystrophy. The genetic disorder leads to heart and breathing problems.

In June, FDA granted limited approval of gene therapy for children ages 4 and 5. The one-time infusion works by replacing the Duchenne variant of dystrophin with a manufactured version of the dystrophin gene.

Craig McDonald, M.D., chair of the UC Davis Health Department of Physical Medicine and Rehabilitation and an award-winning neuromuscular disorders researcher, helped facilitate the patient’s treatment. “I’ve been treating DMD patients for 30 years,” he said. “To now have a situation where we can offer transformational, life-saving gene therapy to these patients to replace a defective gene is incredibly gratifying and rewarding. It’s been an inspiring journey to be on.”

National recognition for heart disease and stroke care

UC Davis Medical Center has been recognized by the American Heart Association with multiple awards for its commitment to following research-based guidelines for the treatment of heart disease and stroke. The practices ultimately lead to more lives saved, shorter recovery times and fewer readmissions. This year, UC Davis Medical Center received these achievement awards:

Get With The Guidelines®- Stroke Gold Plus Award: Target: Stroke Elite Plus Honor Roll; Target: Type 2 Diabetes Honor Roll; and Target: Stroke Advanced Therapy Honor Roll

Get With The Guidelines®- Heart Failure Silver Plus Award: Target: Type 2 Diabetes Honor Roll

And Mission: Lifeline® STEMI Receiving Silver Plus Award.

Designated a Parkinson’s Foundation Center of Excellence

The Parkinson’s Foundation has designated the UC Davis Health Center for Movement Disorders & Neurorestoration as a Parkinson’s Foundation Center of Excellence, making it one of 54 worldwide to receive the designation. Centers of Excellence bring together specialized teams of neurologists, movement disorder specialists, rehabilitation professionals, mental health experts, and others with extensive knowledge in PD medications, treatments, and research.

Cancer center recognized for excellence in surgical oncology

UC Davis Comprehensive Cancer Center has been designated an American College of Surgeons (ACS) Surgical Quality Partner, an award given to cancer programs that excel at providing quality of care, preventing complications, saving lives, and reducing costs.

The designation follows the news that the center and UC Davis Medical Center earned accreditation once again from the Commission on Cancer (CoC), an ACS quality program. The cancer center received a three-year re-accreditation without any non-compliant standards.

New treatment for recurrence of C. Diff infection

Based on clinical trials run by UC Davis Health Chief of Infectious Diseases Stuart Cohen, M.D., the FDA has approved VOWST,™ a microbiota-based therapeutic to prevent recurrence of C. difficile Infection (CDI) in adults following antibacterial treatment for recurrent CDI (rCDIc). There will be an estimated 156,000 episodes of rCDI this year in the U.S., based on CDC data, and the agency has characterized the infection as an Urgent Health Threat. The new treatment is the first and only FDA-approved orally administered microbiota-based therapeutic for rCDI. FDA approval was based on clinical data from Phase 3 trials ECOSPOR III and ECOSPOR IV, overseen by Cohen as a principal investigator.

Fetal ultrasound accreditation

The UC Davis Fetal Care and Treatment Center and UC Davis Health Prenatal Diagnosis Center of Northern California have achieved a key ultrasound accreditation. The Ultrasound Practice Accreditation Council of the American Institute of Ultrasound in Medicine (AIUM) awarded both centers ultrasound practice accreditation in the areas of obstetrics (OB) standard and detailed second trimester OB ultrasound. UC Davis achieved the recognition by meeting rigorous voluntary guidelines set by the diagnostic ultrasound profession.

Clinical programs

UC Davis Health brings in-home urgent care to Sacramento

UC Davis Health is collaborating with DispatchHealth, the nation’s first comprehensive in-home medical care provider, on a new program to provide patients same-day, in-home urgent medical care.

DispatchHealth’s platform provides a wide range of care for injuries and illnesses, ranging from uncomplicated fractures and strains to exacerbation of COPD or congestive heart failure. It also administers bridge care assistance to high-risk patients transitioning from hospital care to home, aiding in recovery and helping prevent readmissions.

“We’re proud to be the first health care system in Northern California to offer our patients and the community this exciting program which literally brings back house calls for health care,” said David Lubarsky, M.D., M.B.A., F.A.S.A., vice chancellor of human health sciences and CEO of UC Davis Health.

DispatchHealth will operate using two vehicles within a 25-mile radius of UC Davis Medical Center, with care furnished by a nurse practitioner or physician assistant and a trained medical technician. A board-certified emergency department physician is available virtually as needed by the on-site care team at the patient’s home. Each vehicle will serve six to eight patients per day.

After either speaking with nurse triage, their primary care provider, UC Davis Health’s Express Care service, or upon discharge from UC Davis Medical Center, patients will have access to DispatchHealth’s in-home urgent care services. Patients cannot directly make an appointment with the service.

Early pregnancy access center opens

UC Davis Health recently launched an early pregnancy access center, offering specialized expertise for patients in the beginning stages of pregnancy.

“This new clinic will provide specialized care for patients who are experiencing complications and want to be seen ASAP,” said Anne Flynn, M.D., M.S.H.P., OB-GYN physician in family planning. “Our clinic will provide expedited and compassionate care to patients during early pregnancy. These may be patients diagnosed with pregnancies that need management, such as miscarriage or ectopic pregnancy. Or these may be patients experiencing symptoms of bleeding and cramping early in pregnancy.”

Eight OB-GYN physicians with subspecialty training in complex family planning will work in the clinic, along with support from OB-GYN fellows and residents. The Early Pregnancy Access Center will provide care for patients with:

• Miscarriage/early pregnancy loss, including diagnosis and management (procedural or medical management)
• Pregnancy of unknown location, in which a positive pregnancy test occurs but ultrasound does not show intrauterine or ectopic gestation (including workup and management)
• Ectopic pregnancies, including cesarean scar ectopic and cervical ectopic pregnancies
• Complications of early pregnancy, such as bleeding and cramping
• Medication or procedural management of undesired pregnancy
• Pregnancy verification for patients not previously seen by a provider and who cannot be scheduled with a new OB provider for some time

Patients who would like to schedule an appointment can call 916-734-6900.

New volunteer doula program

When pregnant patients go into active labor at UC Davis Medical Center, they can now receive support from a trained doula. A new volunteer doula program launched in September currently includes a group of 15 volunteer doulas, and plans to double that by the end of the year.

Patients can request a doula upon admission based on first-come, first-served availability; the service is free to UC Davis patients, with each doula dedicated to one laboring patient and 1:1 support. Doulas are currently available during the day, with evening services envisioned in the future.

Assistance from a doula is shown to promote better birth outcomes, especially for socially disadvantaged mothers at risk for adverse birth outcomes. “Currently, accessing private doula care is very expensive. We are so pleased to provide labor support to all patients at our hospital, regardless of their socioeconomic background,” said Angelique Silva, M.S., RNC-OB, C-EFM, C-ONQS, perinatal unit director and perinatal nurse manager at UC Davis Medical Center. “Having this program will address the disparities in health care that many of our patients face.”

Clinical technology

Robotic nephrectomy on living kidney donor

UC Davis Health transplant surgeons have performed the first fully robotic nephrectomy on a living donor in the Sacramento region, a procedure carried out using the latest Intuitive Surgical Robotic System. Living donor nephrectomies have traditionally been performed using either a laparoscopic technique or open surgery; robotic-assisted procedures enable smaller incisions, which often lead to a quicker recovery with less pain and scarring. Moving forward, nephrectomy procedures will be performed using robotic and laparoscopic techniques, depending on availability of robotic systems. Transplant surgery is one of 14 specialties in which UC Davis Medical Center offers minimally invasive, robotic-assisted technology.

New procedures thanks to state-of-the-art endoscopy suite

UC Davis Health interventional gastroenterologists are offering a broad repertoire of new or advanced endoscopic procedures out of a new leading-edge endoscopy suite, such as:

• Endoscopic treatment for Achalasia, Gastroparesis and Zenker’s diverticulum with peroral endoscopic myotomy (POEM)
• Locating and removing precancerous polyps and early-stage tumors in the colon, esophagus, stomach and duodenum
• Non-surgical treatment for gallbladder problems, gallstones, and obstructions from GI cancers and other conditions
• Characterization of pancreatic cysts using real-time laser microscopy, which obviates need for biopsy

“These procedures will provide our patients with a more effective approach to treat their condition, and keep them from needing painful, costly and more invasive procedures,” said Antonio Mendoza-Ladd, M.D., medical director of endoscopy for gastroenterology.