Rapid establishment of a COVID-19 convalescent plasma program in a regional health care delivery network.

BACKGROUND: COVID-19 convalescent plasma (CCP) represents an appealing approach to the treatment of patients with infections due to SARS-CoV-2. We endeavored to quickly establish a sustainable CCP transfusion program for a regional network of health care facilities. STUDY DESIGN AND METHODS: A regional collaborative group was activated to address the issues necessary to implementing a CCP transfusion program and making the program sustainable. A wide range of health care providers including physicians (critical care, infectious disease, transfusion medicine), nurses, pharmacists, laboratorians, and information technology (IT) specialists were required to make the program a success. RESULTS: The CCP implementation team initially consisted of four members but quickly grew to a group of nearly 20 participants based on different issues related to program implementation. Overall, six major implementation "themes" were addressed: (a) registration of individual hospitals and principal investigators with a national investigational new drug research protocol; (b) collaboration with a regional blood donor center; (c) targeted recruitment of convalesced donors; (d) IT issues related to all aspects of CCP ordering, distribution, and transfusion; (e) prioritization of patients to receive CCP; and (f) evaluation of CCP products including antibody characteristics and patient response to therapy. CONCLUSION: Within 4 weeks of initiation, CCP was successfully transfused at multiple hospitals in our regional health care delivery system. A program infrastructure was established that will make this program sustainable into the future. This approach has broader implications for the success of multi-institutional programs requiring rapid implementation.

A concept for a biologically derived, parabolic implant design.

It has become widely accepted that modern titanium dental implants are successful and predictable. However, there is bone loss in relation to any interface (microgap) that occurs between the implant parts when the microgap is in proximity or apical to the osseous crest. The principle of biologic width may be responsible for such bone remodeling in an apical manner. A new, biologically derived implant design that conceptually may minimize bone remodeling and promote better bone and overlying gingival contours and stability is suggested. The parabolic occlusal platform of this design is in harmony with the biologic width of the soft tissue around the circumference of the implant when the proximal bone is occlusal to the facial and lingual bone. Preservation of proximal bone for an isolated implant, and between implants, will help support and maintain physiologic and cosmetic gingival contours and papillae. This is of particular importance in esthetic areas, where interproximal bone loss between implants or between an implant and an adjacent tooth may cause a reduction in gingival papilla height.