Fresh ground beef patties with (1) no antioxidant (control), (2) 0.02% butylated hydroxyanisole/butylated hydroxytoluene (BHA/BHT), (3) 3% dried plum puree, or (4) 0.25% rosemary extract were aerobically packaged, irradiated at target doses of 0, 1.5, or 2.0 kGy (1.7 and 2.3 kGy actual doses), and stored at 4°C. The samples were evaluated for lipid oxidation on 0, 3, 7, 14, 21, and 28 days of storage after irradiation. When compared to the control, all antioxidant treatments were effective in retarding (P < 0.05) irradiation-induced lipid oxidation during storage as determined by 2-thiobarbituric acid reactive substances (TBARs) values. Rosemary extracts had the same antioxidant effect (P > 0.05) as BHA/BHT in irradiated and nonirradiated beef patties, followed by the dried plum puree treatment. Irradiation increased TBARs values, but no differences were noted in oxidation between irradiation dose levels.

Background: The costimulatory inhibitor belatacept (Bela) has been shown to be an effective alternative in several clinical situations, including calcineurin toxicity, de novo alloantibody formation and thrombotic microscopic angiopathy. To further explore the usefulness of Bela under various clinical scenarios, we performed a retrospective analysis of a prospective database of all recipients who were converted to a belatacept maintenance immunosuppression regimen after kidney transplantation. Methods: This single-center study reviewed the electronic records of all patients who received a KT between 2016 and 2020. A total of 57 patients were converted to Bela. Of these recipients, 25 (43.8%) converted within the first 6 months, and 32 (56.2%) converted after 6 months. The indications for conversion were: calcineurin inhibitor (CNI) toxicity (26.3%), thrombotic microangiopathy (8.8%), de novo DSA (36.8%), chronic antibody rejection (AMR) with or without significant fibrosis (IFTA) (28.1%). Results: Early conversion significantly improved GFR at 3, 6-and 12-months post-conversion. However, late conversion does not affect GFR. Thirty-four (59.63%) patients were converted Bela, mycophenolate and steroids, and 23 (40.4%) converted to Bela, low dose CNI and steroids. Only 6 patients (10.5%) developed rejection after conversion, 5 (83.4%) in early conversion group. Five patients (83.4%) had T cell-mediated cellular rejection, and one (16.6%) had acute antibody-mediated rejection. The rejection rate was 14.7% in the group on belatacept without CNI compared to 4.3% on belatacept with low-dose CNI (p<0.001). All patients with chronic AMR±IFTA were in the late conversion group (59.2%), leading to stabilization in their GFR (32 vs 30 mL/min) at 1-year post-conversion. Out of 21 patients who converted to belatacept due to de-novoDSA, 9 (42.9%) patients had complete or partial resolution of DSA. Interestingly, in the early conversion group, 80% responded vs (31.2%) in the late conversion group (P<0.001). Conclusions: This study showed that conversion to belatacept was effective, especially when performed early after kidney transplantation. Late conversion to belatacept was beneficial for a subgroup of patients with chronic changes.

is increased hematoma expansion in patients with delayed or incomplete INR reversal prior to transfer. Methods: Retrospective 32 month single-center review of patients with warfarin-associated intracranial hemorrhage, INR 1.4 or greater upon tertiary center arrival, and treated per an institution-approved warfarin reversal protocol. Patients were excluded from the study if transitioned to palliative care in the first 24 hours or if direct radiologist comparison between images was not available or if surgical intervention was performed that disallowed assessment of hematoma expansion. The presence or absence of hematoma expansion was documented by the radiologist at time of the study. Results: 53 patients met study criteria. 18 patients (34%) transferred from smaller hospitals. 50% of transferred patients had hematoma expansion compared to 11% admitted directly through our hospital emergency department (p=0.002). Average study age was 75. Initial INR did not correlate with incidence of hematoma expansion (mean INR 3.5, no hematoma expansion, INR mean 3.5, with hematoma expansion, p=0.94). Patient variables were analyzed for confounders between the group that was transferred and those that were directly admitted and no differences were noted in baseline INR, gender, bleed location (extra vs intra-axial), and surgical interventions, however the transfer arm was younger (p=0.018). Conclusions:Study suggests delayed INR reversal for hospital transfers leads to significantly higher incidence of hematoma expansion. Expediting INR reversal may limit hematoma expansion and neurologic injury in patients with warfarinassociated intracranial hemorrhage.Learning Objectives: Cerebral edema and consequent intracranial hypertension (ICH) may result from traumatic brain injuries, intracranial malignancies, ischemic stroke, cerebral venous thrombosis, intracranial hemorrhage. Hypertonic saline (HTS) is frequently used in neurosurgical patients to mitigate cerebral ischemia by reducing intracranial pressure (ICP) and improving cerebral blood flow. There are limited, contradictory findings of the effects of continuous HTS (3%) infusions in this setting. Methods: The purpose of this study was to determine the effect of sodium exposure on serum sodium levels in patients with intracranial hypertension. The hypothesis was that sodium exposure correlated with serum sodium levels. This was a single-center, retrospective, observational study conducted at a tertiary academic medical center. Patients with ICH received a 3% HTS via intravenous continuous infusion at a fixed rate of 50 milliliters/hour. A sample size of 95 subjects was identified using 80% power to detect a correlation of 0.3 or greater (alpha 0.05) between sodium exposure and serum sodium levels. Hierarchical linear and mixed models were used to analyze daily measurements over multiple days for both the response and explanatory variables and control for inter-subject effects. Results: 95 subjects were included in data analysis. Common diagnoses included subarachnoid hemorrhag...