Camden County College

Introduction: Empiric antimicrobial selection in ECMO patients is complicated by evolving resistance patterns and host-related factors. This study aimed to characterize five-year susceptibility trends among Gram-negative rods (GNRs) isolated from ECMO patients. Methods: We reviewed cultures from 81 ECMO patients treated between 2019 and 2023, focusing on GNRs. All isolates collected during ECMO support were included to reflect dynamic resistance changes. Percent susceptibilities were calculated per organism-antibiotic pair, and temporal trends were evaluated using linear regression. Organism-antibiotic combinations with intrinsic resistance or inconsistent testing were excluded. We used AI-assisted tools for statistical coding and editorial refinement. Results: Ertapenem maintained >95% susceptibility throughout all years. Meropenem showed a transient drop in 2022 (62.9%) but recovered to 100% by 2023. Cefepime susceptibility was variable: 88.2% for Serratia marcescens, 75.7% for Klebsiella pneumoniae, 71.4% for Pseudomonas aeruginosa, 95.2% for Klebsiella aerogenes, and 100% for both Enterobacter cloacae and Escherichia coli. In contrast, cefepime susceptibility among Acinetobacter baumannii was only 12.5%. Ampicillin-sulbactam susceptibility improved steadily over time (+11.6% per year; R2 = 0.67; p = 0.088), potentially reflecting reduced usage. Ciprofloxacin susceptibility peaked in 2020–2021 before declining in 2023. Due to inconsistent data, piperacillin-tazobactam was excluded from trend analysis. Conclusions: Antimicrobial susceptibility patterns among GNRs in ECMO patients have fluctuated over the past five years. Carbapenems remain reliable, while recovery of susceptibility to narrower-spectrum agents such as ampicillin-sulbactam and cefepime suggests a potential role for empiric antibiotic cycling. ECMO-specific antibiograms provide critical guidance for treatment and support the role of stewardship in curbing MDRO development in this high-risk population.

We thank Dr. Bruno and Dr. Nichols for their thoughtful comment of our CLEAR and RESCUE-Japan analysis on endovascular therapy of late large vessel occlusion with prestroke disability.1

We applaud Mendelson et al.1 for their investigation showing racial differences among those who decline treatment with thrombolytics.

The significant metastatic potential of uveal melanoma (UVM) lends to high mortality. Even with successful local tumor treatment, many patients will develop metastatic disease. The present study aims to elucidate the relationship between tumor-infiltrating immune cell (TIIC) diversity and survival to identify potential therapeutic targets and improve UVM prognosis. Bulk deconvolution was used to determine the relative proportions of 22 hematopoietic TIIC from 80 UVM tumor samples. Cytolytic activity (CYT) was determined, and associated survival probabilities were mined using time-to-event data. Nominal P-values were subjected to FDR correction. High relative abundance of tumor-infiltrating naïve B cells, resting memory CD4+ T cells, and monocytes correlated with better overall and disease-free survival probability. Low relative abundance of CD8+ T cells correlated with better overall survival and disease-free survival probability. CYT correlated positively with relative abundance of naïve B cells, resting memory CD4+ T cells, and monocytes. CYT correlated negatively with relative abundance of CD8+ T cells. Infiltrating naïve B cells, resting memory CD4+ T cells, monocytes, and CD8+ T cells are potential therapeutic targets in UVM that warrant further investigation. High CYT estimates associate with worse UVM survival outcomes.

Aim This study investigated whether time-estimation task exposure influences the severity of Attention Deficit Hyperactivity Disorder (ADHD), as well as theta band activity in the dorsolateral prefrontal cortex and ventrolateral prefrontal cortex. Material and methods Twenty-two patients with ADHD participated in a crossover experiment with a visual time-estimation task under control conditions (without exposure to time estimation tasks) and experimental (thirty days exposure to time-estimation tasks) in association with electroencephalographic analysis of theta band. Results ADHD patients with thirty days of time-estimation task exposure presented a worse performance of the time-estimation task, as revealed by the measurements of the absolute error and relative error (p ≤ 0.05). However, our findings show the improvement of self-reported symptoms of attention, impulsivity, and emotional control in patients after the time-estimation task exposure (p = 0.0001). Moreover, the theta band oscillations in the right dorsolateral prefrontal cortex and in the ventrolateral prefrontal increased with thirty days of time-estimation task exposure (p ≤ 0.05). Conclusion We propose that the decrease in EEG theta power may indicate an efficient accumulation of temporal pulses, which could be responsible for the improvement in the patient cognitive aspects as demonstrated by the current study. Time-estimation task improves ADHD cognitive symptoms, with a substantial increase in cortical areas activity related to attention and memory, suggesting its use as a tool for cognitive timing function management and non-invasive therapeutic aid in ADHD.