A 58-year-old hypertensive develops sudden severe headache and loss of neurological function

This case originates in Mexico and was sent to us by Dr Gutiérrez Lizardi from the ICU of a hospital in Monterrey, Nuevo León. The male patient has a number of comorbidities but presents to hospital with sudden-onset headache and lack of neurological function. Take a look at this case to discover the results of his full initial medical examination and work through the questions to determine how you would treat this patient. What do you think is the most likely diagnosis and the most appropriate therapeutic strategy? This case is not straightforward and will really test your knowledge of appropriate management in such a patient.

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Review by Jordi Rello
University Hospital Joan XXIII, Tarragona, Spain

Impact of methicillin resistance on mortality in Staphylococcus aureus VAP: a systematic review.
Athanassa Z, Siempos II, Falagas ME. Eur Respir J 2008;31:625–632.

Methicillin resistance continues to be a major problem in hospitals today. This meta-analysis and systematic review was performed to determine whether comorbidities and adequate empiric therapy independently enhanced outcomes in patients with ventilator-associated pneumonia (VAP). Professor Jordi Rello reviews this study and provides his detailed opinion, including the strengths and limitations of the study, and he relates its findings to the AIM Core Principles. Why not read Professor Rello’s comprehensive summary of this paper and learn of the complicated association between methicillin resistance and outcomes in VAP?

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Vienna, 28–29 February 2008

A meeting for intensivists, clinical microbiologists and infectious disease specialists with an interest in intensive care medicine was held in Vienna earlier this year. Although not an AIM event, we believed that a presentation by Roman Kozlov entitled “Managing resistance” would be especially relevant to the AIM programme and we are delighted to share this with you.

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Cartagena, Colombia, 28–29 March 2008

A 4th AIM Latin American Summit recently took place in Colombia and we are pleased to share with you the first of two exciting presentations from this meeting. This presentation was given by Michael S Niederman, entitled “The new paradigm for therapy of serious infections: A focus on appropriate therapy and de-escalation”.

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Sarajevo, Bosnia, 30 May 2008

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We are pleased to tell you that interest in AIM and its website continues to grow! The latest statistics from the AIM website show an increase of 1054 members since our last update in March, giving a total membership of almost 10,900. Seven hundred of these registered during ECCMID in April. The largest proportion of members (35%) remains in Europe, while North America and the Asia/Pacific regions make up the next largest contingencies with 18% each.