The Glucose-Controlled Insulin Infusion System (Biostator) is a modular, computerized, feedback control system for dynamic control of blood glucose concentrations in diabetics. This on-line glucose analyzer for use with whole blood utilizes a novel enzyme (glucose oxidase)-membrane configuration and an electrochemical cell to measure the H202 generated. The analyzer exhibits both short- and long-range stability, and instrument response and analyte concentration are linearly related over the full range of clinical interest. The response is fast, accurate, and precise, and permits determination of blood glucose within 2 min from the moment the blood leaves the patient. Correlation studies were completed to show the agreement between the Biostator Glucose Analyzer and the FDA's recommended hexokinase/glucose-6-phosphate dehydrogenase procedure on whole blood (e.g., average per cent recovered for 11 concentrations between 250 and 900 mg/liter was: hexokinase, 95.6%, Biostator Analyzer, 95.9%; bias and SDd, respectively, at low, normal, and high glucose values were: 12 and 41 mg/liter at the 500 mg/liter level; 4 and 52 mg/liter at the 1000 mg/liter level, and 4 and 128 mg/liter at the 4000 mg/liter level). No appreciable interference is observed with above-normal concentrations of bilirubin, uric acid, creatinine, sodium salicylate, or dextran. Platelet adhesion, which tends to decrease the useful life of the membrane, has been significantly decreased.

No abstract

Following a heat wave in January 2014 in Adelaide, state capital of South Australia, we asked the question whether extreme heat was associated with an increase in stroke incidence. We found in the literature that the association between stroke presentation to hospital and meteorological factors has long been a topic of debate and subject to numerous studies. The literature indicated that an association between heat waves and an increase in admissions for stroke was unlikely in Australia and the United States. We suggest that it may be inappropriate to generalize this conclusion to other countries and rural areas. In view of the global climate change debate, we suggest that prospective studies be focused in developing countries and rural areas to assess the real impact of extreme heat on respective populations to better inform stroke physicians and health policy makers.

No abstract

Recent evidence from the MR CLEAN (1), EXTEND-IA (2), and ESCAPE (3) trials showed intra-arterial treatment in acute ischemic stroke caused by proximal intracranial arterial occlusion resulted in better functional outcomes at 90 days when compared with standard treatment. This contests prior evidence from randomized controlled trials indicating nonsuperiority of endovascular therapy (4-6). We conducted a retrospective analysis of 31 consecutive patients treated with endovascular therapy for acute ischemic stroke between November 2008 and December 2012 at The Queen Elizabeth Hospital, a tertiary referral center at a time of change in South Australia (7). Baseline characteristics and type of endovascular method are outlined in Table 1. Outcomes were assessed using Arterial Occlusive Lesion (AOL) recanalization scores and 90-day Modified Rankin Scores (mRS) (Table 2). Successful recanalization, defined by AOL 2-3, was achieved in 77•4% of our patients. This was lower than MR CLEAN (1) and EXTEND-IA (2), comparable to ESCAPE (3) and IMS III (6) but higher than MR RESCUE (4). Our patient group had higher rates of death, intracranial hemorrhage (ICH), and worse functional outcomes than reported in EXTEND-IA, MR CLEAN, IMS III, and SYNTHESIS (1,2,5,6). However, our study showed better functional outcomes, and ICH was less common than in MR RESCUE (4). We used multiple endovascular modalities, which limits comparison of our results; later-generation mechanical devices may contribute to improved rates of recanalization seen in the more recent