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Index: December 2010
Clinical Focus:Respiratory Care
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December 2010
Clinical Focus: Respiratory Medicine
  • Asthma and the athlete
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    • Exercise-induced bronchospasm
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    • Obesity and COPD
    • Relationship between COPD and nutrition intake
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  • Respiratory infections in winter sports athletes
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  • Fitness and long-term oxygen therapy/lung transplantation
  • Airflow function and the metabolic syndrome
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doi: 10.3810/psm.2000.09.1209
The Physician and Sportsmedicine: Volume 28: No.9
Hyponatremia in Distance Athletes
Pulling the IV on the 'Dehydration Myth'
Timothy D. Noakes, Mb Chb, MD
Abstract: The strength of modern medicine is its relentless quest for an elusive perfection. That quest requires that we examine our errors even more closely than our successes. It is for this reason that the case report of Flinn and Sherer ("Seizure After Exercise in the Heat: Recognizing Life-Threatening Hyponatremia," page 61) is so important. For it records a potential tragedy that was prevented by expeditious and appropriate medical care (1)–care that conflicted with popular dogma. The timeworn understanding is that collapse during or after prolonged exercise is caused by heat exhaustion; heat exhaustion is caused by dehydration; both are prevented by inordinate fluid ingestion; and immediate treatment should be intravenous fluids. I have termed this traditional litany the "dehydration myth" (2,3). It has been relentlessly perpetuated, always in the guise of good science.


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