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The following electronic only articles are published in conjunction with this issue of BJSM
Time for tea, anyone?
P McCrory, M Turner, A Johnston
There have been suggestions that urine samples positive for benzoylecognine, the diagnostic metabolite of cocaine, may be the result of consumption Mate de Coca, a commercially available tea made from coca (Erythroxylon coca) leaves.
The Jockey Club in Great Britain commissioned research into this subject as several jockeys have tested positive for benzoylecognine over the past few years. Urine samples collected at various time points within 24 h after ingestion of a 250 ml infusion of Mate de Coca tea were analysed using three different methods. All samples tested positive for benzoylecognine.
Hyponatraemic encephalopathy despite a modest rate of fluid intake during a 109 km cycle race
J P Dugas, T D Noakes
Objective: To report a case of exertional hyponatraemic encephalopathy that occurred despite a modest rate of fluid intake during a 109 km cycling race.
Methods: Men and women cyclists were weighed before and after the race. All subjects were interviewed and their water bottles measured to quantify fluid ingestion. A blood sample was drawn after the race for the measurement of serum Na+ concentration.
Results: From the full set of data (n = 196), one athlete was found to have hyponatraemic encephalopathy (serum [Na+] 129 mmol/l). She was studied subsequently in the laboratory for measurement of sweat [Na+] and sweat rate.
Conclusions: Despite a modest rate of fluid intake (735 ml/h) and minimal predicted sweat Na+ losses, this female athlete developed hyponatraemic encephalopathy. The rate of fluid intake is well below the rate currently prescribed as optimum. Drinking to thirst and not to a set hourly rate would appear to be the more appropriate behaviour.
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