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This study investigated the relationship between runners' perceptions of fluid needs and drinking behavior under conditions of compensable heat stress (ambient temperature = 20.5 +/- 0.7 degrees C, 68.9 degrees F; relative humidity = 76.6%). Eighteen experienced runners (15 men, 40.5 +/- 2.5 y, and 3 women, 42 +/- 2.3 y) were given ad libitum access to a sports drink (6% carbohydrate-electrolyte solution) at Miles 2, 4, 6, and 8. After the run (75.5 +/- 8.0 min), subjects completed questionnaires that required them to estimate their individual fluid intake and sweat loss. Dehydration averaged 1.9% +/- 0.8% of initial body weight (a mean sweat loss of 21.6 +/- 5.1 mL.kg-1.h-1). Subjects replaced only 30.5% +/- 18.1% of sweat loss and underestimated their sweat loss by 42.5% +/- 36.6% (P

Palatability and voluntary intake of 4 beverages commonly available to athletes were compared in a laboratory exercise protocol designed to mimic aerobic training or competitive conditions in which limited time is available for drinking. Diluted orange juice (DOJ), homemade 6% carbohydrate-electrolyte sports beverage (HCE), commercially available 6% carbohydrate-electrolyte sports beverage (CCE), and water (W) were tested. Fifty adult triathletes and runners (34 males, 16 females) exercised for 75 min at 80-85% of age-predicted heart rate, during which time they were given brief access (60 s) to one of the beverages after 30 min and 60 min of exercise. Results indicated that for overall palatability, CCE > W, HCE, DOJ; W > DOJ, and for amount of beverage consumed, CCE > W, HCE, DOJ; HCE > W, DOJ. The palatability of these beverages varied substantially, as did their voluntary intakes during exercise.

Background and Purpose: There is interest in what happens over time to the thrombus after intravenous alteplase. We study the effect of alteplase on thrombus structure and its impact on clinical outcome in patients with acute stroke. Methods: Intravenous alteplase treated stroke patients with intracranial internal carotid artery or middle cerebral artery occlusion identified on baseline computed tomography angiography and with follow-up vascular imaging (computed tomography angiography or first run of angiography before endovascular therapy) were enrolled from INTERRSeCT study (Identifying New Approaches to Optimize Thrombus Characterization for Predicting Early Recanalization and Reperfusion With IV Alteplase and Other Treatments Using Serial CT Angiography). Thrombus movement after intravenous alteplase was classified into complete recanalization, thrombus migration, thrombus fragmentation, and no change. Thrombus migration was diagnosed when occlusion site moved distally and graded according to degrees of thrombus movement (grade 0–3). Thrombus fragmentation was diagnosed when a new distal occlusion in addition to the primary occlusion was identified on follow-up imaging. The association between thrombus movement and clinical outcome was also evaluated. Results: Among 427 patients in this study, thrombus movement was seen in 54% with a median time of 123 minutes from alteplase administration to follow-up imaging, and sub-classified as marked (thrombus migration grade 2–3 + complete recanalization; 27%) and mild to moderate thrombus movement (thrombus fragmentation + thrombus migration grade 0–1; 27%). In patients with proximal M1/internal carotid artery occlusion, marked thrombus movement was associated with a higher rate of good outcome (90-day modified Rankin Scale, 0–2) compared with mild to moderate movement (52% versus 27%; adjusted odds ratio, 5.64 [95% CI, 1.72–20.10]). No difference was seen in outcomes between mild to moderate thrombus movement and no change. In M1 distal/M2 occlusion, marked thrombus movement was associated with improved 90-day good outcome compared with no change (70% versus 56%; adjusted odds ratio, 2.54 [95% CI, 1.21–5.51]). Conclusions: Early thrombus movement is common after intravenous alteplase. Marked thrombus migration leads to good clinical outcomes. Thrombus dynamics over time should be further evaluated in clinical trials of acute reperfusion therapy.

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