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BACKGROUND: Penetrating thoracic injuries have a significant risk of morbi-mortality. Despite the advancements in damage control methods, a subset of patients with severe pulmonary vascular lesions and bronchial injuries persists. In some of these cases, post-traumatic pneumonectomy is required, and perioperative extracorporeal membrane oxygenation (ECMO) support may be required due to right ventricular failure and respiratory failure. CASE DESCRIPTION: A male was brought to the emergency department (ED) with a penetrating thoracic injury, presenting with massive right hemothorax and active bleeding that required ligation of the right pulmonary hilum to control the bleeding. Subsequently, he developed right ventricular dysfunction and ARDS, necessitating a dynamic hybrid ECMO configuration to support his condition and facilitate recovery. CONCLUSIONS: Penetrating thoracic injuries with severe pulmonary vascular lesions may need pneumonectomy to control bleeding. ECMO support reduces the associated mortality by decreasing the complications rate. A multidisciplinary team is essential to achieve good outcomes in severe compromised patients.

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BACKGROUND: Late hemothorax is a rare complication of blunt chest trauma. The longest reported time interval between the traumatic event and the development of hemothorax is 44 days. CASE PRESENTATION: An elderly patient with right-sided rib fractures from chest trauma, managed initially with closed thoracostomy, presented with a delayed hemothorax that occurred 60 days after initial management, necessitating conservative and then surgical intervention due to the patient's frail condition and associated complications. CONCLUSIONS: This case emphasizes the clinical challenge and significance of delayed hemothorax in chest trauma, highlighting the need for vigilance and potential surgical correction in complex presentations, especially in the elderly.

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Background: Ventricular arrhythmias are a leading cause of sudden death. The objective of this study was to characterise the results of patients with ventricular arrhythmias refractory to standard medical management, undergoing Video-assisted thoracoscopic cardiac sympathetic denervation (VAT-CSD) during 2012-2022 in Cali, Colombia. Methods: This was an observational retrospective study, using the Institutional General Thoracic Surgery Database for patient identification and retrospectively reviewing the clinical charts for data description and analysis. Results: Clinical records of 19 patients who underwent VAT-CSD for ventricular arrhythmia were analysed. The patients were predominantly male (73.7%) with an mean age of 62 years. Ischaemic heart disease was the main underlying condition (52.6%); all individuals had a diagnosis of heart failure, with comorbidities such as hypertension (63.1%), acute MI (57.8%) and diabetes (26.3%) also present. The procedure was performed bilaterally in 89.4% of cases and was successful with minimal perioperative complications. Postoperative follow-up showed improvement in symptoms, including a significant reduction in the number of ICD shocks and emergency department visits. Conclusion: VAT-CSD is a viable, safe and palliative therapeutic option for patients with ventricular arrhythmias who have not responded to conventional treatments, achieving a significant decrease in symptoms with low mortality and perioperative complications.

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A 47-year-old male patient was referred to a level 1 trauma center with refractory acute respiratory distress syndrome, bilateral lung contusions, and flail chest after initial management for injuries sustained 5 days prior from an 8-m fall from a tower crane. Surgical stabilization of the rib fractures was achieved under extracorporeal membrane oxygenation support, with successful decannulation 4 days after surgery. The patient was discharged after 42 days and following multidisciplinary interventions. Use of extracorporeal membrane oxygenation support in blunt chest trauma patients presents a valuable opportunity as it may enable earlier surgical intervention and reduce in-hospital complications.

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Introducción. La lobectomía pulmonar es uno de los procedimientos más frecuentes en la cirugía torácica en Colombia y a nivel mundial. El objetivo de este estudio fue proporcionar información sobre el comportamiento clínico de los individuos sometidos a este tipo de cirugías. Métodos. Estudio observacional retrospectivo en un Hospital Universitario de Cali, Colombia, que incluyó todos los pacientes sometidos a lobectomía pulmonar, por causas benignas o malignas, entre los años 2010 y 2020. La información se extrajo del registro institucional de cirugía de tórax, obteniendo datos demográficos, clínicos y patológicos. Resultados. Se evaluaron los registros clínicos de 207 individuos. El 55,5 % eran mujeres, la edad promedio fue 58 años y el 41 % tuvieron antecedente de tabaquismo. En el 51,6 % de los casos se diagnosticaron neoplasias, de las cuales el 47,8 % eran primarias de pulmón, siendo el adenocarcinoma el subtipo más común. Las enfermedades benignas no tumorales representaron el 48,3 % de los casos y la causa más frecuente fueron las infecciones, dentro de las que se incluyeron 17 casos de tuberculosis pulmonar. La técnica más frecuente fue la cirugía toracoscópica video asistida (82,6 %). Presentaron un porcentaje de reintervención del 5,8 %, 10,6 % de complicaciones severas y una mortalidad hospitalaria del 4,3 %. Conclusión. La población evaluada muestra una carga alta de comorbilidades y riesgo operatorio elevado; de forma consecuente, al compararla con otras series internacionales, se encontró un porcentaje mayor de complicaciones perioperatorias y mortalidad.

Introduction. The pulmonary lobectomies is one of the most common procedures in thoracic surgery in Colombia and worldwide. The objective of this study is to provide information on the clinical behavior of individuals who underwent this type of surgeries. Methods. Retrospective observational study at a University Hospital in Cali, Colombia, including all individuals who had pulmonary lobectomies, between the years 2010 to 2020 for benign and malignant causes. The information was extracted from the institutional registry of thoracic surgery, obtaining demographic, clinical and pathological data. Results. The clinical records of 207 individuals were evaluated, 55.5% were women, the average age was 58 years, and 41% had a history of smoking. Of these cases, 51.6% were diagnosed with neoplasms, of which 47.8% were primary lung neoplasms, with adenocarcinoma being the most common subtype. As for benign diseases, they represented 48.3% of the cases and the most frequent cause was infections, including 17 cases of pulmonary tuberculosis. The most frequent technique was video-assisted thoracoscopic surgery in 82.6%, with a reoperation rate of 5.8%, up to 10.6% of severe complications, a median hospital stay of 6 days, and a hospital mortality of 4.3%.Conclusion. The population evaluated shows a high burden of comorbidities and high operative risk; consequently, when compared with other international series, it shows a higher percentage of perioperative complications, hospital stay, and mortality.

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Background: Penetrating chest trauma that is associated with pulmonary injuries can trigger different sequelae, the most frequent being the presence of contusions or pulmonary lacerations that are accompanied by hemopneumothorax. Materials and methods: Description of a clinical case of interest and review of the literature on the topic. Results: In this study, we present an unusual consequence of this type of trauma, a pulmonary infarction secondary to an extensive pulmonary venous thrombosis stemming from a firearm injury. This finding associated with lung tissue necrosis led to the need for right upper pulmonary bilobectomy. Conclusions: The aim of this study is to understand this unusual form of presentation of pulmonary trauma, understand the pathophysiology that triggers lung injury, review the medical literature on the subject, and expand the general knowledge on this topic. Study type: Therapeutic/care management.

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This study describes a methodology that allows evaluating the behavior of a glass fibre reinforced polymer (GFRP) laminate impacted by a vertical weight drop, analyzing the damage that occurred inside. The purpose of the designers was, by means of characterization tests of the curing processes, evaluation of the cohesion of a particular laminate, application of vertical tests by weight drops and with the use of the readings of an accelerometer in a single direction, know the trend of how intralaminar breaks in the matrix and interlaminar breaks between layers occur. It is proposed to establish the behavior of the laminate before the tests by analyzing curing times, for after the tests by observations with penetrating fluorescent inks. This allows researchers to know the response of the laminate to the loads imposed on the applied structure. For the tests, prepreg material cured outside the autoclave in an oven was used and qualitative quantification of the damage by observing sections of the tested material infiltrated with penetrating fluorescent ink exposed to ultraviolet light.

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BACKGROUND: Loss of vascular tone is a key pathophysiological feature of septic shock. Combination of gradual diastolic hypotension and tachycardia could reflect more serious vasodilatory conditions. We sought to evaluate the relationships between heart rate (HR) to diastolic arterial pressure (DAP) ratios and clinical outcomes during early phases of septic shock. METHODS: Diastolic shock index (DSI) was defined as the ratio between HR and DAP. DSI calculated just before starting vasopressors (Pre-VPs/DSI) in a preliminary cohort of 337 patients with septic shock (January 2015 to February 2017) and at vasopressor start (VPs/DSI) in 424 patients with septic shock included in a recent randomized controlled trial (ANDROMEDA-SHOCK; March 2017 to April 2018) was partitioned into five quantiles to estimate the relative risks (RR) of death with respect to the mean risk of each population (assumed to be 1). Matched HR and DAP subsamples were created to evaluate the effect of the individual components of the DSI on RRs. In addition, time-course of DSI and interaction between DSI and vasopressor dose (DSI*NE.dose) were compared between survivors and non-survivors from both populations, while ROC curves were used to identify variables predicting mortality. Finally, as exploratory observation, effect of early start of vasopressors was evaluated at each Pre-VPs/DSI quintile from the preliminary cohort. RESULTS: Risk of death progressively increased at gradual increments of Pre-VPs/DSI or VPs/DSI (One-way ANOVA, p < 0.001). Progressive DAP decrease or HR increase was associated with higher mortality risks only when DSI concomitantly increased. Areas under the ROC curve for Pre-VPs/DSI, SOFA and initial lactate were similar, while mean arterial pressure and systolic shock index showed poor performances to predict mortality. Time-course of DSI and DSI*NE.dose was significantly higher in non-survivors from both populations (repeated-measures ANOVA, p < 0.001). Very early start of vasopressors exhibited an apparent benefit at higher Pre-VPs/DSI quintile. CONCLUSIONS: DSI at pre-vasopressor and vasopressor start points might represent a very early identifier of patients at high risk of death. Isolated DAP or HR values do not clearly identify such risk. Usefulness of DSI to trigger or to direct therapeutic interventions in early resuscitation of septic shock need to be addressed in future studies.

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BACKGROUND: Optimal timing for the start of vasopressors (VP) in septic shock has not been widely studied since it is assumed that fluids must be administered in advance. We sought to evaluate whether a very early start of VP, even without completing the initial fluid loading, might impact clinical outcomes in septic shock. METHODS: A total of 337 patients with sepsis requiring VP support for at least 6 h were initially selected from a prospectively collected database in a 90-bed mixed-ICU during a 24-month period. They were classified into very-early (VE-VPs) or delayed vasopressor start (D-VPs) categories according to whether norepinephrine was initiated or not within/before the next hour of the first resuscitative fluid load. Then, VE-VPs (n = 93) patients were 1:1 propensity matched to D-VPs (n = 93) based on age; source of admission (emergency room, general wards, intensive care unit); chronic and acute comorbidities; and lactate, heart rate, systolic, and diastolic pressure at vasopressor start. A risk-adjusted Cox proportional hazard model was fitted to assess the association between VE-VPs and day 28 mortality. Finally, a sensitivity analysis was performed also including those patients requiring VP support for less than 6 h. RESULTS: Patients subjected to VE-VPs received significantly less resuscitation fluids at vasopressor starting (0[0-510] vs. 1500[650-2300] mL, p < 0.001) and during the first 8 h of resuscitation (1100[500-1900] vs. 2600[1600-3800] mL, p < 0.001), with no significant increase in acute renal failure and/or renal replacement therapy requirements. VE-VPs was related with significant lower net fluid balances 8 and 24 h after VPs. VE-VPs was also associated with a significant reduction in the risk of death compared to D-VPs (HR 0.31, CI95% 0.17-0.57, p < 0.001) at day 28. Such association was maintained after including patients receiving vasopressors for < 6 h. CONCLUSION: A very early start of vasopressor support seems to be safe, might limit the amount of fluids to resuscitate septic shock, and could lead to better clinical outcomes.

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Introducción: Los pacientes oncológicos son un reto en su manejo general, que por su patología oncológica el riesgo de muerte es inminente. Sin embargo, si bien la mortalidad de este tipo de pacientes es relativamente alta debido a los factores asociados a la misma. Por lo que en este estudio se analizan los factores asociados a la mortalidad de pacientes oncológicos. Métodos: El estudio tipo observacional retrospectivo ha sido realizado con pacientes oncológicos ingresados en la unidad de cuidados intensivos del Hospital SOLCA durante el periodo de septiembre 2018 y septiembre 2019. Resultados: Un total de 230 pacientes fueron incluidos. La mortalidad fue de 22.6%. Los factores asociados a la mortalidad de manera significativa (P<0.01) fueron la patología no quirúrgica, tumor hematológico, los mayores puntajes del score APACHE, SOFA y NUTRIC-SCORE. Además de la asistencia con ventilación mecánica, intubación y vía central. Por otro lado, la neutropenia no mostró asociación a la mortalidad (P=0.565) Conclusión: Se mostraron que los principales factores asociados a la mortalidad de los pacientes oncológicos son, la gravedad medida por los distintos scores, la patología no quirúrgica y el tumor de tipo hematológico. Finalmente, la necesidad de asistencia ventilatoria, intubación y vía central.

Introduction: Oncological patients are a challenge in their general management, which due to their oncological pathology the risk of death is imminent. However, although the mortality of this type of patients is relatively high due to the factors associated with it. Therefore, this study analyzes the factors associated with the mortality of cancer patients. Methods: The study retrospective observational type was conducted with cancer patients admitted to the intensive care unit of the SOLCA Hospital during the period of September 2018 and September 2019. Results: A total of 230 patients were included. Mortality was 22.6%. The factors associated with mortality significantly (P<0.01) were non-surgical pathology, hematological tumor, the highest APACHE, SOFA and NUTRIC-SCORE scores. In addition to assistance with mechanical ventilation, intubation and central line. On the other hand, neutropenia showed no association with mortality (P= 0.565) Conclusion: It was shown that the main factors associated with the mortality of cancer patients are the severity measured by the different scores, the non-surgical pathology and the hematological tumor. Finally, the need for ventilatory assistance, intubation and central route.

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Postoperative flap displacements after Laser In Situ Keratomileusis (LASIK) are uncommon complications, and flap losses are even less frequent, occurring most commonly within 24 hours after the procedure. Although cases of late subluxation have been reported up to 14 years after the surgery, the longest reported time after surgery for late flap loss is four years after LASIK. We report a case of a 54-year-old man that presented a traumatic total flap avulsion and loss 13 years after LASIK. According to our knowledge, this is the longest time reported in such a case in the literature. Medical treatment yielded an acceptable visual result. This case reinforces the concept that there could be a lifelong potential risk of traumatic corneal flap loss after LASIK.

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PURPOSE: To evaluate the results of optical biometry using the IOLMaster 500, Lenstar LS 900 and Aladdin in eyes with cataract. METHODS: In 231 eyes of 152 patients with cataract, the measurements of 3 different biometers were retrospectively compared. Paired comparisons were performed for axial length (AL), mean keratometry (mean K) and anterior chamber depth (ACD). RESULTS: In only 197 of the 231 eyes (85.3%), it was possible to obtain reliable measurements of AL with all the three devices. It was not possible to determine AL in 16 eyes (6.9%) with Lenstar LS 900; in 19 eyes (8.2%) with Aladdin; and in 20 eyes (8.6%) with IOLMaster 500 possibly related to the severity of lens opacification (the corneas had good transparency in the eyes included in the study). There was a statistically significant difference in AL between IOLMaster 500 and the remaining two biometers (P = 0.03). However, the amount of difference was considered clinically not significant (0.04 mm). The mean keratometry (mean K) was determined in 203 eyes (87.9%) with all the three devices. Differences in mean K were between - 0.1 and 0.06 Diopters (D), which were considered neither statistically (P > 0.05) nor clinically significant. The anterior chamber depth (ACD) was determined in 197 eyes (85.28%) with all the three biometers. The differences between the three devices (0.03 to 0.13 mm) were not statistically significant and considered also clinically not significant. CONCLUSIONS: There were no clinically significant differences between these 3 biometers in AL, mean K and ACD.

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Diseño de estudio: Retrospectivo observacional descriptivo. Método: Se recolectaron datos de pacientes con sífilis ocular evaluados en un centro de referencia de oftalmología en Colombia desde marzo de 2015 hasta febrero de 2017. Resultados: Dieciséis pacientes fueron diagnosticados con sífilis ocular durante el período estudiado. Cuatro (25%) pacientes tuvieron afectación de ambos ojos, para un total de 20 ojos. Hubo 11 (68.8%) hombres y 5 (31.3%) mujeres. La edad media de presentación fue de 51.1 años (23-86 años). Cuatro pacientes masculinos estaban coinfectados con VIH. La manifestación más frecuente fue la panuveítis en ocho ojos (40%). Seis pacientes (37.5%) presentaron hallazgos dermatológicos sistémicos. El tratamiento incluyó penicilina cristalina y esteroides sistémicos. El seguimiento medio fue de 16.2 meses (12-21 meses). La agudeza visual media mejoró de 1,01 ± 0,71 logMAR a 0,58 ± 0,64 logMAR después del tratamiento. Conclusión: La sífilis es una causa poco común de infl amación intraocular. Sin embargo, la incidencia ha venido en aumento en los últimos años tanto en pacientes VIH positivo como VIH negativo. La panuveítis es el hallazgo ocular más frecuente. El pronóstico visual es bueno si hay un diagnóstico y tratamiento temprano.

Background: Syphilis is a sexually transmitted disease caused by Treponema pallidum. It can remain dormant in the individual throughout life. The manifestations of ocular involvement are similar to other infl ammatory eye conditions. It is crucial to make an early diagnosis and management in order to avoid complication. Objective: to describe the clinical characteristics and the results of the treatment of patients with ocular syphilis. Study design: observational retrospective study. Method: Retrospective cohort of patients with ocular syphilis evaluated in an ophthalmology reference center in Colombia from March 2015 to February 2017. Results: Sixteen patients were diagnosed with ocular syphilis during the studied period. Four (25%) patients had involvement of both eyes, for a total of 20 eyes. There were 11 (68.8%) men and 5 (31.3%) women. The mean age of presentation was 51.1 years (23-86 years). Four male patients were coinfected with HIV. Th e most frequent manifestation was panuveitis in eight eyes (40%). Six patients (37.5%) presented systemic dermatological fi ndings. Treatment included crystalline penicillin and systemic steroids. The mean follow-up was 16.2 months (12-21 months). The mean visual acuity improved from 1.01 ± 0.71 logMAR to 0.58 ± 0.64 logMAR after treatment. Conclusion: Syphilis is a rare cause of intraocular inflammation. However, the incidence has been increasing in recent years in both HIV positive and HIV negative patients. Panuveitis is the most frequent ocular finding. The visual prognosis is good if there is an early diagnosis and treatment.

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Background: After 52 years of war in 2012, the Colombian government began the negotiation of a process of peace, and by November 2012, a truce was agreed. We sought to analyze casualties who were admitted to the intensive care unit (ICU) before and during the period of the negotiation of the comprehensive Colombian process of peace. Methods: Retrospective study of hostile casualties admitted to the ICU at a Level I trauma center from January 2011 to December 2016. Patients were subsequently divided into two groups: those seen before the declaration of the process of peace truce (November 2012) and those after (November 2012-December 2016). Patients were compared with respect to time periods. Results: Four hundred forty-eight male patients were admitted to the emergency room. Of these, 94 required ICU care. Sixty-five casualties presented before the truce and 29 during the negotiation period. Median injury severity score was significantly higher before the truce. Furthermore, the odds of presenting with severe trauma (ISS > 15) were significantly higher before the truce (OR, 5.4; (95% CI, 2.0-14.2); p < 0.01). There was a gradual decrease in the admissions to the ICU, and the performance of medical and operative procedures during the period observed. Conclusion: We describe a series of war casualties that required ICU care in a period of peace negotiation. Despite our limitations, our study presents a decline in the occurrence, severity, and consequences of war injuries probably as a result in part of the negotiation of the process of peace. The hysteresis of these results should only be interpreted for their implications in the understanding of the peace-health relationship and must not be overinterpreted and used for any political end.

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BACKGROUND: To report the neuro-ophthalmological findings in the TAFRO syndrome in a South American patient. METHODS: This is a case report of a patient with TAFRO syndrome. RESULTS: We present the case of a 66-year-old woman with TAFRO syndrome and multicentric Castleman disease, who developed ophthalmic manifestations, as a rare complication, including optic disk edema and serous retinal detachment, which improved with conventional therapy. CONCLUSIONS: The optic disk edema could be present as a neuro-ophthalmological finding in TAFRO syndrome. To the best of our knowledge, this is the first report on the ophthalmic manifestations in the TAFRO syndrome.

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BACKGROUND: To report the clinical, electrophysiological and the anatomical findings in a patient with Kearns-Sayre syndrome (KSS). CASE PRESENTATION: We present the case of a 55-year-old female with KSS, who developed systemic features and ocular manifestations as ophthalmoplegia and retinal dysfunction, that were corroborated by electrophysiological test and High Definition Spectral Domain Optical Coherence Tomography (HD SD OCT) and OCT-Angiography (OCT-A). CONCLUSION: We report a patient with KSS, accompanied by some alterations of the RPE and photoreceptors observed in the external HD SD OCT and OCT-A. In the best of our knowledge, this is the first report in the literature of HD SD OCT findings in a patient with KSS.

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We performed a retrospective interventional case series including 80 eyes of 48 patients with keratoconus (KC) who were treated with modified corneal cross-linking (CXL) for KC (with a partial deepithelization in a pattern of stripes). The average follow-up was 5.8 years (with a minimum of 5 years). At the last follow-up visit, compared with preoperative values, there were no significant changes in spherical equivalent, average keratometry, corneal thickness, corneal hysteresis, or corneal resistance factor. The distance-corrected visual acuity was 20/39 preoperatively and 20/36 postoperatively (P = 0.3). The endothelial cell count decreased by 4.7% (P < 0.005). These findings suggest that this modified corneal CXL technique is a safe and effective alternative to halt the progression of KC up to five years after the procedure. However, some concerns remain as to whether this technique can affect in some degree the corneal endothelial cells.

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Objetivo: establecer los efectos sobre la osmolalidad y las concentraciones electrolíticas, plasmáticas y urinarias, del consumo de tres bebidas con diferente osmolaridad después de una actividad física de alta intensidad y larga duración. Métodos: nueve corredores de fondo realizaron 88 minutos de carrera en banda rodante, seguidos de 90 minutos de recuperación; inicialmente, sin reposición hídrica –procedimiento deshidratado– (DH); luego, tres procedimientos secuenciales y aleatorios ingiriendo un volumen similar de una de tres bebidas, isoosmolar, hipoosmolar o hiperosmolar –procedimientos con hidratación (RH)–. Los electrolitos, plasmáticos y urinarios, la osmolalidad plasmática y la osmolaridad urinaria se midieron antes y después de la carrera y al final de la recuperación. Resultados: en DH, al final del ejercicio, se observó una deshidratación hipernatrémica e hiperclorémica (p < 0,05); durante todo el procedimiento hubo hipercaliemia (p < 0,011); al final de la recuperación hubo reducción del volumen urinario (p < 0,05) e hipercaliuria (p < 0,001). La reposición parcial de las pérdidas hídricas atenuó la deshidratación y los cambios plasmáticos del sodio y el cloro pero no los del potasio al final del ejercicio. Todas las variables estudiadas se asociaron con la duración de la actividad física (p < 0,03). Hubo correlaciones, con todos los tratamientos, durante todo el procedimiento, entre el sodio y el cloro plasmáticos (r: 0,85-0,96) y entre la osmolaridad y el sodio urinarios (r: 0,50-0,83). Conclusiones: al final de la actividad física se observó en el grupo DH una deshidratación hipernatrémica, hiperclorémica e hipercaliémica; la reposición parcial de las pérdidas hídricas, en el límite inferior de lo recomendado, atenuó la deshidratación y los cambios de los electrolitos plasmáticos excepto los del potasio. Son pocas las investigaciones que emplean un modelo de mediciones secuenciales, doble ciego, como el utilizado en el presente trabajo.

Objetive: To establish the effects on plasma osmolality and serum and urine electrolyte composition of the intake of three beverages with different osmolarities after a high intensity, long duration run in endurance athletes. Methodology: Nine long-distance runners performed 88 minutes of running on a treadmill (1% of inclination at a speed equivalent to 80% of the reserve heart rate), followed by 90 minutes of recovery; at the beginning there was no fluid replacement –dehydrated treatment–(DH); later on three sequential and randomizedprocedures were used, drinking equal volumes of one ofthree beverages, namely: hyperosmolar (Hyper),hyposmolar (Hypo) and isosmolar (Iso). Plasmaticosmolality and urinary osmolarity were measured bymeans of standard laboratory techniques, before andafter the running period.Results: In DH, at the end of the exercise period, ahypernatremic and hyperchloremic dehydration wasobserved (p < 0.05); throughout the procedure there washyperkaliemia (p < 0.011); at the end of the recoveryperiod there were an urinary volume reduction (p <0.05) and hyperkaliuria (p < 0.001). Partial replacement of the water loss, with beverages of different osmolarity,attenuated dehydration and the plasmatic changes ofsodium and chloride, but not those of potassium at theend of the exercise period, or those of urinary potassium at the end of the recovery period. All studied variables, except for the urinary concentration of chlorine, were associated with the duration of the physical activity (p < 0.03); only the weight loss showed time-treatment association (p < 0.001). There were correlations with all treatments and during all procedures between plasmatic sodium and chloride (r: 0.85-0.96) and between urinary osmolarity and sodium (r: 0.50-0.83). Conclusions: At the end of the physical activity there was, in the DH group, a hypernatremic, hyperchloremic and hyperkaliemic type of dehydration; partial replacement of the water loss, although in the lower level of the recommended volume, attenuated dehydration and the plasmatic electrolytic changes, except for those of the potassium; hyperkaliuria did not change either at the end of the procedure. Few investigations have used the double-blinded model of sequential measurements that was used in the present work.

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