The battle that the drug-free athlete engages in is not an easy one. He must face up to drug-using and abusing competition and drug-based competitive standards in every contest. What the Metabolic Diet does is to give him the same kind of benefits the drug user obtains.
By introducing anabolic steroids into his body, the drug user increases the circulating amount of anabolic hormones and other compounds, which in turn produces the desired anabolic effect of muscle growth. The Metabolic Diet does the same thing, only instead of introducing the anabolic substances from an exogenous source outside the body, the diet stimulates the production of anabolic hormones IN THE BODY. It is LEGAL and it is SAFE.
Find out more about the Metabolic Diet and the Anabolic Solution
1: Rev Med Suisse Romande. 2003 Feb;123(2):93-6.
[In Process Citation]
[Article in French]
Zorzoli M.
Service medical Union Cycliste Internationale Aigle. mario.zorzoli@uci.ch
If doping is generally considered a phenomena of the sports world, the use of
substances to achieve a better performance is an attitude which is rapidly
spreading out in our society. Doping behavior is defined as the consumption of a
product in order to face or pass an obstacle and be more performant. Even among
adolescents, the will to increase the efficiency in sport or to modify the body
appearance, push some people to use any kind of products: nutritional
supplements, doping agents (anabolic steroids, amphetamines, etc.), with all the
associated risks due to the doubtful origin of some of these substances, the way
they are consumed or their side effects. It is important that the medical
community, and those who are in contact with the adolescents, realize that this
kind of behavior exists, so to face it in an adequately manner, the same way
they deal with the problem of alcohol, tobacco or drugs.
PMID: 15095688 [PubMed]
2: BMJ. 2004 Apr 17;328(7445):907-8.
Growth hormone: uses and abuses.
Hintz RL.
Publication Types:
Editorial
PMID: 15087325 [PubMed]
3: Heart. 2004 May;90(5):496-501.
Comment in:
Heart. 2004 May;90(5):473-5.
Are the cardiac effects of anabolic steroid abuse in strength athletes
reversible?
Urhausen A, Albers T, Kindermann W.
Institute of Sports and Preventive Medicine, University of Saarland
Saarbruecken, Germany. a.urhausen@rz.uni-sb.de
OBJECTIVE: To investigate the reversibility of adverse cardiovascular effects
after chronic abuse of anabolic androgenic steroids (AAS) in athletes. METHODS:
Doppler echocardiography and cycle ergometry including measurements of blood
pressure at rest and during exercise were undertaken in 32 bodybuilders or
powerlifters, including 15 athletes who had not been taking AAS for at least 12
months (ex-users) and 17 currently abusing AAS (users), as well as in 15
anabolic-free weightlifters. RESULTS: Systolic blood pressure was higher in
users (mean (SD) 140 (10) mm Hg) than in ex-users (130 (5) mm Hg) (p < 0.05) or
weightlifters (125 (10) mm Hg; p < 0.001). Left ventricular muscle mass related
to fat-free body mass and the ratio of mean left ventricular wall thickness to
internal diameter were not significantly higher in users (3.32 (0.48) g/kg and
42.1 (4.4)%) than in ex-users (3.16 (0.53) g/kg and 40.3 (3.8)%), but were lower
in weightlifters (2.43 (0.26) g/kg and 36.5 (4.0)%; p < 0.001). Left ventricular
wall thickness related to fat-free body mass was also lower in weightlifters,
but did not differ between users and ex-users. Left ventricular wall thickness
was correlated with a point score estimating AAS abuse in users (r = 0.49, p <
0.05). In all groups, systolic left ventricular function was within the normal
range. The maximum late transmitral Doppler flow velocity (Amax) was higher in
users (61 (12) cm/s) and ex-users (60 (12) cm/s) than in weightlifters (50 (9)
cm/s; p < 0.05 and p = 0.054). CONCLUSIONS: Several years after discontinuation
of anabolic steroid abuse, strength athletes still show a slight concentric left
ventricular hypertrophy in comparison with AAS-free strength athletes.
PMID: 15084541 [PubMed]
4: Med Sci Sports Exerc. 2004 Apr;36(4):588-93.
Serum sTfR levels may indicate charge profiling of urinary r-hEPO in doping
control.
Nissen-Lie G, Birkeland K, Hemmersbach P, Skibeli V.
Hormone Laboratory, Section for Doping Analyses, Aker University Hospital, Oslo,
Norway. gro.nissen-lie@h-lab.no
PURPOSE: The aim of the study was to demonstrate whether changes in the charge
pattern of urinary human erythropoietin (u-hEPO) from well-trained athletes
before, during and after controlled administration of recombinant human EPO
(r-hEPO) could be related to altered levels of hemoglobin (Hb), hematocrit
(Hct), soluble transferrin receptor (sTfR) and maximal oxygen uptake (VO2max).
METHODS: Urinary samples from athletes in an EPO-receiving group and a control
group were collected before, during and after r-hEPO administration. The samples
were analyzed with respect to the charge pattern of hEPO by iso-electric
focusing (IEF). RESULTS: The charge of the u-hEPO variants shifted from an
acidic to a more basic pattern after initiating r-hEPO administration. This
shift appeared together with increased levels of sTfR, and appeared before
increased levels of Hb, Hct and VO2max. Until three days after the last
injection, the IEF profiles were similar to the charge profile of r-hEPO.
Thereafter the levels of sTfR decreased and the charge profiles of the hEPO
variants gradually became more acidic. In contrast, the levels of Hb, Hct and
VO2max remained elevated for an extended period of time. CONCLUSION: A
significant correlation was found between the relative amount of basic u-hEPO
variants and the relative levels of sTfR, demonstrating that the relative levels
of sTfR may be used as a marker to select urinary samples for further analysis
of r-hEPO by IEF in routine doping control.
PMID: 15064585 [PubMed]
5: Eur J Appl Physiol. 2004 Mar 20 [Epub ahead of print]
Update on nandrolone and norsteroids: how endogenous or xenobiotic are these
substances?
Bricout V, Wright F.
UFR de Sciences, Departement STAPS, Universite d'Avignon, 33 rue Pasteur, 84000,
Avignon, France.
Norsteroids are xenobiotics with androgenic and anabolic properties known since
as far back as the 1930s. In doping controls, the use of the banned xenobiotic
norsteroids is detected in the competitor's urines by the measurement of
norandrosterone (19-NA) and noretiocholanolone (19-NE), which are the main
metabolites for nandrolone (NT) and most norsteroids with anabolic properties.
In 1996, the IOC subcommission "Doping and Biochemistry of Sport" informed the
Heads of the "IOC Accredited Laboratories" that the recommended cut-off limit
for reporting an offence was to be 1-2 ng ml(-1) urine for either 19-NA or
19-NE. We will discuss how technical progress in gas chromatography coupled to
high-resolution mass spectrometry permitted a dramatic increase in sensitivity
with a detection limit of 1 pg ml(-1) urine, or less, and an assay limit of
20-50 pg ml(-1) urine, for either 19-NA or 19-NE. As a paradox, norsteroids have
been known for decades as not only xenobiotics but also obligatory endogenous
intermediates in the biosynthesis of estrogens from androgens in all species,
man included. It is this biochemical observation which fed the active scientific
and medical controversy initiated in 1998 over the possibly endogenous
production of nandrolone and metabolites well over the new IOC's recommended
cut-off limit of 2 ng ml(-1) urine. Notwithstanding the particular technical
difficulties attached, we will provide data and discuss the minute endogenous
levels detected and measured in man either at rest, after performance or
training and compare them to the relatively high levels reported in male
athlete's doping controls today. We will also discuss data on the
pharmacological effects of some contraceptive therapies containing norsteroids
in women. In view of the well-documented noxious effects repeatedly observed
after anabolic steroid misuse, the confirmation and implementation of
technically proven procedures for reporting norsteroid abuse in sports seems an
important enough goal to protect athlete's health against such abuses and
justifies up dating the review of the patent scientific and medical experience
and knowledge gained over the last 50 years on nandrolone and its minor
production in man and woman.
PMID: 15042372 [PubMed]
6: Am J Bioeth. 2004 Winter;4(1):35-6.
Mandatory drug testing of high school athletes: unethical evaluation, unethical
policy.
Louria D.
UMDNJ-New Jersey Medical School.
PMID: 15035943 [PubMed]
7: Am J Bioeth. 2004 Winter;4(1):29-30.
A response to commentators on "Ethics of Research Involving Mandatory Drug
Testing of High School Athletes in Oregon".
Shamoo AE, Moreno JD.
University of Maryland School of Medicine.
PMID: 15035937 [PubMed]
8: Am J Bioeth. 2004 Winter;4(1):25-31.
Ethics of research involving mandatory drug testing of high school athletes in
Oregon.
Shamoo AE, Moreno JD.
University of Maryland.
There is consensus that children have questionable decisional capacity and,
therefore, in general a parent or a guardian must give permission to enroll a
child in a research study. Moreover, freedom from duress and coercion, the
cardinal rule in research involving adults, is even more important for children.
This principle is embodied prominently in the Nuremberg Code (1947) and is
embodied in various federal human research protection regulations. In a program
named "SATURN" (Student Athletic Testing Using Random Notification), each school
in the Oregon public-school system may implement a mandatory drug-testing
program for high school student athletes. A prospective study to identify drug
use among student-athletes, SATURN is designed both to evaluate the influence of
random drug testing and to validate the survey data through identification of
individuals who do not report drug use. The enrollment of students in the
drug-testing study is a requirement for playing a school sport. In addition to
the coercive nature of this study design, there were ethically questionable
practices in recruitment, informed consent, and confidentiality. This article
concerns the question of whether research can be conducted with high school
students in conjunction with a mandatory drug-testing program, while adhering to
prevailing ethical standards regarding human-subjects research and specifically
the participation of children in research.
PMID: 15035935 [PubMed]
9: Sports Med. 2004;34(3):141-50.
Doping with artificial oxygen carriers: an update.
Schumacher YO, Ashenden M.
Department of Sports Medicine, University of Freiburg, Freiburg, Germany.
olaf@msm1.ukl.uni-freiburg.de
There is a long history of science seeking to develop artificial substitutes for
body parts damaged by disease or trauma. While defective teeth and limbs are
commonly replaced by imitations without major loss of functionality, the
development of a substitute for red blood cells has proved elusive. There is a
permanent shortage of donor blood in western societies. Nevertheless, despite
whole blood transfusions carrying measurable risks due to immunogenicity and the
transmission of blood-borne infectious diseases, red blood cells are still
relatively inexpensive, well tolerated and widely available. Researchers seeking
to develop products that are able to meet and perhaps exceed these criteria have
responded to this difficult challenge by adopting many different approaches.
Work has focussed on two classes of substances: modified haemoglobin solutions
and perfluorocarbon emulsions. Other approaches include the creation of
artificial red cells, where haemoglobin and supporting enzyme systems are
encapsulated into liposomes. Haemoglobin is ideally suited to oxygen transport
when encased by the red cell membrane; however, once removed, it rapidly
dissociates into dimers and is cleared by the kidney. Therefore, it must be
stabilised before it can be safely re-infused into humans. Modifications
concomitantly alter the vascular half-life, oxygen affinity and hypertensive
characteristics of raw haemoglobin, which can be sourced from outdated blood
stores, genetically-engineered Escherichia coli or even bovine herds. In
contrast, perfluorocarbons are entirely synthetic molecules that are capable of
dissolving oxygen but biologically inert. Since they dissolve rather than bind
oxygen, their capacity to serve as a blood substitute is determined principally
by the oxygen pressure gradients in the lung and at the target tissue. Blood
substitutes have important potential areas of clinical application including red
cell replacement during surgery, emergency resuscitation of traumatic blood
loss, oxygen therapeutic applications in radiography (oxygenation of tumour
cells is beneficial to the effect of certain chemotherapeutic agents), other
medical applications such as organ preservation, and finally to meet the
requirements of patients who cannot receive donor blood because of religious
beliefs. Given the elite athlete's historical propensity to experiment with
novel doping strategies, it is likely that the burgeoning field of artificial
oxygen carriers has already attracted their attention. Scientific data
concerning the performance benefits associated with blood substitutes are
virtually nonexistent; however, international sporting federations have been
commendably proactive in adding this category to their banned substance lists.
The current situation is vulnerable to exploitation by immoral athletes since
there is still no accepted methodology to test for the presence of artificial
oxygen carriers.
PMID: 14987124 [PubMed]
10: Int J Sports Med. 2004 Feb;25(2):133-8.
Drugs, recreational drug use and attitudes towards doping of high school
athletes.
Laure P, Lecerf T, Friser A, Binsinger C.
Laboratoire de psychologie appliquee Stress et Societe, Universite de Reims,
Moulin de la Housse, Chemin des Rouliers, Reims, France.
patrick.laure@wanadoo.fr
The purpose of this investigation was to determine the substances used, and the
attitudes towards doping of high school athletes. A four-page, self-completed
questionnaire was designed to determine the drugs used (licit, illicit and
doping substances) along with beliefs about doping and the psychosociological
factors associated with their consumption. The questionnaire was distributed to
all the high school students enrolled in a school sports association in the
Lorraine region in Eastern France. The completed forms were received from 1459
athletes: 4 % stated that they had used doping agents at least once in their
life (their main source of supply being peers and health professionals).
Thirty-four percent of the sample smoked some tobacco, 66 % used alcohol, 19 %
cannabis, 4 % ecstasy, 10 % tranquillizers, 9 % hypnotics, 4 % creatine and 41 %
used vitamins against fatigue. Beliefs about doping did not differ among doping
agent users and non-users, except for the associated health risks which were
minimized by users. Users of doping agents stated that the quality of the
relations that they maintain with their parents is sharply degraded, and they
reported that they are susceptible to influence and difficult to live with. More
often than non-doping agent users, these adolescents are neither happy, nor
healthy, while paradoxically, they seem less anxious and they are more
self-confident. Our findings suggest that doping prevention among young athletes
cannot be limited uniquely to the list of banned drugs.
PMID: 14986197 [PubMed]
11: Int J Sports Med. 2004 Feb;25(2):124-9.
Analysis of non-hormonal nutritional supplements for anabolic-androgenic
steroids - results of an international study.
Geyer H, Parr MK, Mareck U, Reinhart U, Schrader Y, Schanzer W.
Institute of Biochemistry, German Sport University, Cologne, Germany.
h.geyer@biochem.dshs-koeln.de
Several recent studies have shown evidence of some nutritional supplements
containing prohibited anabolic androgenic steroids, so-called prohormones, which
were not declared on the label. Therefore, a broad-based investigation of the
international nutritional supplement market was initiated to clarify the extent
of this problem. From October 2000 until November 2001, 634 non-hormonal
nutritional supplements were purchased in 13 countries from 215 different
suppliers. Most supplements were bought in shops in the respective countries
(578 samples = 91.2 %) and on the internet (52 samples = 8.2 %). 289 supplements
were from prohormone-selling companies and 345 supplements came from companies
which do not offer prohormones. After isolation from the supplement matrix 11
different anabolic androgenic steroids, mainly prohormones of testosterone and
nandrolone, were analysed by gas-chromatography/mass spectrometry. Out of the
634 samples analysed 94 (14.8 %) contained anabolic androgenic steroids not
declared on the label ("positive supplements"). We could not obtain reliable
data for 66 samples (10.4 %) due to matrix effects. In relation to the total
number of products purchased per country, most of the positive supplements were
bought in the Netherlands (25.8 %), in Austria (22.7 %), in the UK (18.8 %) and
the USA (18.8 %). According to the label, all positive supplements were from
companies located in only five countries: the USA, the Netherlands, the UK,
Italy and Germany. 21.1 % of the nutritional supplements from prohormone-selling
companies contained anabolic androgenic steroids, whereas 9.6 % of the
supplements from companies not selling prohormones were positive. The positive
supplements showed anabolic androgenic steroid concentrations of 0.01 micro g/g
up to 190 micro g/g. The administration of supplements containing nandrolone
prohormones adding up to a total uptake of more than 1 micro g resulted in
positive doping results for norandrosterone for several hours.
Publication Types:
Clinical Trial
PMID: 14986195 [PubMed]
12: Newsweek. 2004 Feb 23;143(8):35.
The dope on doping.
Starr M.
Publication Types:
News
PMID: 14983598 [PubMed]
13: Ital Heart J. 2003 Dec;4(12):829-37.
Arrhythmogenic effects of illicit drugs in athletes.
Furlanello F, Bentivegna S, Cappato R, De Ambroggi L.
Center of Clinical Arrhythmia and Electrophysiology, Istituto Policlinico San
Donato, University of Milan, San Donato, Milanese, MI, Italy.
furlanello@interfree.it
Cardiac arrhythmias are among the most important causes of non-eligibility to
sports activities, and may be due to different causes (cardiomyopathies,
myocarditis, coronary abnormalities, valvular diseases, primary electrical
disorders, abuse of illicit drugs). The list of illicit drugs banned by the
International Olympic Committee and yearly updated by the World Anti-Doping
Agency includes the following classes: stimulants, narcotics, anabolic agents
(androgenic steroids and others such as beta-2 stimulants), peptide hormones,
mimetics and analogues, diuretics, agents with an antiestrogenic activity,
masking agents. Almost all illicit drugs may cause, through a direct or indirect
arrhythmogenic effect, in the short, medium or long term, a wide range of
cardiac arrhythmias (focal or reentry type, supraventricular and/or
ventricular), lethal or not, even in healthy subjects with no previous history
of cardiac diseases. Therefore, given the widespread abuse of illicit drugs
among athletes, in the management of arrhythmic athletes the cardiologist should
always take into consideration the possibility that the arrhythmias be due to
the assumption of illicit drugs (sometimes more than one type), especially if no
signs of cardiac diseases are present. On the other hand, in the presence of
latent underlying arrhythmogenic heart disease including some inherited
cardiomyopathies at risk of sudden cardiac death, illicit drugs could induce
severe cardiac arrhythmic effects.
Publication Types:
Review
Review, Tutorial
PMID: 14976846 [PubMed]
14: J Sports Sci. 2004 Jan;22(1):95-113.
Dietary supplements.
Maughan RJ, King DS, Lea T.
School of Sport and Exercise Sciences, Loughborough University, Loughborough
LE11 3TU, UK. r.j.maughan@lboro.ac.uk
For the athlete training hard, nutritional supplements are often seen as
promoting adaptations to training, allowing more consistent and intensive
training by promoting recovery between training sessions, reducing interruptions
to training because of illness or injury, and enhancing competitive performance.
Surveys show that the prevalence of supplement use is widespread among sportsmen
and women, but the use of few of these products is supported by a sound research
base and some may even be harmful to the athlete. Special sports foods,
including energy bars and sports drinks, have a real role to play, and some
protein supplements and meal replacements may also be useful in some
circumstances. Where there is a demonstrated deficiency of an essential
nutrient, an increased intake from food or from supplementation may help, but
many athletes ignore the need for caution in supplement use and take supplements
in doses that are not necessary or may even be harmful. Some supplements do
offer the prospect of improved performance; these include creatine, caffeine,
bicarbonate and, perhaps, a very few others. There is no evidence that
prohormones such as androstenedione are effective in enhancing muscle mass or
strength, and these prohormones may result in negative health consequences, as
well as positive drug tests. Contamination of supplements that may cause an
athlete to fail a doping test is widespread.
PMID: 14971436 [PubMed]
15: J Endocrinol Invest. 2003 Sep;26(9):932-6.
Hormone use and abuse: what is the difference between hormones as fountain of
youth and doping in sports?
van der Lely AJ.
Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.
vanderlely@inw3.azr.nl
GH can induce changes in body composition that are considered to be advantageous
to aging subjects especially. However, there are no results indicating that the
use of GH during aging should be advocated, because of the lack of any proven
efficacy for whatever parameter. Also, data indicate that calorie restriction
can extend life spans by altering the rate of decline in reserve capacity as
well as by reducing the cumulative exposure to GH. Moreover, animal data suggest
that lower GH actions are positively correlated with longevity. The abuse of GH
by sportsmen is based on the belief that it has potent anabolic effects, while
it is difficult to detect the abuse. Again, this supposed efficacy cannot be
supported by any scientific data.
PMID: 14964448 [PubMed]
16: J Endocrinol Invest. 2003 Sep;26(9):924-31.
Problems with GH doping in sports.
Bidlingmaier M, Wu Z, Strasburger CJ.
Neuroendocrine Unit, Medizinische Klinik- Innenstadt, Klinikum der
Ludwig-Maximilians - University, Munich, Germany.
bidlingmaier@medinn.med.uni-muenchen.de
Human hGH is listed as a prohibited class E substance by the International
Olympic Committee (IOC), and its use is considered as doping. However, until
today the likelihood of being punished for using recombinant hGH is very
limited: once injected, it is believed to be undetectable by laboratories. No
official test is implemented in the doping control procedures, and the only
situation when athletes were found guilty of doping with hGH arose from actions
of customs officers or policemen arresting athletes carrying ampoules with them.
The primary reason for the lack of an accepted test method is the amino acid
sequence identity between the main fraction of pituitary derived hGH and
recombinant hGH, which makes it difficult to discriminate between endogenous and
exogenous hGH. In addition, hGH is known to have a very short half-life time in
circulation of around 15 min. Recent efforts of endocrine researchers led to the
identification of two main strategies promising to be useful for the detection
of recombinant hGH application, which are reviewed in this article: on the one
hand, changes in GH-dependent parameters after administration of recombinant GH
have been shown to be possible indicators of GH abuse, because the increase in
various parameters following recombinant hGH administration exceeds the
variability commonly observed in normal, healthy subjects. More directly,
another approach focuses on changes in the hGH isoform pattern in serum
occurring after injection of recombinant hGH. Because of the negative feedback
on pituitary hGH secretion, the relative abundance of isoforms other than 22 kD
are greatly reduced after administration of recombinant hGH, which only consists
of the 22 kD hGH isoform.
PMID: 14964447 [PubMed]
17: J Endocrinol Invest. 2003 Sep;26(9):832-7.
Erythropoietin.
Jelkmann W.
Institute of Physiology, University of Lubeck, Lubeck, Germany.
jelkmann@physio.uni-luebeck.de
This article summarizes recent advances in understanding the production and
action of the hormone erythropoietin (Epo) with respect to high altitude
physiology and sports medicine. Hypoxia is the main stimulus for Epo gene
expression. An O2-labile protein (hypoxia-inducible factor 1, HIF-1) has been
identified that is hydroxylated and degraded under normoxic conditions but
active in hypoxia, where it enhances Epo gene transcription resulting in
elevated hemoglobin levels and O2 capacity of the blood. The stimulation of Epo
production at lowered arterial O2 tension can be maladaptive, if erythrocytosis
develops such as seen in high altitude habitants. Within physiological limits
the aerobic power increases in parallel with blood O2 capacity. Therefore, some
elite athletes have misused recombinant human Epo (rhEpo), which is a beneficial
anti-anemic drug in clinical practice. Indirect and direct methods to detect
rhEpo doping have been recently developed.
PMID: 14964434 [PubMed]
18: J Vet Pharmacol Ther. 2003 Dec;26(6):429-34.
Detection and quantification of cocaine metabolites in urine samples from horses
administered cocaine.
Kollias-Baker C, Maxwell L, Stanley S, Boone T.
The Racing Laboratory, College of Veterinary Medicine, University of Florida
Gainesville, FL 32610, USA. baker@mail.vetmed.ufl.edu
Cocaine is a naturally occurring alkaloid that is commonly abused by
human-beings for its psychostimulatory effects. Occasionally, very small
concentrations (i.e. <100 ng/mL) of the primary cocaine metabolite,
benzoylecgonine (BZE) have been detected in urine collected from horses
competing in athletic events. In this study urine samples, collected from four
horses following the administration of 2.5 and 20 mg of cocaine sublingually and
50 mg of cocaine intravenously, were analyzed for the presence of cocaine and/or
its metabolites by enzyme-linked immunosorbent assay (ELISA) and gas
chromatography-mass spectrometry (GC-MS). The results of ELISA analysis of urine
samples collected from all four horses suggested the presence of cocaine and/or
its metabolites up to 10, 48, and 72 h after administration of 2.5, 20, and 50
mg of cocaine, respectively. The results of GC-MS analysis confirmed the
presence of BZE above the limit of quantification (LOQ = 5 ng/mL) in urine
samples collected from all four horses for up to 24 h after administration of
2.5 mg of cocaine and for up to 48 h after administration of 20 and 50 mg of
cocaine. No obvious behavioral effects or overt alterations of heart rate or
rhythm were noted in any of these horses after cocaine administration.
Publication Types:
Evaluation Studies
PMID: 14962054 [PubMed]
19: Drug Ther Bull. 2004 Jan;42(1):1-5.
Medical aspects of drug use in the gym.
[No authors listed]
Use of performance-enhancing drugs by athletes and bodybuilders appears to be
common in the UK. Although there are no comprehensive national figures, there is
evidence that such drugs are also widely used in sections of the general and
gym-using populations, in the expectation of physical and cosmetic benefits. Use
of performance-enhancing drugs often takes place with little knowledge or
acceptance of potential harmful effects, and clinicians in many settings may see
patients who are experiencing problems related to such (usually covert) use.
Here we consider medical aspects of performance-enhancing drugs.
PMID: 14768297 [PubMed]
20: Duodecim. 2003;119(23):2331-5.
[Can doping improve the performance of Santa's reindeer?]
[Article in Finnish]
Leinonen A, Kuoppasalmi K.
WADA:n ja KOK:n valtuuttaman dopingtestauslaboratorion tekninen johtaja Yhtyneet
Laboratoriot Oy. antti.leinonen@yhtyneetlaboratoriot.fi
PMID: 14768262 [PubMed]
21: Clin Chem. 2004 Apr;50(4):723-31. Epub 2004 Feb 05.
Detection of hemoglobin-based oxygen carriers in human serum for doping
analysis: confirmation by size-exclusion HPLC.
Varlet-Marie E, Ashenden M, Lasne F, Sicart MT, Marion B, de Ceaurriz J, Audran
M.
Biophysical & Bioanalysis Laboratory, Faculty of Pharmacy, University
Montpellier I, Montpellier, France.
BACKGROUND: Hemoglobin-based oxygen carriers (HBOCs) are being developed as
potential substitutes for the oxygen-carrying functions of erythrocytes, but
athletes may obtain and experiment with HBOCs as an illicit means of enhancing
oxygen transport. An electrophoretic technique has been developed to screen for
the presence of HBOCs in blood samples (Lasne et al. Clin Chem 2004;50:410-5).
Interest has focused on complementary methods that can provide legally
defensible scientific evidence for the presence of HBOCs in blood samples
collected for doping control. METHODS: The aim of this research was to develop a
size-exclusion SEC-HPLC technique to identify in plasma or serum samples the
presence of HBOCs that are currently under development. This method was also
used to detect a polymerized bovine hemoglobin (Hemopure) after infusion in 12
healthy males. RESULTS: The chromatograms of all HBOCs tested were clearly
separated from the 54-min peak associated with human hemoglobin dimers. It was
possible to differentiate between the different HBOC products based solely on
their chromatographic profiles, provided they were at high concentrations.
Differences were discernible not only based on the presence (or absence) of
peaks, but also the separation between respective peaks. The profiles for serum
samples collected from the men immediately after infusion of Hemopure showed a
distinctive profile. The shape of the chromatographic profile remained
consistent for at least 48 h. CONCLUSIONS: Under the analytical conditions
reported here, SEC-HPLC was able to separate native hemoglobin from the modified
hemoglobin molecules present in each of the HBOC products studied. In tandem
with electrophoretic screening, SEC-HPLC provides evidence of the presence of
HBOCs and can therefore be regarded as a method that satisfies the criteria for
use in an antidoping control setting.
PMID: 14764640 [PubMed]
22: Ann Med Interne (Paris). 2003 Nov;154 Spec No 2:S43-57.
[Doping: health risks and relation to addictive behaviors]
[Article in French]
Siri F, Roques BP.
francoise.siri@free.fr
The paper presents the health hazards of the major doping substances and raises
some questions about the relationship between doping and addictive behavior.
AIMS: Current definitions of doping and addictive behavior are examined. The
paper's goal is: 1- to assess the risks of neurotoxicity and overall toxicity of
doping substances: stimulants, narcotics (seldom used as doping substances), and
hormones, and assess their addictive potential; 2- to present available data on
drug-dependent patients with a record of early prolonged and intensive physical
activity or athletic practice. RESULTS AND DISCUSSION: Some doping substances
present high risks for health at large doses, but usually low addictive
potential and neurotoxicity. Dependency on doping substances and drift towards
dependency to addictive drugs, if any, are therefore determined by genetic and
environmental factors. A significant susceptibility to drug dependence has been
observed in some cases of very intensive and competitive practice.
Over-representation of intensive and competitive athletic antecedents among some
drug-dependent patients could be accounted for in either of two ways. On the
first account, the causal factor is a sensation-seeking character trait, with a
likely genetic component, which predisposes the individual to the use of drugs
or doping substances, as the opportunities arise. On the second account, the
sudden interruption of intensive practice, and of the associated organic stress
and hypersensitization of the hedonic pathway, creates a weaning syndrome and
leads to the search for relief through drugs. Further exploration of this
hypothesis is called for.
Publication Types:
Review
Review, Tutorial
PMID: 14760226 [PubMed]
23: Ann Med Interne (Paris). 2003 Nov;154 Spec No 2:S4-5.
[Stumbling blocks of sports]
[Article in French]
Lowenstein W.
Publication Types:
Editorial
PMID: 14760221 [PubMed]
24: Clin Chem. 2004 Feb;50(2):456-7.
Incidental clostebol contamination in athletes after sexual intercourse.
Pereira HM, Marques MA, Talhas IB, Aquino Neto FR.
Publication Types:
Letter
PMID: 14752023 [PubMed]
25: Br J Sports Med. 2004 Feb;38(1):99-101.
Blood boosting.
Leigh-Smith S.
Defence Medical Services, Edinburgh, Scotland, UK. simonlsuk@aol.com
This article reviews the history, technique, effects, side effects, and
detection of blood boosting. It also considers whether or not this particular
performance enhancement technique is a thing of the past or a continuing form of
abuse among athletes.
Publication Types:
Review
Review, Tutorial
PMID: 14751959 [PubMed]
26: Sci Am. 2004 Feb;290(2):22-3.
Doping by design.
Ashley S.
Publication Types:
News
PMID: 14743721 [PubMed]
27: Tidsskr Nor Laegeforen. 2004 Jan 22;124(2):155.
[Can doping be harmful for the heart?]
[Article in Norwegian]
Solberg EE.
Publication Types:
Editorial
PMID: 14743224 [PubMed]
28: Chem Soc Rev. 2004 Jan 10;33(1):1-13. Epub 2003 Dec 08.
Sports drug testing--an analyst's perspective.
Trout GJ, Kazlauskas R.
Australian Sports Drug Testing Laboratory, Australian Government Analytical
Laboratories, Sydney, Australia. graham.trout@agal.gov.au
Sport plays a major role in the lives of many people, both for active
participation and as entertainment. Sport is now a huge nationally and
internationally based industry. The desire to win has led some athletes to
resort to the use of performance enhancing drugs. With huge financial rewards
now available in some sports the pressure to excel has grown. Some have argued
that drug use should be given free rein, however most people are of the view
that it is athletic prowess that should be applauded not the efficacy of various
performance enhancing drugs. Apart from the obvious aspects of equality and fair
play, the use of drugs is associated with significant health risks. In the
1960's the use of stimulants in sports such as cycling led to the death of at
least one cyclist. Since 1968 the International Olympic Committee (IOC) has
required all Olympic Games' host cities to provide laboratory facilities for the
analysis and detection of performance enhancing drugs. There are now 29 IOC
accredited laboratories throughout the world that routinely test samples from
athletes for the presence of such drugs. The purpose of this tutorial review is
to give an overview of drug testing procedures, including those that were used
at the last summer Olympic Games in Sydney 2000, and the incorporation of the
latest developments in analytical chemistry technology in the drug testing
process. More recently, developments in biotechnology mean that the use of whole
new classes of drugs are banned in sport, often requiring new methodologies and
techniques for their analysis. The contest between those who wish to cheat and
those who wish to maintain fair play in sport is an ongoing one.
Publication Types:
Review
Review, Tutorial
PMID: 14737504 [PubMed]
29: Lancet. 2003 Dec;362 Suppl:s50-1.
Olympic medicine.
Sando B.
Australian Sports Drug Agency, Australia. bsando@senet.com.au
PMID: 14698130 [PubMed]
30: Br J Clin Pharmacol. 2004 Jan;57(1):62-7.
Elimination of ephedrines in urine following multiple dosing: the consequences
for athletes, in relation to doping control.
Chester N, Mottram DR, Reilly T, Powell M.
Research Institute for Sport and Exercise Sciences, Liverpool John Moores
University, Liverpool, UK. n.chester@livjm.ac.uk
AIMS: To study the elimination of ephedrines with reference to the International
Olympic Committee (IOC) doping control cut-off levels, following multiple dosing
of over-the-counter decongestant preparations. METHODS: A double-blind study was
performed in which 16 healthy male volunteers were administered either
pseudoephedrine or phenylpropanolamine in maximal recommended therapeutic doses
over a 36-h period. Urine was collected every two hours between 08:00 and 24:00
h and at 04:00 h throughout the testing period of three days. Urine drug levels
were quantified using high performance liquid chromatography. Side-effects were
assessed, including heart rate and blood pressure, every four hours between
08:00 and 20:00 h. RESULTS: Mean (95% CI) total phenylpropanolamine and
pseudoephedrine eliminated unchanged was 75 (88, 61) and 81 (92, 71)%,
respectively. Maximum urine concentrations of phenylpropanolamine and
pseudoephedrine were 112.1 (164.2, 59.9) and 148.5 (215.0, 82.1) mg.l(-1),
respectively. A peak in drug urine concentration occurred four hours following
the final dose. There were no adverse cardiovascular effects and only mild CNS
stimulation was evident. CONCLUSIONS: Following therapeutic, multiple dosing,
drug levels remain above the IOC cut-off levels for a minimum of 6 h and 16 h
following final doses of phenylpropanolamine and pseudoephedrine, respectively.
Athletes require informed advice on this from their healthcare professionals.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 14678341 [PubMed]
31: Int J Sport Nutr Exerc Metab. 2003 Sep;13(3):320-32.
Dietary supplementation practices of Singaporean athletes.
Slater G, Tan B, Teh KC.
Department of Physiology, Sports Science Sports Medicine Centre, Australian
Institute of Sport, Belconnen ACT, Australia 2616.
The supplementation practices of elite athletes in Singapore were studied using
an anonymous questionnaire. Information was sought on not only the type of
supplements used but also dosage, rationale for use, and other factors that
might influence supplement use including selected demographic parameters and
sources of information relating to supplements. Data was collected from 160
athletes across a spectrum of 30 sports. Use of supplements was widespread, with
77% of respondents acknowledging use of at least 1 product. Respondents ingested
a total of 59 different supplements, with each athlete using on average 3.6 +/-
0.3 different products. Sports drinks, caffeine, vitamin C, multivitamin/mineral
supplements, and essence of chicken were some of the most commonly ingested
products, confirming that while vitamin/mineral supplements are popular, sports
supplements and traditional/herbal preparations were also well accepted.
Respondents preferred to source information pertaining to supplements from
"significant others" and other readily accessible sources. A small number of
respondents acknowledged the use of International Olympic Committee (IOC) banned
or restricted substances, highlighting the need for athletes to consult sports
medicine professionals with specialist knowledge of dietary supplements in
advance of initiating any supplementation regime.
PMID: 14669932 [PubMed]
32: J Mass Spectrom. 2003 Nov;38(11):1197-206.
Liquid chromatography/electrospray ionization tandem mass spectrometric
screening and confirmation methods for beta2-agonists in human or equine urine.
Thevis M, Opfermann G, Schanzer W.
Institute of Biochemistry, German Sport University, Cologne, Carl-Diem Weg 6,
50933 Cologne, Germany. m.thevis@biochem.dshs-koeln.de
Electrospray ionization (ESI) mass spectra of 19 common beta(2)-agonists were
investigated in terms of fragmentation pattern and dissociation behavior of the
analytes, proving the origin of fragment ions and indicating mechanisms of
charge-driven and charge-remote fragmentation. Based on these data, liquid
chromatographic/ESI tandem mass spectrometric (LC/ESI-MS/MS) screening and
confirmation methods were developed for doping control purposes. These
procedures employ established sample preparation steps including either acidic
or enzymatic hydrolysis, alkaline extraction and, in the case of equine urine
specimens, acidic re-extraction of the analytes. In addition, a degradation
product of formoterol caused by acidic hydrolysis during sample preparation
could be identified and utilized as target compound in screening and also
confirmation methods. The screening procedures cover 18 or 19beta(2)-agonists,
the estimated limits of detection of which for equine and human urine samples
vary between 2 and 100 ng ml(-1) and between 2 and 50 ng ml(-1), respectively. A
single LC/MS/MS analysis can be performed in 9 min. Copyright 2003 John Wiley &
Sons, Ltd.
PMID: 14648827 [PubMed]
33: Clin Chem. 2004 Feb;50(2):355-64. Epub 2003 Nov 21.
[13C]Nandrolone excretion in trained athletes: interindividual variability in
metabolism.
Baume N, Avois L, Schweizer C, Cardis C, Dvorak J, Cauderay M, Mangin P, Saugy
M.
Laboratoire suisse d'Analyse du Dopage, Institut de Medecine Legale, Departement
Universitaire de Medecine et Sante Communautaires, Lausanne, Switzerland.
BACKGROUND: Nandrolone is one of the most abused anabolic steroids, and its use
in doping is increasing, as revealed by numerous positive cases during recent
years in various sports. Different authors have reported the possible natural
production of nandrolone metabolites in humans, and some of these authors argued
that exhaustive exercise could increase nandrolone production in the body or
induce dehydration and consequently lead to an increase of nandrolone
metabolites in urine. METHODS: Volunteers (n = 22) ingested two 25-mg doses of
[(13)C]nandrolone at 24-h intervals and collected urine specimens for 5 days.
The labeled nandrolone metabolites 19-norandrosterone and 19-noretiocholanolone
were identified and quantified by gas chromatography-mass spectrometry. RESULTS:
Interindividual variability was observed in nandrolone excretion patterns and
kinetics, as well as for the noretiocholanolone:norandrosterone ratio. The
amounts of nandrolone metabolites measured at the excretion peak varied between
1180 and 38 661 microg/L for norandrosterone and 576 and 12 328 microg/L for
noretiocholanolone. At the end of the excretion period, the
noretiocholanolone:norandrosterone ratio was sometimes >1. The analysis of
numerous spot-urine samples allowed the determination of an acceptable
correlation between urinary creatinine and specific gravity for placebo- and
steroid-treated individuals: y = 0.0052ln(x) + 1.0178 (r(2) = 0.8142) and y =
0.0068ln(x) + 1.0172 (r(2) = 0.7730), respectively. CONCLUSIONS: The excretion
kinetics and patterns of labeled nandrolone show interindividual variability.
More investigations are currently underway to estimate the influence of
exhaustive exercises on excretion of labeled nandrolone metabolites in urine.
Publication Types:
Clinical Trial
PMID: 14633920 [PubMed]
34: Clin Chem. 2004 Feb;50(2):410-5. Epub 2003 Nov 21.
Detection of hemoglobin-based oxygen carriers in human serum for doping
analysis: screening by electrophoresis.
Lasne F, Crepin N, Ashenden M, Audran M, de Ceaurriz J.
National Antidoping Laboratory, Chatenay-Malabry, France. f.lasne@lndd.com
BACKGROUND: Hemoglobin-based oxygen carriers (HBOCs) have recently been included
in the International Olympic Committee and World Anti-Doping Agency lists of
substances and methods prohibited in sports. To enforce this rule and deter
abuse of HBOCs in elite sports, it is necessary to develop HBOC-specific
screening and confirmation tests that are the usual steps in antidoping control
analysis. METHODS: We developed a screening method based on electrophoresis of
serum samples cleared of haptoglobin (Hp). Four successive steps
(immunoprecipitation of Hp, electrophoresis of the cleared serum, Western
blotting of the separated proteins, and detection of hemoglobin-related
molecules based on the peroxidase properties of the heme moiety), provided
electropherograms that could be easily interpreted in terms of the presence of
HBOCs. This method was tested with serum samples enriched with various types of
HBOCs: polymerized, conjugated, and cross-linked hemoglobins. It was also
applied to blood samples collected from 12 healthy volunteers who had been
infused with either 30 or 45 g of Hemopure, a glutaraldehyde-polymerized bovine
hemoglobin. RESULTS: The method clearly detected the presence in serum of the
various types of HBOCs tested and demonstrated no possible confusion with
endogenous hemoglobin that may be present in cases of hemolysis. The test was
able to detect Hemopure for 4-5 days after administration of 45 g to healthy
individuals. CONCLUSIONS: The electrophoretic method is a simple, fast, and
sensitive procedure that appears to fulfill the criteria of a screening test for
the presence of HBOCs in antidoping control samples.
PMID: 14633908 [PubMed]
35: Clin Chem. 2003 Dec;49(12):2106-7.
New scenarios in antidoping research.
Lippi G, Guidi G.
Publication Types:
Letter
PMID: 14633894 [PubMed]
36: Rev Mal Respir. 2003 Nov;20(5 Pt 1):727-34.
[Sport and atopy]
[Article in French]
Didier A, Mazieres J, Kouevijin G, Tetu L, Riviere D.
Service de Pneumologie et d'Allergologie, CHR Rangueil, Toulouse, France.
didier.a@chu-toulouse.fr
INTRODUCTION: The atopic diseases, asthma, allergic rhinitis and atopic
dermatitis, are common in children, adolescents and young adults. They may have
important consequences on physical exercise, especially asthma. STATE OF ART:
Elite athletes have been observed to have a high prevalence of asthma (and
perhaps also rhinitis). The reasons for this observation are still debated, but
different mechanisms linked to the intensity of physical activity in athletes
are probably involved. Exercise-induced symptoms should be confirmed not only
from the clinical history but also by objective measurements of lung function.
In elite athletes confirmation of exercise-induced asthma might be difficult and
may require special diagnostic tests such as bronchial provocation by eucapnic
voluntary hyperventilation. Several drugs are effective in exercise-induced
prevention of nasal and bronchial symptoms. Therapeutic approaches for atopic
diseases in international guidelines (GINA and ARIA) are generally compatible
with anti-doping laws but require compliance with specific prescription rules.
PERSPECTIVES: A better understanding of mechanisms and risk factors involved in
the increase of asthma prevalence in elite athletes may permit prevention by
modifying training conditions during exercise. CONCLUSIONS: Atopic diseases are
common in athletes. They require special therapeutic considerations. The
increasing prevalence of respiratory asthma-like symptoms in elite athlete is
opening new paths for research into airway physiology in extreme conditions.
Publication Types:
Review
Review, Tutorial
PMID: 14631252 [PubMed]
37: J Steroid Biochem Mol Biol. 2003 Oct;87(1):27-34.
Epitestosterone.
Starka L.
Institute of Endocrinology, Narodni; tr. 8, CZ 116 94 Prague 1, Czech Republic.
lstarka@endo.cz
Epitestosterone has been identified as a natural component of biological fluids
of several mammals including man. For a long time it was believed that it is a
metabolite without any hormonal activity and without any marked relationship to
the hormonal state in health and disease. Neither the biosynthetic pathway nor
the site of its formation in man have been unequivocally confirmed to date. It
apparently parallels the formation of testosterone (T), but on the other hand
its concentration is not influenced by exogenous administration of testosterone.
This fact creates the basis of the present doping control of testosterone abuse.
In 1989 an observation was presented in a dermatological study that
epitestosterone exerts an effect counteracting the action of testosterone on
flank organ of Syrian hamster. Further studies showed that a complex action
consisting of competitive binding of epitestosterone to androgen receptor, of
inhibition of testosterone biosynthesis and its reduction to dihydrotestosterone
and of antigonadotropic activity could be demonstrated in rat, mice and human
tissues. It can be presumed that epitestosterone as a natural hormone can
contribute to the regulation of such androgen dependent events as, e.g. the
control of prostate growth or body hair distribution.
Publication Types:
Review
Review Literature
PMID: 14630088 [PubMed]
38: Nature. 2003 Nov 13;426(6963):114-5.
Drugs in sport: no dope.
Knight J.
Publication Types:
News
PMID: 14614473 [PubMed]
39: J Sci Med Sport. 2003 Sep;6(3):247-59.
Sir William Refshauge Lecture 2003. Challenges in sports medicine.
Sando B.
Wakefield Sports Clinic, Adelaide, South Australia.
Publication Types:
Lectures
PMID: 14609141 [PubMed]
40: Haematologica. 2003 Nov;88(11):1284-95.
Proof of homologous blood transfusion through quantification of blood group
antigens.
Nelson M, Popp H, Sharpe K, Ashenden M.
Institute of Haematology Royal Prince Alfred Hospital, Sidney, Australia.
Peggy.Nelson@haem.rpa.cs.nsw.gov.au
BACKGROUND AND OBJECTIVES: Athletes may illegally enhance endurance performance
by transfusing homologous red blood cells (RBCs) and thereby increasing the
oxygen carrying capacity of their blood. Detecting this dangerous practice is
difficult by currently used methods. The aim of this work was to develop tests
capable of detecting a mixed red cell population by flow cytometry, utilizing
the likelihood of differences in minor blood group antigens. DESIGN AND METHODS:
Twelve antisera directed against blood group antigens, derived from donor
plasma, were used in conjunction with a secondary antibody directly conjugated
with fluorescein to label IgG-coated RBCs. Optimal concentrations of RBCs and
antibodies were determined on panel cells used in blood banking for the
identification of specific antibodies. Blood samples from 25 patients
purportedly transfused with 1-3 units of RBCs were screened for evidence of
transfusion, and the percentages of antigen-positive and antigen-negative red
cells were automatically calculated by the software installed in the flow
cytometer after setting gates around these populations on histograms of
fluorescence. RESULTS: Mixed RBC populations were identified in 22 of 25
patients tested. The three patients with antigenically homogeneous populations
of RBCs were subsequently found not to have received their scheduled
transfusions. INTERPRETATION AND CONCLUSIONS: This technique can detect small
(<5%) populations of cells that are antigenically distinct from an individual's
own RBCs. These results show the potential for flow cytometry to identify
illicit homologous blood transfusion in athletes, and suggest the risk of false
positives may be low.
Publication Types:
Evaluation Studies
PMID: 14607758 [PubMed]
41: Lancet. 2003 Nov 1;362(9394):1466.
Athletes' "designer steroid" leads to widening scandal.
Kondro W.
Publication Types:
News
PMID: 14603927 [PubMed]
42: J Clin Endocrinol Metab. 2003 Nov;88(11):5221-6.
High dose growth hormone exerts an anabolic effect at rest and during exercise
in endurance-trained athletes.
Healy ML, Gibney J, Russell-Jones DL, Pentecost C, Croos P, Sonksen PH, Umpleby
AM.
Department of Diabetes and Endocrinology, GKT School of Medicine, St. Thomas
Hospital, London, United Kingdom SE1 7EH.
The anabolic actions of GH in GH-deficient adults and children are well
documented. Replacement with GH in such individuals promotes protein synthesis
and reduces irreversible loss of protein through oxidation. Although GH is known
to be self-administered by athletes, its protein metabolic effects in this
context are unknown. This study was designed to determine whether 4 wk of high
dose recombinant human GH (r-hGH) administration altered whole body leucine
kinetics in endurance-trained athletes at rest and during and after 30 min of
exercise at 60% of maximal oxygen uptake. Eleven endurance-trained male athletes
were studied, six randomized to receive r-hGH (0.067 mg/kg.d), and five to
receive placebo. Whole body leucine turnover was measured at rest and during and
after exercise, using a 5-h primed constant infusion of 1-[(13)C]leucine, from
which rates of leucine appearance (an index of protein breakdown), leucine
oxidation, and nonoxidative leucine disposal (an index of protein synthesis)
were estimated. Under resting conditions, r-hGH administration increased rate of
leucine appearance and nonoxidative leucine disposal, and reduced leucine
oxidation (P < 0.01). This effect was apparent after 1 wk, and was accentuated
after 4 wk, of r-hGH administration (P < 0.05). During and after exercise, GH
attenuated the exercise-induced increase in leucine oxidation (P < 0.05). There
were no changes observed in placebo-treated subjects compared with the baseline
study. We conclude that GH administration to endurance-trained male athletes has
a net anabolic effect on whole body protein metabolism at rest and during and
after exercise.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 14602753 [PubMed]
43: Toxicol In Vitro. 2003 Oct-Dec;17(5-6):509-13.
Drugs of abuse and abuse of drugs in sportsmen: the role of in vitro models to
study effects and mechanisms.
Botre F.
Department CGMIA, University of Rome La Sapienza and Laboratorio Antidoping
FMSI, Largo Giulio Onesti 1, 00197 Rome, Italy. botre@uniroma1.it
A particular field of analytical chemistry applied to forensic toxicology is
represented by the anti-doping analysis, where biological samples (urine and in
some instances blood) collected, either "in competition" or "out of
competition", from athletes ruled for national/international sport federations,
are analyzed to detect the putative use of prohibited substances and methods.
Together with the official anti-doping activity to test the athletes (i.e. who
engages in competitive sport) for the non-physiological enhancement of sport
performance, it is mandatory to activate a new strategy of doping control, that
should necessarily comprise a deep and exhaustive toxicological evaluation of
the entire spectrum of doping substances and methods. An outline of the present
status and of the future trends of the antidoping research is here presented,
showing that most of the new tasks could greatly benefit from an approach based
on in vitro methods, ranging from specific toxicity studies to the possible
detection of new forms of doping.
PMID: 14599438 [PubMed]
44: Int J Sports Med. 2003 Nov;24(8):620-6.
Nandrolone Progress Report to the UK Sports Council from the Expert Committee on
Nandrolone February 2003.
Callicott R, Kicman AT; Expert Committee on Nandrolone, UK Sports Council.
Publication Types:
Guideline
PMID: 14598200 [PubMed]
45: Int J Sports Med. 2003 Nov;24(8):565-70.
The prevalence of doping in Flanders in comparison to the prevalence of doping
in international sports.
Van Eenoo P, Delbeke FT.
Doping Control Laboratory, University of Ghent, Salisburylaan 133, Merelbeke,
Belgium.
For many years, doping has been considered a major problem in sports. Recent
doping cases have shocked the general public and press reports have further
generated the idea that a great number of athletes are doped. In this study
statistical data provided by the International Olympic Committee (1996 - 2000)
to IOC accredited laboratories and results from the Flemish anti-doping program
(1993 - 2000) are discussed. During these periods, the average percentage
positive samples in the IOC accredited laboratories and in Flanders were 1.8 %
and 4.1 %, respectively. The percentage of positive samples was significantly
higher for in-competition than for out-of-competition samples. During the period
1993 - 2000, doping was detected in all sports in Flanders, for which a
representative number of samples (n > 50) was tested except mini-soccer, where
no positive doping samples were found. The use of doping among male athletes is
significantly higher than for female athletes. Bodybuilding and power lifting
had the highest incidence of positive cases in Flanders. The distribution of
detected drugs among the different groups of prohibited substances shows a
significant increase in the number of samples containing cannabis over the last
years. The occurrence of cannabis in all sports and the high frequency of
detection in Flanders, indicate that cannabis is predominantly misused as a
"social" drug rather than for doping purposes. In Flanders, multiple prohibited
substances were detected in 41 % of all positive cases. At least 27.6 % out of
those were due to co-administration of drugs.
PMID: 14598191 [PubMed]
46: Vet Res Commun. 2003 Sep;27(6):463-73.
Comparative pharmacokinetics of diphenhydramine in camels and horses after
intravenous administration.
Wasfi IA, Abdel Hadi AA, Elghazali M, Alkateeri NA, Hussain MM, Hamid AM.
Camelracing Laboratory, Forensic Science Laboratory, PO Box 253, Abu Dhabi,
United Arab Emirates. iawasfi@emirates.net.ae
The pharmacokinetics of diphenhydramine (DPHM) was compared in camels (n = 8)
and horses (n = 6) following intravenous (i.v.) administration of a dose of
0.625 mg/kg body weight. In addition, the metabolism and urinary detection time
of DPHM was evaluated in camels. The data obtained (median and range in
brackets) in camels and horses, respectively, were as follows. The terminal
elimination half lives (h) were 1.58 (1.13-2.58) and 6.11 (4.80-14.1), and the
total body clearances (L/h per kg) were 1.42 (1.13-1.74) and 0.79 (0.66-0.90).
The volumes of distribution at steady state (L/kg) were 2.38 (1.58-4.43) and
5.98 (4.60-8.31) and the volumes of the central compartment of the two
compartment pharmacokinetic model were 1.58 (0.80-2.54) and 2.48 (1.79-3.17).
All the pharmacokinetic parameters in camels were significantly different from
those of horses. Five metabolites of DPHM were tentatively identified in the
camel's urine. Two metabolites, diphenylmethoxyacetic acid and
1-(4-hydroxyphenyl)-phenylmethoxyacetic acid, were present in the acid fraction.
Two metabolites, desamino-DPHM and diphenylmethanol, were identified in the
basic fraction, in addition to DPHM itself, which was present mainly as a
conjugate. Even after enzymatic hydrolysis, DPHM could be detected for up to 24
h in camels after an i.v. dose of 0.625 mg/kg body weight.
PMID: 14582745 [PubMed]
47: Chudoku Kenkyu. 2003 Jul;16(3):315-21.
[The doping of racehorses]
[Article in Japanese]
Ohtake I.
Publication Types:
Review
Review, Tutorial
PMID: 14582354 [PubMed]
48: Chudoku Kenkyu. 2003 Jul;16(3):307-13.
[Recent progress of doping tests in sports]
[Article in Japanese]
Ueki M.
Publication Types:
Review
Review, Tutorial
PMID: 14582353 [PubMed]
49: Chudoku Kenkyu. 2003 Jul;16(3):299-305.
[Sports and doping]
[Article in Japanese]
Yoshida T.
Publication Types:
Review
Review, Tutorial
PMID: 14582352 [PubMed]
50: Nature. 2003 Oct 23;425(6960):752.
Drugs bust reveals athletes' secret steroid.
Knight J.
Publication Types:
News
PMID: 14574369 [PubMed]
51: Anal Chem. 2003 Jul 15;75(14):2955-61.
Doping control analysis of bovine hemoglobin-based oxygen therapeutics in human
plasma by LC-electrospray ionization-MS/MS.
Thevis M, Ogorzalek Loo RR, Loo JA, Schanzer W.
Institute of Biochemistry, German Sport University, Cologne, Germany.
m.thevis@biochem.dshs-koeln.de
Since January 2000, hemoglobin-based oxygen carriers, such as Hemopure, belong
to the list of prohibited substances of the International Olympic Committee.
Hemopure is based on bovine hemoglobin, which is intra- and intermolecularly
cross-linked by glutaraldehyde units causing an average molecular weight of
approximately 250,000. Bovine and human hemoglobins differ by 15% in amino acid
sequence; hence, tryptic digestion of these proteins generates species-common
and -unique peptides. Those specific fragments originate from the alpha- and
beta-subunits of hemoglobin, such as bovine Hb peptides alpha(69-90) (2367.2 Da)
or beta(40-58) (2089.9 Da). By means of LC-MS/MS, peptides of human and bovine
hemoglobin can be separated and identified, enabling the determination of
compounds based on Hb of bovine origin and thus the administration of oxygen
carriers such as Hemopure. Blank plasma samples were spiked with Hemopure or
human or bovine hemoglobin, filtered, enzymatically digested, and analyzed on an
Agilent 1100 Series HPLC interfaced to an Applied Biosystems API 2000 triple
quadrupole mass spectrometer. In plasma aliquots of 50 microL containing 50
microg of Hemopure (1 mg/mL), peptides of bovine hemoglobin were confirmed, and
blank plasma samples as well as 68 specimens of high-performance athletes were
tested with the developed procedure.
PMID: 14570175 [PubMed]
52: Public Health Rep. 2003 Nov-Dec;118(6):487-92.
Addressing the potential risks associated with ephedra use: a review of recent
efforts.
Schulman S.
U.S. Department of Health and Human Services, Office of Inspector General,
Boston, MA 02203, USA. sschulman@oig.hhs.gov
The appropriate amount of oversight for dietary supplements has been a subject
of debate for over a decade. This debate has come to a head recently with herbal
ephedra, which may be associated with adverse events including heart attack,
stroke, seizure, and death. This article reviews and puts into context recent
findings on the safety concerns related to ephedra, based primarily on adverse
event reports. It presents the response from industry and the FDA in light of
this evidence, and describes additional steps taken by other groups who believe
that more restrictive action is required. The article concludes by observing the
lack of explicit, shared criteria for determining whether a supplement is
unsafe, and pointing out ways in which the experience with ephedra can be used
constructively to address that problem.
Publication Types:
Review
Review, Tutorial
PMID: 14563905 [PubMed]
53: Fortune. 2003 Sep 29;148(6):40.
You'll lose sleep over this pill.
Simons J.
Publication Types:
News
PMID: 14521093 [PubMed]
54: J Anal Toxicol. 2003 Sep;27(6):359-65.
Ephedrines in over-the-counter cold medicines and urine specimens collected
during sport competitions.
Tseng YL, Hsu HR, Kuo FH, Shieh MH, Chang CF.
Institute of Pharmacology and Toxicology, Doping Control Center, Tzu Chi
University, Hualien, Taiwan. ying@mail.tcu.edu.tw
Ephedrine (EPH), pseudoephedrine (PEPH), phenylpropanolamine (PPA), and
methylephedrine (MEPH) are ephedrine alkaloids commonly found in cold
medications and are banned by the International Olympic Committee (IOC). These
compounds were detected in the urinary doping tests during the national sport
competitions in Taiwan. To study the sources of these compounds, 91
over-the-counter (OTC) nonprescription cold remedies, along with 1803 athletes'
urine samples collected (from 1999 to 2001) in competitions were analyzed using
gas chromatography-nitrogen-phosphorus detection (GC-NPD) for initial screening
and GC-mass spectrometry (MS) for confirmation. We found that 80% of OTC cold
medicines showed banned ephedrines in their ingredients lists, in which MEPH
(52%) was the most common drug labeled. However, when these OTC cold medicines
were analyzed by GC-NPD and GC-MS, EPH (35.4%) was found substantially higher
than that labeled in the OTC products (1.3%). In the total urine specimens
tested, approximately 2.8% contained banned ephedrines and 1.3% exceeded the IOC
cutoff levels. Within the urine specimens that exceeded the IOC cutoff values,
PEPH accounted for a 44% occurrence rate, followed by EPH (28%), PPA (17%), and
MEPH (11%). In agreement with the other report, bodybuilders showed a high
incidence rate for ephedrines misuse. Nevertheless, it is likely that the high
incidence of doping violations for ephedrine-related substances was related to
misuse of ephedrines present in most OTC common cold medicines and some dietary
supplements for relieving cold symptoms, reducing body weight, and preserving
muscle.
PMID: 14516489 [PubMed]
55: J Anal Toxicol. 2003 Sep;27(6):325-31.
Large-volume injection gas chromatography-mass spectrometry for automated
broad-spectrum drug screening in horse urine.
Stanley SD, McKemie D, Skinner W.
University of California, Davis, Kenneth L Maddy Equine Analytical Chemistry
Laboratory, West Health Science Drive, Davis, California 95616, USA.
A rapid, sensitive, and rugged method for detecting drugs and drug metabolites
in extracts of horse urine is described. The use of large-volume injection (LVI)
gas chromatography-mass spectrometry (GC-MS) for analysis of horse urine
extracts allowed automation of the derivatization procedure and reduction of the
sample volume from 5 mL to 1 mL of urine. An autosampler and
temperature-programmable inlet were used to automatically dissolve the sample
extract and form trimethylsilyl derivatives of over 200 analytes. The
suitability of this procedure for routine GC-MS detection of approximately 80
basic analytes in extracts of racehorse urine was investigated. The formation of
derivatives using LVI with in-liner derivatization was compared to a manual
procedure involving the dissolution of sample extracts in
N,O-bis(trimethylsily)trifluoroacetamide, heating the resulting mixture, and
injecting 1 or 2 microL of the mixture through a splitless injector into the
GC-MS instrument. In all cases, the in-liner derivatization reactions were found
to be as complete as conventional heating block procedures. Ruggedness testing
of the method demonstrated that peak resolution, shape, and area were maintained
through 40 consecutive injections of sample extracts. No evidence of the
accumulation of interfering substances was observed. The limits of detection
using LVI GC-MS for routine screening of basic drugs in urine were generally in
the range of 5-25 ng/mL. The method is currently being used to detect basic
analytes in horse urine extracts with a throughput of approximately 50 urine
sample extracts per instrument per day.
PMID: 14516484 [PubMed]
56: Intern Med J. 2003 Sep-Oct;33(9-10):404.
Prescribe with extreme care to athletes.
Kennedy M.
Department of Clinical Pharmacology and Toxicology, St Vincents Hospital,
Sydney, New South Wales, Australia. drmkenn@ozemail.com.au
PMID: 14511191 [PubMed]
57: Scand J Med Sci Sports. 2003 Oct;13(5):275-83.
The Tour de France: a physiological review.
Lucia A, Earnest C, Arribas C.
Facultad de Ciencias de la Actividad Fisica y el Deporte, Universidad Europea de
Madrid, Madrid, Spain. alejandro.lucia@mrfs.cisa.uem.es
On 5 July 2003, the Tour de France (TDF) has celebrated 100th running. Instead
of a chimney sweep competing during his free time (as in 1903), the recent
winner is a highly trained, professional cyclist whose entire life-style has
been dedicated to reach his pinnacle during this event. The TDF has been held
successfully for 100 years, but the application of the physiologic sciences to
the sport is a relatively recent phenomenon. Although some historical reports
help to understand the unique physiological characteristics of this race,
scientific studies were not available in Sports Science/Applied Physiology
journals until the 1990s. The aim of this article is to review the history of
the TDF. Special emphasis is placed on the last decade where classic physiology
has been integrated into applied scientific cycling data.
Publication Types:
Review
Review, Tutorial
PMID: 14507292 [PubMed]
58: Eur J Clin Pharmacol. 2003 Nov;59(8-9):571-7. Epub 2003 Sep 12.
The anti-doping hot-line, a means to capture the abuse of doping agents in the
Swedish society and a new service function in clinical pharmacology.
Eklof AC, Thurelius AM, Garle M, Rane A, Sjoqvist F.
Department of Clinical Pharmacology, Huddinge University Hospital, 14185
Stockholm, Sweden.
With the support of the Swedish National Institute of Health a national
information service was started in 1993 aiming to capture the abuse of doping
agents in the general public. It was organized as a telephone service, called
the Anti-Doping Hot-Line, from our department and managed by trained nurses
co-operating with clinical pharmacologists. Important information collected
about all callers (anonymous) was: date of call, its origin, category of caller,
doping experience and main question being asked. Abusers were asked about their
age, sex, affiliation, abused drug(s), duration of abuse, habit of
administration and adverse reactions (ADRs). Between October 1993 and December
2000 25,835 calls were received with a peak during spring and autumn. Most calls
(12,400) came from non-abusers, 60% being males. Callers connected with gyms
represented the largest group (30%). Most calls about specific drugs concerned
anabolic androgenic steroids (AAS). Other drugs or products included ephedrine,
clenbuterol and creatine. The most commonly abused anabolic steroids were
testosterone, nandrolone-decanoate, methandienone and stanozolol. The ten most
commonly reported ADRs of AAS were aggressiveness (835), depression (829), acne
(770), gynecomastia (637), anxiousness (637), potency problems (413), testicular
atrophy (404), sleep disorders (328), fluid retention (318) and mood
disturbances (302). Female side effects included menstruation disturbances, hair
growth in the face, lower voice and enlarged clitoris. During the period
1996-200, totally 4339 persons reported about 10,800 side effects. This figure
should be compared with the very low number of ADRs (27) reported by prescribers
to the Swedish ADR committee during the same period. Abuse of doping agents
appears to be a new public health problem that needs detection, medical care and
prevention.
PMID: 13680032 [PubMed]
59: Sports Med. 2003;33(12):921-39.
Popular sports supplements and ergogenic aids.
Juhn M.
Department of Family Medicine, University of Washington School of Medicine,
Seattle, Washington, USA.
This article reviews the evidence-based ergogenic potential and adverse effects
of 14 of the most common products in use by recreational and elite athletes
today. Both legal and prohibited products are discussed. This is an aggressively
marketed and controversial area of sports medicine worldwide. It is therefore
prudent for the clinician to be well versed in the more popular supplements and
drugs reputed to be ergogenic in order to distinguish fact from
fiction.Antioxidants, proteins and amino acids are essential components of diet,
but additional oral supplementation does not increase endurance or strength.
Caffeine is ergogenic in certain aerobic activities. Creatine is ergogenic in
repetitive anaerobic cycling sprints but not running or swimming. Ephedrine and
pseudoephedrine may be ergogenic but have detrimental cardiovascular effects.
Erythropoietin is ergogenic but increases the risk of thromboembolic events.
beta-Hydroxy-beta-methylbutyrate has ergogenic potential in untrained
individuals, but studies are needed on trained individuals. Human growth hormone
and insulin growth factor-I decrease body fat and may increase lean muscle mass
when given subcutaneously. Pyruvate is not ergogenic. The androgenic precursors
androstenedione and dehydroepiandrosterone have not been shown to increase any
parameters of strength and have potentially significant adverse effects.
Anabolic steroids increase protein synthesis and muscle mass but with many
adverse effects, some irreversible. Supplement claims on labels of product
content and efficacy can be inaccurate and misleading.
Publication Types:
Review
Review Literature
PMID: 12974658 [PubMed]
60: Med Sci Sports Exerc. 2003 Sep;35(9):1464-70.
Review of exercise-induced asthma.
Storms WW.
University of Colorado Health Sciences Center, Asthma and Allergy Associates,
Colorado Springs, CO 80907, USA. sneezedoc@aol.com
PURPOSE: The purpose of this manuscript is to review the recent literature on
exercise-induced asthma (EIA) and summarize the pathogenesis, diagnosis, and
treatment of this condition. METHOD: A review of the English language medical
literature was performed to obtain articles on EIA. RESULTS: The pathophysiology
of EIA is not fully understood, but there are two theories: 1) the hyperosmolar
theory and 2) the airway rewarming theory. In addition, there have been data to
show that airway inflammation is present in some elite athletes, especially in
cold weather sports. The diagnosis of EIA is usually straightforward in most
patients, but a number of patients may have atypical symptoms and may be more
difficult to diagnose. They may well need exercise testing or eucapnic voluntary
ventilation testing. Most people respond to treatment with an inhaled beta
agonist and or cromolyn before exercise, but some patients will also need other
medications, including daily medications such as inhaled steroids. When
treatment does not control the problem, then further diagnostic evaluation
should be done to rule out conditions other than EIA, such as vocal cord
dysfunction or cardiac or pulmonary problems. CONCLUSIONS: EIA is a condition
that may occur in schoolchildren in gym class and also in Olympic athletes. The
diagnosis and treatment is usually fairly straightforward, but at times it may
be challenging. However, all patients should be followed to make sure that the
correct diagnosis is made and to make sure that treatment is effective.
Publication Types:
Review
Review, Tutorial
PMID: 12972863 [PubMed]
61: Int J Sports Med. 2003 Oct;24(7):535-40.
Attention deficit hyperactivity disorder in sport: a review.
Corrigan B.
Institute of Sport Medicine Concord Hospital, Sydney, Australia. bc6@bigpond.com
Attention deficit hyperactivity disorder (ADHD) is a controversial problem in
sport since participants with this disorder often require banned stimulant
medication while competing. Little information is available in the literature
concerning this problem or whether sports people should be allowed to
participate while on stimulant therapy. The intention of this review is to
undertake a brief review of recent findings in ADHD, especially as they apply to
sport, and suggest some guidelines that could then be applied by sporting bodies
to allow ADHD sufferers to compete. Recent scientific evidence, clinical,
genetic, and imaging techniques, confirm that ADHD is characterised by
dysfunction in dopamine transmission in the frontal lobes and basal ganglia
structures, regions associated with attention and behaviour. The dopamine
transporter (DAT) regulates dopamine by removing excess. In ADHD people, the
number and density of DATs and DAT binding sites are increased by up to 70 %.
The dopamine agonist methylphenidate blockades DAT, significantly increasing
extra cellular dopamine, so correcting the dopamine deficiency. Methods. A
search of the English literature was made using Medline from the years 1980 to
2002. [nl]The aim of this review is not to debate the use of stimulants or how
often they are necessary or successful in this condition but to point out that a
number of young sport people with ADHD require such medication on a regular
basis. Although there are problems with their use as far as the International
Olympics Committee (IOC) is concerned, it would seem most unfair to penalise
sports people by having to give up their medication, even for a few days or at
some arbitrary age, in order to compete.
Publication Types:
Review
Review, Academic
PMID: 12968213 [PubMed]
62: Rapid Commun Mass Spectrom. 2003;17(18):2107-14.
Validation of a screening method for corticosteroids in doping analysis by
liquid chromatography/tandem mass spectrometry.
Deventer K, Delbeke FT.
Ghent University, Doping Control Laboratory, Salisburylaan 133, B-9820
Merelbeke, Belgium.
A selective and sensitive method for the screening of nine corticosteroids in
human urine has been validated. Analyses were performed using an ion trap
instrument equipped with an electrospray ionisation (ESI) interface. All
corticosteroids were separated in less than 20 min after liquid/liquid
extraction with diethyl ether. The limit of detection for all substances was 4
ng/mL or lower. The method was applied to detect betamethasone after the
intramuscular injection of Diprophos. Betamethasone could be detected for up to
12 days after administration. Validation of the chromatographic separation and
mass spectrometric identification of mixtures of betamethasone and dexamethasone
are also presented. Copyright 2003 John Wiley & Sons, Ltd.
PMID: 12955741 [PubMed]
63: Haematologica. 2003 Aug;88(8):931-40.
The effect of common hematologic abnormalities on the ability of blood models to
detect erythropoietin abuse by athletes.
Parisotto R, Ashenden MJ, Gore CJ, Sharpe K, Hopkins W, Hahn AG.
Department of Physiology, Australian Institute of Sport, PO Box 176, Belconnen
ACT 2616, Australia. robin.parisotto@ausport.gov.au
BACKGROUND AND OBJECTIVES: Algorithms that combine scores from multiple blood
parameters are demonstrably effective in highlighting recombinant human
erythropoietin (rHuEPO) administration, and have been used to deter rHuEPO use
by athletes. These models are sensitive to atypical levels of blood parameters
encountered during altered states of red cell production. Because hematologic
abnormalities can also result in unusual blood profiles, the aim of this study
was to document the incidence and magnitude of such abnormalities in an elite
athlete population. DESIGN AND METHODS: We screened blood samples obtained from
413 female and 739 male elite athletes from 12 countries for known hematologic
abnormalities, and compared the algorithm scores for these athletes with those
of their healthy counterparts. We also established the magnitude of blood
parameters required for model scores to exceed cut-offs associated with rHuEPO
use. RESULTS: We found that 0.7% of male and 2.4% of female athletes were iron
deficient either with our without anemia. An additional 1.4% of males and 1.0%
of females had hemoglobinopathies. On average these athletes' model scores were
at or below the score of their healthy counterparts. The greatest influence on
our models was hemoglobin concentration. Values of other parameters must exceed
normal ranges by a substantial margin in order for model scores to approach
levels associated with rHuEPO use. INTERPRETATION AND CONCLUSIONS: The
hematologic disorders we encountered in elite athletes were not associated with
model scores that exceeded the nominal cut-offs that we have previously
recommended to delineate rHuEPO use. We did not find any abnormalities among
elite endurance athletes that were associated with high model scores.
PMID: 12935982 [PubMed]
64: Leg Med (Tokyo). 2003 Mar;5 Suppl 1:S29-33.
Testing for anabolic steroids in hair: a review.
Kintz P.
Institut de Medecine Legale, 11 rue Humann, F-67000 Strasbourg, France.
pascal.kintz@wanadoo.fr
It is generally accepted that chemical testing of biological fluids is the most
objective means of diagnosis of drug use. The presence of a drug analyte in a
biological specimen can be used to document exposure. The standard in drug
testing is the immunoassay screen, followed by the gas chromatographic-mass
spectrometric confirmation conducted on a urine sample. In recent years,
remarkable advances in sensitive analytical techniques have enabled the analysis
of drugs in unconventional biological specimens such as hair. The advantages of
this sample over traditional media like urine and blood are obvious: collection
is almost noninvasive, relatively easy to perform, and in forensic situations it
may be achieved under close supervision of law enforcement officers to prevent
adulteration or substitution. Moreover, the window of drug detection is
dramatically extended to weeks, months or even years. The aim of this review is
to document the current detection of anabolic steroids in hair.
Publication Types:
Review
Review, Tutorial
PMID: 12935548 [PubMed]
65: Ann Med Interne (Paris). 2003 Jun;154 Spec No 1:S25-34.
[Sporting activities and psychoactive substance use. Data abstracted from the
French part of the European School Survey on Alcohol and other Drugs (ESPAD 99)]
[Article in French]
Arvers P, Choquet M.
Centre de Recherches du Service de Sante des Armees (CRSSA), BP 87, 38702 La
Tronche Cedex.
Few studies have analyzed in the general population psychoactive substance use
among athletes, especially among females. In fact, sporting activity is often
promoted in prevention actions, as an alternative to addiction or alcohol,
tobacco or other substance misuse. So, we propose an analysis of the ESPAD 1999
sample among students (16-18 years old), focused on the relationship between
sporting activities and substance use. Boys play sport more frequently than
girls (71.5% versus 49.5%) and report 8 hours and more a week 4 more times than
girls (14% versus 3.5%). Sixty-eight percent of boys and 36% of girls have
already participated in sport competitions, more often at a local, departmental
or regional level; a minority of them (26% of boys and 20% of girls) have
already participated in sport competitions at a national or international level.
Sporting activity is decreasing with age among girls, students from general
lycee play sport more frequently than others do (vocational lycee); the higher
the father's education level, the more frequently the students play sport.
Moderate sporting activity (1-8 hours a week) is a protective factor against
regular smoking (OR=0.54 in boys and OR=0.60 in girls) and against regular
cannabis use among boys (OR=0.64). Intensive sporting activity (>8 hours a week)
is a risk factor for illicit drugs (except cannabis) use (OR=2.74) and sleeping
drugs/tranquillizers (OR=1.82) only among girls. Competition level is the most
important risk factor for substance misuse as well in boys (except sleeping
drugs/tranquillizers) as in girls. Practical implications are: adjusting health
policy concerning the beneficial effects of sporting activity, raising sports
associations abilities and avoiding doping and addiction in high-level sporting
activities.
PMID: 12910031 [PubMed]
66: Recenti Prog Med. 2003 Feb;94(2):49-50.
[Are the integrators and supplements useful in sports?]
[Article in Italian]
Cristani A, Boldrini E.
Divisione di Medicina Interna II, Dipartimento di Medicina Interna, Universita
degli Studi di Modena e Reggio Emilia.
The continued controversy regarding doping in Italian soccer turns the
discussion to the use of food integration in sports. In Italy, there is only the
word "integrator" to name many products so different regarding biological
features and indication usage. We think it is useful, first of all, to talk
about the meaning of integration, and then to introduce the differences between
nutritional ergogenic aids and supplements and, finally, to think through
relationship between nutrition and athletic performance. On the basis of recent
literature, there is no evidence of any real benefit for athletes in taking
nutritional ergogenic aids or supplements.
PMID: 12908368 [PubMed]
67: Curr Hematol Rep. 2003 Mar;2(2):109-15.
Update on the clinical use and misuse of erythropoietin.
Eagleton HJ, Littlewood TJ.
Department of Haematology, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU,
UK.
Anemia is a common finding in patients with hematologic malignancies and most
commonly can be attributed to the anemia of chronic disease compounded by the
myelotoxic effects of chemotherapy. Symptoms of anemia include fatigue, and the
patient's quality of life may be impaired. Possible treatments for the anemia
are to do nothing, to transfuse with red cells, or to treat with recombinant
human erythropoietin (rhEPO). rhEPO has become standard treatment for the anemia
in chronic renal failure and has been successfully used in anemia secondary to
malignancy. In patients with lymphoproliferative diseases, rhEPO increases the
hemoglobin concentration, decreases the need for transfusion, and improves the
patients' quality of life. Disadvantages of rhEPO include its cost, efficacy in
only around 60% of patients, and delay of 4 to 8 weeks before maximum benefit is
achieved. The anemia in patients with myelodysplasia responds less well to
rhEPO. Misuse of rhEPO is common in the clinical setting but usually not of
clinical importance. Misuse to enhance sporting prowess is probably rare but has
potentially serious consequences.
Publication Types:
Review
Review, Tutorial
PMID: 12901141 [PubMed]
68: Br J Sports Med. 2003 Aug;37(4):356-7.
Insulin as a drug of abuse in body building.
Evans PJ, Lynch RM.
Hull Royal Infirmary, Hull, UK. phil@pjevans.karoo.co.uk
A theoretical benefit of insulin abuse by body builders is that it is
undetectable by currently available tests. A case is presented that highlights
the dangers of such abuse.
Publication Types:
Case Reports
PMID: 12893725 [PubMed]
69: Br J Sports Med. 2003 Aug;37(4):335-8; discussion 338.
General practitioners and doping in sport: attitudes and experience.
Laure P, Binsinger C, Lecerf T.
Laboratoire de Psychologie Appliquee Stress et Societe, Universite de Reims, Bat
6, Moulin de La Housse, 51687 Reims Cedex 2, France. patrick.laure@wanadoo.fr
OBJECTIVES: To examine the attitudes to, and knowledge of, doping in sport of
French general practitioners (GPs), and their contact with drug taking athletes
on an everyday basis. METHODS: A total of 402 GPs were randomly selected from
all over France and interviewed by telephone, using a prepared script. RESULTS:
The response rate was 50.5% (153 men and 49 women; mean (SD) age 45.6 (5.6)
years). Of the respondents, 73% confirmed that they had the list of banned
products, and only 34.5% stated that they were aware of the latest French law,
brought into effect in March 1999, concerning the fight against doping. Some 11%
had directly encountered a request for prescription of doping agents over the
preceding 12 months (the requested substances were mainly anabolic steroids,
stimulants, and corticosteroids), and 10% had been consulted by an athlete who
was using doping drugs and was frightened of the health risks (the substances
used were mainly anabolic steroids). Over half (52%) of the GPs favoured the
prescription of drug substitutions to athletes who used doping agents. According
to 87.5% of respondents, doping is a public health problem, and 80% stated that
doping is a form of drug addiction. Most (89%) said that a GP has a role to play
in doping prevention, but 77% considered themselves poorly prepared to
participate in its prevention. CONCLUSION: The results suggest that (a) GPs have
limited knowledge of doping and (b) are confronted with doping in their daily
practice, at least occasionally.
PMID: 12893720 [PubMed]
70: Br J Sports Med. 2003 Aug;37(4):307-10.
Football and doping: study of African amateur footballers.
Ama PF, Betnga B, Ama Moor VJ, Kamga JP.
National Institute of Youth and Sports, Yaounde, Cameroon. pierreama@yahoo.fr
OBJECTIVE: To investigate use and awareness of lawful and unlawful substances by
amateur footballers in Yaounde, Cameroon. METHODS: A total of 1116 amateur
footballers (1037 male and 79 female) out of 1500 contacted participated in this
study. They were divided into three groups: elite players (n = 314); local
players (n = 723); female players (n = 79). They answered a questionnaire of 30
items grouped under six main topics: identification of players; use of lawful
substances subject to certain restrictions on the International Olympic
Committee (IOC) list; use of IOC banned substances; doping behaviour; awareness
of doping; food supplements. The results of the questionnaire were scrutinised
using Microstat software, and the level of significance was p<0.05. RESULTS: (a)
Use by our footballers of a banned substance (cocaine) and substances subject to
certain restrictions (alcoholic drinks, methylated spirits, and banga
(marijuana)). (b) Doping behaviour: use by our footballers of substances with
similar effects to some IOC banned substances but not listed as such: tobacco,
liboga, wie-wie (narcotic), bilibili (locally made alcohol drink). (c) A large
intake of vitamin C (food supplements) in all three groups. In contrast, the
footballers' knowledge of doping was vague. CONCLUSION: Preventive actions and
an epidemiological study of doping among footballers are urgently required.
PMID: 12893714 [PubMed]
71: Ned Tijdschr Geneeskd. 2003 Jul 12;147(28):1347-51.
[The effects of physical exercise on the immune system]
[Article in Dutch]
Jeurissen A, Bossuyt X, Ceuppens JL, Hespel P.
Afd. Experimentele Laboratoriumgeneeskunde, Universitair Ziekenhuis
Gasthuisberg, Herestraat 49, 3000 Leuven, Belgie.
axel.jeurissen@uz.kuleuven.ac.be
Physical exercise has numerous effects on the human body, including the immune
system. After strenuous exercise, athletes pass through a period of impaired
immune resistance. During this period, athletes are theoretically more
susceptible to upper respiratory tract infections, although a causal relation
has never been demonstrated. Moderate exercise seems to have a beneficial effect
on the immune function, which could protect against upper respiratory tract
infections. Exercise has effects on both the humoral and the cellular immune
system. Doping products, except glucocorticoids, only have modest effects on the
immune system, although erythropoietin may, in rare cases, cause severe
side-effects. Glutamine and vitamin C could, hypothetically, prevent the
negative effects of strenuous exercise on the immune function, but further
studies are needed to demonstrate and explain these effects.
Publication Types:
Review
Review, Tutorial
PMID: 12892009 [PubMed]
72: Ann Clin Biochem. 2003 Jul;40(Pt 4):321-56.
Anabolic steroids in sport: biochemical, clinical and analytical perspectives.
Kicman AT, Gower DB.
Address Drug Control Centre, King's College London, London SE1 9NN, UK.
andrew.kcman@kcl.ac.uk
International Olympic Committee accredited laboratories play a key role in
upholding the principle of fair play and innate ability, as desired by the
majority of sports competitors and spectators. Not only does doping damage the
image of sport, but it can also be harmful to the individual. The great majority
of samples test negative but, when an adverse finding is declared, the
analytical data must be of a sufficiently high standard to withstand legal
challenges by third parties. The most widely misused performance-enhancing drugs
are the anabolic-androgenic steroids, commonly referred to as 'anabolic
steroids'. This review attempts to address the complex issues concerning
anabolic steroids in sport by considering the clinical, biochemical and
analytical perspectives.
Publication Types:
Review
Review, Tutorial
PMID: 12880534 [PubMed]
73: Perspect Biol Med. 2003 Summer;46(3):445-51.
State-sponsored research on creatine supplements and blood doping in elite
Soviet sport.
Kalinski MI.
School of Exercise, Leisure and Sport, Kent State University, OH 44242, USA.
mkalinsk@kent.edu
The former Soviet Union began participating in international sport after World
War II and soon achieved a dominant position in the Olympic Games and other
competitions. The success of Soviet athletic programs led to charges of unfair
practices but, because of secrecy surrounding Soviet research in exercise
biochemistry, it has been difficult to substantiate these charges. This article
presents previously restricted information regarding the development and use of
creatine supplements and blood doping in the USSR. Early work by Olexander
Palladin established the role of creatine in muscle function. In the 1970s,
Soviet scientists showed that oral creatine supplements improved athletic
performance in short, intense activities such as sprints. Subsequent studies in
the West substantiated these investigations and have led to the widespread
acceptance and use of creatine supplements to enhance muscle function and
athletic performance. In addition, however, the Soviet government supported the
development of blood doping, which is banned by the International Olympic
Committee. Blood doping was pervasive in the USSR in the 1970s and 1980s, and
was used by many Soviet athletes in the 1976 and 1980 Olympic Games. Open
publication and discussion may help to prevent the abuses that can come from
secret scientific research.
PMID: 12878813 [PubMed]
74: J Chromatogr A. 2003 Jun 6;1000(1-2):109-24.
Application of comprehensive two-dimensional gas chromatography to drugs
analysis in doping control.
Kueh AJ, Marriott PJ, Wynne PM, Vine JH.
Australian Centre for Research on Separation Science, Department of Applied
Chemistry, RMIT University, GPO Box 2476V, Melbourne, Vic. 3001, Australia.
Comprehensive two-dimensional gas chromatography (GC x GC) now occupies a niche
within the GC technology regime. The technique is undeniably unique in the
manner in which the experiment is conducted, the way results are presented and
the interpretive opportunities offered. For the 1000th volume of this journal it
is appropriate to expand upon these features, and review the progress made in GC
x GC to date. Firstly, brief general comment is made on multidimensional
procedures, and to review key aspects of GC x GC. The use of the targeted
multidimensional GC method allows absolute retentions in the second dimension of
a GC x GC experiment to be estimated, and also offers a novel way to obtain
enhanced response for resolved solutes. Then, to illustrate the utility of the
technique, the application of GC x GC to the screening of drugs and their
metabolites in biological fluids is described using prolintane metabolites in
canine urine as an example, with samples taken at four time intervals after
administration. This example illustrates the first application of GC x GC in the
field of forensic toxicology, an area traditionally dominated by GC-MS. Most
drug compounds were found to be retained on the 0.8-m second column for a
greater time than the modulation period (3 s) used for initial analysis, under
the conditions described. Hence a 0.4-m D2 BPX50 (50% phenyl methyl
polysilphenylene) column was then used throughout, with most compounds retained
less than 4 s. For the standard drug mixture, three overlapping drugs on the
first dimension column (BPX5) were subsequently baseline resolved on the BPX50
column. For prolintane administration samples, the parent drug and metabolites
could be effectively resolved from background matrix peaks. Likewise a 23-drug
spike standard in horse urine blank gave acceptable resolution of the drugs from
matrix peaks.
Publication Types:
Review
Review, Tutorial
PMID: 12877168 [PubMed]
75: Int J Sports Med. 2003 Jul;24(5):352-8.
Blood tests and fair competition: the biathlon experience.
Manfredini F, Carrabre JE, Litmanen H, Zhukovskaja L, Malagoni AM, Dal Follo D,
Haberstroh J.
International Biathlon Union-Medical Committee. mdf@unife.it
In recent years, some international sports federations have introduced blood
testing procedures that can lead to suspension from competition for athletes
whose haematologic values exceed certain established limits. In 1994 the
International Biathlon Union initiated a three-phase blood testing program to
safeguard athletes' health and ensure fair competition. The first phase, lasting
three years, was aimed at measuring the haematocrit values of biathletes in
order to determine statistically acceptable limits for participation in
competition. The second phase, lasting four years, consisted of pre-race testing
for an increasing number of athletes and suspension from competition for those
whose haematocrit values exceeded 52 % for males and 48 % for females. The
results of this second phase (third phase now in progress) are reported.
Progressive increases have been made in the numbers of countries examined,
athletes tested, and tests performed. This retrospective study reveals a
reassuring trend in average values for haematocrit and haemoglobin in the entire
study population, a minimal number of athletes with excessive values and a
consequent low risk of false positive results, an acceptable incidence of
relatively high values (50 % for males and 45 % for females), and constant
non-elevated haematological profiles for elite athletes. The variability in
individual haematocrit levels among all biathletes with a minimum of four
observations during the four-year period is also evaluated and discussed.
PMID: 12868046 [PubMed]
76: Am J Addict. 2003;12 Suppl 2:S48-54.
Steroid and nutritional supplement use in professional athletes.
Millman RB, Ross EJ.
Department of Psychiatry and Public Health, Weill Medical College, Cornell
University, New York, NY. rbm2002@med.cornell.edu
The use of performance-enhancing substances by athletes is nearly as old as
sport itself. There are two primary categories of substances available to modern
athletes: anabolic androgenic steroids (AAS) and nutritional supplements. All
AAS and many of the nutritional supplements are used to increase testosterone
levels in the body, thereby enhancing the athlete's ability to build lean muscle
mass. Other nutritional supplements are used to increase the amount of energy
available for workouts or competition. Although steroids are available in the US
via physician prescription, nutritional supplements are widely available to all
consumers with relatively scant regulation. Steroids are associated with a
variety of side effects that can lead to physical changes, psychological
disturbances, morbidity, and even mortality. The side effects of nutritional
supplements are not as well studied but are presumed to be similarly dangerous.
However, for many athletes at all levels facing pressure to excel, the potential
benefits of taking these substances appear to be outweighing the associated
risks. Increased testing at all levels is recommended.
Publication Types:
Historical Article
Review
Review, Tutorial
PMID: 12857663 [PubMed]
77: Tijdschr Diergeneeskd. 2003 Jun 15;128(12):382.
[The doping investigation in horses and the role of the treating veterinarian]
[Article in Dutch]
Breukink HJ.
PMID: 12838755 [PubMed]
78: Curr Sports Med Rep. 2003 Aug;2(4):226-32.
An update on regulatory issues in antidoping programs in sport.
Hilderbrand RL, Wanninger R, Bowers LD.
United States Anti-Doping Agency, 2550 Tenderfoot Hills Street, Suite 200,
Colorado Springs, CO 80906, USA. rwanninger@usantidoping.org
Doping control for national- and international-level athletes has undergone
major changes in the past few years, and will continue to change at an
accelerated rate. National antidoping organizations (NADOs) such as the United
States Anti-Doping Agency (USADA) are being established by major nations to work
with national governing bodies of sport. The World Anti-Doping Agency has been
established to coordinate worldwide antidoping efforts with the NADOs and
international federations of sport, and to implement a recently drafted World
Anti-Doping code, which clarifies the definition of doping and establishes
procedures to harmonize international efforts in sample collection process,
testing laboratory accreditation, result reporting, and result adjudication. A
number of substances and methods currently used in doping present serious
challenges to the scientific community, and are described briefly. In addition,
brief descriptions of other issues of significance to doping control, including
the role of physicians in doping and the operation of the USADA, are presented.
Publication Types:
Review
Review, Tutorial
PMID: 12834579 [PubMed]
79: Curr Sports Med Rep. 2003 Aug;2(4):220-5.
Ephedrine and other stimulants as ergogenic aids.
Bohn AM, Khodaee M, Schwenk TL.
Department of Family Medicine, 1500 East Medical Center Drive, L2003 Womens, Box
0239, Ann Arbor, MI 48109, USA. tschwenk@umich.edu
Several recreational, prescription, and illicit drugs have psychotropic effects
that may be perceived to be ergogenic. The ephedra alkaloids have received
recent attention for their wide use by athletes and their potential serious side
effects, despite the lack of evidence regarding any ergogenic or performance
benefit. Some prescription drugs (eg, methylphenidate and bupropion) raise
complex issues regarding their appropriate therapeutic use in athletes.
Recreational drugs, some of which are illegal (eg, cocaine), are commonly used
by athletes and cause a wide range of potentially ergolytic effects. In total,
these drugs are important for their frequent use, the frequency with which they
are mentioned in the media, and their potential for causing significant adverse
effects.
Publication Types:
Review
Review, Tutorial
PMID: 12834578 [PubMed]
80: Curr Sports Med Rep. 2003 Aug;2(4):213-9.
Caffeine and exercise.
Paluska SA.
University of Washington, Department of Family Medicine, Roosevelt Medical
Center, 4245 Roosevelt Way NE, Box 354775, Seattle, WA 98105, USA.
spaluska@u.washington.edu
Caffeine is the most commonly consumed drug in the world, and athletes
frequently use it as an ergogenic aid. It improves performance and endurance
during prolonged, exhaustive exercise. To a lesser degree it also enhances
short-term, high-intensity athletic performance. Caffeine improves
concentration, reduces fatigue, and enhances alertness. Habitual intake does not
diminish caffeine's ergogenic properties. Several mechanisms have been proposed
to explain the physiologic effects of caffeine, but adenosine receptor
antagonism most likely accounts for the primary mode of action. It is relatively
safe and has no known negative performance effects, nor does it cause
significant dehydration or electrolyte imbalance during exercise. Routine
caffeine consumption may cause tolerance or dependence, and abrupt
discontinuation produces irritability, mood shifts, headache, drowsiness, or
fatigue. Major sport governing bodies ban excessive use of caffeine, but current
monitoring techniques are inadequate, and ethical dilemmas persist regarding
caffeine intake by athletes.
Publication Types:
Review
Review, Tutorial
PMID: 12834577 [PubMed]
81: Proteomics. 2003 Jun;3(6):937-41.
Epoetin alpha, epoetin beta and darbepoetin alfa: two-dimensional gel
electrophoresis isoforms characterization and mass spectrometry analysis.
Caldini A, Moneti G, Fanelli A, Bruschettini A, Mercurio S, Pieraccini G, Cini
E, Ognibene A, Luceri F, Messeri G.
Laboratorio Centrale Analisi Biochimico-Cliniche, Azienda Ospedaliera Careggi,
Florence, Italy. caldinia@ao-careggi.toscana.it
Since 1989 recombinant human erythropoietin (rhEPO) has been used as a drug for
the correction of anemia, but the misuse of rhEPO as an ergogenic agent among
athletes is a widespread doping practice. As a consequence there is a need for
developing reference methods for the detection of rhEPO in biological fluids,
and to be able to differentiate the recombinant from the natural protein.
Recombinant human erythropoietin differs from its natural counterpart in the
glycidic part of the molecule. Three different commercial recombinant products
Epoetin alpha (Eprex, Janssen Cilag), Epoetin beta (Neorecormon, Roche) and
Darbepoetin alfa (Nespo, Dompe) have been used to evaluate the performance of
two-dimensional gel electrophoresis (2-DE) and mass spectrometry (MS) for the
separation of isoforms and the identification of the proteins respectively. All
the compounds studied were well separated by means of 2-DE: Epoetin alpha and
beta focused in the same isoelectric point region giving rise to six and eight
spots respectively, whereas Darbepoetin alfa was found in a more acidic zone
with two spots. Results obtained with micro high-performance liquid
chromatography-electrospray ionization-time of flight (TOF) MS and
matrix-assisted laser desorption/ionization-time of flight MS for the three
rhEPOs are reported. These preliminary results suggest that by means of 2-DE and
MS it should be possible to reveal the presence of rhEPOs for antidoping
purposes.
PMID: 12833517 [PubMed]
82: Curr Sports Med Rep. 2002 Apr;1(2):103-6.
Effects of creatine use on the athlete's kidney.
Farquhar WB, Zambraski EJ.
HRCA Research and Training Institute, Harvard Division on Aging, 1200 Centre
Street, Boston, MA 02131, USA. farquhar@mail.hrca.harvard.edu
With regard to athletes attempting to improve their performance, at the present
time creatine monohydrate is clearly the most widely used dietary supplement or
ergogenic aid. Loading doses as high as 20 g/d are typical among athletes. The
majority (> 90%) of the creatine ingested is removed from the plasma by the
kidney and excreted in the urine. Despite relatively few isolated reports of
renal dysfunction in persons taking creatine, the studies completed to date
suggest that in normal healthy individuals the kidneys are able to excrete
creatine, and its end product creatinine, in a manner that does not adversely
alter renal function. This situation would be predicted to be different in
persons with impaired glomerular filtration or inherent renal disease. The
question of whether long-term creatine supplementation (ie, months to years) has
any deleterious affects on renal structure or function can not be answered at
this time. The limited number of studies that have addressed the issue of the
chronic use of creatine have not seen remarkable changes in renal function.
However, physicians should be aware that the safety of long-term creatine
supplementation, in regard to the effects on the kidneys, cannot be guaranteed.
More information is needed on possible changes in blood pressure,
protein/albumin excretion, and glomerular filtration in athletes who are
habitual users of this compound.
Publication Types:
Case Reports
Review
Review, Tutorial
PMID: 12831718 [PubMed]
83: Curr Sports Med Rep. 2002 Aug;1(4):239-45.
Creatine and other nonsteroidal strength-enhancing aids.
Bohn AM, Betts S, Schwenk TL.
Department of Family Medicine, University of Michigan Health System, L2003
Womens, Box 0239, Ann Arbor, MI 48109, USA.
Although most discussions of ergogenic supplements to enhance strength focus on
anabolic steroids, there are several nonsteroidal supplements of importance.
These agents, including creatine, beta-hydroxy-beta-methylbutyrate (HMB),
chromium, human growth hormone, and insulin-like growth factor are popular,
easily accessible, sometimes impossible to detect, and (in some cases, ie,
creatine) not banned by official sports organizations. They are purported to be
natural and safe because they are not anabolic steroids, have at least a
theoretic basis for potential benefit, and in some cases, have data suggesting
athletic improvement in certain controlled conditions. They also have a
significant potential for causing at least bothersome if not dangerous adverse
effects. Studies to date have generally addressed efficacy, with little data to
support effectiveness in unmonitored, uncontrolled use. Human growth hormone is
officially banned. In general, none of these agents can be recommended at
present.
Publication Types:
Review
Review, Tutorial
PMID: 12831701 [PubMed]
84: Curr Sports Med Rep. 2003 Feb;2(1):1-2.
Ephedrine use is risky business.
Landry GL.
University of Wisconsin Medical School, 2880 University Avenue, Madison, WI
53705, USA. gllandry@facstaff.wisc.edu
Publication Types:
Review
Review, Tutorial
PMID: 12831669 [PubMed]
85: Acta Pharm Hung. 2002;72(4):231-44.
[Doping agents and their analytical control]
[Article in Hungarian]
Szokan G.
Eotvos Lorand Tudomanyegyetem Szerves Kemia Tanszek, Nagyhatekonysagu
folyadekkromatografias laboratorium, Budapest 112, Pf.32.-1518.
Doping is defined as the use of substances and/or forbidden methods for the
artificial performance-enforcement of an athlete during competition or in the
preparation period. A survey is given on the misuse of doping agents in recent
years, with special emphasis on stimulants, beta blockers, diuretics, exogenous
and endogenous steroids and peptide hormones. The introduction of new doping
substances including perfluorocarbons, ecdysteroids, synthetic hemoglobin and
peptide hormones (e.g. growth-hormone) precursors is described. Hyphenated
separation techniques achieved great progress in doping analysis and control, of
which some of the recent methods such as LC-MS, GC-MS CE-MS are briefly reviewed
here.
Publication Types:
Review
Review, Tutorial
PMID: 12812043 [PubMed]
86: J Endocrinol Invest. 2003 Mar;26(3):274-88.
Molecular heterogeneity of human GH: from basic research to clinical
implications.
Boguszewski CL.
Service of Endocrinology and Metabolism, Clinical Hospital, Federal University
of Parana (SEMPR), Department of Internal Medicine, Curitiba, Brazil.
cesarlui@hc.ufpr.br
Publication Types:
Review
Review, Tutorial
PMID: 12809181 [PubMed]
87: Haematologica. 2003 Jun;88(6):712-4.
The influence of exercise on serum markers of altered erythropoiesis and the
indirect detection models of recombinant human erythropoietin abuse in athletes.
Schumacher YO, Temme J, Bueltermann D, Schmid A, Berg A.
Abteilung Sportmedizin, Medizinische Universitatsklinik Freiburg, Freiburg,
Germany. olaf@msm1.ukl.uni-freiburg.de
Publication Types:
Letter
PMID: 12801849 [PubMed]
88: Haematologica. 2003 Jun;88(6):601-5.
Erythropoietin therapy: need for rationality and active surveillance.
Cazzola M.
University of Pavia Medical School, Division of Hematology, IRCCS Policlinico S.
Matteo, Pavia, Italy. mario.cazzola@unipv.it
Publication Types:
Editorial
PMID: 12801832 [PubMed]
89: Sports Med. 2003;33(8):553-61.
Occurrence of chronic disease in former top-level athletes. Predominance of
benefits, risks or selection effects?
Kujala UM, Marti P, Kaprio J, Hernelahti M, Tikkanen H, Sarna S.
Unit for Sports and Exercise Medicine, Institute of Clinical Medicine,
University of Helsinki, Helsinki, Finland.
Former elite athletes from most sports disciplines have lower overall morbidity
risk and enjoy better self-rated health in later years compared with the general
population and matched controls who were healthy at young age. This is seen
particularly among former endurance athletes who have a lower incidence of
coronary heart disease and type 2 diabetes mellitus. Most often data are
available only for men. Based on the available data, participation in elite
sports cannot be regarded as an overall health hazard. However, aside from a
high risk of acute injury in specific sports, possible negative effects of
long-standing athletic activity on the development of osteoarthritis should not
be neglected. It should also be remembered that elite athletes are a
biologically and genetically select group who are not representative of the
population at large. Given the nature of the available data, the possible health
consequences of recent changes in different characteristics of sports, such as
training practices, professionalism and use of doping, cannot be properly
predicted.
PMID: 12797837 [PubMed]
90: Clin J Sport Med. 2003 May;13(3):183-5.
Vasospasm-induced stroke in a varsity athlete secondary to ephedrine ingestion.
Foxford RJ, Sahlas DJ, Wingfield KA.
Department of Emergency Medicine, McGill University, Montreal, Quebec, Canada.
drbob1@sympatico.ca
Publication Types:
Case Reports
PMID: 12792214 [PubMed]
91: Clin J Sport Med. 2003 May;13(3):132-7.
Abnormal hematologic profiles in elite cross-country skiers: blood doping or?
Stray-Gundersen J, Videman T, Penttila I, Lereim I.
jimsg@singlepoint.net
OBJECTIVE: There is widespread public concern about fairness in sports. Blood
doping undermines fairness and places athletes' health at risk. The purpose of
this study was to examine the prevalence of abnormal hematologic profiles in
elite cross-country skiers, which may indicate a high probability of blood
doping. SETTING AND PARTICIPANTS: Samples were obtained as part of routine
International Ski Federation blood testing procedures from participants at the
World Ski Championships. Sixty-eight percent of all skiers and 92% of those
finishing in the top 10 places were tested. MAIN OUTCOME MEASURES: Using flow
cytometry, we analyzed erythrocyte and reticulocyte indices. Reference values
were from the 1989 Nordic Ski World Championships data set and the International
Olympic Committee Erythropoietin 2000 project. RESULTS: Of the skiers tested and
finishing within the top 50 places in the competitions, 17% had "highly
abnormal" hematologic profiles, 19% had "abnormal" values, and 64% were normal.
Fifty percent of medal winners and 33% of those finishing from 4th to 10th place
had highly abnormal hematologic profiles. In contrast, only 3% of skiers
finishing from 41st to 50th place had highly abnormal values. CONCLUSIONS: These
data suggest that blood doping is both prevalent and effective in cross-country
ski racing, and current testing programs for blood doping are ineffective. It is
unlikely that blood doping is less common in other endurance sports.
Ramifications of doping affect not only elite athletes who may feel compelled to
risk their health but also the general population, particularly young people.
PMID: 12792206 [PubMed]
92: Br J Sports Med. 2003 Jun;37(3):192-3.
Super athletes or gene cheats?
McCrory P.
Centre for Sports Medicine Research and Education and the Brain Research
Institute, University of Melbourne, Australia. pmccrory@compuserve.com
PMID: 12782540 [PubMed]
93: Br J Sports Med. 2003 Jun;37(3):190-1.
VO2MAX, blood doping, and erythropoietin.
Joyner MJ.
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
joyner.michael@mayo.edu
PMID: 12782539 [PubMed]
94: Clin Hemorheol Microcirc. 2003;28(3):161-73.
Hemorheological correlates of fitness and unfitness in athletes: moving beyond
the apparent "paradox of hematocrit"?
Gaudard A, Varlet-Marie E, Bressolle F, Mercier J, Brun JF.
Laboratoire de Pharmacocinetique clinique, Faculte de Pharmacie, BP 14491,
Universite Montpellier I, 34093 Montpellier Cedex 5, France.
Negative correlations between blood viscosity parameters and fitness have been
reported, but their physiological meaning remains incompletely understood. Since
rheo-active treatments are used in athletes doping, we aimed at clarifying the
relationships between hematocrit (Hct), viscosity and performance by comparing
aerobic capacity, overtraining questionnaire, and hemorheological parameters.
SUBJECTS AND METHODS: 29 sportsmen (24.71+/-1.05 yr; 74.90+/-1.44 kg;
178.5+/-1.05 cm) underwent a standardised exercise test. Physical working
capacity (W170), maximal power output (Wmax) and maximal oxygen consumption
(VO2max ) were calculated. Viscometric measurements were done with a MT 90
Medicatest viscosimeter. Hct was measured with microcentrifuge. All subjects
answered the overtraining questionnaire proposed by the French Society for
Sports Medicine. RESULTS: The best correlate of maximal power output (Wmax) was
whole blood viscosity (r=-0.383, p<0.001). The stepwise regression analysis only
selected Hct as W170 determinant (r=-0.66, p<0.001). Similarly the best
determinant of VO2max, expressed as a percentage of theoretical values, was Hct
(r=-0.462, p=0.01). Hct/viscosity ratio (Hct/eta), a proposed index of Hct's
positive influence on O2 transfer to tissues, was positively correlated to Wmax
expressed as a percentage of theoretical values (r=0.487, p=0.02). The
overtraining score was correlated to plasma viscosity (r=0.450, p=0.016).
CONCLUSION: The best hemorheogical correlate of fitness is a low hematocrit and
the best hemorheological correlate of overtraining is increased plasma
viscosity.
PMID: 12775898 [PubMed]
95: Clin Chem. 2003 Jun;49(6 Pt 1):901-7.
Detection of recombinant human erythropoietin in urine by isoelectric focusing.
Breidbach A, Catlin DH, Green GA, Tregub I, Truong H, Gorzek J.
UCLA Olympic Analytical Laboratory, University of California at Los Angeles, Los
Angeles, CA 90025, USA.
BACKGROUND: Doping with erythropoietic proteins such as recombinant human
erythropoietin (rHuEPO) and darbepoetin alfa is a serious issue in sport. There
is little information on the time course of detection of rHuEPO in urine and on
methods to evaluate electrophoresis-based data. METHODS: We used a recently
described isoelectric focusing method for detecting rHuEPO and endogenous EPO in
urine obtained from individuals treated with placebo or epoetin alfa. The latter
was administered subcutaneously at 50 IU/kg on days 0, 2, 4, 7, 9, 11, 14, 16,
and 18. Blood and urine samples were collected during the morning of study days
-3, 0, 2, 4, 7, 9, 11, 14, 16, and 18 and on days 2, 3, 4, and 7
postadministration. We developed visual and numerical (two-band ratio)
techniques to evaluate the electropherograms for the presence of rHuEPO.
RESULTS: Compared with the placebo group, the epoetin alfa-treated group
responded with increases in hematocrit, reticulocytes, macrocytes, serum EPO,
and serum soluble transferrin receptor. The electropherograms showed that the
pattern of bands arising from urinary rHuEPO is different from that of
endogenous urinary EPO. Both the two-band ratio and the visual technique
detected rHuEPO in all 14 epoetin alfa-treated individuals 3 days after the last
dose. On the 7th day after the last dose, both techniques detected rHuEPO in
approximately one-half of the participants. rHuEPO was not detected in the
placebo-treated individuals. CONCLUSIONS: The isoelectric focusing method
detects rHuEPO in most urine samples collected 3 days after nine doses of
epoetin alfa. The numerical two-band ratio was equivalent to a visual method for
detecting rHuEPO in urine.
PMID: 12765986 [PubMed]
96: Anal Bioanal Chem. 2003 Jul;376(5):696-700. Epub 2003 May 16.
Potential parameters for the detection of hGH doping.
Kniess A, Ziegler E, Kratzsch J, Thieme D, Muller RK.
Institut fur Dopinganalytik und Sportbiochemie, 01731, Kreischa, Germany.
astrid.kniess@idas-kreischa.de
The aim of our hGH application study with non-competitive athletes was the
investigation of selected serum parameters from different processes affected by
hGH. Fifteen athletes (age 21-33, mean 24) were treated with 0.06 IU hGH/kg BW
per day or placebo (10 hGH, 5 placebo) respectively for 14 days. Blood samples
were taken prior to, during and until 10 weeks after treatment.The
concentrations of the following markers were determined in relevant serum
samples: IGF-I, IGFBP-3, ALS, PIIINP, PINP, osteocalcin, and leptin. The IGF-I
concentration increased rapidly within the hGH treatment group and showed
significantly higher levels compared to baseline even 3 days after application.
The response of the IGFBP-3 to the hGH applications was lower in comparison to
IGF-I. The hGH group showed an increasing IGFBP-3 compared to baseline from day
4 till day 15. The response of PIIINP to hGH is clearly delayed compared to the
IGF-I axis, but the PIIINP concentration remains on an increased level for a
longer period (from day 4 until day 21). The time course and the extent of
response varied strongly interindividually. PINP and osteocalcin showed only a
small response to hGH applications. These parameters are characterised by a
strong scattering of base values compared with the small response. In the hGH
treatment group very different leptin concentrations were found at the beginning
of the study, but after treatment decreasing leptin levels were observed in all
cases.The determination of only one parameter will not be sufficient for
detection of hGH abuse. A combination of markers by mathematical methods can be
helpful to distinguish between placebo and hGH-treated athletes. By using the
suggested discriminant function the data sets of hGH and placebo-treated
athletes could be separated without false positive results.
Publication Types:
Evaluation Studies
PMID: 12750868 [PubMed]
97: Haematologica. 2003 May;88(5):570-81.
Hematologic passport for athletes competing in endurance sports: a feasibility
study.
Malcovati L, Pascutto C, Cazzola M.
Division of Hematology, University of Pavia Medical School and IRCCS Policlinico
S. Matteo, Pavia, Italy.
BACKGROUND AND OBJECTIVES: Strategies based on the use of upper thresholds of
hemoglobin or hematocrit to detect blood doping in endurance sports have
essentially failed to deter this malpractice. With the aim of establishing a
more effective strategy, we analyzed the biological variations of hematologic
parameters in professional athletes and investigated the possibility of defining
subject-specific reference ranges that could distinguish between physiologic and
abnormal variability. DESIGN AND METHODS: Hemoglobin concentration, hematocrit,
reticulocyte count, serum ferritin and soluble transferrin receptor levels were
sequentially evaluated in 923 professional football players. Using the analysis
of variance we tested the effect of age, ethnicity, exercise modalities and
training phases on hematologic parameters and then estimated components of
variation. The significance of the difference between two measures was obtained
from the distribution of the within-subject variance (the so-called reference
change). Subject-specific reference ranges were centered around the individual
mean value with dispersion based on the 95th percentile of the coefficient of
variation distribution. RESULTS: A total of 2,506 hematologic determinations
were made. Exercise modalities were found to have important effects on
hematologic parameters. Hemoglobin and hematocrit values were higher at the
beginning of the competition season, and then declined in well-trained athletes.
Aerobic exercise was clearly associated with lower values, suggesting that
marginally low hemoglobin and hematocrit values should physiologically be found
in endurance sports. At least five determinations were required to define
subject-specific reference ranges reliably. Considering athletes showing normal
indices of red cell production (i.e., reticulocyte count and soluble transferrin
receptor), the 95th percentile of the coefficient of variation distribution was
lower than 5% for both hemoglobin and hematocrit. Increases exceeding 10% in
these latter parameters should to be considered abnormal. Score systems capable
of efficiently detecting non-physiologic increases in red cell production were
developed. INTERPRETATION AND CONCLUSIONS: Using proper sequential
determinations of hematologic variables subject-specific reference ranges can be
defined for hemoglobin and hematocrit. Thus, the hematologic passport is
feasible and might be employed to exclude athletes with non-physiologic
increases in hemoglobin and hematocrit from competitions. The hematologic
passport should be used within a global strategy to deter blood doping.
PMID: 12745277 [PubMed]
98: Sports Med. 2003;33(6):401-6.
Allergic rhinoconjunctivitis in elite athletes: optimal management for quality
of life and performance.
Katelaris CH, Carrozzi FM, Burke TV.
Institute of Immunology and Allergy Research, Westmead Hospital, Westmead 2145,
Sydney, New South Wales, Australia.
Allergic rhinoconjunctivitis is a common condition with a peak incidence in the
age range of the majority of elite athletes. The condition has been shown to
have a significant impact on the quality of life of those affected and poses
particular challenges when present in the elite athlete. When an athlete is
looking for exceptional performance at events such as the Olympic Games, any
factor which affects quality of life by interfering with sleep, decreasing the
ability to concentrate, or reducing peak physical fitness, may have a
significant impact on the ability to perform at one's best. Optimal management
begins with correct diagnosis and identification of triggering factors.There are
a number of therapeutic options available to the treating physician. When
formulating a management plan for the elite athlete, the physician must consider
"doping" rules and the possible effect of medication on athletic performance.
Medication choices include the newer, non-sedating antihistamines, used either
orally or topically, and the prophylactic use of intranasal corticosteroids.
When allergic conjunctivitis is the principal problem, the newer, topical
antihistamines are highly effective and have a rapid onset of action. Since
avoidance strategies are rarely practical for the athlete, consideration should
be given to strategies such as immunotherapy, where long-term benefit is
possible.
Publication Types:
Review
Review, Tutorial
PMID: 12744714 [PubMed]
99: Sports Med. 2003;33(6):395-9.
Marijuana as doping in sports.
Campos DR, Yonamine M, de Moraes Moreau RL.
Laboratory of Analytical Toxicology, College of Pharmaceutical Sciences,
University of Sao Paulo, CEP:05508-900, Sao Paulo, Av. Prof. Lineu Prestes 580,
B13B, Brazil.
A high incidence of positive cases for cannabinoids, in analyses for doping
control in sports, has been observed since the International Olympic Committee
(IOC) included them in the 1989 list of prohibited drugs under the title of
classes of prohibited substances in certain circumstances. Where the rules of
sports federations so provide, tests are conducted for marijuana, hashish or any
other cannabis product exposure by means of urinalysis of
11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid (carboxy-THC) the main
metabolite of delta-9-tetrahydrocannabinol (THC). Concentrations >15 ng/mL
(cut-off value) in confirmatory analytical procedures are considered doping.
Cannabis is an illicit drug in several countries and has received much attention
in the media for its potential therapeutic uses and the efforts to legalise its
use.Studies have demonstrated that the use of cannabinoids can reduce anxiety,
but it does not have ergogenic potential in sports activities. An increase in
heart rate and blood pressure, decline of cardiac output and reduced psychomotor
activity are some of the pharmacological effects of THC that will determine a
decrease in athletic performance. An ergolytic activity of cannabis products has
been observed in athletes of several different sport categories. In Brazil,
analyses for doping control in sports, performed in our laboratories, have
detected positive cases for carboxy-THC in urine samples of soccer, volleyball,
cycling and other athletes.It is our intention to discuss in this article some
points that may discourage individuals from using cannabis products during
sports activities, even in the so-called permitted circumstances defined by the
IOC and some sports federations.
Publication Types:
Review
Review, Tutorial
PMID: 12744713 [PubMed]
100: Int J Sports Med. 2003 Apr;24(3):195-6.
Androgenic anabolic steroid use and severe hypothalamic-pituitary dysfunction: a
case study.
van Breda E, Keizer HA, Kuipers H, Wolffenbuttel BH.
Department of Movement Sciences, Nutrition and Toxicology Research Institute
Maastricht (NUTRIM), University, PO Box 616, 6200 MD Maastricht, the
Netherlands. eric.vanbreda@bw.unimaas.nl
The data of the present case demonstrate that the abuse of androgenic anabolic
steroids (AAS) may lead to serious health effects. Although most clinical
attention is usually directed towards peripheral side effects, the most serious
central side effect, hypothalamic-pituitary-dysfunction, is often overlooked in
severe cases. Although this latter central side-effect usually recovers
spontaneously when AAS intake is discontinued, the present case shows that
spontaneous recovery does not always take place. We suggest that
hypothalamic-pituitary dysfunction should always be considered in the
differential diagnosis in athletes seen with typical presentation of anabolic
steroid use. In order to regain normal hypothalamic-pituitary function,
supraphysiological doses of 200 microg LH-RH should be considered when the
physiological challenge test with LH-RH (50 microg) fails to show an acceptable
response.
Publication Types:
Case Reports
PMID: 12740738 [PubMed]
101: J Sch Health. 2003 Apr;73(4):159-64.
Relationship between student illicit drug use and school drug-testing policies.
Yamaguchi R, Johnston LD, O'Malley PM.
Institute for Social Research, University of Michigan, 426 Thompson St., Ann
Arbor, MI 48106-1248, USA. ryokoy@umich.edu
This report provides information about drug testing by American secondary
schools, based on results from national surveys. The study provides descriptive
information on drug-testing practices by schools from 1998 to 2001, and examines
the association between drug testing by schools and reported drug use by
students. School-level data on drug testing were obtained through the Youth,
Education, and Society study, and student-level survey data were obtained from
the same schools participating in the Monitoring the Future study. A relatively
small percentage of schools (about 18%) reported testing students for drug use,
with more high schools than middle schools reporting drug testing. Drug testing
was not associated with students' reported illicit drug use, or with rate of use
among experienced marijuana users. Drug testing of athletes was not associated
with illicit drug use among male high school athletes. Policy implications are
discussed.
PMID: 12728615 [PubMed]
102: J Steroid Biochem Mol Biol. 2003 Feb;84(2-3):369-75.
Reversibility of the effects on blood cells, lipids, liver function and hormones
in former anabolic-androgenic steroid abusers.
Urhausen A, Torsten A, Wilfried K.
Faculty of Clinical Medicine, Institute of Sports and Preventive Medicine,
University of Saarland, Germany. a.urhausen@rz.uni-sb.de
BACKGROUND: In contrast to the acute effects of anabolic-androgenic steroid
(AAS) abuse, the long-term risk profile of former long-term abusers (ExA) is
less clear. METHODS: Blood parameters of 32 male bodybuilders and powerlifters
were studied. Fifteen ExA had not been abusing AAS for at least 12-43 months on
average (mean dosage 700 mg for 26 weeks per year over 9 years), 17 athletes (A)
were still abusing AAS (750 mg for 33 weeks per 8 years). FINDINGS: Hemoglobin
(+5%), leucocytes (+33%) and platelets (+38%) were significantly higher in A.
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were higher,
cholinesterase activity (CHE) lower in A (65+/-55, 38+/-27 and 3719+/-1528U/l)
compared to ExA (24+/-10, 18+/-11 and 6345+/-975U/l; each P<0.001) with normal
values for gamma-glutamyl transpeptidase (gamma-GT) and bilirubin. ALT, AST and
CHE correlated significantly with the extent (duration and weekly dosage,
expressed as a point score) of AAS abuse in A (r=0.68, 0.57 and -0.62; each
P<0.01). Total and LDL-cholesterol were similar, HDL-cholesterol was distinctly
lower in A than in ExA (17+/-11 and 43+/-11 mg/dl; P<0.001) and correlated
negatively with the extent of AAS abuse (r=-0.50; P<0.05). Testosterone and
estradiol were significantly higher, while LH, FSH and the
sexual-hormone-binding (SHB) protein were lower in A than in ExA (each P<0.001).
Two ExA had testosterone levels below the normal range. INTERPRETATION: The
alterations in cell counts, HDL-cholesterol, liver function and most hormones of
the pituitary-testicular axis induced by a long-term abuse of AAS were
reversible after stopping the medication for over 1 year. In some ExA, an
increased ALT activity and a depressed testosterone synthesis were found.
PMID: 12711025 [PubMed]
103: Z Kardiol. 2003 Apr;92(4):326-31.
[Coronary thrombosis and ectasia of coronary arteries after long-term use of
anabolic steroids]
[Article in German]
Tischer KH, Heyny-von Haussen R, Mall G, Doenecke P.
Klinikum Darmstadt, Medizinische Klinik I, Grafenstrasse 9, 64283 Darmstadt,
Germany.
Chronic abuse of anabolic steroids is widespread. Hypertrophy of skeletal and
heart muscle is a well-known effect of chronic anabolic steroid abuse.
Structural alterations of blood vessels are new side effects. We report a case
of a 32-year-old bodybuilder after long-term use of anabolic steroids who died
of cardiac arrest. Coronary angiography and autopsy findings showed especially a
hypertrophic heart, structural changes of coronary arteries, intracoronary
thrombosis and myocardial infarction, ventricular thrombosis and systemic
embolism
Publication Types:
Case Reports
PMID: 12707792 [PubMed]
104: Sports Med. 2003;33(4):301-15.
Pharmacokinetics/pharmacodynamics of recombinant human erythropoietins in doping
control.
Varlet-Marie E, Gaudard A, Audran M, Bressolle F.
Clinical Pharmacokinetic Laboratory, Faculty of Pharmacy, University Montpellier
I, Montpellier, France.
The purpose of this paper is: (i) to compare recombinant human erythropoietin
(rHuEPO) pharmacokinetics in athletes and healthy individuals; and (ii) to
report pharmacokinetic/pharmacodynamic (PK/PD) studies performed in athletes.
Effect parameters in PK/PD studies included: (i) red blood cell variables
(haematocrit, reticulocyte count); and (ii) markers of iron metabolism (serum
soluble transferrin receptors [sTfR], ferritin [fr] and sTfR : fr ratio). To
understand the choice of these markers, we first performed a brief review of the
pharmacological effects of rHuEPO. Few studies have been conducted in healthy
individuals and there are minimal references concerning pharmacokinetics in
athletes. A 'flip-flop' phenomenon was noted after subcutaneous administration.
The pharmacokinetics appeared linear from 50-1000 U/kg, but this linearity was
not observed at the lowest dose of 10 U/kg. A negative-feedback loop of
endogenous erythropoietin production occurred at the end of treatment. The
half-life of the terminal part of the curves seemed to be slightly higher in
athletes (36-42 vs 32 hours) than in untrained individuals and total clearance
tended to be greater (17.5 vs 6.5 mL/h/kg). In conclusion, more investigations
are needed to better understand the relationship between rHuEPO administration
and changes in haematological and iron-metabolism parameters in athletes,
particularly after chronic low-dose administration of rHuEPO.
Publication Types:
Review
Review, Tutorial
PMID: 12688828 [PubMed]
105: J Pharm Biomed Anal. 2003 Apr 1;31(5):859-65.
A sensitive fluorescence optosensor for analysing propranolol in pharmaceutical
preparations and a test for its control in urine in sport.
Fernandez-Sanchez JF, Carretero AS, Cruces-Blanco C, Fernandez-Gutierrez A.
Department of Analytical Chemistry, Faculty of Sciences, University of Granada,
C/Fuentenueva s/n, E-18071 Granada, Spain.
We describe a simple and selective method for analysing propranolol and a
sensitive test for its control in urine. A flow-through fluorescence optosensor
based on on-line immobilization in a non-ionic-exchanger (Amberlite XAD-7) solid
support in a continuous flow was used in both cases. Determination was made in 5
mM H(2)PO(4)(-)/HPO(4)(2-) buffer solution at pH 6 at a working temperature of
20 degrees C. Fluorescence intensities were measured at lambda(ex/em) = 300/338
nm with a response time of 80 s, thus obtaining a linear concentration range of
between 0 and 250.0 ng ml(-1) with a detection limit of 1.3 ng ml(-1), an
analytical sensitivity of 6.0 ng ml(-1) and a standard deviation of 2.40% at a
150 ng ml(-1) concentration level for propranolol. We also propose a test to
detect propranolol in urine with a linear concentration range between 0 and
100.0 ng ml(-1), a detection limit of 0.2 ng ml(-1), an analytical sensitivity
of 1.0 ng ml(-1), and a standard deviation of 0.84% at a 75 ng ml(-1)
concentration level. The effect of proteins presents in urine samples were
evaluated. The two proposed methods were satisfactorily applied to commercial
formulations and urine samples respectively. Copyright 2003 Elsevier Science
B.V.
PMID: 12684098 [PubMed]
106: Vet Hum Toxicol. 2003 Mar;45(2):97-102.
The toxic torch of the modern Olympic Games.
Prendergast HM, Bannen T, Erickson TB, Honore KR.
Department of Emergency Medicine, University of Illinois Medical Center at
Chicago, 800 S Wood Street, Chicago, IL 60612-7354, USA. hprender@uic.edu
One of the most enduring symbols of the Olympics is the torch or flame, an icon
of peace and sportsmanship that has its roots in Ancient Greece. According to
the Creed of the Olympics: "The important thing in the Games is not winning, but
taking part. The essential thing is not conquering. but fighting well." The
modern Olympic Games (1896-2000) have been heavy laden with controversy, as
athletes have abused performance enhancing drugs to thrust themselves into the
limelight in search of gold. It was not until 1967 that the International
Olympic Medical Commission began banning drugs. Full-scale drug testing was
instituted in 1972.: Retrospective review of modern summer and winter Olympics
Game sources (1896-2002) was done for documentation of drug abuse, drug-related
overdoses, and positive drug screens. Data were collected for the type of drug
documented. the athlete's name, their country of origin, and Olympic event.
Seventy cases were identified. The most common class of agents were steroids
(29), followed by stimulants (22), diuretics (7), beta-2 agonists (2), and beta
blockers (1). Alcohol and marijuana, while not historically prohibited, have
been outlawed by several individual sport federations. Toxicities of these 2
agents were most likely under-reported. Countries of origin of individual
athletes included Bulgaria (7), USA (7), Sweden (4), Spain (4), Japan (2),
Poland (2), Greece (2), Canada (2), Hungary (2), Russia (2), Austria (2), and
Great Britain, Norway, Romania, Armenian, and Latvian, each with 1. The most
common Olympic events in which drug abuse was documented were weightlifting
(25), trackand field (12), skiing (5), wrestling (5), volleyball (3), modern
pentathlon (3), cycling (2), swimming (2), gymnastics (1), and rowing (1). As
athletic pressures and financial gains of the Olympic Games heighten, more
toxicities are likely to occur despite attempts at restricting
performance-enhancing drugs.
Publication Types:
Historical Article
PMID: 12678299 [PubMed]
107: Int J Sports Med. 2003 Feb;24(2):131-7.
The effect of marathon cycling on renal function.
Neumayr G, Pfister R, Hoertnagl H, Mitterbauer G, Getzner W, Ulmer H, Gaenzer H,
Joannidis M.
Institute of Sports Medicine, University Clinics of Innsbruck, Anichstrasse 35,
6020 Innsbruck, Austria. guenther.neymayr@sb-bruneck.it
The stress of strenuous long-term exercise may alter renal function. Whether
this is also true for marathon cycling is unknown so far. The purpose of this
study was to evaluate renal function following competitive marathon cycling. We
investigated 38-male, well-trained recreational cyclists credibly not taking any
kind of doping who participated in the Otztal Radmarathon. Blood and urine
specimens were taken the day before, immediately after and one day after
competition. Baseline renal functional parameters--normal before
competition--increased significantly afterwards and remained elevated during 24
hours of recovery. The rises in serum creatinine, urea and uric acid were 20, 54
and 42 % (p < 0.001 respectively). The corresponding decline in estimated
creatinine clearance was 18 %. In all athletes the serum urea/creatinine ratio
rose above 40, fractional sodium excretion and fractional uric acid excretion
fell below 0.4 % and 15 %, indicating reduced renal perfusion. The observed
effects lasted for at least 24 h despite a stable fluid balance during the race
and an expanding plasma volume (PV) in the recovery period. Levels of
haematocrit remained unchanged immediately post-race but significantly declined
from 0.44 to 0.41 on the following day (p < 0.001). The calculated rise in PV
was + 10.8 %. Electrolyte homeostasis was preserved throughout the observation
period. Post-exercise proteinuria was small and of the mixed glomerular-tubular
type. There was neither evidence for exercise-induced haemolysis, nor for
significant skeletal muscle damage. The finding obtained from well-hydrated
recreational athletes reveals that the extraordinary strains of marathon cycling
influence renal function only on a minimal scale. Though minor, the
physiological effects were long-lasting. The results obtained suggest that a
reduced renal perfusion is the mechanism responsible for the slight impairment
of renal function following exhaustive marathon cycling.
PMID: 12669260 [PubMed]
108: Wake Forest Law Rev. 1999 Fall;34(3):671-714.
How will we regulate genetic enhancement?
Mehlman MJ.
The Law-Medicine Center, Case Western Reserve University, USA.
Genetic enhancement technologies present difficult and novel regulatory issues,
including the problem of measuring and comparing risks and benefits and dealing
with the impact of these technologies on social values. This Article describes
and evaluates the potential approaches that may be taken to regulate these
technologies. The author concludes that a variety of approaches will be
necessary, involving self-regulation, government restrictions on access and use,
licensing, and a national lottery.
PMID: 12664908 [PubMed]
109: Sports Med. 2003;33(3):187-212.
Drugs for increasing oxygen and their potential use in doping: a review.
Gaudard A, Varlet-Marie E, Bressolle F, Audran M.
Clinical Pharmacokinetic Laboratory, Faculty of Pharmacy, University Montpellier
I, Montpellier, France.
Blood oxygenation is a fundamental factor in optimising muscular activity.
Enhancement of oxygen delivery to tissues is associated with a substantial
improvement in athletic performance, particularly in endurance sports. Progress
in medical research has led to the identification of new chemicals for the
treatment of severe anaemia. Effective and promising molecules have been created
and sometimes used for doping purposes. The aim of this review is to present
methods, and drugs, known to be (or that might be) used by athletes to increase
oxygen transport in an attempt to improve endurance capacity. These methods and
drugs include: (i) blood transfusion; (ii) endogenous stimulation of red blood
cell production at altitude, or using hypoxic rooms, erythropoietins (EPOs), EPO
gene therapy or EPO mimetics; (iii) allosteric effectors of haemoglobin; and
(iv) blood substitutes such as modified haemoglobin solutions and
perfluorochemicals. Often, new chemicals are used before safety tests have been
completed and athletes are taking great health risks. Such new chemicals have
also created the need for new instrumental strategies in doping control
laboratories, but not all of these chemicals are detectable. Further progress in
analytical research is necessary.
Publication Types:
Review
Review, Academic
PMID: 12656640 [PubMed]
110: Haematologica. 2003 Mar;88(3):333-44.
Second-generation blood tests to detect erythropoietin abuse by athletes.
Gore CJ, Parisotto R, Ashenden MJ, Stray-Gundersen J, Sharpe K, Hopkins W,
Emslie KR, Howe C, Trout GJ, Kazlauskas R, Hahn AG.
Australian Institute of Sport, Adelaide, SA 5022, Australia.
chris.gore@ausport.gov.au
BACKGROUND AND OBJECTIVES: We previously developed blood tests that were
introduced at the Sydney 2000 Olympic Games to identify athletes injecting
recombinant human erythropoietin (rHuEPO). The aim of this study was to
re-analyse our existing database to develop models with heightened sensitivity,
using wherever possible blood parameters measurable with appropriate standards
of analytical performance. DESIGN AND METHODS: The principal database for this
study was derived from a double-blind trial in which 57 recreational athletes
were administered either rHuEPO or placebo. Standard discriminant analysis was
used to derive two ON models (ON-hes and ON-he) and two OFF models (OFF-hr and
OFF-hre) sensitive to accelerated and decelerated erythropoiesis respectively,
utilising concentrations of hemoglobin (h), erythropoietin (e) and serum
transferrin receptor (s), as well as percent reticulocytes (r). The ability of
our models to detect rHuEPO administration was assessed by comparing model
scores of subjects in the administration trial with the model scores of 1152
elite athletes from 12 countries. RESULTS: The ability of the new models to
detect rHuEPO administration was generally higher than that of our previous
models, particularly during phases when low doses of rHuEPO were used, and after
injections had ceased. INTERPRETATION AND CONCLUSIONS. The increased stability
of the new blood parameters facilitates transport of samples to central
laboratories, and the heightened sensitivity of the new models makes them better
than existing models for federations wishing to screen samples for urine testing
and to identify and target suspect athletes for out-of-competition testing.
However procedures should be incorporated that respect an elevated model score
caused by genetic, health or environmental circumstances.
PMID: 12651273 [PubMed]
111: J Steroid Biochem Mol Biol. 2002 Dec;83(1-5):245-51.
Prohormones and sport.
Delbeke FT, Van Eenoo P, Van Thuyne W, Desmet N.
Doping Control Unit, Faculty of Veterinary Medicine, Ghent University,
Salisburylaan 133, B-9820 Merelbeke, Belgium. frans.delbeke@rug.ac.be
Several precursors of testosterone and nandrolone introduced on the nutritional
supplement market as performance enhancing drugs are banned in sports. Until now
they are legally sold without a prescription in the US. Results of excretion
studies with related compounds including 7-keto-DHEA and 1-androstenediol are
presented. The main metabolites of 7-keto-DHEA are 7-hydroxylated compounds. The
commercial 1-androstenediol preparation was contaminated with several other
anabolic steroids. Oxidation of 1-androstenediol to 1-androstenedione seems to
be the major renal metabolic pathway. Additionally contaminated nutritional
supplements containing banned substances not indicated on the label were
administered. The results of the excretion studies indicate that after the
intake of amounts substantially lower than the recommended dose athletes can
fail a doping test for periods up to 120 h.
PMID: 12650722 [PubMed]
112: Scand J Med Sci Sports. 2003 Apr;13(2):138-44.
Nutritional supplements in Norwegian elite athletes--impact of international
ranking and advisors.
Sundgot-Borgen J, Berglund B, Torstveit MK.
Norwegian University of Sport and Physical Education, Oslo, Norway.
jorunn@nih.no
The aims of this study were to investigate (a) the use of nutritional
supplements (NS) (vitamins, minerals, Omega 3, antioxidants, ginseng, amino
acids, Creatine and energy supplements) in elite athletes of different
international ranking (b) why athletes are using NS, and (c) who recommends the
elite athletes to use NS. The total population of elite athletes in Norwegian
National Teams (n = 1620, 960 males and 660 females aged 15-39 years) and
randomly selected (n = 1681) (916 males and 765 females) controls from the
general population, were given a questionnaire including questions about use of
nutritional supplements (NS), and from whom athletes had received information
about nutrition and recommendations to use NS. The response rate was 76% for
male and 92% for female athletes and 75% and 81% for male and female controls,
respectively. A similar percentage of female athletes (54%) and controls (52%)
reported use of one or more NS, but more male athletes (51%) than male controls
(32%) used NS (P < 0.001). However, independent of gender, more athletes as
compared to controls used minerals (males 26% vs. 8%; females 42% vs. 20%),
amino acids (males 12% vs. 4%; females 3% vs. 0), and Creatine (males 12% vs.
2%; females 3% vs. 0). A lower percentage of NS users were observed in the best
female athletes (52%) as compared to female athletes with less experience of
international competition (73%) (P < 0.01). In male athletes, NS use was
independent of international ranking (49%-53%). The coach was the main advisor
for use of NS for both male (58%) and female athletes (52%). For male and female
athletes, the main reason for using NS was that they felt it was needed in
addition to their daily intake (56% and 67%, respectively). Forty one percent of
the male and 37% of the female athletes using NS felt they were well informed
about nutrition in general and NS. However, 8% of the NS users did not know
whether the NS they used was doping classified or not. In conclusion: we found
that a similar percentage of female elite athletes and controls, but a higher
percentage of male elite athletes than controls, reported the use of NS. There
was a lower percentage of NS use among the top female athletes, but not the top
male athletes as compared to the less successful elite athletes. The coach was
the main advisor for NS use both for male and female elite athletes.
PMID: 12641646 [PubMed]
113: Time. 2003 Mar 3;161(9):60.
A major league loss.
Cloud J.
Publication Types:
Case Reports
News
PMID: 12632674 [PubMed]
114: J Sports Med Phys Fitness. 2003 Mar;43(1):111-8.
Over-the-counter drug use amongst athletes and non-athletes.
Chester N, Reilly T, Mottram DR.
School of Sport and Exercise Sciences, Liverpool John Moores University,
Liverpool, UK.
AIM: Many over-the-counter (OTC) drugs used in the symptomatic relief of upper
respiratory tract (URT) conditions are banned by sports governing bodies. It
would appear therefore that athletes are being penalised for practising
conventional pharmacological methods in the management of common ailments. The
aim was to identify any differences between athletes and non-athletes and
amongst athletic groups, with respect to the prevalence of URT conditions and
the use of OTC drugs to treat such conditions. METHODS: Questionnaires were
distributed at domestic and international athletics meetings and at university
lectures and tutorials. Respondents (n=401) represented both track and field
athletes (n=199) and non-athletes (n=202). RESULTS: No differences were found
between athletes and non-athletes and between elite and non-elite athletes in
terms of the frequency of episodes of URT conditions reported in the previous
year. A higher proportion of elite, as opposed to non-elite athletes did not
take OTC medicines (p=0.028) and of those that did take OTC medicines a higher
proportion of elite athletes (68%) as opposed to non-elite (32%) took those not
containing sympathomimetics, banned by the International Olympic Committee
(IOC). Athletes were found to have greater knowledge of IOC banned OTC drugs
(p=0.002) and within this group, elite athletes were most knowledgeable
(p=0.0003). Although most respondents (81%) believed that OTC drugs should not
be prohibited in sport, athletes made up the greatest proportion in support of
prohibition (23.5% as opposed to 14.4% of non-athletes) with elite as opposed to
non-elite most in favour (p=0.0181). CONCLUSION: These results suggest that URT
conditions are no more prevalent between athletes and non-athletes or between
endurance and power athletes. Athletes competing at the highest level tended to
avoid OTC medicines or those containing IOC banned drugs and were most
knowledgeable in terms of banned OTC drugs and most in favour of their
prohibition suggesting that the control mechanisms in place are only reaching
elite athletes.
PMID: 12629472 [PubMed]
115: Ann Biol Clin (Paris). 2003 Jan-Feb;61(1):41-8.
[Growth hormone and doping]
[Article in French]
Pelissier-Alicot AL, Leonetti G.
Laboratoire de toxicologie, Service de medecine legale, Faculte de medecine, 27
boulevard Jean Moulin, 13385 Marseille cedex 5.
Growth hormone is widely used as a doping agent, particularly because of his
anabolic and lipolytic properties. The potential benefit of large doses of
growth hormone on acute exercise is not clearly demonstrated, but the associated
side effects are well known. The detection of growth hormone abuse is not yet
possible with the techniques available. This article describes the GH axis
physiology, especially during acute exercise, the use of GH as a doping agent,
as well as the difficulties and perspectives in GH doping detection.
Publication Types:
Review
Review, Tutorial
PMID: 12604385 [PubMed]
116: Radiologe. 2002 Dec;42(12):1016-24; quiz 1024-5.
[The safety and registration of pharmaceuticals from the point of view of the
medical practitioner]
[Article in German]
Kaiser RH.
LandesarztekammerHessen, Frankfurt. roland.kaiser@laekh.de
PMID: 12602329 [PubMed]
117: Clin Lab. 2003;49(1-2):57-62.
Effects of exercise on the secondary blood markers commonly used to suspect
erythropoietin doping.
Robinson N, Saugy M, Mangin P.
Laboratoire Suisse d'Analyse du Dopage, Institut Universitaire de Medecine
Legale, Lausanne, Switzerland. Neil.Robinson@inst.hospvd.ch
Numerous trials have reported that some haematological and biochemical
parameters could be put together and be used to detect and fight recombinant
erythropoietin doping. Unfortunately, none of the studies mentioned the
necessity of taking pre-analytical precautions to avoid possible suspicious
results coming from major plasma volume changes caused notably by dehydration.
Therefore we studied the behaviour of the most common secondary blood markers
before and after a strenuous physical activity to find out how reliable these
parameters were. The soluble transferrin receptor and the haemoglobin
concentrations as well as the haematocrit level increased significantly after
effort, whereas the plasma EPO concentration and the reticulocyte count remained
constant. On the other hand, if the values were corrected for
haemoconcentration, the soluble transferrin receptor concentration remained
stable.
PMID: 12593476 [PubMed]
118: J Anal Toxicol. 2003 Jan-Feb;27(1):53-6.
Urinary concentrations of morphine and codeine after consumption of poppy seeds.
Thevis M, Opfermann G, Schanzer W.
Institute of Biochemistry, German Sport University Cologne, Carl-Diem-Weg 6,
50933 Koln, Germany. mthevis@chem.ucla.edu
A quantitative analysis of morphine and codeine in human urine was performed
after oral intake of cakes containing commercially available poppy seeds in
order to estimate the possibility of positive doping results. Therefore, eight
products from different manufacturers (poppy seeds or baking mixtures) and
origin were obtained and analyzed by gas chromatography-mass spectrometry for
the presence of the alkaloids. One selected batch of poppy seeds was used as an
ingredient in a typical cake and was the object of an excretion study with nine
volunteers. After application, several urine specimens contained morphine with
concentrations higher than 1 microg/mL, and peak values of approximately 10.0
microg/mL were detected. Because the International Olympic Committee set a
cutoff limit for morphine at 1 microg/mL, high-performance athletes could
possibly test positive in doping control after consumption of products
containing poppy seeds.
PMID: 12587685 [PubMed]
119: J Chromatogr A. 2003 Jan 24;985(1-2):375-86.
Improvement in steroid screening for doping control with special emphasis on
stanozolol.
Huenerbein A, Sipoli Marques MA, Pereira Ados S, de Aquino Neto FR.
LABDOP-LADETEC, Instituto de Quimica, Ilha do Fundao, Centro de Tecnologia,
Bloco A. sala 512, Universidade Federal do Rio de Janeiro, Rio de Janeiro
21949-900, RJ, Brazil. andreashuenerbein@student.uni-halle.de
The Medical Commission of the International Olympic Committee forbids the use of
anabolic androgenic steroids and beta2-agonists to improve athletic performance.
In this work we have selected examples of anabolic androgenic compounds and
their metabolites to evaluate the GC-MS analysis of some trimethylsilyl
derivatives. The aim is to set the best GC conditions to improve the detection
within the whole range of analyte elution temperatures. The initial column
temperature was changed to 105 or 140 degrees C followed by 40 degrees C min(-1)
to 200 degrees C and then 15 degrees C min(-1) to 300 degrees C. Using 140
degrees C as the initial oven temperature it was possible to obtain narrower
initial analyte distributions for the compounds that elutes at the beginning of
the chromatogram as clenbuterol, mabuterol, epimethylenediol and
norandrosterone, without loss of derivatized metabolites signal. Later. eluting
analytes, such as the stanozolol metabolites, furazabol and oxandrolone were not
affected. Temperatures below 140 degrees C. resulted in partial derivatization
for some analytes mainly stanozolol related structures. Therefore evaluation of
derivatization conditions as occurring in three steps, the vial, vaporization
chamber and capillary column, was thoroughly assessed. The new program
temperature improves the signal-to-noise ratio for some compounds and shows
adequate resolution for endogenous compounds. Some of the difficult key
separations necessary for doping control enforcement were also obtained with the
proposed method.
PMID: 12580506 [PubMed]
120: Presse Med. 2002 Dec 21;31(40):1904-8.
[Blood doping and cardiovascular consequences]
[Article in French]
Gauthier J.
Federation Internationale de Football (FIFA) Club des Cardiologues du Sport,
Arles.
THE REASONS FOR BLOOD DOPING: The aim of doping the hematological functions is
to increase the quantity of oxygen supplied to the muscles in activity. THE
DOPING METHODS: Self blood transfusion was one of the first methods used. The
incriminated substances are blood substitutes, non-specific and specific
hematopoietic growth factors such as erythropoietin and granulocyte macrophage
colony stimulating factor, and other substances such as perfluorocarbon and
RSR13. DELETERIOUS CONSEQUENCES: The major risk is that of a hyperviscosity
syndrome, responsible for thrombosis and decreased cardiac output. IN PRACTICE:
All physicians are concerned, since they may be confronted with the
complications of doping in their daily practice. They should also know the list
of prohibited substances, in order to avoid any errors in prescription.
PMID: 12579085 [PubMed]
121: Ann Cardiol Angeiol (Paris). 2001 Sep;50(5):293-8.
[Cardiovascular effects of doping]
[Article in French]
Gauthier J.
Federation internationale de football (FIFA), 21, boulevard Georges Clemenceau,
13200 Arles, France. gauthierfifa@wanadoo.fr
Cardiovascular effects of doping drugs are numerous, with different mechanisms:
vasoconstriction of amphetamines, erythropoietin and cocaine; sodium water
retention of anabolic steroids and corticosteroids; elevation in blood viscosity
of erythropoietin, perflurocarbon emulsion, recombinant hemoglobin and anabolic
steroids; sympathetic nervous system activation of amphetamines, beta 2 agonists
and clenbuterol; lipids profile disorder of anabolic steroids. Physical activity
consequences, particularly bradycardia and dehydration, are worsening.
Thrombosis and arrythmogenic effects, with possibility of sudden death, are the
severe immediate events. Hypertension and coronary diseases are medium-term
effects; acute myocardial infarction is frequent. Heart failure can be secondary
to cardiac muscle direct fibrosis, like with anabolic steroids. These
cardiovascular effects are serious and it is necessary to early detect the
doping drugs use in sporstmen; all prescribing physician should be aware of
existing drugs and their clinical events.
Publication Types:
Review
Review, Tutorial
PMID: 12555590 [PubMed]
122: J Chromatogr B Analyt Technol Biomed Life Sci. 2003 Mar 5;785(2):205-18.
Matrix-assisted laser-desorption time-of flight ionisation and high-performance
liquid chromatography-electrospray ionisation mass spectral analyses of two
glycosylated recombinant epoetins.
Stanley SM, Poljak A.
The Australian Racing Forensic Laboratory, Randwick Racecourse, Kensington,
Sydney, Australia. shawn_stanley@turfclub.com.sg
Mass spectrometric analyses of the recombinant proteins in Eprex and Aranesp
were undertaken with the goal of producing reference mass spectra and evaluating
strategies to improve its applicability as a method for equine and canine doping
control of these substances. A simple, low chemical noise deglycosylation
reaction removed microheterogeneity due to post-translational carbohydrate
attachment and both proteins were detectable using MALDI-TOF-MS. Deglycosylated
human erythropoietin (hEPO) was also detected using HPLC-ESI-MS. This is the
first time that spectra of deglycosylated Eprex and Aranesp have been published.
Eight synthetic reference standards, which match peptides produced by
endoproteinase Glu-C enzymatic cleavage of Aranesp and/or Eprex, were analysed
by ESI-MS and ESI-MS-MS. The E12 Glu-C peptide, common to both proteins, was
detected at the low femtomole-level using gradient nano-HPLC-ESI-MS-MS in the
positive ion mode. Copyright 2002 Elsevier Science B.V.
PMID: 12554133 [PubMed]
123: Genet Med. 2002 Nov-Dec;4(6 Suppl):27S-32S.
Reflections on the ethics of genetic enhancement.
Murray TH.
The Hastings Center, Garrison, NY 10524, USA.
The technologies made available by new research in genetics and genomics have
been and will be used not only to diagnose and treat disease, but also to
attempt to enhance human traits and capacities. A broad definition of
genetic-enhancement technologies, not merely gene manipulation, but also
indirect genetic technologies, such as biosynthetic drugs, is needed to capture
the full range of possible applications. It is difficult, but often possible, to
anticipate the enhancement temptations of new therapies. Such anticipation may
help us in shaping the marketing, availability, or other aspects of those
technologies. Appropriate public and professional policies are needed, and work
on them should begin immediately. Most important, we must stimulate public
education and dialogue to encourage personal ethical reflection on the
appropriate uses and limits of genetic-enhancement technologies.
Publication Types:
Review
Review, Tutorial
PMID: 12544484 [PubMed]
124: Clin J Sport Med. 2003 Jan;13(1):33-40.
Medication use in athletes selected for doping control at the Sydney Olympics
(2000).
Corrigan B, Kazlauskas R.
NSW Institute of Sport, Concord hospital, Sydney, Australia.
abc@southernx.com.au
During the Olympic Games held in Sydney in September, 2000 Doping Control was
undertaken as specified in the International Olympic Code. During this process
information about the medications taken by athletes was collected as a routine
and formed part of the paperwork associated with a urine test. In their Post
Games Report the World Anti-Doping Agency (WADA) recommended that the
information about medications be collated with a view to assessing their use by
athletes. Mandatory doping control for winners of events as well as random
selection of athletes both during competition and out of competition allowed
data to be collected about medications and supplements used by athletes. At the
Doping Control Stations all competitors selected for a test, after providing a
urine sample for analysis, were asked the same question: "what medications have
you taken in the past three days?" The answer was to include all prescription
drugs, over-the-counter medications, any other substances taken by mouth,
injection, inhalation, ointment or by suppository, as well as vitamins,
minerals, and all other supplements. This paper reviews the data from the 2758
Declaration Forms obtained at doping control. The prevalence of use of
medications, the number used by an individual, and the pattern of use by these
elite sports people were examined. The trends seen in this survey point to a
dangerous overuse of nonsteroidal anti-inflammatory agents and an unnecessary
overuse of vitamins in this population, while pointing out the increased
prevalence of asthma and the dangers of drug interactions. OBJECTIVE: The main
objective here is to review some of the medications used by athletes in the
Olympic Games in Sydney 2000. DATA SOURCES: During these Games Doping Control
was undertaken as specified by the International Olympic Committee. As well as a
urine test, information about medications routinely taken was collected.
Mandatory doping control for winners of events as well as random selection of
athletes both during competition and out of competition required data to be
collected about medications and supplements used by athletes as part of the
sample collection protocol. At the Doping Control Stations all competitors
selected for a test, after providing a urine sample for analysis, were asked the
same question: "what medications have you taken in the past three days?" The
answer was to include all prescription drugs, over-the-counter medications, any
other substances taken by mouth, injection, inhalation, ointment or by
suppository, as well as vitamins, minerals, and all other supplements. DATA
SELECTION: In this article we review the data from the laboratory copy of the
2758 Declaration Forms obtained at doping control. The cut down version of the
Declaration Form submitted to the laboratory had all information identifying the
athlete removed. Thus all information used in this article is completely
anonymous. The prevalence of use of medications, the number used by an
individual, and the pattern of use by these elite sports people were examined at
the request of the IOC. CONCLUSIONS: In their Post-Games Report, the World
Anti-Doping Agency (WADA) acting as independent observers of the anti-doping
process recommended to the IOC that the information obtained in the Athlete
Declaration Forms concerning medications be collated with a view to assessing
their use by athletes. The trends in their use seen in this survey point to an
overuse of supplements as well as a dangerous overuse of drugs such as
nonsteroidal anti-inflammatory agents together with multiple drug use
emphasising the dangers of drug interactions and points out the increased
prevalence of asthma in this population.
PMID: 12544162 [PubMed]
125: Neurosurgery. 2003 Jan;52(1):252-5; author reply 255-7.
Comment on:
Neurosurgery. 2002 Aug;51(2):283-6; discussion 286-8.
The neurosurgeon in sport: awareness of the risks of heatstroke and dietary
supplements.
Kreider RB, Burke ER, Clark JF, Earnest C, Greenwood M, Harris R, Kalman DS,
Kleiner SM, Serrano E, Volek JS, Ziegenfuss TN, Willoughby DS.
Publication Types:
Comment
Letter
PMID: 12532918 [PubMed]
126: Rhinology. 2002 Dec;40(4):211-4.
Treating allergic rhinitis in the athlete.
Keles N.
Department of ORL, Istanbul Faculty of Medicine, Istanbul University, Capa,
Istanbul, Turkey. nkeles@e-kolay.net
Allergic rhinitis may affect athletes like any other member of society. It is a
major problem for the atopic athlete. Either perennial or seasonal, it may cause
problems with nasal function depending upon the type and quantity of allergen
exposure. Moreover, exposure to irritants, chemicals and air pollutants may
exacerbate allergic rhinitis. In this patient group, special diagnostic and
particularly therapeutic considerations are warranted for the disease. Treatment
of the athlete should be based on two important principles: no medication given
should be on any list of doping products and no medication used should affect
the athlete's performance. Antihistamines, topical cromolyn, and topical
steroids may be used to control allergic rhinitis without violating
'anti-doping' regulations.
Publication Types:
Review
Review, Tutorial
PMID: 12526250 [PubMed]
127: Med J Aust. 2002 Dec 2-16;177(11-12):683.
Medicine and sport.
Isaacs D, Fitzgerald D.
Department of Medical Humour, Children's Hospital at Westmead, NSW.
PMID: 12523332 [PubMed]
128: J Clin Endocrinol Metab. 2003 Jan;88(1):394-401.
The growth hormone/insulin-like growth factor-I axis hormones and bone markers
in elite athletes in response to a maximum exercise test.
Ehrnborg C, Lange KH, Dall R, Christiansen JS, Lundberg PA, Baxter RC,
Boroujerdi MA, Bengtsson BA, Healey ML, Pentecost C, Longobardi S, Napoli R,
Rosen T; GH-2000 Study Group.
Endocrine Division, Department of Internal Medicine (C.E., B.-A.B., T.R.),
Sahlgrenska University Hospital, S-413 45 Goteborg, Sweden.
The aim of the GH-2000 project is to develop a method for detecting GH doping
among athletes. Previous papers in the GH-2000 project have proposed that a
forthcoming method to detect GH doping will need specific components from the
GH/IGF-I axis and bone markers because these specific variables seem more
sensitive to exogenous GH than to exercise. The present study examined the
responses of the serum concentrations of these specific variables to a maximum
exercise test in elite athletes from selected sports. A total of 117 elite
athletes (84 males and 33 females; mean age, 25 yr; range, 18-53 yr) from
Denmark, the United Kingdom, Italy, and Sweden participated in the study. The
serum concentrations of total GH, GH22 kDa, IGF-I, IGF binding protein
(IGFBP)-2, IGFBP-3, acid-labile subunit, procollagen type III (P-III-P), and the
bone markers osteocalcin, carboxy-terminal cross-linked telopeptide of type I
collagen (ICTP), and carboxy-terminal propeptide of type I procollagen were
measured. The maximum exercise test showed, in both genders, a peak
concentration of total GH (P < 0.001) and GH22 kDa (P < 0.001) by the time
exercise ended compared with baseline, and a subsequent decrease to baseline
levels within 30-60 min after exercise. The mean time to peak value for total GH
and GH22 kDa was significantly shorter in males than females (P < 0.001). The
components of the IGF-I axis showed a similar pattern, with a peak value after
exercise compared with baseline for IGF-I (P < 0.001, males and females);
IGFBP-3 (P < 0.001, males and females); acid-labile subunit [P < 0.001, males;
not significant (NS), females], and IGFBP-2 (P < 0.05, females; NS, males). The
serum concentrations of the bone markers ICTP (P < 0.001, males; P < 0.05,
females) and P-III-P (P < 0.001, males and females) increased in both genders,
with a peak value in the direct post-exercise phase and a subsequent decrease to
baseline levels or below within 120 min. The osteocalcin and propeptide of type
I procollagen values did not change during the exercise test. Specific reference
ranges for each variable in the GH/IGF-I axis and bone markers at specific time
points are presented. Most of the variables correlated negatively with age. In
summary, the maximum exercise test showed a rather uniform pattern, with peak
concentrations of the GH/IGF-I axis hormones and the bone markers ICTP and
P-III-P immediately after exercise, followed by a subsequent decrease to
baseline levels. The time to peak value for total GH and GH22 kDa was
significantly shorter for females compared with males. This paper presents
reference ranges for each marker in each gender at specific time points in
connection to a maximum exercise test to be used in the development of a test
for detection of GH abuse in sports.
PMID: 12519882 [PubMed]
129: J Adolesc Health. 2003 Jan;32(1):16-25.
Erratum in:
J Adolesc Health. 2003 Apr;32(4):325..
Drug testing athletes to prevent substance abuse: background and pilot study
results of the SATURN (Student Athlete Testing Using Random Notification) study.
Goldberg L, Elliot DL, MacKinnon DP, Moe E, Kuehl KS, Nohre L, Lockwood CM.
Department of Medicine, Oregon Health and Science University, Portland, Oregon
97201-3098, USA. goldberl@ohsu.edu
PURPOSE: To assess the deterrent effect of mandatory, random drug testing among
high school (HS) athletes in a controlled setting. METHODS: Two high schools,
one with mandatory drug testing (DT) consent before sports participation, and a
control school (C), without DT, were assessed during the 1999-2000 school year.
Athletes (A) and nonathletes (NA) in each school completed confidential (A) or
anonymous (NA) questionnaires developed for this study, respectively, at the
beginning and end of the school year. Positive alcohol or drug tests required
parent notification and mandatory counseling without team or school suspension.
Thirty percent of the DT athletes were tested. Data were analyzed using the end
of the school year measure, adjusted for the initial questionnaire results.
Demographics of the athlete sample revealed that mean age was 15.5 years with
81.5% white, 9.6% Hispanic, 4.5% Asian, 2.6% American Indian/Native Alaskan,
1.3% African-American, and 1.3% Native Hawaiian/Pacific Islander. RESULTS: A (n
= 276) and NA (n = 507) were assessed at the beginning (baseline) and at the end
of the school year (A, n = 159; NA, n = 338). The past 30-day index of illicit
drugs (4-fold difference) and athletic enhancing substances (3-fold difference)
were lower (p < .05) among DT athletes at follow-up without difference in
alcohol use. However, most drug use risk factors, including norms of use, belief
in lower risk of drugs, and poorer attitudes toward the school, increased among
DT athletes (p < .05). Although a reduction in the illicit drug use index was
present among nonathletes at the DT school, at the end of the school year, it
did not achieve statistical significance (p < .10). CONCLUSIONS: Random DT may
have reduced substance use among athletes. However, worsening of risk factors
and small sample size suggests caution to this drug prevention approach. A
larger long-term study to confirm these findings is necessary. Copyright Society
for Adolescent Medicine, 2003
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 12507797 [PubMed]
130: J Anal Toxicol. 2002 Nov-Dec;26(8):582-3.
A single therapeutic treatment with betamethasone is detectable in hair.
Raul JS, Cirimele V, Ludes B, Kintz P.
Institut de Medecine Legale, 11, rue Humann, F-67000 Strasbourg, France.
Jean-Sebastien.Raul@iml-ulp.u-strasbg.fr
PMID: 12501917 [PubMed]
131: Haematologica. 2002 Dec;87(12):1248-57.
Development of reference ranges in elite athletes for markers of altered
erythropoiesis.
Sharpe K, Hopkins W, Emslie KR, Howe C, Trout GJ, Kazlauskas R, Ashenden MJ,
Gore CJ, Parisotto R, Hahn AG.
Department of Mathematics and Statistics, University of Melbourne, Australia.
k.sharpe@ms.unimelb.edu.au
BACKGROUND AND OBJECTIVES: Our previous research developed two statistical
models that are useful indicators of current (ON-model) or recently discontinued
(OFF-model) recombinant human erythropoietin (rHuEPO) use by athletes. The
component variables of the ON-model are hematocrit (Hct), reticulocyte
hematocrit (RetHct), serum erythropoietin (EPO), percent macrocytes (%Macro),
and soluble transferrin receptor (sTfr), whilst the OFF-model uses only the
first three variables. Genetics and training modalities of elite athletes may
conceivably produce unusual values for blood parameters related to
erythropoiesis. The aims of this study were to develop reference ranges in elite
athletes for key hematologic parameters as well as ON- and OFF-models scores,
and to evaluate the effect of ethnicity, gender, residence at moderate altitude
(approximately 2000 m) and within-individual variation on the variables and
model scores. DESIGN AND METHODS: Over a period of three weeks, 413 female and
739 male elite athletes from 12 countries visited laboratories to provide three
blood samples for analysis of blood parameters sensitive to erythropoiesis. For
each parameter and for the ON- and OFF-model scores, we used mixed modeling to
establish the range within which we could be 95% certain that the value for a
randomly chosen athlete would fall, taking into account various random effects
(variation within and between subjects and laboratories) and fixed effects
(means for different levels of ethnicity, age, sport, altitude of residency). We
performed similar analyses for changes in the ON- and OFF-model scores between
the three visits. RESULTS: Most fixed effects were accompanied by clear-cut,
small to moderate differences in several parameters. However, residency at
moderate altitude was accompanied by a much higher hematocrit than residency
nearer sea level, with the mean (and 95% confidence limits) for the difference
being 2.3 (0.9 to 3.7) and 1.8 (0.1 to 3.5) units for males and females,
respectively. Males at altitude also demonstrated a moderately higher ON-model
score. Otherwise the influence of these effects was small for ON-, OFF- and
changes in model scores. INTERPRETATION AND CONCLUSIONS: Assessment of an
athlete's blood parameters and ON- and OFF-model scores may need adjustment for
training modalities and other characteristics of the subject. Changes in model
scores (together with monitoring of urine samples for the presence of rHuEPO)
provide a promising approach to detection of rHuEPO abuse, because they are less
sensitive to subject characteristics and less variable than raw model scores.
PMID: 12495898 [PubMed]
132: Nasnewsletter. 2002 Nov;17(6):14.
Supreme court rules on student drug testing.
Meier E.
PMID: 12484099 [PubMed]
133: Rapid Commun Mass Spectrom. 2002;16(24):2209-14.
Identification of the aromatase inhibitor aminoglutethimide in urine by gas
chromatography/mass spectrometry.
Mareck U, Sigmund G, Opfermann G, Geyer H, Schanzer W.
Institute of Biochemistry, German Sport University Cologne, Carl-Diem-Weg 6,
50933 Cologne, Germany. u.mareck@biochem.dshs-koeln.de
Aminoglutethimide is used therapeutically as an aromatase inhibitor in the
treatment of metastatic breast cancer in post-menopausal women. For doping
purposes, aminoglutethimide may be used for treatment of adverse effects of an
extensive abuse of anabolic androgenic steroids (gynaecomastia) and to increase
the testosterone concentration and stimulation of testosterone biosynthesis. The
use of aromatase inhibitors has been prohibited for male athletes since
September 1, 2001. The purpose of this study was to develop methods for the
identification of the parent compound or its main metabolite and the inclusion
of this information into established screening procedures in doping analysis. An
excretion study was conducted using oral application of one single therapeutic
dose (500 mg) of Orimeten. The analysis was performed by gas chromatography/mass
spectrometry (GC/MS). Aminoglutethimide is excreted almost totally as
unconjugated parent compound and is detectable by different screening procedures
for up to 165 h. Most suitable for the detection of aminoglutethimide is the
screening procedure for heavy volatile nitrogen-containing drugs ('Screening
2'). However, since only competition samples are analysed in that screening
procedure, the additional inclusion of aminoglutethimide in the screening
procedure for anabolic androgenic agents ('Screening 4') is recommended. Full
mass spectra and diagnostic ions for the analysis of aminoglutethimide are
presented. Copyright 2002 John Wiley & Sons, Ltd.
PMID: 12478562 [PubMed]
134: Biomed Chromatogr. 2002 Dec;16(8):529-35.
Screening for 18 diuretics and probenecid in doping analysis by liquid
chromatography-tandem mass spectrometry.
Deventer K, Delbeke FT, Roels K, Van Eenoo P.
Ghent University, Doping Control Unit, Faculty of Veterinary Medicine,
Salisburylaan 133, B-9820 Merelbeke, Belgium.
A fast and selective liquid chromatography-tandem mass spectrometric (LC/MS/MS)
method for the screening of 18 diuretics and probenecid in human urine is
presented. Analyses were performed on a LCQ-Deca instrument equipped with
ESI-interface using scan by scan polarity changing. All diuretics and probenecid
were separated in less than 20 min after liquid-liquid extraction with ethyl
acetate. The LOD for all substances was 100 ng/mL or better. The method was
applied to detect diuretics after the oral administration of several drugs
including hydrochlorothiazide, bumetanide, spironolactone, furosemide,
amiloride, triamterene, chlortalidone and epithizide. All diuretics could be
detected for periods up to 96 h after the intake of therapeutic amounts.
Copyright 2002 John Wiley & Sons, Ltd.
PMID: 12474217 [PubMed]
135: Biomed Chromatogr. 2002 Dec;16(8):508-12.
Testing for nandrolone metabolites in urine samples of professional athletes and
sedentary subjects by GC/MS/MS analysis.
Gambelunghe C, Sommavilla M, Rossi R.
Department of Clinical and Experimental Medicine, Division of Sports Medicine,
University of Perugia, Italy. medsport@unipg.it
The concentrations of nandrolone metabolites, 19-norandrosterone (19-NA) and
19-noretiocholanolone (19-NE) were analysed in urine samples of professional
athletes doing intense physical activity and sedentary subjects to verify if
there was endogenous production of nandrolone and if there was any link between
physical effort and the urinary metabolites of the steroid. We collected 18
urine samples from professional footballers age range 20-30 years, all from the
same team, and 18 urine samples from males not doing any physical activity, age
range 20-30 years. Neither group used nandrolone. Qualitative and quantitative
analyses of urinary nandrolone metabolites were carried out by GC/MS followed by
GC/MS/MS to confirm positive samples. This technique has been demonstrated to be
an excellent analytical approach for the determination of anabolic steroids at
very low detection limits in complex matrices such as urine. In five urine
samples from professional footballers traces of 19-NA were detected. No trace of
19-NA was found in the group of sedentary subjects and no trace of 19-NE was
found in any urine sample. The absence of nandrolone metabolites in sedentary
subjects supports the hypothesis that the presence of 19-NA and 19-NE could be
linked to physical effort even though the origin is not yet clear. Copyright
2002 John Wiley & Sons, Ltd.
PMID: 12474213 [PubMed]
136: Sante. 2002 Jul-Sep;12(3):297-300.
[Doping practices and behaviours among Ivorian soccer players]
[Article in French]
Dah C, Bogui P, Yavo JC, Gourouza I, Ouattara S, Keita M.
Laboratoire de physiologie et service des explorations fonctionnelles, UFR des
sciences medicales, BP V 166, Abidjan, Cote d'Ivoire.
We have conducted a survey of doping among soccer players in Cote d'Ivoire with
a representative sample of 150 soccer players who filled out an anonymous
questionnaire. The aim of this survey was to get a clearer picture of doping in
Ivorian soccer in order to suggest preventive actions against doping. The
results of this study showed that doping was known by the Ivorian soccer
players; about 18.7% admitted to the use of doping substances, 42% recognised
that they felt tempted by doping, while 38% knew another soccer player who had
already used a doping substance. Government and sports organisations should
recognize the importance of education and information in the antidoping campaign
and agree on effective preventive as well as repressive strategies.
PMID: 12473523 [PubMed]
137: Med Health R I. 2002 Nov;85(11):338-40.
Medical complications of anabolic steroids.
Feller AA, Mylonakis E, Rich JD.
Miriam Hospital, USA. Alexander_Feller@brown.edu
PMID: 12462865 [PubMed]
138: Scand J Med Sci Sports. 2002 Dec;12(6):354-7.
Erythropoietin concentrations and isoforms in urine of anonymous Olympic
athletes during the Nagano Olympic Games.
Berglund B, Wide L.
Division of Medicine, Karolinska Hospital, Stockholm, Sweden.
The ordinary doping control urine samples of 36 anonymous participants
(cross-country skiers, biathlon athletes, and curling athletes) of the 1998
Nagano Olympic Games were analyzed for erythropoietin and erythropoietin
isoforms. The urine erythropoietin concentration (IU/l) was determined with a
competitive radioimmunoassay method and the isoforms were studied by
electrophoresis and given as milli albumin mobility units (mAMU). Erythropoietin
was detectable in 23 out of 36 specimens (64%). The biathlon and curling
athletes had similar urine concentration of erythropoietin. The group of 16
cross-country skiers had significantly (P < 0.05) increased urine concentration
of erythropoietin as compared to curling athletes and four of them had urine
erythropoietin concentrations between 3.6 and 5.1 IU/l. The electrophoretic
mobility of erythropoietin was determined in all eight samples with urine
concentration of erythropoietin of more than 2 (range 2.1-5.1) IU/l. No single
urine specimen with a median erythropoietin electrophoretic mobility below the
cut-off level of 670 mAMU (indicative of doping with recombinant erythropoietin)
was registered. Erythropoietin in urine was detected in 71% and the isoforms of
Epo characterized in 29% of the anonymous Olympic endurance athletes. The urine
concentration of erythropoietin in the biathlon and curling athletes were
similar to those of non-athletes. The group of cross-country skiers had higher
levels of erythropoietin in urine. These higher levels of urine erythropoietin
in cross-country skiers are partly due to more concentrated urine specimens.
PMID: 12453162 [PubMed]
139: Vet Ther. 2002 Fall;3(3):297-307.
Erratum in:
Vet Ther. 2002 Winter;3(4):363..
Apparent ELISA detection times for albuterol after administration with the torpex
equine inhaler device.
Dirikolu L, Mollett BA, Troppmann A, Woods WE, Bratton C, Cashman CP, Schroedter
D, Mayer B, Lehner AF, Karpiesiuk W, Hughes C, Boyles J, Harkins JD, Tobin T.
University of Kentucky, Department of Veterinary Science, Lexington, KY 40546,
USA.
Single doses of one, three, and six actuations (120 micro g albuterol/actuation)
and multiple daily doses (six actuations per dose four times daily) for 5 days
of aerosol albuterol sulfate were sequentially administered to each of six
horses using an equine inhaler device (Torpex, 3M Animal Care Products, St.
Paul, MN [corrected] and Boehringer Ingleheim Vetmedica, Inc., St. Joseph, MO
[corrected]). A 2-week washout period was allowed between each dose. ELISA
testing revealed no evidence of albuterol in urine at 24 hours after any
single-dose administration. Results indicated that 48 hours or longer should be
allowed for albuterol to be cleared from urine after single doses. When given at
the maximum recommended rate of six actuations per dose four times a day for 5
days, urine samples tested by ELISA showed no evidence of albuterol at 48 hours
after the final dose. Testing of nasal swabs by ELISA demonstrated the presence
of albuterol for 8 hours after each single dose, and some horses might have
detectable levels of albuterol in nasal swabs for several days following
administration of multiple doses. As a guideline for withdrawal time, 72 hours
or longer should be allowed after administration of aerosol albuterol sulfate to
horses before participation in equestrian competitions that are regulated for
detection of certain performance-enhancing substances. However, these
recommendations were based on a small sample of horses and the specific ELISA
test used and interpreted as described. Factors specific to individual horses
may influence these detection times.
Publication Types:
Clinical Trial
PMID: 12447838 [PubMed]
140: Proc West Pharmacol Soc. 2002;45:191-2.
Monoclonal antibody urine assay for amphetamines, cocaine and cannabinoids: a
pilot study of Mexican athletes.
Padilla J, Eguialis MC, Mendoza F, Santos VA, Ojeda P.
Lab. Fisiologia del Ejercicio, 3er Piso, Edif. de Gob. Escuela Superior de
Medicina IPN, Mexico 11340, D.F. jppgenius@hotmail.com
PMID: 12434578 [PubMed]
141: Dent Traumatol. 2002 Oct;18(5):231-6.
Sports dentistry and dental traumatology.
Ranalli DN.
School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA.
dnr4@pitt.edu
Sports dentistry had its origins in the 1980s. More recently, the Academy for
Sports Dentistry joined forces with the International Association of Dental
Traumatology in cosponsoring the World Congress on Sports Dentistry and Dental
Traumatology. It is the intent of the present paper to introduce readers to the
arena of sports dentistry, suggest future areas for collaborative research, and
stimulate authors to submit high quality, scientifically based manuscripts on
sports dentistry to Dental Traumatology.
Publication Types:
Review
Review, Tutorial
PMID: 12427197 [PubMed]
142: Minerva Pediatr. 2002 Dec;54(6):587-97.
[Management of the asthmatic adolescent]
[Article in Italian]
Marchi A, Ricci A.
Dipartimento di Scienze Pediatriche, Universita degli Studi di Pavia,
Policlinico San Matteo IRCCS, Pavia, Italy.
Bronchial asthma is a chronic condition that is on the increase in adolescents
as it is among other age groups; often under-diagnosed it prevalently affects
males and is 10% sustained by an allergic diathesis. Adolescence, with its
peculiarities and characteristic psychological and physical changes affects the
clinical expression of asthma and above all requires particular diagnostic and
therapeutic attention from the treating paediatrician. The physician should act
as a direct, credible interlocutor of the adolescent. Regular sporting activity
appropriate to the subject's age and asthmatic condition, and under close
medical supervision, must be recommended in the asthmatic adolescent. Bronchial
asthma in adolescence often presents as asthma due to physical effort. The onset
of asthma must not represent an impediment to regular physical activity;
adequate management strategies are however necessary (so as to prevent the
symptom occurring after effort). These strategies range from the choice of type
of training (environment and work loads) to pharmacological prevention measures.
The asthmatic adolescent may also perform physical activity at competitive level
although in this case special attention must be paid to the choice of drugs so
as to avoid running into problems of disqualification due to doping.
PMID: 12388949 [PubMed]
143: J Chromatogr B Analyt Technol Biomed Life Sci. 2002 Nov 15;780(1):145-53.
Erratum in:
J Chromatogr B Analyt Technol Biomed Life Sci. 2003 Apr 25;787(2):427.
Evaluation of human hepatocyte incubation as a new tool for metabolism study of
androstenedione and norandrostenedione in a doping control perspective.
Levesque JF, Gaudreault M, Houle R, Chauret N.
Merck Frosst Centre for Therapeutic Research, P O Box 1005,
Pointe-Claire-Dorval, H9R 4P8, Quebec, Canada. jeanfrancois_levesque@merck.com
Human hepatocyte incubations were used to study the metabolism of precursors of
testosterone and nortestosterone and to evaluate qualitatively the correlation
between in vitro and published in vivo urinary metabolic profiles. Both phase I
and phase II biotransformations were observed in vitro: oxidoreduction at C-3
and C-17, reduction at C-4,5, hydroxylation at C-6 beta and C-16,
glucuronidation and sulfation. All major metabolites detected in urine following
oral administration of androstenedione and norandrostenedione were present in
human hepatocyte incubations. The good correlation between in vitro and in vivo
metabolic profiles indicates that hepatocyte incubations can be a useful tool to
identify and characterize metabolites that could be potential urinary markers
for detection of steroid abuse by athletes.
Publication Types:
Evaluation Studies
PMID: 12383490 [PubMed]
144: Ann Pharm Fr. 2002 Sep;60(5):310-3.
[Methodologies used to screen for doping agents]
[Article in French]
Audran M.
Laboratoire de Biophysique et Bioanalyse, Faculte de Pharmacie, 15 avenue
Charles Flahaut, 34093 Montpellier, France.
The detection of doping agents is a major challenge due both to the large number
of compounds involved, their structural diversity, and to the sensitivity
thresholds required in a small volume of urine. In addition, laboratories are
requested to delivery their reports within a short delay. Mass spectrometry "ion
trap" and "high-resolution" methods can be used to screen for xenobiotics at the
required sensitivity levels. The search for endogenous substances used as doping
agents is more complex: here the difference between physiological production and
exogenous input must be recognized. Isotopic mass spectrometry appears to
provide a means of resolving this problem for compounds with a low molecular
mass such as steroids. Search for peptide hormones is limited to erythropoietin,
with the exception of quantification procedures for human gonadotropin chorionic
hormone. Direct urine screening is however a long costly operation which does
not always produce interpretable results. Indirect detection using hematological
and biochemical parameters can only provide presumptive proof.
Publication Types:
Review
Review, Tutorial
PMID: 12378139 [PubMed]
145: Ann Pharm Fr. 2002 Sep;60(5):303-9.
[Doping in high-level athletes]
[Article in French]
Chalchat B.
Chalchat, 7, rue Marie-Bonaparte, F92210 Saint-Cloud, France.
Recent doping affairs clearly demonstrate that all sports are concerned, leading
to a generalized suspicion concerning champions and their performance. Many
athletes struggling to reach their own personal goals have the unacceptable
impression that they cannot compete fairly with competitors who are presumably
(or effectively) doped. This situation may easily lead to deviant behavior. The
sincerity of many high-level athletes when they discuss doping is very
questionable in light of the notoriety and financial aspect linked with success.
Public image is all important.Unfortunately, at this level is appears to be
utopic to assume preventive measures would be effective. Several factors are
involved Taking into consideration these different elements, one could be rather
pessimistic concerning the eradication of doping in high-level athletes. There
could even be a risk of seeing a trend towards public acceptance of more or less
"tolerated" doping among professional athletes, similar to what is observed in
the United States. It might be preferable to concentrate efforts on education
and prevention in the young population.
Publication Types:
Review
Review, Tutorial
PMID: 12378138 [PubMed]
146: Ann Pharm Fr. 2002 Sep;60(5):296-302.
[High-performance society and doping]
[Article in French]
Gallien CL.
Gallien, 4, domaine de Seignelay, F 92290 Chatenay-Malabry, France.
Doping is not limited to high-level athletes. Likewise it is not limited to the
field of sports activities. The doping phenomenon observed in sports actually
reveals an underlying question concerning the notion of sports itself, and more
widely, the society's conception of sports. In a high-performance society, which
is also a high-risk society, doping behavior is observed in a large number of
persons who may or may not participate in sports activities. The motivation is
the search for individual success or profit. The fight against doping must
therefore focus on individual responsibility and prevention in order to preserve
athlete's health and maintain the ethical and educational value of sports
activities.
Publication Types:
Review
Review, Tutorial
PMID: 12378137 [PubMed]
147: Ann Pharm Fr. 2002 Sep;60(5):291-5.
[New provisions for prevention and fight against doping]
[Article in French]
Boulu RG.
Academie nationale de Pharmacie, 4, avenue de l'Observatoire, 75270 Paris Cedex
06.
Doping which is largely a sport-related phenomenon, led the French government of
enact a series of laws in 1965, 1984, and 1989. Due to the apparent extension of
doping, a new law was enacted on March 23, 1999. This law concerns medical
surveillance of athletes and prevention and fight against doping. A council for
the prevention and fight against doping was created. This nine-member council
includes a representative of the French International Academy of Pharmacy and
its president is a state counsellor. The council has three main areas of
activity: disciplinary judgements concerning doped athletes, establishment of
prevention policies, coordination of scientific research in the field of sport
medicine and doping. The law also provides for penal sanctions for resellers.
Antidoping activities are also managed on an international level. Contributors
include the Council of Europe, the European Community, the International Olympic
Committee, and the recently created (1999) World Antidoping Agency.
Publication Types:
Review
Review, Tutorial
PMID: 12378136 [PubMed]
148: J Mass Spectrom. 2002 Oct;37(10):1059-73.
Fast screening of anabolic steroids and other banned doping substances in human
urine by gas chromatography/tandem mass spectrometry.
Marcos J, Pascual JA, de la Torre X, Segura J.
Pharmacology Research Unit, Institut Municipal d'Investigacio Medica, IMIM,
Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Dr.
Aiguader 80, 08003 Barcelona, Spain.
A fast and sensitive method for the comprehensive screening of anabolic agents
and other banned doping substances using gas chromatography/tandem mass
spectrometry (GC/MS/MS) with an external ionization ion trap mass spectrometer
is presented. The method takes advantage of the resolving power of MS/MS to
eliminate background interferences, thus speeding up the chromatographic
analysis. For each compound, different fragmentation reactions were studied and
their collision energies optimized to obtain the best sensitivity in terms of
their signal-to-noise ratio (S/N). A dramatic reduction in overall analysis time
was achieved compared with other common approaches. More than 50 substances
could finally be monitored in less than 7.4 min with detection limits (S/N >3)
lower than 0.5 ng ml(-1) for most of the compounds with special sensitivity
requirements according to the International Olympic Committee (IOC). A
validation procedure for qualitative analysis was performed. The selectivity of
the method showed that no interfering peaks were observed at the retention time
of the analytes. Good intermediate precision, below 25% for most of the
compounds, and robustness were observed. The optimized method was successfully
applied to analyse more than 100 real human urine samples with optimum
sensitivity and specificity rates. Copyright 2002 John Wiley & Sons, Ltd.
PMID: 12375280 [PubMed]
149: Med Sci Sports Exerc. 2002 Oct;34(10):1685-90.
Symposium: conference on the science and policy of performance-enhancing
products.
Fomous CM, Costello RB, Coates PM.
Council for Responsible Nutrition, Washington, DC, USA. Office of Dietary
Supplements, National Institutes of Health, Bethesda, MD, USA.
Publication Types:
Congresses
PMID: 12370572 [PubMed]
150: Vet J. 2002 Sep;164(2):83-4.
Comment on:
Vet J. 2002 Sep;164(2):129-41.
Prohibited practices in equine sport - how to root out malpractice.
Webbon P.
Publication Types:
Comment
Editorial
PMID: 12359459 [PubMed]
151: J Forensic Sci. 2002 Sep;47(5):1022-4.
Successful DNA typing of a urine sample in a doping control case using human
mitochondrial DNA analysis.
Junge A, Steevens M, Madea B.
Institute of Legal Medicine Rheinische Friedrich-Wilhelms-University Bonn,
Germany. a.junge@uni-bonn.de
In a doping control case, a urine sample was tested positive for nandrolon. We
were asked by the athlete to perform DNA investigations on the questioned urine
sample and compare these to a fresh blood sample taken from the athlete in order
to detect or rule out manipulation and/or switching of the samples. The urine
sample had been collected nine months prior to the investigation and had been
stored at 4 degrees C. In a first approach, nuclear DNA systems were
investigated that failed with the exception of the Amelogenin system. Due to the
high copy number of mitochondrial DNA molecules and the robustness of the
mitochondrial genome, we investigated the HVR I and HVR II regions of
mitochondrial DNA and obtained reproducible and clear sequencing results for
both the blood and the urine samples. Due to the identical sequences, it could
not be excluded that the blood sample and the urine sample were from the same
individual or an individual having the same maternal lineage.
PMID: 12356033 [PubMed]
152: Br J Sports Med. 2002 Oct;36(5):325-9.
Urine nandrolone metabolites: false positive doping test?
Kohler RM, Lambert MI.
MRC/UCT Research Unit for Exercise Science and Sports Medicine, Department of
Human Biology, University of Cape Town, Sports Science Institute of South
Africa, Newlands, South Africa.
The aim of this review is to analyse the studies on nandrolone metabolism to
determine if it is possible for an athlete to test positive for nandrolone
without having ingested or injected nandrolone.
Publication Types:
Review
Review, Tutorial
PMID: 12351328 [PubMed]
153: Clin Chem. 2002 Oct;48(10):1799-801.
Candida albicans in urine can produce testosterone: impact on the
testosterone/epitestosterone sports drug test.
Kicman AT, Fallon JK, Cowan DA, Walker C, Easmon S, Mackintosh D.
Drug Control Centre, King's College London, Franklin-Wilkins Bldg., 150 Stamford
St., London SE1 9NN, United Kingdom. andrew.kicman@kcl.ac.uk
PMID: 12324504 [PubMed]
154: Pediatr Clin North Am. 2002 Aug;49(4):829-55.
Sports doping in the adolescent athlete the hope, hype, and hyperbole.
Greydanus DE, Patel DR.
Pediatrics Program, Michigan State University, Kalamazoo Center for Medical
Studies, 49008-1284, USA. greydanus@kcms.msu.edu
A well-balanced diet with appropriate training is the key to maximizing athletic
performance. Nutritional counseling should be an essential part of anticipatory
guidance, especially for certain teens, such as those who are vegetarians or
those with low-calorie intakes. Other considerations for anticipatory guidance
are listed in Box 8. Adequate hydration before, during, and after practice or a
game is important to maintain hemodynamic balance, prevent heat disorders, and
optimize performance. Cool water is adequate for short-duration activities,
while carbohydrate-electrolyte fluids are more desirable for long-term
activities, especially those lasting more than an hour. Such drinks are also
more palatable and the athlete is more likely to consume them. Carbohydrates
(meaning hydrates of carbon) are an important part of the athlete's diet;
carbohydrates are rapidly broken down and their energy is quickly supplied to
the body. The body stores only a small amount of carbohydrates in the form of
glycogen in the liver, while muscle glycogen is an immediate source of energy.
Thus, carbohydrate loading has been used to increase glycogen stores and aid the
athlete involved in endurance events.
Publication Types:
Review
Review Literature
PMID: 12296535 [PubMed]
155: Phys Sportsmed. 1988 Feb;16(2):175, 179.
IOC rescinds ban on birth control drug.
Duda M.
PIP: The controversy over the International Olympic Committee (IOC) ban on
norethindrone, a progestin found in most oral contraceptives (OCs), and the
subsequent rescinding of this ban illustrate problems inherent in the drug
testing process. The ban was overturned in September 1987, after being in
effect for 5 months, largely as a result of pressure from major sports
organizations. The initial ban was imposed because some drug testing
laboratories have trouble differentiating the metabolites of norethindrone and
nandrolone, a common anabolic-androgenic steroid. Although the ostensible
reason for the ban was to prevent confusion over false-positive results, the IOC
also feared that some athletes who use nandrolone would begin using
norethindrone to conceal their steroid use. Enforcement of the ban would have
required about 80% of female athletes who rely on OCs to change brands.
Although 9 of the 31 OC brands available do not contain norethindrone,
norethindrone is associated with reduced side effects. Some athletes would have
turned to less effective methods of birth control, making the ban an attack on
the reproductive well-being of this group of women. Another concern was that
the ban would have dictated prescription guidelines to physicians, even though
norethindrone has a legitimate medical purpose and is not a
performance-enhancing drug. Overall, sports officials argued that the ban
greatly damaged the credibility of drug testing programs. It has subsequently
been shown that norethindrone and nandrolone are easily distinguishable with
careful analysis of drug testing results.
PMID: 12282224 [PubMed]
156: J Anal Toxicol. 2002 Sep;26(6):355-9.
1H NMR urine analysis as an effective tool to detect creatine supplementation.
Cartigny B, Azaroual N, Mille-Hamard L, Imbenotte M, Kintz P, Vermeersch G,
Lhermitte M.
Laboratoire de Biochimie et Biologie Moleculaire, Hjpital Calmette, Lille,
France.
Creatine is one of the main compounds in muscular energetic metabolism leading
to phosphocreatine to maintain high ATP levels. Creatine is found in blood and
excreted in small amounts in urine. Creatine supplementation and athletic
performances are supposed to be correlated, particularly in intensive and
intermittent efforts. After oral creatine supplementation, a 1H nuclear magnetic
resonance (NMR) spectroscopy method was developed for its direct analysis,
without any pretreament of urine samples. This method can be used to detect any
supplementation of creatine, a substance prohibited in France. The detection
limit is 10 micromol/L (1.31 mg/L) and analysis is performed in 10 min. After a
single oral supplementation of 2.1 g to three subjects, a kinetic investigation
reveals a maximum concentration of 20 mmol/L (2.62 g/L), observed between 1 and
6 h after ingestion. This procedure was used to test 13 urine specimens obtained
from bodybuilders. From the concentrations measured (range: 0.41 to 10.30
mmol/L, 54 to 1350 mg/L), the doping practices of at least nine athletes could
be observed. Creatine is not often analyzed in hospital laboratories. This paper
documents how easily creatine can be determined and quantitated by 1H NMR
spectroscopy.
PMID: 12220017 [PubMed]
157: Alcohol Alcohol. 2002 Sep-Oct;37(5):468-71.
Alcohol and/or other drug use among adult non-occupant motor vehicle crash
victims.
Weber JE, Maio RF, Blow FC, Hill EM, Barry KL, Waller PF.
Department of Emergency Medicine, University of Michigan Medical School, USA.
AIMS: To identify the frequency of current or lifetime history of alcohol and/or
other drug (AOD) use among the full range (admitted and discharged) of injured
bicyclists and pedestrians involved in motor vehicle crashes. METHODS: In a
prospective study of non-occupant motor vehicle crash (NOMVC) victims >or=18
years over a 29-month period, blood was obtained for alcohol and drug testing.
Current alcohol abuse/alcohol dependence (AA/AD) or drug abuse/drug dependence
(DA/DD) was based on the Diagnostic Interview Survey. RESULTS: In all, there
were 108 NOMVC victims. Eleven per cent were alcohol (+), 7% drug (+), and 3%
both. Sixteen per cent were AA/AD (+), 2.7% DA/DD (+), and 1.4% both.
CONCLUSIONS: A substantial portion of patients with NOMVC injuries tested AOD
(+) and had a current or lifetime substance abuse (AA/AD; DA/DD) diagnosis.
PMID: 12217940 [PubMed]
158: Pediatr Rev. 2002 Sep;23(9):310-7.
Performance-enhancing: substances and their use among adolescent athletes.
Koch JJ.
Southdale Pediatrics, Edina, MN, USA.
PMID: 12205298 [PubMed]
159: Soc Sci Med. 2002 Sep;55(5):695-708.
Vocabularies of motive for illicit steroid use among bodybuilders.
Monaghan LF.
Cardiff School of Social Sciences, Cardiff University, UK. monaghanlf1@cf.ac.uk
Illicit steroid use, for purposes of performance and physique enhancement, is
widely deemed unnecessary, wrong and dangerous. Such activity would appear
especially foolhardy when engaged in by non-professional athletes who otherwise
adhere to 'healthy' exercise regimens. Here a gap exists between many illicit
steroid users' actions and societal expectations. Using qualitative data
generated in South Wales, this paper explores bodybuilders' vocabularies of
motive for illicit steroid use. These accounts which justified, rather than
excused, steroid use were predominant during question situations between the
participant observer and the researched. In supporting the fundamental tenets of
their drug subculture, and as part of the underlying negotiation of
self-identity, respondents espoused three main justifications for their own
and/or other bodybuilders' illicit steroid use; namely: self-fulfilment
accounts, condemnation of condemners and a denial of injury. Here steroid use
was rationalised as a legitimate means to an end, observers passing negative
judgements were rejected and it was claimed steroids do not (seriously) harm the
user's health or threaten society more generally. These vocabularies of motive,
acquired and honoured within bodybuilding settings, comprise a complex of
subjective meanings which seem to the actor to be an adequate ground for the
conduct in question. Similar to other sociological studies, this paper states
that it is imperative to explore the social meanings which illicit drug users
attach to their 'risk' practices. Without these understandings, researchers and
health promoters may struggle to appreciate fully why illicit drug users behave
as they do.
Publication Types:
Evaluation Studies
PMID: 12190264 [PubMed]
160: Med Sci Sports Exerc. 2002 Aug;34(8):1270-8.
IGF-I, IGFBP-2, and -3: do they have a role in detecting rhGH abuse in trained
men?
Di Luigi L, Guidetti L.
Endocrinology Unit, Laboratory of Endocrine Research, University Institute of
Motor Sciences (IUSM), Piazza Lauro de Bosis 15, 00194 Rome, Italy.
iusm.endocrinol@iusm.it
PURPOSE: Although the illegal use of recombinant human growth hormone (rhGH) to
enhance performance is increasing among athletes, no official test for its
detection has yet been implemented. The aim of this work was to study how
prolonged rhGH administration in trained subjects influences the insulin-like
growth factor (IGF) system, in order to evaluate new methods in antidoping
tests. METHODS: Morning serum growth hormone (GH), IGF-I, IGF binding protein
(BP)-2, IGFBP-3, IGF-I/IGFBP-2, and IGFBP-3/IGFBP-2 ratios were evaluated
before, during (8th and 15th days), and at the end and after cessation (+3, +6,
+9, +12, and +15 d) of a 3-wk treatment with different doses of rhGH (0.09 IU.kg
BW(-1).d(-1) for 6 or 3 d a week, i.e., the A and B trials, respectively) in
seven well-trained subjects not involved in competitive sports. The blood
collections pre- and during treatment were performed immediately before the
daily rhGH dose. RESULTS: In both trials, significant increases of IGF-I (higher
in the A trial) and IGFBP-3 serum concentrations during rhGH administration were
observed. Serum IGFBP-3 remained significantly increased in the A trial 3 d
after treatment cessation. In the A trial only, two subjects had IFG-I
concentrations exceeding the upper limit of the reference range. No
modifications of serum GH, IGFBP-2 and IGF-I/IGFBP-2, and IGFBP-3/IGFBP-2 ratios
were observed. The z-score evaluation for IGFBP-3 detected GH exposure in 100%
of subjects only at end treatment in A trial. CONCLUSION: Although IGF-I and
IGFBP-3 seem potentially the most specific markers of rhGH assumption, our data
suggest that for antidoping purposes a single evaluation of their absolute serum
concentration is not a sufficiently secure method to detect rhGH abuse in all
subjects, especially in the case of low rhGH doses.
Publication Types:
Clinical Trial
Controlled Clinical Trial
PMID: 12165681 [PubMed]
161: Haematologica. 2002 Aug;87(8):881-2.
Detection of homologous blood transfusion by flow cytometry: a deterrent against
blood doping.
Nelson M, Ashenden M, Langshaw M, Popp H.
Institute of Hematology, Royal Prince Alfred Hospital, Missenden Road,
Camperdown, NSW 2050, Australia. peggy.nelson@haem.rpa.cs.nsw.gov.au
PMID: 12161365 [PubMed]
162: NY Times (Print). 2001 May 11;:A1, D5.
Someday soon, athletic edge may be from altered gene.
Longman J.
Publication Types:
Newspaper Article
PMID: 12159857 [PubMed]
163: Clin J Sport Med. 2002 Jul;12(4):254-8.
The war on drugs in sport: a perspective from the front-line.
Mendoza J.
Australian Sports Drug Agency, Canberra, Australian Capital Territory,
Australia. jmendoza@asda.org.au
CONTEXT: Recent international developments have served to solidify the
international approach to doping in sport. The development of the World
Anti-Doping Agency (WADA) has resulted in new, coordinated efforts to address
this important sport issue. An array of new efforts and initiatives has been
initiated by the new agency. The Sydney and Salt Lake City Olympics were
characterized by intensive efforts to minimize doping. The antidoping
environment is evolving rapidly, and several profoundly important developments
will take place in the immediate future. OBJECTIVES: To outline the challenges,
opportunities, and changing circumstances of the current antidoping environment
so that sport medicine practitioners might understand the context in which a
variety of new initiatives and approaches will develop. At the same time, to
ensure that practitioners understand the importance of appropriately developed
and delivered antidoping policies, programs, and procedures, and the need for
their harmonization. To ensure that sport medicine practitioners appreciate the
need for a comprehensive approach to doping control, i.e., programs that include
much more than drug testing. DATA SOURCE: A review of relevant policy documents
derived from a variety of sport and antidoping organizations; selected
references drawn from MEDLINE; and materials prepared by colleagues drawn from
the international antidoping community. CONCLUSIONS: The increased global effort
to address doping is welcome. It will require that several critical issues be
addressed that will test the resolve of all involved.
Publication Types:
Review
Review, Tutorial
PMID: 12131061 [PubMed]
164: Clin J Sport Med. 2002 Jul;12(4):250-3.
Does exogenous growth hormone improve athletic performance?
Dean H.
Section of Pediatric Endocrinology, Department of Pediatrics, University of
Manitoba, Winnipeg, Manitoba, Canada. hdean@cc.umanitoba.ca
OBJECTIVE: To conduct a critical appraisal of the literature to address the
question of whether human growth hormone (HGH) improves performance in trained
athletes. DATA SOURCES: Used PubMed using the search terms of "growth hormone
athletes" and the reference lists of previous reviews of the subject. STUDY
SELECTION: Randomized double-blind placebo-controlled study of exogenous HGH on
muscle power in trained athletes. Only one study matched the search criteria.
CONCLUSION: There is no evidence of increased muscle strength with HGH in
trained athletes.
Publication Types:
Meta-Analysis
PMID: 12131060 [PubMed]
165: Clin J Sport Med. 2002 Jul;12(4):245-9.
Nutritional supplements and doping.
Pipe A, Ayotte C.
Canadian Centre for Ethics in Sport, University of Ottawa Heart Institute,
Ottawa, Ontario, Canada. apipe@ottawaheart.ca
CONTEXT: The problems of doping in sport and the increasing use of nutritional
supplements by athletes are issues that intersect to the degree that a large
number of supplements may contain substances that are banned in sport. Many
supplements contain substances that are associated with significant health
hazards. Athletes consuming such supplement products may jeopardize their
sporting status, and their health. OBJECTIVES: To clarify and summarize the
current status of dietary supplements in general, and to describe specific
problems that can be associated with supplement use so that sport physicians
might be better prepared to address these issues with their athlete-patients.
DATA SOURCE: An analysis of recent and relevant literature accessed through
MEDLINE, and interactions with clinicians, laboratory scientists, colleagues,
and athletes. CONCLUSIONS: The dietary supplement industry is completely
unregulated in the United States; as a consequence, an abundance of supplement
products of dubious value, content, and quality are now available around the
world. It is known that many supplement products contain substances that are
prohibited in sport-typically stimulants or anabolic steroid precursors. Many
supplements contain substances (e.g., ephedrine) that have been associated with
significant morbidity and mortality. Sport practitioners have particular
responsibilities in addressing this issue. Athletes need to be aware of the
problems that can follow supplement use, and sport authorities need to ensure
that nutritional education and guidance for athletes is of the highest standard.
The need for the appropriate regulation of dietary supplements is emphasized.
Publication Types:
Review
Review, Tutorial
PMID: 12131059 [PubMed]
166: Clin J Sport Med. 2002 Jul;12(4):242-4.
Beyond EPO.
Corrigan B.
Institute of Sport, Concord Hospital, Sydney, New South Wales, Australia.
abc@southernx.com.au
The objective of this review is to examine newer compounds coming on the market
capable of boosting red blood cell concentration and thus improving aerobic
activities in particular. Erythropoietin (EPO) has been used extensively in the
past by the athletic community in this role. Its main disadvantages are the side
effects due to increased viscosity, and the recent development of a blood test
for drug testing methods. Two new methods of increasing red blood cell
concentration for use in medicine are hemoglobin oxygen carriers and
perfluorocarbons, each having a different structure, but which allow oxygen to
be delivered to the tissues. Hemoglobin oxygen carriers physically alter the
hemoglobin molecule by several methods so that complications such as renal
toxicity are obviated. Perfluorocarbons belong to a group of synthetic compounds
containing hydrocarbons to which fluorine is added. Evidence is available to
suggest that athletes are already adapting these newer molecules for their
benefit.
Publication Types:
Review
Review, Tutorial
PMID: 12131058 [PubMed]
167: Clin J Sport Med. 2002 Jul;12(4):229-35.
Strategies for rhEPO detection in sport.
Kazlauskas R, Howe C, Trout G.
Australian Sports Drug Testing Laboratory, Australian Government Analytical
Laboratories, Pymble, New South Wales, Australia. ray.kazlauskas@agal.gov.au
This article examines available strategies for the detection of recombinant
erythropoietin (rhEPO) abuse in sport. RhEPO was quickly recognized as an
effective but hazardous performance-enhancing agent. In the absence of a valid
procedure to detect rhEPO doping, at-competition health checks were introduced,
which excluded athletes from competition when their hemoglobin or hematocrit
values exceeded an arbitrary limit. This limited the danger to athletes, but did
nothing to eliminate the use of rhEPO.Through the last decade, both direct and
indirect methods for detecting rhEPO were investigated. No single indirect
marker was found that satisfactorily demonstrated rhEPO use. A combination of
blood and urine tests together formed the procedure and strategy approved by the
International Olympic Committee (IOC) for detecting rhEPO use at the Sydney
Olympics.However strategies for testing for EPO are as important as the
developed laboratory analytical procedures. The use of extensive
out-of-competition testing and analysis within the IOC accredited laboratory
system is critical to any testing program. At-competition blood tests have merit
as true health checks and will also be needed to detect acutely useful agents
such as hemoglobin-based oxygen carriers. However the persistence of the "health
check" rationale for on-site at-competition rhEPO testing has led to much wasted
testing effort, as rhEPO use by athletes will rarely occur near to or at the
time of the competition for fear of detection. Thus, direct testing methods
(such as the rhEPO urine test) especially will fail due to the completed
metabolism and elimination of administered rhEPO before the test, unless the
international sporting federations use the information gathered to assist in
targeted out-of-competition testing. This article discusses the limitations of
testing at competition and proposed strategies for dealing with various phases
of EPO doping in detail, concluding that no one single currently used strategy
will detect all users of rhEPO.The development of strategies to diagnose rhEPO
abuse may serve as a model to detect other biological agents.
Publication Types:
Review
Review, Tutorial
PMID: 12131056 [PubMed]
168: Clin J Sport Med. 2002 Jul;12(4):225-8.
The asthmatic athlete, inhaled beta agonists, and performance.
McKenzie DC, Stewart IB, Fitch KD.
Division of Sports Medicine, The University of British Columbia, Vancouver,
British Columbia, Canada. kari@interchange.ubc.ca
INTRODUCTION: The large increase in the number of athletes who apply to use
inhaled beta agonists (IBAs) at the Olympic Games is a concern to the medical
community. This review will examine the use of IBAs in the asthmatic athlete,
the variability that exists between countries and sport, and outline a plan to
justify the use of these medications. DATA SOURCES: Much of this article is a
result of an International Olympic Committee (IOC) Medical Commission-sponsored
meeting that took place in May 2001. Records of the use of IBAs at previous
Olympics were reviewed. MEDLINE Searches (PubMed interface) were performed using
key words to locate published work relating to asthma, elite athletes,
performance, treatment, and ergogenic aids. MAIN RESULTS: Since 1984 there have
been significant increases in the use of IBAs at the Olympic Games as well as
marked geographical differences in the percentage of athletes requesting the use
of IBAs. There are large differences in the incidence of IBA use between sports
with a trend towards increased use in endurance sports. There are no ergogenic
effects of any IOC-approved IBA given in a therapeutic dose. CONCLUSIONS: In
many cases, the prescription of IBAs to this population has been made on
empirical grounds. Beginning with the 2002 Winter Games, athletes will be
required to submit to the IOC Medical Commission clinical and laboratory
evidence that justifies the use of this medication. The eucapnic voluntary
hyperpnea test will be used to assess individuals who have not satisfied an
independent medical panel of the need to use an IBA.
PMID: 12131055 [PubMed]
169: Clin J Sport Med. 2002 Jul;12(4):209-24.
Informed decision-making on sympathomimetic use in sport and health.
Bouchard R, Weber AR, Geiger JD.
Department of Pharmacology, University of Manitoba, Winnipeg, Manitoba, Canada.
The International Olympic Committee, the World Anti-Doping Agency, and
International Sport Federations have banned and restricted the use of many
stimulants including prescription and over-the-counter medications and dietary
supplements. In addition to elite athletes, people of all ages use stimulants in
attempts to improve athletic performance, alter body composition, and increase
levels of energy. Here we introduce a seven-stage model designed to facilitate
informed decision-making by individuals taking or thinking of taking stimulants
for sport, health, and/or appearance reasons. We review for amphetamines,
over-the counter sympathomimetics, and caffeine their performance-enhancing and
performance-degrading effects, health benefits and mechanisms of action, medical
side effects, and legal, ethical, safety, and financial implications.
Publication Types:
Review
Review, Tutorial
PMID: 12131054 [PubMed]
170: Clin J Sport Med. 2002 Jul;12(4):203-8.
Sports physicians and the doping crisis in elite sport.
Hoberman J.
Department of Germanic Studies, University of Texas, Austin, Texas 78712, USA.
The participation of sports physicians in the "doping" of athletes with banned
drugs can be documented as far back as the 1890s. Concern about the ethics and
safety of doping elite athletes appeared during the 1920s and 1930s as sport
became an increasingly important form of popular culture. While organized
medicine has opposed doping as a matter of policy at least since the 1950s,
sports physicians have never adequately confronted the conflicts of interest
that arise when they choose to work with elite athletes whose first priority is
performance rather than with healing in the traditional sense.Confronted with
the demands of their athlete-clients, sports physicians have divided into two
factions regarding the wisdom and propriety of administering doping drugs to
athletes. While most physicians are, in all likelihood, unwilling to violate
laws, regulations, and medical standards by doping athletes, a significant
minority of doctors has used one or more arguments to justify doping athletes:
drugs are necessary to compete effectively; athletes should be free to medicate
themselves as they please; drugs do not differ essentially from other
performance-enhancing techniques or equipment; and medically supervised doping
is safer than self-medication by athletes. Physicians can also rationalize
doping as an occupational requirement of some professional athletes. In summary,
physicians have played a significant, and largely unacknowledged, role in the
doping of many elite athletes over the past 50 years.
Publication Types:
Historical Article
PMID: 12131053 [PubMed]
171: Clin J Sport Med. 2002 Jul;12(4):201-2.
Drugs, sport, and medical practice.
Pipe A, Best T.
Publication Types:
Editorial
PMID: 12131052 [PubMed]
172: Lancet. 2002 Jul 13;360(9327):99-100.
Doping in sport.
Jenkins P.
Department of Endocrinology, St Bartholomew's Hospital, London EC1A 7BE, UK.
P.J.Jenkins@qmul.ac.uk
PMID: 12126814 [PubMed]
173: Pharmacotherapy. 2002 Jul;22(7):889-97.
Darbepoetin-alpha: a review of the literature.
Overbay DK, Manley HJ.
Dialysis Clinic, Inc., Kansas City, Missouri, USA.
Anemia is a chronic condition that affects many patients with chronic kidney
disease (CKD). These patients often require recombinant human erythropoietin
(rHuEPO) to stimulate bone marrow to produce red blood cells. The agent often
has to be administered 2-3 times/week for maximum efficacy A new product,
darbepoetin-alpha, is a hyperglycosylated erythropoiesis-stimulating protein
that has a longer terminal half-life than rHuEPO (25.3 vs 8.5 hrs), which allows
for less frequent dosing. At an equivalent dosage as rHuEPO, darbepoetin-alpha
maintains hemoglobin values within target range and has a similar adverse effect
profile. It is safe and effective for treatment of anemia of CKD.
Pharmacoeconomic and quality-of-life studies are warranted to determine the
compound's overall benefit.
Publication Types:
Review
Review, Tutorial
PMID: 12126221 [PubMed]
174: J Mass Spectrom. 2002 Jul;37(7):693-8.
Liquid chromatography/mass spectrometry in anabolic steroid
analysis--optimization and comparison of three ionization techniques:
electrospray ionization, atmospheric pressure chemical ionization and
atmospheric pressure photoionization.
Leinonen A, Kuuranne T, Kostiainen R.
Doping Control Laboratory, United Laboratories Ltd, Helsinki, Finland.
The applicability of liquid chromatography/tandem mass spectrometry (LC/MS/MS)
for the detection of the free anabolic steroid fraction in human urine was
examined. Electrospray ionization (ESI), atmospheric pressure chemical
ionization and atmospheric pressure photoionization methods were optimized
regarding eluent composition, ion source parameters and fragmentation. The
methods were compared with respect to specificity and detection limit. Although
all methods proved suitable, LC/ESI-MS/MS with a methanol-water gradient
including 5 mM ammonium acetate and 0.01% acetic acid was found best for the
purpose. Multiple reaction monitoring allowed the determination of steroids in
urine at low nanogram per milliliter levels. LC/MS/MS exhibited high sensitivity
and specificity for the detection of free steroids and may be a suitable
technique for screening for the abuse of anabolic steroids in sports. Copyright
2002 John Wiley & Sons, Ltd.
PMID: 12125002 [PubMed]
175: Rapid Commun Mass Spectrom. 2002;16(13):1273-5.
Detection of norbolethone, an anabolic steroid never marketed, in athletes'
urine.
Catlin DH, Ahrens BD, Kucherova Y.
UCLA Olympic Analytical Laboratory, Department of Molecular Pharmacology,
University of California, Los Angeles, CA 90025, USA. dcatlin@ucla.edu
Norbolethone (13-ethyl-17-hydroxy-18,19-dinor-17alpha-pregn-4-en-3-one) is a
19-nor anabolic steroid first synthesized in 1966. During the 1960s it was
administered to humans in efficacy studies concerned with short stature and
underweight conditions. It has never been reported by doping control
laboratories. Norbolethone was identified in two urine samples from one athlete
by matching the mass spectra and chromatographic retention times with those of a
reference standard. The samples also contained at least one likely metabolite.
The samples were also unusual because the concentrations of endogenous steroids
were exceptionally low. Since norbolethone is not known to be marketed by any
pharmaceutical company, a clandestine source of norbolethone may exist.
Copyright 2002 John Wiley & Sons, Ltd.
PMID: 12112254 [PubMed]
176: Equine Vet J. 2002 May;34(3):242-9.
Comment in:
Equine Vet J. 2002 May;34(3):220-1.
Pharmacokinetic/pharmacodynamic approach to assess irrelevant plasma or urine
drug concentrations in postcompetition samples for drug control in the horse.
Toutain PL, Lassourd V.
UMR 181 INRA/ENVT Physiopathologie et Toxicologie Experimentales, Ecole
Nationale Veterinaire de Toulouse, France.
The current performance of analytical techniques used for drug control in horses
lead the Regulatory Authorities to decide whether trace levels of drugs
legitimately used for therapeutic medication should or should not be reported.
Here, we propose a well-ordered and nonexperimental
pharmacokinetic/pharmacodynamic approach for the determination of irrelevant
drug plasma (IPC) and urine concentrations (IUC). The published plasma clearance
is used to transform an effective (marketed) dose into an effective
concentration (EPC). EPC is transformed into an IPC by applying a safety factor
(SF). This method is based on several assumptions (eg, drug effects reversibly
driven by plasma concentration, linearity of drug disposition). The suitability
of the computed IPC and IUC can be checked by calculating the residual amount of
drug at IPC and computing a minimal drug withdrawal time. It is concluded that
controlling the drug effect (using drug or any analyte concentration as a
marker) rather than the drug exposure will be more demanding and also makes
urine a less than ideal matrix.
PMID: 12108741 [PubMed]
177: Equine Vet J. 2002 May;34(3):220-1.
Comment on:
Equine Vet J. 2002 May;34(3):242-9.
Medication: a way forward from zero tolerance to irrelevant plasma
concentrations.
Webbon P.
Publication Types:
Comment
Editorial
PMID: 12108737 [PubMed]
178: Tidsskr Nor Laegeforen. 2002 May 30;122(14):1363-4.
[Dnitrophenol--a dangerous doping agent]
[Article in Norwegian]
Sand P, Madsen S.
Humana Medisinske Senter Postboks 63 1300 Sandvika.
BACKGROUND: Performance-enhancing drugs are frequently used by bodybuilders:
anabolic steroids, growth hormone and insulin, only to mention a few. Many
little known drugs are also used. MATERIAL AND METHODS: Two men aged 20 and 32
years, both active bodybuilders, complained about lassitude and malaise.
Clinical and laboratory evaluation revealed an unusual cause of their
complaints. RESULTS: Laboratory investigation showed very low serum levels of
free thyroxin and thyroid stimulating hormone (TSH), suggesting central
depression of thyroid function. Both men then admitted taking dinitrophenol
(approximately 5 mg/kg bodyweight/day) to "burn fat" before body-building
competitions. INTERPRETATION: Doctors should be aware that bodybuilders might
use dinitrophenol. This toxic compound has severe metabolic effects. Overdose
may cause hyperpyrexia and death. Use should be strongly discouraged.
Publication Types:
Case Reports
PMID: 12098904 [PubMed]
179: J Sports Med Phys Fitness. 2002 Sep;42(3):354-9.
Combating drug use in competitive sports. An analysis from the athletes'
perspective.
Striegel H, Vollkommer G, Dickhuth HH.
Medical Clinic and Policlinic, Department of Sports Medicine, University of
Tuebingen, Tubingen, Germany. heiko.striegel@web.de
BACKGROUND: Doping has developed into a widespread problem in competitive and
high-performance sports due to increasing professionalism in, and
commercialization of sports. In contrast, governments and sports organizations
have limited financial resources to support all competitive sports. Therefore,
further improvement of anti-doping measures can only be achieved through the
inclusion and active participation of the athletes themselves. METHODS: In this
study, 101 German athletes who are subject to national and international
anti-doping tests were asked if doping in sports should be combatted, and which
anti-doping measures appeared effective from an athlete's perspective. RESULTS:
Ninety-eight point zero two per cent of those questioned felt that measures
should be taken against doping in sports. Improved methods of detection and more
information on the health risks were favored, as opposed to more severe
punishments. In addition, more than two thirds of the athletes supported the
introduction of an anti-doping law. The desire for more frequent drug testing
was also expressed, despite the distinct invasion of the athletes' privacy.
CONCLUSIONS: An anti-doping law, as requested by the athletes, should include
measures for educating the public about the health risks involved with doping.
In addition, such a law would also make it possible to develop suitable methods
of detection.
PMID: 12094127 [PubMed]
180: Nutrition. 2002 Jul-Aug;18(7-8):566-7.
Effects of oral bovine colostrum supplementation on serum insulin-like growth
factor-I levels.
Kuipers H, van Breda E, Verlaan G, Smeets R.
Department of Movement Sciences, PO Box 616, Maastricht University, 6200 MD
Maastricht, The Netherlands. harm.kuipers@bw.unimaas.nl
OBJECTIVES: We investigated whether supplementation with 60 g/d of bovine
colostrum affects blood levels of insulin-like growth factor-I (IGF-I) and IGF
binding protein-3 in relation to doping testing. Nine endurance-trained men
ingested 60 g/d of bovine colostrum for 4 wk. METHODS: Blood and urine were
sampled before starting supplementation. After 4 wk urine and blood samples were
taken after an overnight fast and 2 h after ingestion of the last portion to
study possible acute effects. RESULTS: Blood IGF-I levels before supplementation
were (mean +/- standard deviation) 31 +/- 13 nM/L, and no acute effects were
observed after 4 wk of supplementation (33 +/- 9 nM/L). Levels of IGF-binding
protein-3 were 136 +/- 11 nM/L before supplementation and 135 +/- 16 nM/L after
4 wk of supplementation. Two hours after ingestion of the last portion, the
level of IGF binding protein-3 was 131 +/- 19 nM/L, which was not different from
baseline values. Drug testing in a laboratory accredited by the International
Olympic Committee did not show any forbidden substance before or after 4 wk of
supplementation. CONCLUSIONS: Daily supplementation with 60 g of bovine
colostrum for 4 wk does not change blood IGF-I or IGF binding protein-3 levels
and does not elicit positive results on drug tests.
PMID: 12093430 [PubMed]
181: Haematologica. 2002 Jul;87(7):ELT31; author reply ELT32.
Comment on:
Haematologica. 2002 Mar;87(3):225-32.
Addendum to strategies to deter blood doping in sports.
D'Onofrio G, Zini G.
Publication Types:
Comment
Letter
PMID: 12091146 [PubMed]
182: Lakartidningen. 2002 May 23;99(21):2432.
[Doping--time for reflection and reconsideration!?]
[Article in Swedish]
Hagglof M.
Publication Types:
Letter
PMID: 12090180 [PubMed]
183: BMJ. 2002 Jun 29;324(7353):1544.
Doped East German athletes to receive compensation.
Tuffs A.
Publication Types:
News
PMID: 12089087 [PubMed]
184: Prescrire Int. 2002 Jun;11(59):88-90.
Creatine: little impact on athletic performance, but a risk of adverse effects.
[No authors listed]
(1) Creatine occurs naturally in the body. Some is derived from dietary sources,
but endogenous synthesis covers individual requirements. Creatine deficiency
occurs only in subjects with genetic disorders. (2) Oral creatine
supplementation at supraphysiological doses seems to slightly improve the
performance of some types of muscle exercise, but only those lasting less than
30 seconds; even this small effect is inconsistent. (3) The vague regulatory
status of creatine supplements hinders effective monitoring of adverse events.
Serious adverse events have been reported in people taking creatine supplements,
but it's still unclear whether or not the creatine is responsible. Animal data
suggest a link with cancer after long term exposure. (4) The precise composition
of creatine supplements is unclear: contamination is possible, and other
substances, especially doping agents, are sometimes added. (5) Taking creatine
supplements is inadvisable.
PMID: 12068849 [PubMed]
185: J Forensic Sci. 2002 Jan;47(1):211-4.
Hair analysis of seven bodybuilders for anabolic steroids, ephedrine, and
clenbuterol.
Dumestre-Toulet V, Cirimele V, Ludes B, Gromb S, Kintz P.
Laboratoire BIOffice, Artigues Pres Bordeaux, France. vdumestr@alienor.fr
Several bodybuilders, all winners of international competitions, were arrested
for trafficking of a number of doping agents including anabolic steroids,
ephedrine, beta-adrenergics, human chorionic gonadotropin, antidepressants, and
diuretics. In accordance with the recent French law against doping, the judge
asked to test seven bodybuilders to identify doping practices. Hair and urine
specimens were collected for analysis. After decontamination, a 100 mg hair
strand was pulverized in a ball mill, hydrolyzed, extracted, and derivatized to
be tested by GC/MS for anabolic steroids, beta-adrenergic compounds, ephedrine,
and other doping agents. Urine was analyzed for anabolic steroids and
metabolites, beta-adrenergic compounds, ephedrine, and human chorionic
gonadotropin, in addition to a broad spectrum screening with GC/MS. The
following compounds were detected in urine: ephedrine (29 and 36 ng/mL, n = 2),
clenbuterol (0.2 to 0.3 ng/mL, n = 3), norandrosterone (4.7 to 100.7 ng/mL, n =
7), norethiocholanolone (0.9 to 161.8 ng/mL, n = 6), stanozolol (1 to 25.8
ng/mL, n = 4), methenolone (2.5 to 29.7 ng/mL, n = 4), testosterone (3 to 59.6
ng/mL, n = 7), epitestosterone (1 to 20.4 ng/mL, n = 7) and ratio
testosterone/epitestosterone >6 for four subjects (18.5 to 59.6). The following
drugs were detected in hair: ephedrine (0.67 and 10.70 ng/mg, n = 2), salbutamol
(15 to 31 pg/mg, n = 3), clenbuterol (15 to 122 pg/mg, n = 6), nandrolone (1 to
7.5 pg/mg, n = 3), stanozolol (2 to 84 pg/mg, n = 4), methenolone (17 and 34
ng/ml, n = 2), testosterone enanthate (0.6 to 18.8 ng/mg, n = 5), and
testosterone cypionate (3.3 to 4.8 ng/mg, n = 2). These results document the
doping practice and demonstrate repetitive exposure to anabolic compounds and
confirm the value of hair analysis as a complement to urinalysis in the control
of doping practice.
Publication Types:
Case Reports
PMID: 12064656 [PubMed]
186: Z Kardiol. 2002 Apr;91(4):357-62.
[Cardiomyopathy associated with uncontrolled self medication of anabolic
steroids]
[Article in German]
Vogt AM, Geyer H, Jahn L, Schanzer W, Kubler W.
Universitatsklinikum Heidelberg Abteilung Innere Medizin III Schwerpunkt
Kardiologie, Angiologie, Pneumologie Bergheimer Str. 58, 69115 Heidelberg,
Germany. Achim_Vogt@med.uni-heidelberg.de
Though doping has become increasingly ostracized in the context of professional
sports, an enormous number of unrecorded cases must be assumed in
semi-professional competitive sports as well as in popular sports. This holds
especially true for those forms of sports which are done in order to obtain a
well-proportioned, athletic, healthy looking body. This case report describes a
formerly healthy young man who had to be urgently admitted to an intensive care
unit due to severe myocardial pump failure. As anamnestic information was
insufficient and inadequate, the taking of anabolic steroids in high doses was
proven, as their metabolites could be detected by urine analysis. Until now,
myocardial contractile dysfunction has persisted for more than twelve months
after the initial admission. Though other diagnoses which might have led to this
impaired myocardial contractile performance have been excluded, cardiomyopathy
associated with the taking of anabolic steroids must be assumed. Even in
non-professional and public sports, a widespread abuse of doping substances
exists. Hence, cardiomyopathy associated with the misuse of anabolic steroids
has to be considered especially in young, formerly healthy patients.
Publication Types:
Case Reports
PMID: 12063710 [PubMed]
187: J Pharm Biomed Anal. 2002 Jun 20;29(1-2):317-23.
The isomeric metabolites of doxepin in equine serum and urine.
Hagedorn HW, Meiser H, Zankl H, Schulz R.
Institute of Pharmacology, Toxicology and Pharmacy, Veterinary Faculty,
University of Munich, Koniginstrasse 16, D-80539 Munich, Germany.
Due to its tranquilizing properties, the tricyclic antidepressant doxepin may be
misused as a doping agent in competition horses. Therefore, efficient analytical
procedures are required to detect this drug in samples submitted for doping
control. To screen for parent doxepin in equine blood and urine, a less specific
method has been accepted employing gas chromatography (GC) combined with
electron impact (EI) mass spectrometry (MS). The aim of this study was
identification of doxepin metabolites providing more specific MS data to verify
positives resulting from screening. Thus, after a horse was given doxepin-HCl (1
mg/kg, i.v.), blood and urine were analyzed for free or conjugated metabolites
using GC combined with EI- and positive chemical ionization (PCI) MS. In both of
the sample materials, cis- and trans-isomers of desmethyldoxepin were detected
for up to 48 h after treatment using trifluoracetylation and GC/EI-MS. Following
enzymic hydrolysis of urine and propionylation of extracts, each four isomers of
hydroxy desmethyldoxepin and hydroxydoxepin were recovered for up to 24 and 48
h, respectively. These compounds were characterized by their EI- and PCI-mass
spectra. Although distinct positions of the hydroxyl groups could not be
determined, the presence of each two cis/trans-isomeric pairs of differently
monohydroxylated metabolites may be assumed. Results reported here suggest, that
screening horses for parent doxepin should be completed by analysis of its major
isomeric metabolites, desmethyldoxepin and hydroxydoxepin, providing MS data
specific enough for confirmatory analysis.
PMID: 12062692 [PubMed]
188: J Chromatogr A. 2002 Apr 19;954(1-2):199-206.
Artifact formation due to ethyl thio-incorporation into silylated steroid
structures as determined in doping analysis.
van de Kerkhof DH, van Ooijen RD, de Boer D, Fokkens RH, Nibbering NM, Zwikker
JW, Thijssen JH, Maes RA.
Department of Human Toxicology, Utrecht Institute of Pharmaceutical Sciences
(UIPS), University of Utrecht, The Netherlands. d.h.vandekerkhof@pharm.uu.nl
Trimethylsilylation of target substances in a mixture of
N-methyl-N-trimethylsilyltrifluoroacetamide (MSTFA), ammonium iodide and
ethanethiol is frequently applied for the application of gas chromatography-mass
spectrometry (GC-MS) in steroid analysis. However, artifacts were formed when
using this mixture to silylate the steroids androsterone and etiocholanolone
obtained from a urine matrix. The artifacts were identified as ethyl
thio-containing products of the respective trimethylsilyl derivatives. The
conversion of the studied products increased slowly as a function of time, was
dependent on the presence of the urine matrix and was significantly accelerated
by adding diethyl disulfide to the reagent before incubation. Also ethyl
thio-incorporation into testosterone and epitestosterone was established. A
mechanism for ethyl thio-incorporation is proposed. The conversion achieved
after 120-h sample storage at room temperature was insufficient to significantly
influence the analysis of androsterone and etiocholanolone under the studied
conditions. However, the results provide fundamental insight into the mechanism
of silylation and the occurring side-reactions. Moreover, when investigating the
formation of new metabolites, the ethyl thio-incorporation can lead to
misinterpretation.
PMID: 12058904 [PubMed]
189: J Vet Diagn Invest. 2002 May;14(3):231-5.
Values of urine specific gravity for thoroughbred horses treated with furosemide
prior to racing compared with untreated horses.
Cohen ND, Peck KE, Smith SA, Ray AC.
Department of Large Animal Medicine, College of Veterinary Medicine, Texas A&M
University, College Station 77843-4475, USA.
The distribution of specific gravity values for 2,599 urine samples collected
from racing Thoroughbred horses that were known to have received furosemide
prior to racing was compared with that for 1,669 urine samples from racing
Thoroughbred horses that reportedly had not received furosemide. Values of
specific gravity for furosemide-treated horses were significantly lower (P <
0.001) than those for horses that had not received furosemide, and the
proportion of horses with urine specific gravity either <1.010 or <1.012 was
significantly greater (P < 0.001) among the furosemide-treated horses. These
data indicate that evaluation of urine specific gravity would be a useful
component of drug testing programs for regulation of furosemide use.
PMID: 12033679 [PubMed]
190: Haematologica. 2002 Jun;87(6):ELT28.
The interpretation of secondary blood markers can get hazardous in case of a
discontinuous rhEPO treatment.
Robinson N, Saugy M, Buclin T, Gremion G, Mangin P.
Laboratoire Suisse d'Analyse du Dopage, Institut Universitaire de Medecine
Legale, Rue du Bugnon 21, 1005 Lausanne, Switzerland.
neil.robinson@inst.hospvd.ch
Publication Types:
Letter
PMID: 12031936 [PubMed]
191: Med Law. 2002;21(1):201-9.
Sports medicine and the law.
Frenkel DA.
Department of Business Administration, School of Management, Ben-Gurion
University of the Negev, Beer-Sheva, Israel.
Legal problems occur in sports medicine as well as in other fields. To whom do
sports doctors owe their duty - to the club, to the team or to its members?
Doping has become a part of competitive sport. What is the doctor's
responsibility in relation to this? Medical "treatments" given sometimes on
demand, in order to enable athletes to continue the game or competition despite
the high risk of future severe irreparable damage, may constitute gross
negligence. Consent given by athletes in such circumstances may be considered
invalid. The club is obliged to insure its members against personal injuries.
However, insurance companies may refuse to cover cases where a priori negligent
medical treatment was demanded, or will sue the doctor for reimbursement.
Medical confidentiality should be kept even regarding athletes, and disclosing
any information is unlawful without the athletes' consent. Doctors' professional
duty to the athletes should override any duty to the club that hired them, and
professional medical opinion should override any caprice of the athlete.
PMID: 12017443 [PubMed]
192: Int J Sports Med. 2002 May;23(4):237-41.
The effect of ad libitum ingestion of a caffeinated carbohydrate-electrolyte
solution on urinary caffeine concentration after 4 hours of endurance exercise.
Kovacs EM, Martin AM, Brouns F.
Department of Human Biology, Maastricht University, The Netherlands.
E.Kovacs@HB.UNIMAAS.NL
The purpose of the present study was to examine the effect of ad libitum
ingestion of a carbohydrate-electrolyte solution (CES) with 150 mg x L (-1)
caffeine (CAF) on urinary CAF concentration after 4 h of endurance exercise.
Fifty-eight healthy and well-trained male subjects ingested ad libitum a 7 % CES
with 150 mg x L (-1) CAF during 4 h cycling at 50 % of maximal work capacity.
Total fluid consumption (mean +/- SE) was 2799 +/- 72 mL and CAF intake was 420
+/- 11 mg (5.7 +/- 0.2 mg x kg (-1) body weight). The post-exercise urinary CAF
concentration (4.53 +/- 0.25 microg x mL (-1)) was below the doping level of the
International Olympic Committee (12 microg x mL (-1)) in all subjects (range
1.20 - 10.84 microg x mL (-1)). A highly positive correlation was observed
between CAF intake and post-exercise urinary CAF concentration (r = 0.68, p <
0.001). It is concluded that ad libitum ingestion of a CES with 150 mg x L (-1)
CAF during 4 h cycling resulted in post-exercise urinary concentration below the
doping level in all subjects.
Publication Types:
Clinical Trial
PMID: 12015622 [PubMed]
193: J Chromatogr B Analyt Technol Biomed Life Sci. 2002 Jun 15;773(1):7-16.
Determination of clenbuterol in human urine by GC-MS-MS-MS: confirmation
analysis in antidoping control.
Amendola L, Colamonici C, Rossi F, Botre F.
Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio
Onesti 1, 00197, Rome, Italy.
This work presents a GC-MS-MS-MS method for the direct determination of
clenbuterol in human urine. The method comprises a pretreatment procedure and
the instrumental analysis of the derivatives performed by GC-MS(3) (ion trap)
with electron impact ionization. The GC-MS(3) analysis allows isolation and
characterization of specific fragments from the original (MS(1)) molecular
structure, and in particular, those fragments originating from the precursor ion
cluster (m/z=335-337) characteristic of clenbuterol. The MS(2) product fragment
m/z=300 is in turn used as a further precursor fragment giving rise to a MS(3)
spectrum specific for clenbuterol. MS(4) fragmentation spectra were also
investigated. However, further fragmentation of MS(3) product ions does not lead
to functional MS(4) spectra nor to any significant increase in the
signal-to-noise ratio. The sensitivity limit of the MS(3) technique is lower
than 0.2 microg/l, with a linear range between 0.5 and 5 microg/l, thus matching
the basic requirements for antidoping analysis according to the guidelines of
the International Olympic Committee. Due to its overall analytical performance,
the method is presently being evaluated as a confirmation protocol to be
followed to detect illicit clenbuterol administration to the athletes, and
compared with reference GC-MS and GC-MS-MS techniques.
PMID: 12015265 [PubMed]
194: J Chromatogr B Analyt Technol Biomed Life Sci. 2002 Apr
25;770(1-2):207-16.
Rapid analysis of furosemide in human urine by capillary electrophoresis with
laser-induced fluorescence and electrospray ionization-ion trap mass
spectrometric detection.
Caslavska J, Thormann W.
Department of Clinical Pharmacology, University of Bern, Switzerland.
Furosemide, a drug that promotes urine excretion, is used in the pharmacotherapy
of various diseases and is considered as a doping agent in sports. Using
alkaline electrolytes, analysis of furosemide by dodecyl sulfate based micellar
electrokinetic capillary chromatography (MECC) and capillary zone
electrophoresis (CZE) with laser-induced fluorescence detection (LIF, analyte
excitation with the 325 nm line of a HeCd laser) is described. Data produced by
injection of plain or diluted patient urines are confirmed with those obtained
via analysis of urinary solid-phase extracts. CZE-LIF and MECC-LIF are thereby
shown to permit unambiguous recognition of furosemide in urines collected after
ingestion of therapeutic doses of this drug. This is in contrast to solute
detection via UV absorbance for which the extraction of furosemide is required.
MECC based electropherograms are somewhat more complex compared to those
obtained by CZE-LIF, this suggesting that the latter approach is more suitable
for rapid screening of urines with direct sample injection and LIF detection.
Alternatively, capillary electrophoresis with negative electrospray
ionization-ion-trap tandem mass spectrometry (CE-MS2) is shown to permit the
direct confirmation of furosemide in human urine. This approach is based upon
the monitoring of the m/z 329.3-->4m/z 285.2 precursor-product ion transition.
CZE-LIF and CE-MS2 with injection of plain or diluted urine represent simple,
rapid and attractive urinary screening and confirmation assays for furosemide in
patient urines.
PMID: 12013228 [PubMed]
195: Enferm Infecc Microbiol Clin. 2002 May;20(5):238.
[Use of quinolones in high level sports]
[Article in Spanish]
Drobnic F, Segura J, Riera J.
Publication Types:
Letter
PMID: 12006267 [PubMed]
196: Pediatr Clin North Am. 2002 Apr;49(2):435-61.
Supplements and drugs used to enhance athletic performance.
Congeni J, Miller S.
Department of Pediatrics, Northeastern Ohio Universities College of Medicine,
Rootstown, OH, USA. jcongeni@chmca.org
The temptation of using drugs and supplements as shortcuts to improving athletic
performance or even to enhance appearance is very seductive to adolescents. This
age group is often characterized by a desire for quick results and a lack of
concern for future consequences. Preventing the use of drugs to enhance athletic
performance is difficult even when we have good medical and scientific evidence
to prove a dangerous risk-benefit ratio, such as with AASs. The use of
"nutritional supplements" is even more difficult to control. The protection of
these substances by the Dietary Supplement Health and Education Act of 1994
removed control of these substances from the FDA. Therefore, release and
widespread use of new supplements occurs before significant clinical study of
benefit and adverse effects takes place. The distributors' financial interest,
the products' promotional claims, and the athletes' and coaches' insatiable
desire to win at all costs are a volatile combination. This spawns the
production of a huge number of "natural" products, making it even more difficult
to assess efficacy, safety, legality, and purity of these substances. Health
care professionals need to rely on research when available, stay current on
trends in athletes' drug and supplement use, and discuss the individual
athlete's concerns when they arise. The preparticipation physical examination
can be a good opportunity for discussion. Finally, physicians need to educate
athletes, parents, coaches, trainers, and other physicians. A reasonable
strength and conditioning program and a well-balanced diet must be presented as
a sensible alternative to a riskier, shortcut mindset.
Publication Types:
Review
Review, Academic
PMID: 11993292 [PubMed]
197: Eur J Appl Physiol. 2002 Jan;86(3):233-9.
Misuse of androgenic-anabolic steroids and human deltoid muscle fibers:
differences between polydrug regimens and single drug administration.
Hartgens F, van Straaten H, Fideldij S, Rietjens G, Keizer HA, Kuipers H.
Netherlands Centre for Doping Affairs, Capelle aan den IJssel, The Netherlands.
fred.hartgens@bw.unimaas.nl
The objective of this investigation was to study the effects of
androgenic-anabolic steroid (AAS) misuse on deltoid muscle fiber characteristics
in experienced, male strength-trained athletes. In a double-blind study, 15
volunteers were administered nandrolone decanoate (ND) for 8 weeks (200 mg/week,
intramuscularly). In an additional study, 12 subjects self-administered various
AASs at supratherapeutic dosages (AAS group), while 7 non-users served as
controls. In all subjects, a percutaneous needle biopsy sample of the deltoid
muscle was obtained at baseline and after 8 weeks. Muscle sections were
pre-incubated at pH 4.4, stained with adenosine triphosphatase and analyzed
morphometrically. In each biopsy sample, at least 150 fibers were classified for
"gray level" and "lesser fiber diameter" to determine the mean fiber size, the
sizes of type I and type II fibers, and the fiber type distribution. ND
administration did not seem to affect any of those parameters. In the AAS group,
mean muscle fiber size (+ 12.6%), and the size of type I (+ 10.8%) and type II
(+ 14.6%) muscle fibers increased. The fiber type distribution remained
unaltered. We conclude that polydrug regimens of AAS misuse at supratherapeutic
dosages increased the size of deltoid muscle fibers (especially type II fibers)
in experienced strength-trained athletes, while ND at a therapeutic
intramuscular dose of 200 mg did not exert any effect.
Publication Types:
Clinical Trial
Controlled Clinical Trial
PMID: 11990732 [PubMed]
198: Ann Med Interne (Paris). 2001 Nov;152 Suppl 7:37-49.
[Sports, use of performance enhancing drugs and addiction. A conceptual and
epidemiological review]
[Article in French]
Franques P, Auriacombe M, Tignol J.
Unite de Soins d'Addictologie, Consultation d'Addictologie et Psychopathologie
dans le Sport, Service Universitaire de Psychiatrie, CHU de Bordeaux et Centre
Hospitalier Charles-Perrens, Bordeaux, France.
BACKGROUND: Both the general public and non-sports medicine health professionals
have recently been made aware of a large use of performance enhancing drugs
among sports practicing subjects. It has been suggested that this behavior is
similar to that of substance dependence. Also some have reported that practice
of a sport could be in itself an addictive behavior. OBJECTIVE: The main
objective was to address the following question: is performance enhancing drug
use in sports an addictive behavior? Methodology. We first reviewed the
definition of performance enhancing drug use in sports and the diagnostic
criteria of substance dependence as they are currently accepted and attempted to
determine a possible common factor. Secondly we reviewed epidemiological data
from the literature according to three approaches: RESULTS: Use of performance
enhancing drugs is an important and increasing phenomenon among adolescents. It
is sometimes associated to risk taking behaviors for health (syringe use and
sharing). Competition participants are at increased risk (up to 20% according to
some authors) and some substances (anabolic steroids) are also used by
non-sports practicing individuals. It has not been shown that sports practicing
subjects were more at risk of using addictive substances compared to non-sports
practicing subjects. It is not established that practice of a sport is by itself
a risk factor for substance use. However, it could be that a sub-group of
individuals that practice certain types of sports in an intensive way, that use
both performance enhancing drugs and addictive substances and that engage in
health risk taking behaviors have an increased risk for developing a dependence
syndrome to both addictive and performance enhancing drugs. This sub-group is
even more at risk because some performance enhancing drugs (anabolic steroids)
could increase the risk for occurrence of a substance dependence syndrome
through neurobiological actions. Yet, the few available clinical studies show
that at most only half of regular users actually meet criteria for dependence.
Also, one study has reported an overrepresentation of sports professionals among
patients seeking treatment for heroin addiction. CONCLUSION: The large majority
of sports practicing subjects have no dependence to either performance enhancing
or addictive drugs. However, a subgroup of individuals that practice sports
intensely and makes use of both addictive and performance enhancing drugs appear
to be at increased risk for developing a substance dependence syndrome.
Publication Types:
Review
Review Literature
PMID: 11965097 [PubMed]
199: Hautarzt. 2002 Feb;53(2):98-103.
[Sports as a risk factor and therapeutic principle in dermatology]
[Article in German]
Karamfilov T, Elsner P.
Sanitas Alpenklinik Inzell, Schulstr. 4, 83334 Inzell.
tkaramfilov.inzell@sanitas-kliniken.de
Sporting activities may exert positive and negative health effects. This applies
not only to the cardiovascular and musculoskeletal system, but also to skin.
During sporting activities a person is exposed to environmental factors such as
temperature, irradiation, and allergens. These factors may play a key role in
the development of skin diseases. Mechanical trauma is caused by acute injury as
well as chronic damage. Infectious skin diseases caused by viruses, bacteria or
fungi can be transmitted by body contact or the use of communal showers or
locker rooms. Intake of performance-enhancing substances may provoke skin
changes such as striae distensae, androgenetic alopecia, hypertrichosis and
acne. Preexisting skin diseases such as psoriasis, lichen planus, vitiligo,
polymorphous light eruption, lupus erythematosus, porphyria, urticaria, and acne
rosacea may be aggravated by sporting activities. On the other hand, physical
exercise has a therapeutic potential which has hardly been exploited by
dermatologists. Especially in chronic skin diseases positive effects have been
observed. Therapeutic use of team sports has been shown to decrease suffering,
depression, and emotional disturbances and increase life quality in patients
with atopic eczema, psoriasis, and venous leg ulcers.
Publication Types:
Review
Review, Tutorial
PMID: 11963201 [PubMed]
200: Expert Rev Mol Diagn. 2002 Mar;2(2):95.
Blood test may help discourage doping.
[No authors listed]
Publication Types:
News
PMID: 11962345 [PubMed]
201: Adv Exp Med Biol. 2001;502:207-24.
Erythropoietin use and abuse: When physiology and pharmacology collide.
Spivak JL.
Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore,
MD, USA.
The major function of the erythrocyte is to transport oxygen from the lungs to
the other tissues, a function ensured by the glycoprotein hormone erythropoietin
which couples red cell production to long term tissue oxygen requirements.
Tissue hypoxia is the only physiological mechanism for increasing erythropoietin
production but there are a variety of mechanisms for its down regulation
including hyperoxia, increased catabolism by an expanded erythroid progenitor
cell pool, blood hyperviscosity independently of its oxygen content, renal
disease and the cytokines produced in inflammatory, infectious and neoplastic
disorders. Erythropoietin lack results in severe and often transfusion-dependent
anemia but if bone marrow function is otherwise normal, recombinant human
erythropoietin therapy can restore the red cell mass and alleviate the
transfusion need. However, elevation of the red cell mass by recombinant human
erythropoietin is associated with a reduction in plasma volume and in some
patients, hypertension is induced. Elevation of the red cell mass is also
associated with a reduction in cerebral blood flow. When used to gradually
elevate the hematocrit to 36% in anemic patients, recombinant human
erythropoietin therapy is usually uneventful. However, when the normal
hematocrit level is exceeded, the risk for thrombotic events increases since
blood viscosity varies exponentially with the hematocrit. Increasing the
hematocrit by autologous blood transfusions can enhance athletic performance in
fit individuals and recombinant human erythropoietin administration is an
obvious surrogate for autologous blood transfusions. However, paradoxically, its
effects are the opposite of those of endurance training, namely a change in red
cell mass without an increase in the total blood volume. Thus, the use of
recombinant human erythropoietin as a performance-enhancing agent is dangerous,
particularly in the less fit athlete, and probably of little benefit in the
highly conditioned one. Differences in the carbohydrate content of native and
recombinant human erythropoietin are identifiable by isoelectric focusing,
providing a direct means for detecting erythropoietin abuse using urine
specimens; a panel of surrogate blood markers of enhanced erythropoiesis such as
soluble transferrin receptors, serum erythropoietin, reticulocyte hematocrit and
percent macrocytes provide an indirect means for this purpose. Timing of
surveillance is, of course, critical due to biological limitations on the
physical presence of the hormone. However, education about its dangers may prove
to be the most valuable solution to abuse of recombinant human erythropoietin
for competitive advantage.
Publication Types:
Review
Review, Tutorial
PMID: 11950139 [PubMed]
202: Sports Med. 2002;32(5):285-96.
Anabolic steroids: a review for the clinician.
Kutscher EC, Lund BC, Perry PJ.
Western Missouri Mental Health Center, Kansas City, Missouri 64108, USA.
eckutscher@yahoo.com
The number of athletes self-administering ergogenic pharmacological agents to
increase their competitive edge continues to be a problem. Most athletes using
anabolic steroids (AS) have acquired a crude pharmacological database regarding
these drugs. Their opinions regarding steroids have been derived from their
subjective experiences and anecdotal information. For this reason, traditional
warnings regarding the lack of efficacy and potential dangers of steroid misuse
are disregarded. A common widely held opinion among bodybuilders is that the
anabolic steroid experts are the athletic gurus who for years have utilised
themselves as the experimental participants and then dispensed their empirical
findings. This review will address the common anabolic steroid misconceptions
held by many of today's athletes by providing an evaluation of the scientific
literature related to AS in athletic performance.
Publication Types:
Review
Review, Tutorial
PMID: 11929356 [PubMed]
203: Sports Med. 2002;32(4):269-84.
A conceptual framework for achieving performance enhancing drug compliance in
sport.
Donovan RJ, Egger G, Kapernick V, Mendoza J.
Division of Health Sciences, Curtin University of Technology, Perth, Western
Australia, Australia. rdonovan@curtin.edu.au
There has been, and continues to be, widespread international concern about
athletes' use of banned performance enhancing drugs (PEDs). This concern
culminated in the formation of the World Anti-Doping Agency (WADA) in November
1999. To date, the main focus on controlling the use of PEDs has been on testing
athletes and the development of tests to detect usage. Although athletes'
beliefs and values are known to influence whether or not an athlete will use
drugs, little is known about athletes' beliefs and attitudes, and the limited
empirical literature shows little use of behavioural science frameworks to guide
research methodology, results interpretation, and intervention implications.
Mindful of this in preparing its anti-doping strategy for the 2000 Olympics, the
Australian Sports Drug Agency (ASDA) in 1997 commissioned a study to assess the
extent to which models of attitude-behaviour change in the public health/injury
prevention literature had useful implications for compliance campaigns in the
sport drug area. A preliminary compliance model was developed from three
behavioural science frameworks: social cognition models; threat (or fear)
appeals; and instrumental and normative approaches. A subsequent review of the
performance enhancing drug literature confirmed that the overall framework was
consistent with known empirical data, and therefore had at least face validity
if not construct validity. The overall model showed six major inputs to an
athlete's attitudes and intentions with respect to performance enhancing drug
usage: personality factors, threat appraisal, benefit appraisal, reference group
influences, personal morality and legitimacy. The model demonstrated that a
comprehensive, fully integrated programme is necessary for maximal effect, and
provides anti-doping agencies with a structured framework for strategic planning
and implementing interventions. Programmes can be developed in each of the six
major areas, with allocation of resources to each area based on needs-assessment
research with athletes and other relevant groups.
Publication Types:
Review
Review, Tutorial
PMID: 11929355 [PubMed]
204: Rinsho Byori. 2002 Feb;50(2):151-5.
[Drug of abuse]
[Article in Japanese]
Ueki M.
Doping Control Laboratory, Mitsubishi Kagaku Bio-Clinical Laboratories, Inc.,
Itabashi-ku, Tokyo 174-8555.
Recent development of various dietary supplements after enforcement of "Dietary
Supplement Health and Education Act of 1994 (DSHEA)" in the USA enabled better
availability of the products through the Internet in Japan as well. Because of
differences in the definitions of the term "dietary supplement" and drug control
laws between the USA and Japan, health risks due to uncontrolled use of a
drug-based foreign dietary supplement without a medical doctor's advice, and
side effects due to co-administration of any problematic supplements with
prescription drugs has become a problem in Japan. Classes of typical dietary
supplements, the method of distribution, and known problems during use or
overuse of these products with prescription drugs are discussed. Several recent
positive cases are known to be due to the use of contaminated food supplements,
which were sold not only to athletes but also to the general public as memory
enhancing or anti-aging drugs. These phenomena indicate that trends in drug use
in sports and in society becoming increasingly similar.
Publication Types:
Review
Review, Tutorial
PMID: 11925852 [PubMed]
205: Br J Sports Med. 2002 Apr;36(2):148-9.
Growth hormone and insulin-like growth factor I in a Sydney Olympic gold
medallist.
Armanini D, Faggian D, Scaroni C, Plebani M.
Department of Medical and Surgical Sciences and Endocrinology, University of
Padua, Padua, Italy. decio.armanini@unipd.it
An Italian athlete who won a gold medal at the Sydney Olympic Games was studied.
She was accused of doping after the finding of high levels of plasma growth
hormone (GH) before the Games. She was studied firstly under stressed and then
under unstressed conditions. In the first study, GH was measured every 20
minutes for one hour; it was above the normal range in all blood samples,
whereas insulin-like growth factor I (IGF-I) was normal. In the second study, GH
progressively returned to accepted normal levels; IGF-I was again normal. It was
concluded that the normal range for GH in athletes must be reconsidered for
doping purposes, because athletes are subject to stress and thus to wide
variations in GH levels.
Publication Types:
Case Reports
PMID: 11916901 [PubMed]
206: Br J Sports Med. 2002 Apr;36(2):79.
Do drug cheats ever prosper?
McCrory P.
Publication Types:
Editorial
PMID: 11916883 [PubMed]
207: Int J Sports Med. 2002 Apr;23(3):158-61.
Short-term effects of prolonged strenuous endurance exercise on the level of
haematocrit in amateur cyclists.
Neumayr G, Pfister R, Mitterbauer G, Gaenzer H, Joannidis M, Eibl G, Hoertnagl
H.
Institute of Sports Medicine, University Clinics of Innsbruck, Austria.
guenther.neumayr@uklibk.ac.at
Knowledge is sparse about the extent of potential dehydration due to prolonged
strenuous cycling and its haematological acute effects on the haematocrit (Hct)
in study populations credibly not taking any kind of doping. With increasing
training load levels of Hct and haemoglobin (Hb) decrease in both amateurs and
professionals as a long-term consequence due to expanded plasma volume (PV). On
a short-term basis, however, counteracting dehydration potentially brought about
by endurance exercise may cause a rise in Hct bringing competitive cyclists into
conflict with the current condition regulations and Hct cut-off of 50 % set by
the International Cycling Union (UCI) in its fight against erythropoietin
(rhEPO) doping. On the other hand adequate and sufficient fluid substitution
being substantial for a successful endurance performance should prevent any
pronounced Hct rises. To study the haematological acute effects of prolonged
strenuous cycling we measured Hct, Hb, red blood cell (RBC) count and plasma
protein in a reliably 'clean' population of 38 well-trained male amateur
cyclists before, immediately after and one day after an extraordinary
ultramarathon. The pre-race levels of Hct, Hb and RBC count were placed in the
lower range of normal distribution and well below the Hct cut-off limit of the
UCI. Immediately post-exercise the mean levels of Hct, Hb, RBC count and protein
remained unchanged. One day after race, however, all four parameters
significantly dropped by 3 %, 6.7 %, 6.5 %, 9.9 % respectively (p < 0.001),
indicating marked post-exercise PV expansion. The calculated percentage increase
in PV was 11.9 %. No evidence for coexisting exercise-induced haemolysis was
found. Our study shows that in "clean, rhEPO-free" amateur cyclists who involve
in strenuous marathon cycling the haematological short-term effects of
extraordinary marathon cycling consist in considerable PV expansion making Hct
values fall on the following day. The findings - gained from amateurs though -
suggest that despite all its disadvantages the UCI Hct cut-off represents an
appropriate means to discourage from excessive rhEPO doping at least as long as
the available direct methods for detecting this kind of misuse are not yet
applied by the international sports federations.
PMID: 11914976 [PubMed]
208: Duodecim. 1999;115(11):1257,1259.
[A feverish patient in good condition]
[Article in Finnish]
Mattila J.
Kotkan terveyskeskus, Kirkkokatu 20 C 37 48100 Kotka
Publication Types:
Case Reports
PMID: 11902132 [PubMed]
209: Clin Chem. 2002;48(4):629-36.
Detection of epitestosterone doping by isotope ratio mass spectrometry.
Aguilera R, Hatton CK, Catlin DH.
UCLA Olympic Analytical Laboratory, Department of Molecular and Medical
Pharmacology, University of California, Los Angeles, Los Angeles, CA 90025-6106,
USA.
BACKGROUND: Epitestosterone is prohibited by sport authorities because its
administration will lower the urinary testosterone/epitestosterone ratio, a
marker of testosterone administration. A definitive method for detecting
epitestosterone administration is needed. METHODS: We developed a gas
chromatography-combustion-isotope ratio mass spectrometry method for measuring
the delta(13)C values for urinary epitestosterone. Sample preparation included
deconjugation with beta-glucuronidase, solid-phase extraction, and
semipreparative HPLC. Epitestosterone concentrations were determined by gas
chromatography-mass spectrometry for urines obtained from a control group of 456
healthy males. Epitestosterone delta(13)C values were determined for 43 control
urines with epitestosterone concentrations > or =40 microg/L (139 nmol/L) and 10
athletes' urines with epitestosterone concentrations > or =180 microg/L (624
nmol/L), respectively. RESULTS: The log epitestosterone concentration
distribution was gaussian [mean, 3.30; SD, 0.706; geometric mean, 27.0 microg/L
(93.6 nmol/L)]. The delta(13)C values for four synthetic epitestosterones were
low (less than or equal to -30.3 per thousand) and differed significantly (P
<0.0001). The SDs of between-assay precision studies were low (< or =0.73 per
thousand). The mean delta(13)C values for urine samples obtained from 43 healthy
males was -23.8 per thousand (SD, 0.93 per thousand). Nine of 10 athletes' urine
samples with epitestosterone concentrations >180 microg/L (624 nmol/L) had
delta(13)C values within +/- 3 SD of the control group. The delta(13)C value of
epitestosterone in one sample was -32.6 per thousand (z-score, 9.4), suggesting
that epitestosterone was administered. In addition, the likelihood of
simultaneous testosterone administration was supported by low delta(13)C values
for androsterone and etiocholanolone. CONCLUSIONS: Determining delta(13)C values
for urinary epitestosterone is useful for detecting cases of epitestosterone
administration because the mean delta(13)C values for a control group is high
(-23.8 per thousand) compared with the delta(13)C values for synthetic
epitestosterones.
PMID: 11901061 [PubMed]
210: Ther Drug Monit. 2002 Apr;24(2):247-54.
Role of gas chromatography-mass spectrometry with negative ion chemical
ionization in clinical and forensic toxicology, doping control, and
biomonitoring.
Maurer HH.
Department of Experimental and Clinical Toxicology, Institute of Experimental
and Clinical Pharmacology and Toxicology, University of Saarland, D-66421
Homburg (Saar), Germany. hans.maurer@uniklinik-saarland.de
This paper reviews procedures for the detection or quantification of drugs,
pesticides, pollutants, and/or their metabolites relevant to clinical and
forensic toxicology, doping control, or biomonitoring using gas
chromatography-mass spectrometry with negative ion chemical ionization
(GC-MS-NICI). Papers written in English between 1995 and 2000 are reviewed.
Procedures are included for the analysis of the following halogen-containing or
derivatizable compounds in common biosamples, such as whole blood, plasma, or
urine, and in alternative matrices such as sweat, hair, bone, or muscle samples
of humans or rats: benzodiazepines, cannabinoids, opioids, acetylsalicylic acid,
angiotensin-converting enzyme inhibitors, ketoprofen, methylphenidate
enantiomers, tegafur, zacopride, anabolic steroids, chlorophenols, chlorpyrifos,
hexachlorocyclohexanes, organochlorines, and polychlorinated biphenyls. The
principal information on each procedure is summarized in three tables to
facilitate the selection of a method suitable for a specific analytic problem.
Publication Types:
Review
Review, Tutorial
PMID: 11897971 [PubMed]
211: Ther Drug Monit. 2002 Apr;24(2):239-46.
Use of alternative specimens: drugs of abuse in saliva and doping agents in
hair.
Kintz P, Samyn N.
Institut de Medecine Legale, 11 rue Humann, F-67000 Strasbourg, France.
It is generally accepted that chemical testing of biologic fluids is the most
objective means of diagnosis of drug use. The presence of a drug analyte in a
biologic specimen can be used to document exposure. The standard for drug
testing in toxicology is an immunoassay screen conducted on a urine sample,
followed by confirmation by gas chromatography with mass spectrometric
detection. In recent years, remarkable advances in sensitive analytic techniques
have enabled the analysis of drugs in unconventional biologic specimens such as
saliva or hair. The aim of this review is to document the current status of
drugs of abuse testing in saliva and some doping agents in hair. The influence
on drug concentration of the procedure of saliva sampling is described.
Screening procedures along with specific methods are reviewed for the
determination of amphetamines, cannabis, cocaine, and opiates in saliva. Before
an extensive review on the detection of anabolics, corticosteroids, and
beta-adrenergic stimulants in hair, the place of this specimen in doping control
is discussed, with a focus on the potential problems of this new technology.
Publication Types:
Review
Review, Tutorial
PMID: 11897970 [PubMed]
212: Can J Appl Physiol. 2001;26 Suppl:S192-201.
The adverse effects of elite competition on health and well-being.
Pipe A.
Department of Family Medicine and Division of Cardiac Surgery, University of
Ottawa, Ottawa, ON.
It is often assumed that participation in sport will produce only an array of
health benefits. The adverse consequences of sport participation, particularly
at the elite level, are rarely explored. Evidence continues to accumulate of a
variety of unfortunate consequences that may accompany elite sport
participation. Sport involvement may exacerbate pre-existing health problems,
cause injury or even death. The sport environment may be hazardous in a variety
of physical, emotional, and social ways. The common training and competition
practices of certain sport cultures may themselves be harmful. Athletes may
sacrifice health, home, education and normal social development in the pursuit
of sport "success." Sport medicine professionals and sport scientists have
particular opportunities and responsibilities to act as an athlete's
advocate--and to protect their health and well being.
Publication Types:
Review
Review, Tutorial
PMID: 11897895 [PubMed]
213: Can J Appl Physiol. 2001;26 Suppl:S120-9.
Sport nutritional supplements: quality and doping controls.
Ayotte C, Levesque JF, Cle roux M, Lajeunesse A, Goudreault D, Fakirian A.
INRS-Institut Armand-Frappier, Pointe-Claire, QC.
Nutritional supplements are part of the diet of many athletes. With the
exception of caffeine and ephedrine alkaloids, most of these products do not
contain substances that are prohibited to competing sportsmen. In recent years,
androgens, pro-hormones such as DHEA, androstenedione, androstenediol and
19-norsteroids became available for oral self-administration in many countries
and on the Internet. Their claimed actions, efficiency or potency, and the
possible adverse effects have not been thoroughly investigated by controlled
clinical studies. Some products were shown to contain prohibited substances such
as ephedrine, caffeine, or steroids, that were not listed on the label. Urine
samples collected after the administration of these supplements can test
positive. The administration of natural steroids such as testosterone and its
precursors cannot be proven by the sole identification of the substances in the
urine. The approach to detection is based upon the deviation of selected
parameters of the metabolic profiles from the range of values normally found in
humans. The individual's norm is also studied to exclude the few cases of
systematic and natural excretion of extreme values. The combination of the GC/MS
and the GC/C/IRMS offers a powerful tool to discriminate between the natural and
synthetic origin of the urinary steroids.
Publication Types:
Review
Review, Tutorial
PMID: 11897888 [PubMed]
214: J Anal Toxicol. 2002 Jan-Feb;26(1):43-7.
Endogenous nandrolone metabolites in human urine. Two-year monitoring of male
professional soccer players.
Le BB, Bryand F, Gaudin I, Monteau F, Poulain F, Andre F.
LABERCA, Ecole Nationale Veterinaire, Nantes, France. lebizec@vet-nantes.fr
19-Norandrosterone (19-NA) and 19-noretiocholanolone (19-NE) are the two main
indicators used to prove the illegal use of nandrolone by humans. Recent studies
showed that 19-NA and 19-NE can be endogenously produced in some individuals.
The mediated cases observed over the last three years generated some questions
about the appropriateness of the official International Olympic Committee cutoff
level, which is 2 ng/mL of 19-NA in male urine samples. In the present study,
professional soccer players belonging to the French First League were studied
over a period of 19 months. In total, 385 urine samples were taken immediately
before and after soccer competitions and were coupled with 200 blood samples for
testosterone and LH determination. Results of the study showed that the mean
values for 19-NA and 19-NE were 0.097 ng/mL and 0.033 ng/mL, respectively. For
19-NA, 70% of the samples proved to be below 0.1 ng/mL, whereas less than 20%
were found to be between 0.1 and 0.2 ng/mL, and 7% were between 0.2 and 0.3
ng/mL. Only four urine samples were above 1.0 ng/mL; the maximal value was 1.79
ng/mL. For 19-NE, only one sample was above 1.0 ng/mL; the value was 1.42 ng/mL.
Concentrations of these compounds after games were generally significantly
higher than those before games.
Publication Types:
Clinical Trial
PMID: 11888015 [PubMed]
215: J Chromatogr B Analyt Technol Biomed Life Sci. 2002 Feb 15;767(2):341-51.
Validation of qualitative chromatographic methods: strategy in antidoping
control laboratories.
Jimenez C, Ventura R, Segura J.
Unitat de Farmacologia, Institut Municipal d'Investigacio Medica, Barcelona,
Spain.
An experimental approach for the validation of chromatographic qualitative
methods and its application in an antidoping control laboratory is described.
The proposed strategy for validation of qualitative methods consists of the
verification of selectivity/specificity, limit of detection (LOD), extraction
recovery and repeatability (intra-assay precision). A one-day assay protocol,
based on the analysis of five blank samples obtained from different sources and
four replicates of control samples at two different concentrations of the
analytes, has been defined to evaluate the validation parameters. The following
evaluation criteria have been applied: absence of interfering substances at the
retention time of the analytes in the blank samples to check the
selectivity/specificity of the method, the LOD recommended by international
sports authorities has to be attained, and for repeatability, the relative
standard deviation should be <25% for the low concentration control sample and
<15% for the high concentration control sample. Qualitative screening procedures
are able to detect a great number of analytes so that extraction and analysis
conditions are always a compromise for the different analytes. For this reason,
no minimum acceptance criteria have been defined for data of extraction
recoveries. The proposed protocol has been used for the validation of the
screening and confirmation qualitative methods included in the scope of the
accreditation of an antidoping control laboratory according to ISO quality
standards.
Publication Types:
Validation Studies
PMID: 11885863 [PubMed]
216: New Sci. 2000 Jan 15;165(2221):24-9.
Gene cheats.
Aschwanden C.
PMID: 11885621 [PubMed]
217: Tidsskr Nor Laegeforen. 2001 Jun 30;121(17):2095-6.
Comment on:
Tidsskr Nor Laegeforen. 2001 May 20;121(13):1563.
[Doping]
[Article in Norwegian]
Sundal E.
Publication Types:
Comment
Letter
PMID: 11875914 [PubMed]
218: Haematologica. 2002 Mar;87(3):232.
Further concerns about the medical risks of blood doping.
Cazzola M.
Publication Types:
Editorial
PMID: 11869931 [PubMed]
219: Haematologica. 2002 Mar;87(3):225-32.
Comment in:
Haematologica. 2002 Jul;87(7):ELT31; author reply ELT32.
A strategy to deter blood doping in sport.
Ashenden MJ.
Publication Types:
Editorial
PMID: 11869930 [PubMed]
220: Neurology. 2002 Feb 26;58(4):665.
Cyclist's doping associated with cerebral sinus thrombosis.
Lage JM, Panizo C, Masdeu J, Rocha E.
Department of Neurology and Neurosurgery, Clinica Universitaria de Navarra,
Pamplona, Spain.
Publication Types:
Case Reports
PMID: 11865158 [PubMed]
221: Tex Med. 2002 Feb;98(2):41-6.
Performance-enhancing substances in adolescent athletes.
Gomez JE.
Pediatric Sports Medicine & Fitness Clinic, Department of Pediatrics, University
of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio,
TX 78229-3900, USA. gomezje@uthscsa.edu
Use of performance-enhancing substances is widespread among adolescents.
Anabolic steroids, creatine, and androstenedione are currently among the most
used ergogenic substances. In the past 10 years, the amount of data regarding
these substances from well-designed clinical trials has increased dramatically.
Anabolic steroids remain difficult to study because of their known harmful side
effects. The vast amount of data on creatine and exercise performance does not
support the dramatic claims of muscle building and power development by
manufacturers. Androstenedione has been popularized by high-profile sports
stars, but initial studies cast doubt about its performance-enhancing potential.
The physician requires factual information about these substances to be able to
counsel youth about their effects.
PMID: 11862891 [PubMed]
222: Recenti Prog Med. 2002 Jan;93(1):1-8.
[The new frontiers of blood doping]
[Article in Italian]
Lippi G, Franchini M.
Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologiche
e Biomediche, Universita, Verona. ulippi@tin.it
Blood oxygenation and peripheral perfusion are pivotal factors to optimize
intensity and length of the muscular activity. Enhancement and optimization of
oxygen delivery to peripheral tissues is associated with a substantial
improvement of the athletic performances, especially in endurance sports.
Remarkable progresses in medical research promoted the introduction and
commercialization of novel methods and molecules for the therapy of severe
systemic pathologies, characterized by detrimental peripheral oxygenation.
Unfortunately, the evident benefits of some promising classes of molecules
propitiated the gradual diffusion to some sport disciplines, in form of doping.
Aim of this review is to give further insights into new techniques of blood
doping, chiefly focusing on blood transfusion, oxygen-carrying blood
substitutes, synthetic haemoglobin allosteric modulators and administration of
substances promoting synthesis and maturation of erythrocytes.
Publication Types:
Review
Review, Tutorial
PMID: 11850993 [PubMed]
223: Clin Lab Haematol. 2002 Feb;24(1):65-6.
Haematocrit measurement and antidoping policies.
Lippi G, Franchini M, Guidi G.
Publication Types:
Letter
PMID: 11843902 [PubMed]
224: Drug Alcohol Depend. 2002 Feb 1;65(3):303-8.
Pumping iron, risking infection? Exposure to hepatitis C, hepatitis B and HIV
among anabolic-androgenic steroid injectors in Victoria, Australia.
Aitken C, Delalande C, Stanton K.
The Macfarlane Burnet Centre for Medical Research, P.O. Box 254, Fairfield,
3078, Victoria, Australia. aitkenc@burnet.edu.au
AIMS: To measure exposure to the hepatitis C and B viruses and HIV among
Victorian steroid injectors and evaluate associations between exposure and risk
behaviour, and report other characteristics of the study group. DESIGN:
Seroprevalence study using a convenience sample. SETTING: Victoria, Australia.
PARTICIPANTS: Current injectors of illicit anabolic steroids. MEASUREMENTS:
Prevalences of exposure to HIV and the hepatitis B and C viruses; associations
of characteristics and behaviours with exposure; descriptive statistics for the
sample. FINDINGS: Six of 63 blood samples (9.5%) contained hepatitis C virus
antibodies; 12.0% tested positive for hepatitis B core antibody; none contained
anti-HIV. Hepatitis C virus exposure was associated with heroin injection,
imprisonment, sharing needles to inject other drugs, number of tattoos, and
hepatitis B virus exposure. No significant differences existed in the
steroid-related risk behaviour of exposed and non-exposed individuals. Hepatitis
B virus exposure was associated only with hepatitis C virus exposure, past
imprisonment and age of first injection. CONCLUSIONS: Exposure to the hepatitis
B and C viruses was detected; hepatitis C virus exposure was at much lower
prevalence than normally found among other drug injectors. Factors other than
steroid injecting were associated with exposure. Nonetheless, the hepatitis
C-exposed reported many steroid-related and other risk behaviours which could
spread the virus. Steroid injectors should not be neglected in blood-borne virus
prevention efforts.
PMID: 11841901 [PubMed]
225: J Chromatogr B Analyt Technol Biomed Life Sci. 2002 Jan 25;766(2):257-63.
Human nutritional supplements in the horse: comparative effects of
19-norandrostenedione and 19-norandrostenediol on the 19-norsteroid profile and
consequences for doping control.
Dehennin L, Bonnaire Y, Plou P.
Laboratoire de la Federation Nationale des Courses Francaises, Chatenay-Malabry,
France. ldehennin@aol.com
The dietary supplements 19-norandrostenedione and 19-norandrostenediol are
potential metabolic precursors of nandrolone. They are considered by law in the
United States as prohormones without proven therapeutic, curative or diagnostic
properties, and therefore available as over-the-counter drugs. Oral dosages of
0.1-1 mg/kg body weight were readily absorbed in the equine intestinal tract and
thereby led to urinary excretion of drastically increased
5alpha-estrane-3beta,17alpha-diol conjugates, which are known to be final
metabolites of nandrolone. The actual rules for detection of illicit nandrolone
administration to the horse have been found applicable for the detection of
surreptitious oral 19-norandrostenedione and 19-norandrostenediol
supplementation. Secondary markers of these administrations were high-level
excretions of conjugated nandrolone, epinandrolone, 19-noretiocholanolone and
19-norepiandrosterone. No significant increase of circulating, biologically
active nandrolone could be firmly evidenced, and it is therefore unclear to what
extent continuous long-term administrations may have anabolic action.
PMID: 11824814 [PubMed]
226: J Chromatogr B Analyt Technol Biomed Life Sci. 2002 Jan 5;766(1):161-7.
Doping control for methenolone using hair analysis by gas chromatography-tandem
mass spectrometry.
Kintz P, Cirimele V, Dumestre-Toulet V, Villain M, Ludes B.
Institut de Medecine Legale, Strasbourg, France. pascal.kintz@wanadoo.fr
A sensitive, specific and reproducible method for the quantitative determination
of methenolone in human hair has been developed. The sample preparation involved
a decontamination step of the hair with methylene chloride. The hair sample
(about 100 mg) was solubilized in 1 ml 1 M NaOH, 15 min at 95 degrees C, in
presence of 1 ng testosterone-d3 used as internal standard. The homogenate was
neutralized and extracted using consecutively a solid-phase (Isolute C18 eluted
with methanol) and a liquid-liquid (pentane) extraction. The residue was
derivatized by adding 50 microl MSTFA-NH4I-2-mercaptoethanol (1000:2:5, v/v/v),
then incubated for 20 ml at 60 degrees C. A 1.5-microl aliquot of the
derivatized extract was injected into the column (HP5-MS capillary column, 5%
phenyl-95% methylsiloxane, 30 m x 0.25 mm I.D., 0.25 microm film thickness) of a
Hewlett-Packard (Palo Alto, CA, USA) gas chromatograph (6890 Series).
Methenolone was detected by its parent ion at m/z 446 and daughter ions at m/z
208 and 195 through a Finnigan TSQ 700 MS-MS system. The assay was capable of
detecting 1 pg/mg of methenolone when approximately 100 mg hair material was
processed. Linearity was observed for methenolone concentrations ranging from 2
to 100 pg/mg with a correlation coefficients of 0.965-0.981. Intra-day and
between-day precisions at 2, 10 and 25 pg/mg were 10.9-14.1% and 13.7-16.8%,
respectively, with an extraction recovery of 97.6%. The analysis of a strand of
hair obtained from two bodybuilders, revealed the presence of methenolone at the
concentrations of 7.3 and 8.8 pg/mg.
PMID: 11820291 [PubMed]
227: Sports Med. 2002;32(2):125-42.
Detection of DNA-recombinant human epoetin-alfa as a pharmacological ergogenic
aid.
Wilber RL.
Sport Science and Technology Division, United States Olympic Committee, Colorado
Springs, Colorado 80909, USA. randy.wilber@uso.org
The use of DNA-recombinant human epoetin-alfa (rhEPO) as a pharmacological
ergogenic aid for the enhancement of aerobic performance is estimated to be
practised by at least 3 to 7% of elite endurance sport athletes. rhEPO is
synthesised from Chinese hamster ovary cells, and is nearly identical
biochemically and immunologically to endogenous epoetin-alfa (EPO). In a
clinical setting, rhEPO is used to stimulate erythrocyte production in patients
with end-stage renal disease and anaemia. A limited number of human studies have
suggested that rhEPO provides a significant erythropoietic and ergogenic benefit
in trained individuals as evidenced by increments in haemoglobin, haematocrit,
maximal oxygen uptake (VO2max) and exercise endurance time. The purpose of this
review is to summarise the various technologies and methodologies currently
available for the detection of illicit use of rhEPO in athletes. The
International Olympic Committee (IOC) banned the use of rhEPO as an ergogenic
aid in 1990. Since then a number of methods have been proposed as potential
techniques for detecting the illegal use of rhEPO. Most of these techniques use
indirect markers to detect rhEPO in blood samples. These indirect markers
include macrocytic hypochromatic erythrocytes and serum soluble transferrin
receptor (sTfr) concentration. Another indirect technique uses a combination of
5 markers of enhanced erythropoiesis (haematocrit, reticulocyte haematocrit,
percentage of macrocytic red blood cells, serum EPO, sTfr) to detect rhEPO. The
electrophoretic mobility technique provides a direct measurement of urine and
serum levels of rhEPO, and is based on the principle that the rhEPO molecule is
less negatively charged versus the endogenous EPO molecule. Isoelectric
patterning/focusing has emerged recently as a potential method for the direct
analysis of rhEPO in urine. Among these various methodologies, the indirect
technique that utilises multiple markers of enhanced erythropoiesis appears to
be the most valid, reliable and feasible protocol currently available for the
detection of rhEPO in athletes. In August 2000, the IOC Medical Commission
approved this protocol known as the 'ON model', and it was subsequently used in
combination with a second, confirmatory test (isoelectric patterning) to detect
rhEPO abusers competing in the 2000 Sydney Summer Olympics. This combined blood
and urine test was approved with modifications by the IOC in November 2001 for
use in the 2002 Salt Lake City Winter Olympics.
Publication Types:
Review
Review, Tutorial
PMID: 11817997 [PubMed]
228: Ther Drug Monit. 2002 Feb;24(1):178-81.
Abuse of performance-enhancing drugs in sport.
Bowers LD.
United States Anti-Doping Agency, Colorado Springs, Colorado 80906, USA.
ldb@usantidoping.org
Publication Types:
Review
Review, Tutorial
PMID: 11805741 [PubMed]
229: Res Vet Sci. 2001 Dec;71(3):167-73.
IGF -I plasma concentrations in non-treated horses and horses administered with
methionyl equine somatotropin.
Popot MA, Bobin S, Bonnaire Y, Delahaut PH, Closset J.
LAB/FNCF, 169 Avenue de la Division Leclerc, Chatenay-Malabry 92290, France.
mariepopot@wanadoo.fr
Insulin-like growth factor-I (IGF -I) is likely to be an indicator of
somatotropin (ST) administration in the horse. To investigate the different ways
ST administration may be detected, the following aspects of IGF -I
concentrations in plasma were studied: (i) the daily variation; (ii) variation
following a treadmill test; (iii) concentrations at rest and after exercise; and
(iv) concentrations in plasma from two young horses and two adults treated with
methionyl equine somatotropin (e ST). In the population of horses at rest, IGF
-I mean concentration (SEM) was 261 (104) ng ml(-1). In post race samples, IGF
-I mean concentration was 187 (100) ng ml(-1). All of these data indicate that
exercise does not modify IGF -I concentration in plasma. The magnitude of the
increase in IGF -I following administration of e ST differed according to the
age of the horses. The critical value of 700 ng ml(-1)was exceeded for 1 day in
adult horses and for at least 11 days in young horses. These results show that
IGF -I has potential as an indirect marker of ST administration in horses.
Copyright 2001 Harcourt Publishers Ltd.
PMID: 11798290 [PubMed]
230: Ann Pharm Fr. 2001 Sep;59(5):350-4.
[Radioimmunoassay of testosterone concentrations in hair: use in doping control]
[Article in French]
Mornay E, Deveaux M, Soudan B, Gosset D.
Institut de Medecine Legale, Place Theo Varlet, F59000 Lille.
The measurement of doping agents in hair is attractive since it offers an
increase in retrospective detection of doping with these substances. Hair
analysis has a wide window of detection, ranging from months to years, depending
on the length of the hair shaft and provides information concerning the pattern
of an individual's drug abuse. The aim of the present study was to evaluate the
ability of a radioimmunological method to determine physiological concentrations
of testosterone in hair. Specimens of hair were collected from four children,
nine women and twelve men. None of the subjects was an athlete. Hair samples
were weighed, decontaminated and digested in sodium hydroxide. The homogenates
were extracted by organic solvent. After evaporation, testosterone was measured
by radioimmuno-assay. Hair testosterone concentrations ranged 0.6-2.7 pg/mg,
1.8-6.4 pg/mg and 3.6-23.3 pg/mg for children, women and men respectively. This
method is fast and accurate and could have applications in doping control, for
screening easily numerous hair samples. GCMS is absolutely necessary to confirm
results above 30 pg/mg.
PMID: 11787430 [PubMed]
231: Ann Pharm Fr. 2001 Sep;59(5):345-9.
[Urinary nandrolone metabolites in antidoping control]
[Article in French]
Pepin G, Vayssette F, Gaillard Y.
Laboratoire d'expertise TOXLAB, 7, rue Jacques Cartier, F75018 Paris.
The French National Laboratory of the International Olympic Committee (IOC) has
detected norandrosterone (NA) and noretiocholanolone (NE) in urine samples from
several sportsmen. These two substances are known to be urinary metabolites
after nandrolone intake. In such cases, the NA level is always higher than the
Ne level. However, in the urine samples of sportsmen tested positive, the NE
concentrations were systematically higher than the NA levels. We therefore
searched for other steroid precursors (commercially available capsules or
tablets of dehydroepiandrosterone, 4-androstenediol, 5-androstenediol,
4-androstenedione, 19-norandrostenediol and 19-norandrostenedione, also
illegally used in France) which could lead to an excretion of NA and NE and to
an inverted ratio of these metabolites.
PMID: 11787429 [PubMed]
232: Vet Clin North Am Equine Pract. 2001 Dec;17(3):433-44.
Residues and considerations for use of pharmaceutics in the performance horse.
Kollias-Baker C.
K.L. Maddy Equine Analytical Chemistry Laboratory, School of Veterinary
Medicine, University of California, Davis, California, USA. cbaker@ucdavis.edu
Analytic chemistry laboratories responding to the concerns of the industry over
drug use and abuse in performance horses should continue to develop more
sensitive methods of drug detection. The unwanted result of this increase in
sensitivity is the detection of therapeutic medications days to weeks after
administration. The adoption of decision or threshold concentrations for
residues of nonpermitted medications should allow laboratories to focus their
efforts on drugs of abuse in the performance horse industries and permit
veterinarians to provide appropriate medical care to these equine athletes.
Publication Types:
Review
Review, Tutorial
PMID: 11780278 [PubMed]
233: Lakartidningen. 2001 Nov 28;98(48):5490-2, 5495-6.
[Doping in endurance sports. Survey of individual [Hb] levels can expose doping]
[Article in Swedish]
Ekblom B, Holmberg HC, Eriksson K.
Institutionen for fysiologi och farmakologi, Karolinska institutet, Stockholm.
bjorn.ekblom@fyta.ki.se
Doping through increasing [Hb] increases physical performance in sport.
Therefore, no cross-country skiers with [Hb] values above 160 and 175 g/l for
women and men, respectively, may start in competitions. Even plasma expanders
have been used, possibly for lowering a high [Hb] but this procedure may not
increase physical performance. There are methods available for detecting the use
of erythropoietin but not reinfusion of erythrocytes to increase [Hb]. To make
it more difficult to increase [Hb] by different unethical methods we suggest
that the [Hb] in endurance athletes is determined both during the training and
the competition season to establish individual [Hb] mean values and range. Since
endurance training at altitude does not increase [Hb] after return to sea level,
an occasional increased [Hb] is suspicious. In such a case complementary doping
tests may be used.
PMID: 11769364 [PubMed]
234: Presse Med. 2001 Nov 24;30(35):1733-9.
[Doping in sports. Cases reported to the Poison Control Center of Marseille from
1992 to 2000]
[Article in French]
Spadari M, Coja C, Rodor F, Monnier B, Affaton MF, Arditti J, Hayek-Lanthois M,
David JM, Valli M.
Centre antipoison, Centre d'evaluation et d'information sur la
pharmacodependance, Hopital Salvator, Marseille. michel.spadari@voila.fr
OBJECTIVE: To study the doping substances used in sport and their toxicity.
METHODS: Retrospective analysis from January 1992 to December 2000 of the cases
of use of doping substances in sport reported by telephone to the anti-poison
center in Marseilles. RESULTS: Fifty-one cases were reported concerning 48 men
and 3 women with a mean age of 30, ranging from 10 to 55 years. Sixty-three
percent of cases were reported over the last four years. The sport practiced was
bodybuilding, except in 2 cases (cycling in one case and running in the other).
The products used were mainly anabolizing hormones (15 times), clenbuterol (14
times) and creatine (7 times). A third of cases concerned associations of
substances and 19 cases presented with symptomatology. CONCLUSION: The diversity
in nature and status of the substances mentioned and their association requires
enhanced vigilance with regard to the use of drugs in sport. The recent measures
voted within the framework of the anti-doping law dated 23/3/99 are aimed at
increasing surveillance with the development of anti-doping antennae.
PMID: 11769066 [PubMed]
235: J Anal Toxicol. 2001 Nov-Dec;25(8):685-90.
Human nutritional supplements in the horse. Dehydroepiandrosterone versus
androstenedione: comparative effects on the androgen profile and consequences
for doping analysis.
Dehennin L, Bonnaire Y, Plou P.
Laboratoire de la Federation Nationale des Courses Francaises, Chatenay-Malabry,
France. ldehennin@aol.com
Dehydroepiandrosterone (DHEA) and androstenedione are weak androgens, which need
conversion to more potent testosterone in order to enhance anabolic action.
Consequences of oral dosing at 1 mg/kg on the urinary and plasma androgen
profile of mare and gelding have been evaluated with an analytical method
involving conjugate fractionation and selective hydrolysis, group separation,
and quantitation by gas chromatography-mass spectrometry with selected ion
monitoring of trimethylsilyl ethers. Peak levels of testosterone total
conjugates in urine (range 300-6000 microg/L) were attained a few hours after
dosing. Renal clearance was fast, so the testosterone detection period lasted
only 20 to 33 h, the longest time being generated by androstenedione. The
urinary testosterone/epitestosterone ratio for detection of exogenous
testosterone in the mare was inoperative after DHEA administration because there
was a concomitant increase of epitestosterone, which thereby acted as a masking
agent. Androstanediols and androstenediols, as well as some 17-ketosteroids,
were additional markers. A transient increase of circulating free testosterone
has been evidenced, and this would support possible anabolic/androgenic action
by supplementation with DHEA and androstenedione along the oral route.
PMID: 11765025 [PubMed]
236: Clin J Sport Med. 2001 Oct;11(4):254-9.
Analysis of over-the-counter dietary supplements.
Green GA, Catlin DH, Starcevic B.
Department of Family Medicine, Division of Sports Medicine, University of
California at Los Angeles, 90095-7087, USA. green@mednet.ucla.edu
OBJECTIVE: To determine if steroids containing over-the-counter (OTC) dietary
supplements conform to the labeling requirements of the 1994 Dietary Supplement
Health and Education Act (DSHEA). DESIGN: 12 brands of OTC supplements
containing 8 different steroids were randomly selected for purchase in stores
that cater to athletes. There are two androstenediones (4- and
5-androstene-3,17-dione), two androstenediols (4- and 5-androstene-3beta,
17beta-diol), and 4 more are 19-nor cogeners (19-nor-4- and
5-androstene-3,17-dione and 19-nor-4- and 5-androstene-3beta, 17beta-diol). MAIN
OUTCOME MEASURES: 12 brands of OTC anabolic-androgenic supplements were analyzed
by high-pressure liquid chromatography. RESULTS: We found that 11 of 12 brands
tested did not meet the labeling requirements set out in the 1994 Dietary
Supplement Health and Education Act. One brand contained 10 mg of testosterone,
a controlled steroid, another contained 77% more than the label stated, and 11
of 12 contained less than the amount stated on the label. CONCLUSIONS: These
mislabeling problems show that the labels of the dietary steroid supplements
studied herein cannot be trusted for content and purity information. In
addition, many sport organizations prohibit OTC steroids; thus, athletes who use
them are at risk for positive urine test results. In this article we provide the
details of the analyses, a summary of the steroids by name and structure, and
information on the nature of the positive test results. Athletes and their
physicians need this information because of the potential medical consequences
and positive urine test results.
PMID: 11753063 [PubMed]
237: Rapid Commun Mass Spectrom. 2001;15(24):2379-82.
RSR13, a potential athletic performance enhancement agent: detection in urine by
gas chromatography/mass spectrometry.
Breidbach A, Catlin DH.
UCLA Olympic Analytical Laboratory, Department of Molecular and Medical
Pharmacology, University of California, Los Angeles, CA 90025, USA.
RSR13 (2-[4-[[(3,5-dimethylanilino)carbonyl]methyl]phenoxyl]-2-methylpropionic
acid) is a synthetic allosteric modifier of hemoglobin that is currently in a
phase III clinical trial as a radio-enhancing agent. RSR13 has been shown to
increase maximum oxygen uptake (VO(2max)) in a canine skeletal model, which
makes it a potential performance-enhancing agent for endurance athletes, since
VO(2max) is an index of aerobic capacity. In this study we present a method for
the detection of RSR13-bis-TMS in human urine by gas chromatography/electron
impact ionization mass spectrometry (GC/EI-MS) suitable for doping control
laboratories. The presence of RSR13 is detected by monitoring the ions m/z 485
([M](+.)) and 470 ([M - CH3](+)). The limit of detection (LOD) is less than 2
ng/mL in urine. Urine samples collected from clinical trial subjects immediately
prior to receiving an infusion of RSR13 showed no evidence of RSR13, whereas
post-infusion urine samples contained up to 1181 microg/mL. A urine sample
collected 36 h after administration of a small dose (10 mg/kg) and diluted
100-fold showed a signal 80 times higher than the LOD. Urine samples obtained
from 100 randomly selected athletes in our routine testing program did not show
any traces of RSR13. Sport authorities may wish to add RSR13 to the list of
prohibited substances. Copyright 2001 John Wiley & Sons, Ltd.
Publication Types:
Clinical Trial
PMID: 11746905 [PubMed]
238: Nature. 2001 Dec 6;414(6864):569-70.
Gene therapy may be up to speed for cheats at 2008 Olympics.
Adam D.
Publication Types:
News
PMID: 11740511 [PubMed]
239: Steroids. 2002 Jan;67(1):39-50.
Plasma and urinary markers of oral testosterone undecanoate misuse.
Peng SH, Segura J, Farre M, Gonzalez JC, de la Torre X.
Institut Municipal d'Investigacio Medica, Barcelona, Spain.
Orally administered testosterone undecanoate (TU), an anabolic, androgenic
steroid, can potentially be abused by athletes. Indirect evidence for detecting
oral TU intake could be deduced from the changes in steroid profile
post-administration. Direct evidence could be obtained by detection of unchanged
TU in plasma. To this end, both urinary and plasma steroid profiles of six
healthy male subjects given a single oral dose of 120 mg of TU were studied by
gas chromatography/mass spectrometry (GC/MS) and gas chromatography/tandem mass
spectrometry (GC/MS/MS). The increased concentration of glucuronidated
testosterone in plasma appears to be the most characteristic sign of oral TU
intake. The testosterone glucuronide (TG)/nonconjugated testosterone (T) ratio,
TG/17-hydroxyprogesterone (17OHP) ratio, and TG/luteinizing hormone (LH) ratio
were observed to be significantly elevated above their basal levels for 10 h, 10
h, and 6 h, respectively. Urinary ratios of TG/epitestosterone glucuronide (EG)
were found to be higher than the cut-off value of 6 for the period 4
approximately 8 h post-administration, but only in three subjects. One subject
failed to respond with respect to all of the above-mentioned indirect markers,
as TG was not significantly increased in either plasma or urine. Unchanged TU
was directly detected in plasma of all six subjects from 1 approximately 1.5 h
to 4 approximately 6 h after oral TU intake by GC/MS/MS, providing unequivocal
proof of exogenous testosterone intake. Distinct and complementary markers for
detecting oral TU intake could be obtained from plasma and urine, respectively.
PMID: 11728520 [PubMed]
240: J Strength Cond Res. 2001 Nov;15(4):507-13.
Dietary practices, attitudes, and physiological status of collegiate freshman
football players.
Jonnalagadda SS, Rosenbloom CA, Skinner R.
Department of Nutrition, Georgia State University, Atlanta, GA 30303, USA.
The purpose of this study was to determine the dietary practices, attitudes, and
physiological status of freshman collegiate football players. Thirty-one
freshman football players at a National Collegiate Athletic Association division
I school completed a self-administered nutrition screening questionnaire
designed to determine their dietary practices and attitudes. Fasting blood
samples were collected and height and weight were measured. The mean age of
these athletes was 18 years. These players reported eating 3.6 times per day and
on the average eating out 4.8 times per week. Fast food was the most common
choice when eating out (55%). Of these athletes, 42% reported the use of dietary
supplements, the most popular one being creatine (36%). Although more than 90%
of the athletes recognized the importance of maintaining proper hydration
status, greater than 50% believed that protein supplements were necessary for
muscle growth and development, protein was the primary source of energy for
muscle, and vitamin and mineral supplements increased energy levels. The plasma
lipid profiles of the majority (76%) of the athletes were within normal ranges.
The data suggest that these athletes may require education about healthy dietary
practices and on the proper use of dietary supplements. This is not only
important to help improve performance but to also promote healthy dietary
practices in the long term.
PMID: 11726265 [PubMed]
241: Int J Sports Med. 2001 Nov;22(8):566-71.
Artificial oxygen carriers--the new doping threat in endurance sport?
Schumacher YO, Schmid A, Dinkelmann S, Berg A, Northoff H.
Abteilung Rehabilitation, Pravention und Sportmedizin, Medizinische
Universitatsklinik Freiburg, Germany. olaf@msm1.ukl.uni-freiburg.de
Maximal oxygen uptake is the major performance limiting factor in endurance
sports. Sophisticated training methods have been developed to increase this
variable. On the other hand, attempts have been made to improve maximal oxygen
uptake by artificial means: blood doping and the misuse of recombinant human
erythropoietin have beneficial effects on aerobic exercise capacity. Both
methods have been banned by international sporting federations. A new class of
substances might represent the next step of fraudulent improvement of the
maximal oxygen uptake: artificial oxygen carriers, such as solutions based on
recombinant, bovine or human hemoglobin and perfluorocarbon-emulsions have been
shown to improve oxygen delivery to the muscle. Hemoglobin-based solutions
improve aerobic exercise capacity in animal and human testing. Both substances
have potentially lethal side effects including renal toxicity, increased
systemic and pulmonary blood pressure and impairment of the immune system.
Hemoglobin-based carriers can be detected in drug testing with routine
laboratory tests based on the detection of free hemoglobin. Perfluorocarbon is
not metabolized by the body and exhaled through the lung and can be measured
with chromatography. No screening for these substances in drug tests has been
performed so far. International sporting federations should be aware of this
new, emerging doping threat.
Publication Types:
Review
Review, Tutorial
PMID: 11719891 [PubMed]
242: Int J Sports Med. 2001 Nov;22(8):545.
Doping in sport--exercise scientists have to take responsibility.
Kuipers H.
Publication Types:
Editorial
PMID: 11719887 [PubMed]
243: J Sports Sci. 2001 Nov;19(11):831-7.
A comparison of the physiological response to simulated altitude exposure and
r-HuEpo administration.
Ashenden MJ, Hahn AG, Martin DT, Logan P, Parisotto R, Gore CJ.
Department of Physiology, Australian Institute of Sport, Belconnen, ACT.
michael.ashenden@ausport.gov.au
Concerns have been raised about the morality of using simulated altitude
facilities in an attempt to improve athletic performance. One assumption that
has been influential in this debate is the belief that altitude houses simply
mimic the physiological effects of illegal recombinant human erythropoietin
(r-HuEpo) doping. To test the validity of this assumption, the haematological
and physiological responses of 23 well-trained athletes exposed to a simulated
altitude of 2650-3000 m for 11-23 nights were contrasted with those of healthy
volunteers receiving a low dose (150 IU x kg(-1) per week) of r-HuEpo for 25
days. Serial blood samples were analysed for serum erythropoietin and percent
reticulocytes; maximal oxygen uptake (VO2max) was assessed before and after
r-HuEpo administration or simulated altitude exposure. The group mean increase
in serum erythropoietin (422% for r-HuEpo vs 59% for simulated altitude),
percent reticulocytes (89% vs 30%) and VO2max (6.6% vs -2.0%) indicated that
simulated altitude did not induce the changes obtained with r-HuEpo
administration. Based on the disparity of these responses, we conclude that
simulated altitude facilities should not be considered unethical based solely on
the tenet that they provide an alternative means of obtaining the benefits
sought by illegal r-HuEpo doping.
PMID: 11695504 [PubMed]
244: Am J Med Sci. 2001 Oct;322(4):200-3.
Exercise-induced asthma: an overview.
Cummiskey J.
Olympic Council of Ireland, IOC Medical Commission, Subcommission Sports
Medicine and Physiology, Dublin. joecummiskey@hotmail.com
Asthmatic attack in exercise-induced asthma is brought about by hyperventilation
(not necessarily to exercise), cold air, and low humidity of the air breathed.
The effects are an increase in airway resistance, damage to bronchial mucosa,
and an increase in bronchovascular permeability. The mechanism of these changes
is the release of mediators such as histamine, leukotrienes, nitric oxide,
sensory neuropeptides, the inhibition of neuronal activity, and bronchovascular
permeability. The cause of asthma and exercise-induced asthma is unknown. It is
probably an abnormality of vascular control in the peribronchium and/or an
alteration in local adrenergic function. The importance of exercise-induced
asthma definition and the use of stimulants in sport and antidoping in sport are
discussed.
Publication Types:
Historical Article
Review
Review, Tutorial
PMID: 11678516 [PubMed]
245: Minerva Pediatr. 2001 Oct;53(5):409.
[Drugs and nutritional supplements in sports: use and abuse. The sports
physician's point of view]
[Article in Italian]
Levizzani G.
Medico Sportivo, Milan, Italy.
PMID: 11668260 [PubMed]
246: Minerva Pediatr. 2001 Oct;53(5):403-7.
[Drugs and nutritional supplements in sports: use and abuse. The nutritionist's
point of view]
[Article in Italian]
Calderone G.
Dipartimento di Medicina, Reparto Valutazione Clinica e Nutrizionale, Istituto
di Scienze dello Sport, Rome, Italy.
PMID: 11668259 [PubMed]
247: Minerva Pediatr. 2001 Oct;53(5):397-401.
[Drugs and nutritional supplements in sports: use and abuse. The pediatrician's
point of view]
[Article in Italian]
Cappa M, Bizzarrri C, Fioriti E, Ubertini M, Barnabei A.
UO di Auxologia, Ospedale Pediatrico del Bambino Gesu IRCCS, Palidoro -
Fiumicino (Rome), Italy. cappa@opbg.net
PMID: 11668258 [PubMed]
248: Minerva Pediatr. 2001 Oct;53(5):395-6.
Drugs and food supplements in sports. The nandrolone lessons.
Benzi G, Ceci A.
Departments of Physiology and Pharmacology, Universities of Pavia and Bari,
Italy. farsb@unipv.it
PMID: 11668257 [PubMed]
249: Nature. 1985 Aug 8;316(6028):479.
Athletic doping: Hungarian owns up.
Rich V.
Publication Types:
News
PMID: 11653658 [PubMed]
250: Brief Med Ethics. 1991 Mar;No. 8:4 p.
Doping in sport.
[No authors listed]
PMID: 11650972 [PubMed]
251: Med Secoli. 1992;4(2):1-10.
[Sport doping in times]
[Article in Italian]
D'Este BR.
Storia dell'Educazione Fisica e degli Sport, Padova.
The employment of various substances drawn from three different kingdoms of
Nature, to invigorate consumed, tired bodies has its origins in the most remote
ages. As sport professionalism spreads, doping in sports developes in a gradual
and progressive manner: it becomes a sequence of more or less illegal (or
outlawed) practices aimed at increasing physical resistance and reaction speed,
as well as to lessen the emotional effects of competition. These practices,
which often are at dubious efficacy, are associated with the risk of collateral
effects, some of which may be lethal. This complex problem, which at times deals
with questions of an ethical, medical-legal and social nature, demands an urgent
and informed adjustment (or modification) of the current laws that deal with
this matter.
Publication Types:
Historical Article
PMID: 11640126 [PubMed]
252: Int J Sport Nutr Exerc Metab. 2001 Sep;11(3):397-400.
An interview with Dr. Gary Green about supplements and doping problems from an
NCAA perspective. Interview by Louise Burke.
Green G.
Publication Types:
Interview
PMID: 11599507 [PubMed]
253: J Pediatr Endocrinol Metab. 2001 Sep-Oct;14(8):1077-83.
Doping with growth hormone.
Bidlingmaier M, Wu Z, Strasburger CJ.
Medizinische Klinik, Klinikum der LMU-Innenstadt, Munich, Germany.
bidlingmaier@medinn.med.uni-muenchen.de
Triggered by the Olympic games in Sydney last year, many articles in the press
suggested that recombinant human growth hormone (hGH) is one of the most popular
performance enhancing drugs used by athletes. However, any hard facts on hGH
abuse were provided by Australian customs officers--and not by laboratory
assessment. The lack of an official test for hGH doping together with the
widespread rumours on its tremendous beneficial effects seem to make this
compound attractive for athletes. From a scientific point of view, there are two
major questions about this issue: First, as there is no controlled study
demonstrating a profound effect of hGH administration on workload capacity in
healthy adults, why do athletes use hGH? Second, how could the application of a
substance naturally occurring in the human body be detected? Both aspects are
discussed in this article.
Publication Types:
Review
Review, Tutorial
PMID: 11592563 [PubMed]
254: Int J Sport Nutr Exerc Metab. 2001 Sep;11(3):365-83.
Inadvertent doping through supplement use by athletes: assessment and management
of the risk in Australia.
Baylis A, Cameron-Smith D, Burke LM.
School of Health Sciences, Deakin University, Burwood, Victoria, Australia 3125.
Many athletes report using a wide range of special sports foods and supplements.
In the present study of 77 elite Australian swimmers, 99% of those surveyed
reported the use of these special preparations, with 94% of swimmers reporting
the use of non-food supplements. The most popular dietary supplements were
vitamin or mineral supplements (used by 94% of the group), herbal preparations
(61%), and creatine (31%). Eighty-seven percent of swimmers reported using a
sports drink or other energy-providing sports food. In total, 207 different
products were reported in this survey. Sports supplements, particularly
supplements presented as pills or other non-food form, are poorly regulated in
most countries, with little assurance of quality control. The risk of an
inadvertent "positive doping test" through the use of sports supplements or
sports foods is a small but real problem facing athletes who compete in events
governed by anti-doping rules. The elite swimmers in this survey reported that
information about the "doping safety" of supplements was important and should be
funded by supplement manufacturers. Although it is challenging to provide such
information, we suggest a model to provide an accredited testing program
suitable for the Australian situation, with targeted athlete education about the
"sports safety" of sports supplements and foods.
PMID: 11591885 [PubMed]
255: Ann Ig. 2001 Jul-Aug;13(4):351-8.
[Dietary supplements and doping in a population of non-professional athletes:
prevalence study]
[Article in Italian]
Moretti G, Saia M, Cecchetto E, Marin V.
Dip. di Medicina Ambientale e Sanita Pubblica, Universita degli Studi di Padova.
PMID: 11590870 [PubMed]
256: Sports Med. 2001;31(11):785-807.
Caffeine and exercise: metabolism, endurance and performance.
Graham TE.
Human Biology and Nutritional Sciences, University of Guelph, Ontario, Canada.
terrygra@uoguelph.ca
Caffeine is a common substance in the diets of most athletes and it is now
appearing in many new products, including energy drinks, sport gels, alcoholic
beverages and diet aids. It can be a powerful ergogenic aid at levels that are
considerably lower than the acceptable limit of the International Olympic
Committee and could be beneficial in training and in competition. Caffeine does
not improve maximal oxygen capacity directly, but could permit the athlete to
train at a greater power output and/or to train longer. It has also been shown
to increase speed and/or power output in simulated race conditions. These
effects have been found in activities that last as little as 60 seconds or as
long as 2 hours. There is less information about the effects of caffeine on
strength; however, recent work suggests no effect on maximal ability, but
enhanced endurance or resistance to fatigue. There is no evidence that caffeine
ingestion before exercise leads to dehydration, ion imbalance, or any other
adverse effects. The ingestion of caffeine as coffee appears to be ineffective
compared to doping with pure caffeine. Related compounds such as theophylline
are also potent ergogenic aids. Caffeine may act synergistically with other
drugs including ephedrine and anti-inflammatory agents. It appears that male and
female athletes have similar caffeine pharmacokinetics, i.e., for a given dose
of caffeine, the time course and absolute plasma concentrations of caffeine and
its metabolites are the same. In addition, exercise or dehydration does not
affect caffeine pharmacokinetics. The limited information available suggests
that caffeine non-users and users respond similarly and that withdrawal from
caffeine may not be important. The mechanism(s) by which caffeine elicits its
ergogenic effects are unknown, but the popular theory that it enhances fat
oxidation and spares muscle glycogen has very little support and is an
incomplete explanation at best. Caffeine may work, in part, by creating a more
favourable intracellular ionic environment in active muscle. This could
facilitate force production by each motor unit.
Publication Types:
Review
Review, Academic
PMID: 11583104 [PubMed]
257: Br J Sports Med. 2001 Oct;35(5):286-7.
Headache in sport.
McCrory P.
Publication Types:
Editorial
PMID: 11579054 [PubMed]
258: Br J Sports Med. 2001 Oct;35(5):285.
Warm up. A whiff of the future.
[No authors listed]
Publication Types:
Editorial
PMID: 11579053 [PubMed]
259: Hosp Secur Saf Manage. 2001 Aug;22(4):3-4.
Theft of 'uncontrolled' drugs from pharmacy, treatment centers.
[No authors listed]
PMID: 11561344 [PubMed]
260: Biomed Chromatogr. 2001 Oct;15(6):393-402.
High speed determination of beta-receptor blocking agents in human urine by
liquid chromatography/tandem mass spectrometry.
Thevis M, Opfermann G, Schanzer W.
Institute of Biochemistry, German Sport University Cologne, Carl-Diem-Weg 6,
50933 Cologne, Germany. mario@biochem.dshs-koeln.de
Beta-receptor blocking agents are present on the international market in a huge
variety. The International Olympic Committee prohibits the use of these drugs in
several sport sections and doping control laboratories analyse urine samples of
high-performance athletes with different techniques. Therefore, fast and
reliable methods are required to enable a sensitive detection of many drugs and
a high throughput of samples. In the present study a screening procedure is
described using high speed liquid chromatography and multiple reaction
monitoring to identify 32 beta-receptor blocking agents extracted from human
urine. Urine specimens (blank urine samples, spiked urine samples and specimens
of excretion studies) were hydrolysed, extracted and analysed within 7 min.
Quasi-molecular ions (M(+) + H) of the beta-blockers are generated by means of
an atmospheric pressure chemical ionization interface followed by
collision-induced dissociation in a triple quadrupole mass spectrometer and
subsequent detection of daughter ions. Proposals for the origin of common and
individual secondary ions are presented. Copyright 2001 John Wiley & Sons, Ltd.
PMID: 11559924 [PubMed]
261: J Chromatogr A. 2001 Aug 10;926(1):87-95.
Method for confirmation of synthetic corticosteroids in doping urine samples by
liquid chromatography-electrospray ionisation mass spectrometry.
Fluri K, Rivier L, Dienes-Nagy A, You C, Maitre A, Schweizer C, Saugy M, Mangin
P.
Institut Universitaire de Medecine Legale, Lausanne, Switzerland.
In this study, we report on the development of a method to confirm
simultaneously nine of the most commonly abused synthetic corticosteroids in
urine based on liquid chromatography-electrospray ionisation mass spectrometry.
A considerable simplified sample preparation procedure, including liquid-liquid
phase extraction with Extrelut-NT3 columns, provided both excellent sample
purification and high overall recoveries. Complete HPLC separations were
obtained on a reversed-phase column with 1 mM ammonium acetate-acetonitrile
(60:40, v/v) as mobile phase. Mass spectral acquisition was done in the negative
ion, and selected ion monitoring modes to identify the drugs with at least three
characteristic ions. Detection limits were determined at < or =1 ng/ml and the
confirmation limits at 1 to 5 ng/ml.
Publication Types:
Validation Studies
PMID: 11554422 [PubMed]
262: J Chromatogr B Biomed Sci Appl. 2001 Sep 5;760(2):255-61.
Simultaneous quantitation of ephedrines in urine by gas
chromatography-nitrogen-phosphorus detection for doping control purposes.
Van Eenoo P, Delbeke FT, Roels K, De Backer P.
Ghent University, Department of Pharmacology, Pharmacy and Toxicology,
Merelbeke, Belgium.
A gas chromatographic method for the simultaneous quantitation of ephedrine,
pseudoephedrine, norephedrine (phenylpropanolamine), norpseudoephedrine
(cathine) and methylephedrine in urine is described. The method consists of a
liquid-liquid extraction with tert.-butyl methyl ether at pH 14. The extracts
are analysed on a GC system equipped with an Rtx-5 Amine column and a
nitrogen-phosphorus detector. Method validation shows excellent separation,
linearity, specificity, accuracy, precision, intra-laboratory repeatability and
reproducibility, making the method especially suitable for quantitation of
ephedrines in urine samples for doping control purposes. A statistical analysis
on the abuse of the different ephedrines in urine from athletes controlled in
the Flemish doping control laboratory during the period 1993-2000 is included.
PMID: 11530984 [PubMed]
263: Growth Horm IGF Res. 2001 Jun;11 Suppl A:S71-7.
Growth hormone and exercise: physiology, use and abuse.
Jenkins PJ.
Department of Endocrinology, St Bartholomew's Hospital, London, UK.
P.J.Jenkins@mds.qmw.ac.uk
This review summarizes the interactions between growth hormone (GH) and
exercise. Exercise has profound effects upon the GH-insulin-like growth factor I
axis per se. In addition, there is increasing evidence that such physiological
perturbations might be influential in the performance responses to repeated
training. However, the ergogenic effects of systemic administration of
recombinant human GH by athletes and bodybuilders remain unproven. What is
certain is that the prevalence of GH abuse by sportspeople will increase, not
least because it is currently undetectable. The frequent and potentially severe
side-effects associated with such 'doping' will be of increasing relevance to
endocrinologists.
Publication Types:
Review
Review, Tutorial
PMID: 11527092 [PubMed]
264: Electrophoresis. 2001 Jul;22(11):2201-9.
Analyses of quaternary ammonium drugs in horse urine by capillary
electrophoresis-mass spectrometry.
Tang FP, Leung GN, Wan TS.
Racing Laboratory, The Hong Kong Jockey Club, Shatin, PR China.
A capillary electrophoresis-mass spectrometry (CE-MS) method for the analysis of
quaternary ammonium drugs in equine urine was developed. Quaternary ammonium
drugs were first extracted from equine urine by ion-pair extraction and then
analysed by CE-MS in the positive electrospray ionization (ESI) mode. Within 12
min, eight quaternary ammonium drugs, each at 1 ng/mL in horse urine, could be
detected. The confirmation of these drugs in urine samples was achieved by
capillary electrophoresis tandem mass spectrometry (CE-MS/MS). A direct
comparison of this method was made with existing liquid chromatography/mass
spectrometry (LC-MS) methods in the detection and confirmation of glycopyrrolate
and ipratropium bromide in horse urine. While the two drugs could be detected
within the same CE-MS run at 1 ng/mL in urine, they could only be detected in
separate LC-MS runs at 5 ng/mL in urine. In addition, CE-MS consumed a much
smaller volume of extract; the analyte peak widths, in some cases, were much
narrower; and as the quaternary ammonium ions were well separated
electrophoretically from the mainly neutral urine matrix, a much cleaner
background in the CE-MS total ion trace was observed.
PMID: 11504053 [PubMed]
265: J Chromatogr B Biomed Sci Appl. 2001 Aug 15;759(2):267-75.
Gas chromatography-combustion-isotope ratio mass spectrometry analysis of
19-norsteroids: application to the detection of a nandrolone metabolite in
urine.
Mathurin JC, Herrou V, Bourgogne E, Pascaud L, de Ceaurriz J.
Laboratoire National de Depistage du Dopage, CREPS, Chatenay Malabry, France.
jc.mathurin@wanadoo.fr
Determination of whether the major metabolite of nandrolone in urine,
19-norandrosterone (19-NA), is exogenous or endogenous in origin is one of the
most exciting challenges for antidoping laboratories. Gas
chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS) can be
used to differentiate these two origins by carbon isotopic ratio analysis. A
complete method for purification of 19-NA in urine has been established.
Acetylated ketosteroids, and in particular 19-NA, are isolated from the urine
matrix before analysis after hydrolysis and purification of urine by
reversed-phase and normal solid-phase extraction. The limit of detection for
19-NA was about 60 ng with recoveries of 54-60%. Evidence of exogenous
administration of 19-NA may be established from isotope ratio determination from
the 13C/12C ratios of several synthetic 19-norsteroids compared to those
obtained for endogenous steroids.
PMID: 11499480 [PubMed]
266: BMJ. 2001 Aug 11;323(7308):328-31.
Recent advances: Sports medicine.
Bahr R.
Oslo Sports Trauma Research Center, University of Sports and Physical Education,
0806 Oslo, Norway. roald@nih.no
Publication Types:
Review
Review, Academic
PMID: 11498493 [PubMed]
267: Clin Sports Med. 2001 Jul;20(3):481-90.
Upper extremity injuries associated with strength training.
Haupt HA.
Orthopedic Associates, LLC, St. Louis, Missouri, USA.
Most injuries sustained during strength training are mild strains that resolve
with appropriate rest. More severe injuries include traumatic shoulder
dislocations, tendon ruptures of the pectoralis major, biceps, and triceps;
stress fractures of the distal clavicle, humerus, radius, and ulna; traumatic
fractures of the distal radius and ulna in adolescent weightlifters; and
compressive and stretch neuropathies. These more severe injuries are usually the
result of improperly performing a strength training exercise. Educating athletes
regarding proper strength-training techniques serves to reverse established
injury patterns and to prevent these injuries in the first place. Recognizing
the association of anabolic steroid use to several of the injury patterns
further reinforces the need for medical specialists to counsel athletes against
their use. With the increasing use of supplements such as creatine, the
incidence and nature of strength-training injuries may change further. Greater
emphasis on the competitive performance of younger athletes undoubtedly will
generate enthusiasm for strength training at earlier ages in both sexes. The
importance of proper supervision of these young athletes by knowledgeable
persons will increase. As the popularity of strength training grows, there will
be ample opportunity to continue to catalog the injury patterns associated with
this activity.
Publication Types:
Review
Review of Reported Cases
PMID: 11494836 [PubMed]
268: J Chromatogr B Biomed Sci Appl. 2001 Jul 15;758(2):235-48.
Systematic analysis of acid, neutral and basic drugs in horse plasma by
combination of solid-phase extraction, non-aqueous partitioning and gas
chromatography-mass spectrometry.
Takeda A, Tanaka H, Shinohara T, Ohtake I.
Racing Chemistry Laboratory, Utsunomiya, Tochigi, Japan. a-takeda@lrc.or.jp
A sample preparation method for mass chromatographic detection of doping drugs
from horse plasma is described. Bond Elut Certify (1 g/6 ml) is used for the
extraction of 4 ml of horse plasma. Fractionation is performed with 6 ml of
CHCl3-Me2CO (8:2) and 5 ml of 1% TEA-MeOH according to its property. Simple and
effective clean-up based on non-aqueous partitioning is adopted to remove
co-eluted contaminants in both acid and basic fractions. Two kinds of
1-(N,N-diisopropylamino)-n-alkanes are co-injected with the sample into the
GC-MS system for the calculation of the retention index. Total recoveries of 107
drugs are examined. Some data of post administration plasma are presented. This
procedure achieves sufficient recoveries and clean extracts for GC-MS analysis.
The method is able to detect ng/ml drug levels in horse plasma.
PMID: 11486834 [PubMed]
269: Dent Clin North Am. 2001 Jul;45(3):523-39, vi-vii.
Oral health issues for women athletes.
Ranalli DN, Rye LA.
Department of Pediatric Dentistry, School of Dental Medicine, University of
Pittsburgh, Pennsylvania, USA. dnr4+@pitt.edu
More women are participating in sports at all levels. This article presents
information for dental professionals to enhance awareness of emerging issues in
women's oral health, with specific emphasis on female athletes. These issues
include the prevalence, prediction, and prevention of sports-related traumatic
orofacial injuries as well as fads and habits such as tongue piercing, smokeless
tobacco, eating disorders, and performance-enhancing drugs.
Publication Types:
Review
Review, Tutorial
PMID: 11486663 [PubMed]
270: Pediatrics. 2001 Aug;108(2):421-5.
Creatine use among young athletes.
Metzl JD, Small E, Levine SR, Gershel JC.
Sports Medicine Service, Hospital for Special Surgery, Department of Pediatrics,
Cornell Medical College, New York, New York 10021, USA. MetzlJ@HSS.EDU
OBJECTIVE: Creatine is a nutritional supplement that is purported to be a safe
ergogenic aid in adults. Although as many as 28% of collegiate athletes admit
taking creatine, there is little information about creatine use or potential
health risk in children and adolescents. Although the use of creatine is not
recommended in people less than 18 years of age, numerous anecdotal reports
indicate widespread use in young athletes. The purpose of this study was to
determine the frequency, risk factors, and demographics of creatine use among
middle and high school student athletes. METHODS: Before their annual sports
preparticipation physical examinations, middle and high school athletes aged 10
to 18 in Westchester County, a suburb north of New York City, were surveyed in a
confidential manner. Information was collected regarding school grade, gender,
specific sport participation, and creatine use. RESULTS: Overall, 62 of 1103
participants (5.6%) admitted taking creatine. Creatine use was reported in every
grade, from 6 to 12. Forty-four percent of grade 12 athletes surveyed reported
using creatine. Creatine use was significantly more common (P <.001) among boys
(53/604, 8.8%) than girls (9/492, 1.8%). Although creatine was taken by
participants in every sport, use was significantly more common among football
players, wrestlers, hockey players, gymnasts, and lacrosse players (P <.001 for
all). The most common reasons cited for taking creatine were enhanced
performance (74.2% of users) and improved appearance (61.3%), and the most
common reason cited for not taking creatine was safety (45.7% of nonusers).
CONCLUSIONS: Despite current recommendations against use in adolescents less
than 18 years old, creatine is being used by middle and high school athletes at
all grade levels. The prevalence in grades 11 and 12 approaches levels reported
among collegiate athletes. Until the safety of creatine can be established in
adolescents, the use of this product should be discouraged.
PMID: 11483809 [PubMed]
271: Br J Sports Med. 2001 Aug;35(4):212-3.
The use of local anaesthetic injections in professional football.
Orchard J.
South Sydney Sports Medicine, 111 Anzac Parade, Kensington NSW 2033, Australia.
johnorchard@msn.com.au
PMID: 11477011 [PubMed]
272: Rev Med Liege. 2001 May;56(5):306-12.
[Sports and hypertension]
[Article in French]
Krzesinski JM, Ancion G.
Service de Nephrologie et Hypertension Arterielle, CHU Sart Tilman.
Regular physical exercise belongs to the non pharmacological tools for the
control of high blood pressure. When practising it almost daily at low intensity
during 30 minutes, and mainly on a dynamic mode, blood pressure can decrease
almost of the same order of magnitude as with an antihypertensive drug. In
severe hypertension, blood pressure must be first controlled by drugs before
starting the physical exercise training. An exercise test is preferable before
exercise suggestion in sedentary people older than 40 years. In hypertensive
people who enter sportive competition, diuretics and betablockers are forbidden.
These agents can also reduce performance.
PMID: 11475925 [PubMed]
273: Curr Pharm Biotechnol. 2000 Jul;1(1):11-31.
Use of recombinant human erythropoietin as an antianemic and performance
enhancing drug.
Jelkmann W.
Institut fur Physiologie, Medizinische Universitat zu Lubeck, Germany.
Jelkmann@physio.mu-Luebeck.de
The glycoprotein hormone erythropoietin is an essential viability and growth
factor for the erythrocytic progenitors in the bone marrow. Tissue hypoxia is
the main stimulus for the synthesis of the hormone in the kidneys and the liver.
Endogenous erythropoietin and recombinant human erythropoietin (rHu-EPO) are
similar with respect to their biological and chemical properties except for some
microheterogeneities in their 4 carbohydrate chains. Generic products and
alternatives to rHu-EPO are in development. Renal anemia can be corrected by
rHu-EPO in a dose-dependent and predictable way without major side effects apart
from a possible increase in arterial blood pressure. The optimal target
hematocrit still needs to be defined. There are rare reports of antibody
formation towards rHu-EPO in humans. Patients suffering from non-renal anemias
may also benefit from the prescription of rHu-EPO. The drug has been approved
for treatment of tumor patients with platinum-induced anemia. The
cost-effectiveness and medical justification of the administration of rHu-EPO in
tumor patients with respect to its positive effects on tumor oxygenation, tumor
growth inhibition and support of chemo- and radiotherapy is still a matter of
debate. In surgical patients, the pharmacological application of rHu-EPO can
increase the yield of blood units in autologous blood donation programs and
lower the severity and duration of postoperative anemia, if applicated some days
prior to surgery. While rHu-EPO is a godsend in medical practice, its abuse as
an performance enhancing drug by athletes in endurance sports is an unethical
and potentially dangerous procedure. Unequivocal methods for detection of
rHu-EPO doping still need to be established.
Publication Types:
Review
Review, Academic
PMID: 11467358 [PubMed]
274: Anaesthesist. 2001 Jun;50(6):436-41.
[Bicycling versus intensive care units--twice "hemoglobin doping"?]
[Article in German]
Welte M, Schaffartzik W.
Klinik fur Anaesthesiologie und operative Intensivmedizin, Klinikum Benjamin
Franklin der Freien Universitat Berlin, Hindenburgdamm 30, 12200 Berlin.
welte@medizin.fu-berlin.de
Publication Types:
Review
Review, Tutorial
PMID: 11458726 [PubMed]
275: Respir Med. 2001 Jul;95(7):571-6.
Can asthma treatment in sports be doping? The effect of the rapid onset,
long-acting inhaled beta2-agonist formoterol upon endurance performance in
healthy well-trained athletes.
Carlsen KH, Hem E, Stensrud T, Held T, Herland K, Mowinckel P.
Voksentoppen Centre and Research Institute for Asthma, Allergy and Chronic Lung
Diseases in Children, Oslo, Norway. k.h.carlsen@usit.no
Inhaled beta2-agonists have been subject to restrictions in relationship to
sports due to fear of possible improvement in endurance performance. According
to the international doping regulations only inhaled salbutamol, terbutaline and
salmeterol are allowed for use in sports. Formoterol is a recently introduced
rapid onset-long-acting inhaled beta2-agonist. The main aim of the present
randomized, double-blind placebo-controlled study was to investigate possible
improvement in endurance performance of inhaled formoterol in 24 healthy
well-trained competitive male athletes, 21-29 years old. Lung function
(flow-volume loops) was measured before, 15 min after each inhaled study drug
and before and repeatedly after exercise. On day 1, maximum oxygen uptake
(VO2max), peak ventilation (VEpeak) and running time till exhaustion were
measured and used to determine the exercise load on days 2 and 3. On days 2 and
3 the subjects inhaled the study drugs, rested for 1 h, then exercised, and
VO2max, VEpeak and running time until exhaustion were determined. Inhaled
formoterol did not improve any parameter of endurance performance. On the other
hand a statistically significant, although not clinically significant (0.05
ml(-1) min kg(-1)), change was found in estimated difference of VO2max between
formoterol and placebo in favour of placebo. Lung function increased
significantly after inhaled formoterol, and after exercise also for placebo, but
without differences between the beta2-agonist and placebo after exercise. In
conclusion, inhaled formoterol did not improve endurance performance compared to
placebo.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 11453313 [PubMed]
276: Fresenius J Anal Chem. 2001 Jun;370(2-3):194-9.
GC-FID as a primary method for establishing the purity of organic CRMs used for
drugs in sport analysis.
King B, Westwood S.
National Analytical Reference Laboratory, Pymble, NSW, Australia.
bernard.king@agal.gov.au
The National Analytical Reference Laboratory has synthesized and characterized
67 anabolic steroid marker metabolites, both unlabelled and deuterated, and 37
key glucuronide and sulfate steroid conjugate pure substance reference
materials. Work is also in process to establish their full traceability so that
they can be issued as certified and primary reference materials. Both identity
and purity have been rigorously characterized using a number of techniques and a
primary method for purity assessment developed, based gas chromatography
combined with flame ionization detection for the parent steroids and HPLC with
evaporative light scattering detection for non-volatile steroid conjugates.
Strategies for establishing traceability and for estimating measurement
uncertainty are reported. The strategies described are considered applicable to
a wide range of organic pure substance reference materials.
Publication Types:
Review
Review, Tutorial
PMID: 11451235 [PubMed]
277: Tidsskr Nor Laegeforen. 2001 May 20;121(13):1563.
Comment in:
Tidsskr Nor Laegeforen. 2001 Jun 30;121(17):2095-6.
[National and international work against doping]
[Article in Norwegian]
Lereim I.
Publication Types:
Editorial
PMID: 11446036 [PubMed]
278: South Med J. 2001 Jun;94(6):608-12.
Use of oral creatine as an ergogenic aid for increased sports performance:
perceptions of adolescent athletes.
Ray TR, Eck JC, Covington LA, Murphy RB, Williams R, Knudtson J.
Center for Sports Medicine and Orthopaedics Foundation for Research,
Chattanooga, Tenn, USA.
BACKGROUND: Competitive athletes, including adolescents, seek ways to gain
advantage over competitors. One ergogenic aid is creatine, a naturally occurring
nitrogen compound found primarily in skeletal muscle. Increasing creatine levels
may prolong skeletal muscle activity, enhancing work output. METHODS: A
questionnaire assessing awareness and use of creatine supplementation was
completed by 674 athletes from 11 high schools. Data were statistically analyzed
to determine variation among groups. RESULTS: Of those surveyed, 75% had
knowledge of creatine supplements, and 16% used creatine to enhance athletic
performance. Percentage of use increased with age and grade level. Awareness and
use were greater among boys than girls. Adverse effects were reported by 26%.
Most athletes consumed creatine using a method inconsistent with scientific
recommendations. CONCLUSIONS: Use of creatine by adolescent athletes is
significant and inconsistent with optimal dosing. Physicians, athletic trainers,
and coaches should disseminate proper information and advise these adolescent
athletes.
PMID: 11440329 [PubMed]
279: Ir Med J. 2001 Apr;94(4):102.
Comment on:
Ir Med J. 1999 May-Jun;92(4):325-7.
Anabolic steroids, brain and behaviour.
Daly RC.
Publication Types:
Comment
Editorial
PMID: 11440042 [PubMed]
280: Eur J Emerg Med. 2001 Jun;8(2):155-7.
Exertional rhabdomyolysis in a body builder abusing anabolic androgenic
steroids.
Braseth NR, Allison EJ Jr, Gough JE.
Department of Emergency Medicine, East Carolina University School of Medicine,
Greenville, North Carolina 27858-4354, USA.
Rhabdomyolysis, or acute skeletal muscle destruction, may be accompanied by
myoglobinaemia, myoglobinuria, and an elevated serum creatine kinase level. This
disorder has many potential causes. In this article, the authors describe a case
of rhabdomyolysis occurring after vigorous weight lifting by a man who was
supplementing his weight-training programme with the intake of anabolic
androgenic steroids dispensed to him by a colleague.
Publication Types:
Case Reports
PMID: 11436915 [PubMed]
281: J Endocrinol. 2001 Jul;170(1):55-61.
Drugs in sport - the role of the physician.
Dawson RT.
Drugs In Sport Clinic and User's Support (DISCUS), Adderstone House, Dene Road,
Rowlands Gill, Tyne & Wear, NE39 1DU, UK.
Sportsmen have used anabolic steroids since the 1950s and yet it was not until
the 1980s that we, as physicians, admitted that they could improve performance.
We now find ourselves in the insidious position of being unable to predict
convincingly either safety or major health risks with performance-enhancing drug
use. The use of performance-enhancing drugs is no longer limited to the elite
athlete. In 1993 the Canadian Center for Drug-free Sport estimated that 83 000
children between the ages of 11 and 18 had used anabolic steroids in the
previous 12 months. Recent evidence suggests anabolic steroids are now the third
most commonly offered drugs to children in the UK, behind cannabis and
amphetamines. The role of the physician of today is to regain our position of
impartiality and objectivity within both the sporting and general community.
Only then will we be able to pursue a harm minimisation strategy designed to
convince the public that it is better to be the best you can be naturally. For
the majority, the improvement through the use of performance-enhancing drugs can
equally be achieved through dietary and training advice. For the elite athlete,
what price a gold medal that is tarnished by deceit? Its value then can only lie
with the sponsors and politicians, for they can no longer claim to be sportsmen,
only entertainers.
Publication Types:
Review
Review, Tutorial
PMID: 11431137 [PubMed]
282: J Endocrinol. 2001 Jul;170(1):49-54.
Ethical aspects and the prevalence of hormone abuse in sport.
Verroken M.
UK Sport, 40 Bernard Street, London WC1N 1ST, UK.
michele.verroken@uksport.gov.uk
Abuse of hormones by sportsmen or sportswomen might lead to some serious health
consequences for the individual user. Such abuse also damages the very spirit of
sport, cheating fellow athletes, the officials and spectators. Where hormone
findings cause most controversy is with endogenously produced substances. Some
hormone findings might be indicators of a medical condition, and it requires
sensitive handling to discover the facts. Examining the prevalence of hormone
abuse using a theoretical perspective on ethics permits a philosophical study of
the dilemmas facing sport, and a clearer identification of the issues that
science can help sport to resolve. This paper looks at the way in which rules on
doping have evolved in an attempt to set out the ethical standards that should
apply and to discuss how some sportsmen and sportswomen have worked around the
rules, challenging them to the extent that the anti-doping system itself is
questioned. The data emerging from the testing programmes give one guide to the
actual prevalence of hormone findings. However, as not all findings may
constitute doping offences this cannot be said to be the definitive guide to the
extent of hormone abuse. Use of hormone medications with or without a
therapeutical indication further complicates the disciplinary process. Sensitive
management of hormone findings is absolutely necessary to avoid accusations of
doping or embarrassing breaches of confidentiality when the origin may be a
serious medical condition. Because hormone findings require careful
consideration, the door is open for the anti-doping system to be exploited by
unscrupulous scientists, raising challenges that test the limits of credibility.
Sex, alcohol and decomposition are arguments that have been put forward to
explain findings. A close partnership between scientists and sport is called for
to avoid the athlete becoming a victim of the rules that are intended to protect
sport.
PMID: 11431136 [PubMed]
283: J Endocrinol. 2001 Jul;170(1):27-38.
Proof of the effect of testosterone on skeletal muscle.
Bhasin S, Woodhouse L, Storer TW.
Division of Endocrinology, Metabolism, and Molecular Medicine, Charles R Drew
University of Medicine and Science, Los Angeles, California 90059, USA.
In spite of the widespread abuse of androgenic steroids by athletes and
recreational body-builders, the effects of these agents on athletic performance
and physical function remain poorly understood. Experimentally induced androgen
deficiency is associated with a loss of fat-free mass; conversely, physiologic
testosterone replacement of healthy, androgen-deficient men increases fat-free
mass and muscle protein synthesis. Testosterone supplementation of HIV-infected
men with low testosterone levels and of older men with normally low testosterone
concentrations also increases muscle mass. However, we do not know whether
physiologic testosterone replacement can improve physical function and
health-related quality of life, and reduce the risk of falls and disability in
older men or those with chronic illness. Testosterone increases maximal
voluntary strength in a dose-dependent manner and thus might improve performance
in power-lifting events. However, testosterone has not been shown to improve
performance in endurance events. The mechanisms by which testosterone increases
muscle mass are not known, but probably involve alterations in the expression of
multiple muscle growth regulators.
Publication Types:
Review
Review, Tutorial
PMID: 11431134 [PubMed]
284: J Endocrinol. 2001 Jul;170(1):13-25.
Insulin, growth hormone and sport.
Sonksen PH.
Guy's, King's and St Thomas' School of Medicine, St Thomas' Hospital, London SE1
7EH, UK. peter.sonksen@kcl.ac.uk
This review examines some interesting 'new' histories of insulin and reviews our
current understanding of its physiological actions and synergy with GH in the
regulation of metabolism and body composition. It reviews the history of GH
abuse that antedates by many years the awareness of endocrinologists to its
potent anabolic actions. Promising methods for detection of GH abuse have been
developed but have yet to be sufficiently well validated to be ready for
introduction into competitive sport. So far, there are two promising avenues for
detecting GH abuse. The first uses immunoassays that can distinguish the isomers
of pituitary-derived GH from the monomer of recombinant human GH. The second
works through demonstrating circulating concentrations of one or more
GH-sensitive substances that exceed the extremes of normal physiological
variability. Both methods require blood rather than urine samples. The first
method has a window of opportunity lasting about 24 h after an injection and is
most suitable for 'out of competition' testing. The second method has reasonable
sensitivity for as long as 2 weeks after the last injection of GH and is
uninfluenced by extreme exercise and suitable for post-competition samples. This
method has a greater sensitivity in men than in women. The specificity of both
methods seems acceptably high but lawyers need to decide what level of
scientific probability is needed to obtain a conviction. Both methods need
further validation before implementation. Research work carried out as part of
the fight against doping in sport has opened up a new and exciting area of
endocrinology.
Publication Types:
Review
Review, Tutorial
PMID: 11431133 [PubMed]
285: Rev Med Liege. 2001 Apr;56(4):276-9.
[Ethical reflections regarding the decree promoting health through sports]
[Article in French]
Sturbois X.
Departement education physique et revalidation, Universite catholique de
Louvain.
The Parliament of the French Community has edited a decree concerning the
promotion of health by sport, the fight against doping in the French Community.
This decree declares that federations are responsible for the public health in
sport practice. This establishes a link between sport and health. The sport
physician must add to his medical practice an ethical dimension. The decree
proposes a profound reflection about the good practice in sport medicine.
PMID: 11421168 [PubMed]
286: Rev Med Liege. 2001 Apr;56(4):269-75.
[Legal aspects of medicine and sports doping]
[Article in French]
Misson L, Botteman C.
Barreau de Liege.
Classically, doping is envisaged in terms of the penal or disciplinary
consequences it can entail for the sportsman or his (her) sport physician. In
our Community, the sportsman who uses doping will in the future not be
prosecuted. Another question remains: is a sportsman who was given doping
substances by his physician and suffered from this treatment entitled to bring
an action against the physician?
Publication Types:
Review
Review, Tutorial
PMID: 11421167 [PubMed]
287: Rev Med Liege. 2001 Apr;56(4):265-8.
[Doping in sports]
[Article in French]
Pirnay F.
Universite de Liege.
Doping consists in the use of artificial means or substances with the unique aim
of improving performance despite adverse effects on health. Amphetamines
stimulate the central nervous system by increasing motivation and vigilance.
Often consumed in association with analgesics, they increase the fatigue
threshold during prolonged or repeated exercise. Addiction and dependency to
these substances are extremely rapid. Side-effects include insomnia, exhaustion,
violence and can lead to serious heart diseases. By enhancing capacity for
intensive training, anabolic steroids improve strength, alertness and speed.
This action is often further strengthened by the use of growth hormones DHEA and
IGF-1. Extremely high dosage is used and is in no way comparable with natural
secretions or those necessary to re-balance an exhausted glandular system.
During prolonged endurance exercise, doping aims at improving the circulation of
oxygen in the blood and thus its availability to the muscles. Firstly, the blood
haemoglobin concentration was increased by blood transfusions. At present the
production of red blood cells is stimulated by repeated injections of exogenous
erythropoietin. The extreme viscosity of the blood leads to a risk of vascular
thromboses and high blood pressure and accentuates greatly and sometimes even
fatally the possibility of brachycardia which is common with sportsmen.
Publication Types:
Review
Review, Tutorial
PMID: 11421166 [PubMed]
288: Rev Med Liege. 2001 Apr;56(4):261-4.
[Skin betrayal, above athletic performance]
[Article in French]
Martalo O, Claessens N, Pierard GE.
Service de Dermatopathologie, Universite de Liege.
Several compounds listed as illicit doping agents can express some effects on
the skin. The cutaneous signs are diverse. The clue of the intake of such
compounds can be supported by objective non-invasive biometrological
assessments. However, such evaluations do not bring the irrefutable proof. The
skin can also present unwanted reactions indicating intolerance to the doping
agent. Such physiopathological manifestations are not limited to the sport
competition, but can also affect some groups of the population searching for a
look reminiscent of the ideal young and performing athlete.
Publication Types:
Review
Review, Tutorial
PMID: 11421165 [PubMed]
289: Eur J Public Health. 2001 Jun;11(2):195-7.
The prevalence of the use of androgenic anabolic steroids by adolescents in a
county of Sweden.
Nilsson S, Baigi A, Marklund B, Fridlund B.
Department of Primary Health Care, Neptun kliniken, Sodra Hamnvagen 4, 43244
Varberg, Sweden. nilssonsverker@hotmail.com
BACKGROUND: The prevalence of the use of androgenic anabolic steroids has been
poorly studied in Europe. This study was undertaken to examine the prevalence of
the misuse--the non-medical use--of androgenic anabolic steroids among
adolescents in a county of Sweden. METHODS: The total population of 16 and 17
year old male and female adolescents in a county on the south-west coast of
Sweden was studied. The investigation was done by an anonymous multiple-choice
questionnaire. The questionnaire was completed by 5,827 pupils and statistically
analysed. The participation rate was 95%. RESULTS: Among male adolescents 16 and
17 years old, 3.6% and 2.8% had misused androgenic anabolic steroids,
respectively. These male adolescents had also misused alcohol, growth hormones
and narcotic drugs more than the steroid hormone non-users. Among female
adolescents there was no recorded misuse of these drugs (0.0%). CONCLUSIONS: The
misuse of androgenic anabolic steroids is a reality in both small and large
municipalities in Sweden. The prevalence figures are higher among 16 year old
compared to 17 year old male adolescents. There is an association between this
drug misuse and other substance misuse such as narcotic drugs. Female
adolescents do not misuse steroid hormones. The findings indicate the need for
preventive work among male adolescents in order to induce adolescents not to
start misusing androgenic anabolic steroids.
PMID: 11420810 [PubMed]
290: J Chromatogr B Biomed Sci Appl. 2001 Jun 5;757(1):49-57.
Screening, confirmation and quantification of diuretics in urine for doping
control analysis by high-performance liquid chromatography-atmospheric pressure
ionisation tandem mass spectrometry.
Thieme D, Grosse J, Lang R, Mueller RK, Wahl A.
Institute of Doping Analysis and Sports Biochemistry, Kreischa (near Dresden),
Germany. detlef.thieme@idas-kreischa.de
A sensitive, selective, robust and fast method to identify 32 diuretics and
masking agents in urine is described. The analytical procedure is reduced to a
single XAD extraction step for sample preparation, followed by reversed-phase
liquid chromatography in combination with atmospheric pressure ionisation/tandem
mass spectrometry. This technique is, after minor modifications, suitable for
screening analyses and confirmation of identity as well as quantitation of
diuretics. Considerations relating to the stability and metabolism of the
compounds are given if relevant for routine screening analyses.
PMID: 11419748 [PubMed]
291: Clin J Sport Med. 2001 Apr;11(2):126.
Effects of testosterone precursor supplementation on intensive weight training.
Pipe A.
University of Ottawa Heart Institute, Ontario, Canada.
PMID: 11403114 [PubMed]
292: Clin J Sport Med. 2001 Apr;11(2):115-7.
Blood testing in sports: hematological profile of a convicted athlete.
Schumacher YO, Schmid A, Lenz T, Keul J.
Medizinische Universitatsklinik Freiburg, Abteilung Rehabilitation, Pravention
und Sportmedizin, Germany. olaf@msm1.ukl.uni-freiburg.de
Publication Types:
Case Reports
PMID: 11403111 [PubMed]
293: Int J Sport Nutr Exerc Metab. 2001 Jun;11(2):258-63.
Nutritional supplements as a source for positive doping cases?
Kamber M, Baume N, Saugy M, Rivier L.
Institute of Sports Sciences, Federal Office of Sports, CH-2532 Magglingen,
Switazerland.
We report the findings of the analysis of 75 different nutritional supplements
bought through the internet. Seven products (all from the class of prohormones)
contained other hormone substances than indicated on the labels, and two further
products contained ephedrine and caffeine without a clear indication on the
labels.
PMID: 11402257 [PubMed]
294: J Anal Toxicol. 2001 May-Jun;25(4):280-7.
Clenbuterol in the horse: confirmation and quantitation of serum clenbuterol by
LC-MS-MS after oral and intratracheal administration.
Lehner AF, Harkins JD, Karpiesiuk W, Woods WE, Robinson NE, Dirikolu L, Fisher
M, Tobin T.
Maxwell H Gluck Equine Research Center and the Department of Veterinary Science,
University of Kentucky, Lexington 40506, USA.
Clenbuterol is a beta2 agonist/antagonist bronchodilator, and its identification
in post-race samples may lead to sanctions. The objective of this study was to
develop a specific and highly sensitive serum quantitation method for
clenbuterol that would allow effective regulatory control of this agent in
horses. Therefore, clenbuterol-d9 was synthesized for use as an internal
standard, an automated solid-phase extraction method was developed, and both
were used in conjunction with a multiple reaction monitoring liquid
chromatography-tandem mass spectrometry (LC-MS-MS) method to allow unequivocal
identification and quantitation of clenbuterol in 2 mL of serum at
concentrations as low as 10 pg/mL. Five horses were dosed with oral clenbuterol
(0.8 microg/kg, BID) for 10 days, and serum was collected for 14 days
thereafter. Serum clenbuterol showed mean trough concentrations of approximately
150 pg/mL. After the last dose on day 10, serum clenbuterol reached a peak of
approximately 500 pg/mL and then declined with a half-life of approximately 7 h.
Serum clenbuterol declined to 30 and 10 pg/mL at 48 and 72 h after dosing,
respectively. By 96 h after dosing, the concentration was below 4 pg/mL, the
limit of detection for this method. Compared with previous results obtained in
parallel urinary experiments, the serum-based approach was more reliable and
satisfactory for regulation of the use of clenbuterol. Clenbuterol (90 microg)
was also administered intratracheally to five horses. Peak serum concentrations
of approximately 230 pg/mL were detected 10 min after administration, dropping
to approximately 50 pg/mL within 30 min and declining much more slowly
thereafter. These observations suggest that intratracheal administration of
clenbuterol shortly before race time can be detected with this serum test.
Traditionally, equine drug testing has been dependent on urine testing because
of the small volume of serum samples and the low concentrations of drugs found
therein. Using LC-MS-MS testing, it is now possible to unequivocally identify
and quantitate low concentrations (10 pg/mL) of drugs in serum. Based on the
utility of this approach, the speed with which new tests can be developed, and
the confidence with which the findings can be applied in the forensic situation,
this approach offers considerable scientific and regulatory advantages over more
traditional urine testing approaches.
PMID: 11386642 [PubMed]
295: Vet Rec. 2001 May 12;148(19):584.
Reprimand after breach of greyhound racing rules.
[No authors listed]
Publication Types:
News
PMID: 11386442 [PubMed]
296: Blood Cells Mol Dis. 2001 May-Jun;27(3):559-71.
Identification of blood erythroid markers useful in revealing erythropoietin
abuse in athletes.
Magnani M, Corsi D, Bianchi M, Paiardini M, Galluzzi L, Gargiullo E, Parisi A,
Pigozzi F.
Institute of Biological Chemistry G. Fornaini, University of Urbino, Via Saffi
2, 61029-Urbino, Italy. magnani@bib.uniurb.it
Recombinant human erythropoietin (rEpo) is being used with increasing frequency
by endurance athletes to improve aerobic potential. Although rEpo administration
has been banned by the International Olympic Committee, no methods are available
to unequivocally detect its abuse in sports. Prompted by these considerations,
we evaluated the main hematological and biochemical modifications measured in
the blood of 18 volunteers upon rEpo administration. Different rEpo regimens,
iron, folic acid, and vitamin B12 administration did not significantly modify
the percentage increase in hematocrit. However, a significant decrease in
circulating ferritin (fr) and an increase in the soluble transferrin receptor
(sTfr) were not found in athletes receiving low (30 IU/kg) doses of rEpo. Thus,
an increase in the sTfr/fr ratio cannot be used as an indicator of rEpo abuse,
at least when the hormone is administered at low concentrations. In contrast,
the amounts of beta-globin mRNA detected by quantitative competitive (RT)-PCR in
whole blood samples significantly increased above the threshold levels in all of
the treatments investigated. Taken together, these data suggest that hematocrit
value, reticulocyte count, soluble transferrin receptor content, and
concentration of beta-globin mRNA, when included in a new multiparametric
formula, can detect rEpo abuse in 57.5% of the samples examined with a
confidence interval of 99.99%. Thus, the method reported in this paper could
significantly improve the tests currently available, which in similar
experiments allowed the detection of rEpo abuse in only 7.6% of the samples
examined. Copyright 2001 Academic Press.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 11355895 [PubMed]
297: J Vet Pharmacol Ther. 2001 Feb;24(1):7-14.
Clenbuterol in the horse: urinary concentrations determined by ELISA and GC/MS
after clinical doses.
Harkins JD, Woods WE, Lehner AF, Fisher M, Tobin T.
Maxwell H. Gluck Equine Research Center and the Department of Veterinary
Science, University of Kentucky, KY 40506-0099, USA.
Clenbuterol is a beta2 agonist/antagonist bronchodilator marketed as Ventipulmin
and is the only member of this group of drugs approved by the US Food and Drug
Administration (FDA) for use in horses. Clenbuterol is a class 3 drug in the
Association of Racing Commissioners International (ARCI) classification system;
therefore, its identification in postrace samples may lead to sanctions.
Recently, the sensitivity of postrace testing for clenbuterol has been
substantially increased. The objective of this study was to determine the
'detection times' for clenbuterol after administration of an oral clinical dose
(0.8 g/kg, b.i.d.) of Ventipulmin syrup. Five horses received oral clenbuterol
(0.8 g/kg, b.i.d.) for 10 days, and urine concentrations of clenbuterol were
determined by an enhanced enzyme-linked immunoabsorbent assay (ELISA) test and
gas chromatography/mass spectrometric (GC/MS) analysis by two different methods
for 30 days after administration. Twenty-four hours after the last
administration, urine concentrations of apparent clenbuterol, as measured by
ELISA, averaged about 500 ng/mL, dropping to about 1 ng/mL by day 5
posttreatment. However, there was a later transient increase in the mean
concentrations of apparent clenbuterol in urine, peaking at 7 ng/mL on day 10
postadministration. The urine samples were also analysed using mass spectral
quantification of both the trimethylsilyl (TMS) and methane boronic acid (MBA)
derivatives of clenbuterol. Analysis using the TMS method showed that, at 24 h
after the last administration, the mean concentration of recovered clenbuterol
was about 22 ng/mL. Thereafter, clenbuterol concentrations fell below the limit
of detection of the TMS-method by day 5 after administration but became
transiently detectable again at day 10, with a mean concentration of about 1
ng/mL. Derivatization with MBA offers significant advantages over TMS for the
mass spectral detection of clenbuterol, primarily because MBA derivatization
yields a high molecular weight base peak of 243 m/z, which is ideal for
quantitative purposes. Therefore, mass spectral analyses of selected urine
samples, including the transient peak on day 10, were repeated using MBA
derivatization, and comparable results were obtained. The results show that
clenbuterol was undetectable in horse urine by day 5 after administration.
However, an unexpected secondary peak of clenbuterol was observed at day 10
after administration that averaged approximately 1 ng/mL. Because of this
secondary peak, the detection time for clenbuterol (0.8 g/kg, b.i.d. x 10 days)
is at least 11 days if the threshold for detection is set at 1 ng/mL.
PMID: 11348482 [PubMed]
298: Sports Med. 2001;31(5):325-37.
Physiology of professional road cycling.
Lucia A, Hoyos J, Chicharro JL.
Department of Anatomy and Physiology, European University of Madrid, Spain.
alejandro.lucia@mrfs.cisa.uem.es
Professional road cycling is an extreme endurance sport. Approximately 30000 to
35000 km are cycled each year in training and competition and some races, such
as the Tour de France last 21 days (approximately 100 hours of competition)
during which professional cyclists (PC) must cover >3500 km. In some phases of
such a demanding sport, on the other hand, exercise intensity is surprisingly
high, since PC must complete prolonged periods of exercise (i.e. time trials,
high mountain ascents) at high percentages (approximately 90%) of maximal oxygen
uptake (VO2max) [above the anaerobic threshold (AT)]. Although numerous studies
have analysed the physiological responses of elite, amateur level road cyclists
during the last 2 decades, their findings might not be directly extrapolated to
professional cycling. Several studies have recently shown that PC exhibit some
remarkable physiological responses and adaptations such as: an efficient
respiratory system (i.e. lack of 'tachypnoeic shift' at high exercise
intensities); a considerable reliance on fat metabolism even at high power
outputs; or several neuromuscular adaptations (i.e. a great resistance to
fatigue of slow motor units). This article extensively reviews the different
responses and adaptations (cardiopulmonary system, metabolism, neuromuscular
factors or endocrine system) to this sport. A special emphasis is placed on the
evaluation of performance both in the laboratory (i.e. the controversial Conconi
test, distinction between climbing and time trial ability, etc.) and during
actual competitions such as the Tour de France.
Publication Types:
Review
Review, Tutorial
PMID: 11347684 [PubMed]
299: Sports Med. 2001;31(5):321-4.
The possibilities of hair analysis in the determination of involuntary doping in
sports.
Midio AF, de Moraes Moreau RL, Silva OA.
College of Pharmaceutical Sciences, Laboratory of Analytical Toxicology,
University of Sao Paulo, Sao Paulo, Brazil.
Although not yet fully recognised by international sporting committees, hair
analysis in doping control may be a useful adjunct to drug testing of urine. It
may permit access to retrospective information and the identification of banned
substances, especially when exogenous abuse has to be distinguished from other
forms of involuntary exposure to identical substances. Negative hair results
coupled with positive urine samples may be used to draw conclusions of
involuntary doping in sports whenever athletes claim not to have ingested any
drug, identical substances are present in their environment or are normal
constituents of food and beverages served to them immediately before the
competition. Two cases are well described in the literature in which hair
analyses were fundamental in documenting positive doping after urinalysis. In
Brazil, 2 cases of athletes testing positive for banned substances caught our
attention because of the possibility of involuntary doping; hair analysis, if
performed, may have helped to clarify the results of the urinalysis. Despite the
fact that it cannot be used for routine control and overrule positive
urinalysis, hair analysis can detect long term exposure as well as those
substances which are not excreted in urine. In the current International Olympic
Committee (IOC) code, hair analysis is not yet considered useful even in special
cases of doping control.
Publication Types:
Case Reports
PMID: 11347683 [PubMed]
300: Ther Umsch. 2001 Apr;58(4):239-45.
["Doping and ethics"--a traditional and obviously never ending subject! Why is
it so difficult to act ethically responsibly also in sports?]
[Article in German]
Hotz A.
Everybody knows that doping is not allowed. Whether doping is also unethical is
less clear. To use doping agens as long as they are prohibited is clearly
unethical. But why do we have to ban doping agens? This needs some reflections
and has to be discussed all the time!
Publication Types:
Review
Review, Tutorial
PMID: 11344956 [PubMed]
301: Ther Umsch. 2001 Apr;58(4):232-8.
[Doping-related problems in clinical practice]
[Article in German]
Villiger B, Monnat A.
Medizinisches Zentrum Bad Ragaz. beat.villiger@resortragaz.ch
The complexity of the new antidoping regulations of the International Olympic
Committee (IOC), the International Federations (IF) and the National Olympic
Committees (NOC) rises a lot of problems in handling the prescriptions of
medication in athletes in the daily practice. In addition, several countries
have passed antidoping laws which makes the prescription and the delivery of
doping agens illegal. This may have severe consequences for the prescribing
doctors. It is therefore the goal of the article to inform the practitioning
doctors about the new antidoping regulations and their impact on prescribing or
delivering potential doping agens to athletes. It will focus on the new
dopinglists, the different doping control systems, the problems with the
pharmacological treatment of certain diseases as asthma and the necessary
reports which have to be sent to the NOC's or the IF's after prescribing certain
medications or methods.
Publication Types:
Review
Review, Tutorial
PMID: 11344955 [PubMed]
302: Ther Umsch. 2001 Apr;58(4):226-31.
[Misuse of drugs in recreational sports]
[Article in German]
Mahler N.
Sportwissenschaftliches Institut, Bundesamt fur Sport, Magglingen.
nadja.mahler@baspo.admin.ch
The extent of drug abuse in mass sport is only poorly documented. Studies about
drug abuse investigated only the prohibited substances according to the Olympic
movement antidoping code. So for instance about the use of anabolic androgenic
steroids (AAS) by school children or young students. But only few investigations
point to the drug abuse in mass sport regarding the easily accessible
over-the-counter drugs of the class of nonsteroidal anti-inflammatory drugs
(NSAID). These drugs permit an athlete to compete at his normal level of
performance despite injuries or pain. However, the masking of pain may
exacerbate the injury. Precautions should be taken to prevent the unwarranted or
unmonitored use of anti-inflammatory agents during treatment of sport injuries.
The abuse may be extensive since most people consider over-the-counter drugs,
such as aspirin and ibuprofen, harmless. Studies in Switzerland among endurance
athletes in mass sport examining the use of medications before an event showed a
prevalence between 5 and 10% of NSAID. Even if this seems a small number,
further investigations should focus on the use of medications among different
age groups and preventive information to abstain from the use of certain
medication for competitors in mass sport should be worked out.
Publication Types:
Review
Review, Tutorial
PMID: 11344954 [PubMed]
303: Ther Umsch. 2001 Apr;58(4):220-5.
[Fight against doping--national and international developments after Tour de
France 1998]
[Article in German]
Kamber M.
Sportwissenschaftliches Institut, Bundesamt fur Sport, Magglingen.
matthias.kamber@baspo.admin.ch
After the scandal at the Tour de France 1998, the fight against doping was
intensified on national as well as international levels. In particular, the
foundation of the new World Anti-Doping Agency (WADA) has been a landmark: for
the first time in the history of the fight against doping, there exists now an
international structure that includes partners from the Olympic movement as well
as from the governments. The importance of the WADA has already been
demonstrated during the Olympic Games 2000 in Sydney. First, it conducted
several thousands of un-announced doping tests internationally and second,
members of the WADA acted as independent observers to judge the carrying out of
doping controls during the games. In Switzerland, important new measures were
taken in the past years: The introduction of an independent attorney for the
judgment of sanctions or the employment of four professional doping control
officers had a clear effect on the quality of doping controls. In addition,
research--e.g. a survey on the perception of doping among the population or the
development of new technologies for doping analysis--was intensified. In the
fields of information and prevention, the existing printed material was extended
with a website on doping (www.dopinginfo.ch). Furthermore, international
cooperation to develop new didactical material for schools is intended. On the
legal level, Switzerland will introduce a new law in mid 2001. It will enable
the government to fight against the entourage of athletes when it provides
doping substances to athletes. The sanctioning of athletes using doping will
still be in the jurisdiction of the sports federations.
Publication Types:
Review
Review, Tutorial
PMID: 11344953 [PubMed]
304: Ther Umsch. 2001 Apr;58(4):179.
[Wellness--fitness--doping]
[Article in German]
Villiger B.
Publication Types:
Editorial
PMID: 11344946 [PubMed]
305: Psychother Psychosom. 2001 May-Jun;70(3):137-40.
Over-the-counter drug use in gymnasiums: an underrecognized substance abuse
problem?
Kanayama G, Gruber AJ, Pope HG Jr, Borowiecki JJ, Hudson JI.
Biological Psychiatry Laboratory, McLean Hospital, Belmont, Mass, and Department
of Psychiatry, Harvard Medical School, Boston, Mass, USA.
OBJECTIVE: Many individuals, attempting to gain muscle or lose fat, use 'dietary
supplements'. Though widely available over the counter or by mail order in
America and Europe, some of these 'supplements' are actually potent drugs such
as androstenedione and ephedrine. We sought to estimate the prevalence of these
forms of drug use in American gymnasiums. METHODS: We distributed anonymous
questionnaires to 511 clients entering five gymnasiums, asking about use of both
supplements and anabolic steroids. RESULTS: Among men, 18% reported use of
androstenedione and/or other adrenal hormones, 25% reported ephedrine use, and
5% reported anabolic steroid use within the last 3 years; among women these
rates were 3, 13 and 0%. Extrapolating from these figures to the United States
as a whole, we estimated that possibly 1.5 million American gymnasium clients
have used adrenal hormones and 2.8 million have used ephedrine within the last 3
years. CONCLUSIONS: Millions of men and women are currently using potent drugs,
widely sold over the counter as 'supplements', despite their known adverse
effects, unknown long-term risks, and possible potential for causing abuse or
dependence. Copyright 2001 S. Karger AG, Basel
PMID: 11340414 [PubMed]
306: Cleve Clin J Med. 2001 Apr;68(4):283, 288-9, 295-7 passim.
Performance-enhancing substances: what athletes are using.
Krcik JA.
Section of Sports Medicine, Department of Orthopaedic Surgery, Cleveland Clinic,
USA.
Use of performance-enhancing substances is widespread among competitive
athletes, whether professional or amateur, adolescent or adult. Some of these
substances are legal and beneficial, but others are illegal or have adverse or
unproven effects. This article describes the action and effects of these
substances, their legality, and their potential for abuse.
Publication Types:
Clinical Conference
PMID: 11326808 [PubMed]
307: J Sports Med Phys Fitness. 2001 Mar;41(1):132-6.
Attitudes of coaches towards doping.
Laure P, Thouvenin F, Lecerf T.
Faculte de Medecine, Laboratoire de Physiologie, Vandoeuvre, France.
patrick.laure@wanadoo.fr
BACKGROUND: Coaches are usually held to be among the main actors of doping
prevention campaigns. The aim of this study was to document certain attitudes of
professional coaches faced with doping, and to evaluate how they confronted it
on an everyday basis. METHODS: Experimental design: prospective study by
self-reporting questionnaire. Setting and participants: the questionnaire was
mailed to the last 800 graduated coaches (1994-1997) in the Lorraine region,
Eastern France. The 260 responding coaches comprised 77 women and 183 men, the
average age being 30.8 +/- 8.0 years (mean +/- standard deviation). RESULTS:
10.3% of coaches consider that an athlete may use doping with no health hazard
with the help of a physician, and 30.0% that an athlete who declines doping has
little chance of succeeding. 5.8% had used doping drugs in the last twelve
months (1 to 6 times). 13.5% of coaches mention that athletes (1 to 5 per coach
on average) told them they had been prompted to use doping drugs during the
previous 12 months. 80.7% consider that the current methods of preventing doping
in sport are ineffective, and 98.1% of them consider that they have a role to
play within this context, but 80.3% consider themselves badly trained in the
prevention of doping. Only 10.4% have organized a doping prevention action
during the last 12 months. CONCLUSIONS: In this study, professional coaches do
not seem to be efficient in the prevention of doping. Further education and
training for coaches on doping is advisable.
PMID: 11317161 [PubMed]
308: Med J Aust. 2001 Feb 19;174(4):204.
Comment on:
Med J Aust. 2000 Sep 18;173(6):312-3.
Drug testing at the Sydney Olympic Games.
Millar AP.
Publication Types:
Comment
Letter
PMID: 11270771 [PubMed]
309: Med J Aust. 2001 Feb 19;174(4):203-4.
Comment on:
Med J Aust. 2000 Sep 18;173(6):312-3.
Med J Aust. 2000 Sep 18;173(6):314-7.
Med J Aust. 2000 Sep 18;173(6):323-7.
Drug testing at the Sydney Olympics.
Gray P.
Publication Types:
Comment
Letter
PMID: 11270770 [PubMed]
310: Int J Sports Med. 2001 Jan;22(1):2-7.
Catecholamines response of high performance wheelchair athletes at rest and
during exercise with autonomic dysreflexia.
Schmid A, Schmidt-Trucksass A, Huonker M, Konig D, Eisenbarth I, Sauerwein H,
Brunner C, Storch MJ, Lehmann M, Keul J.
University of Freiburg, Center of Internal Medicine, Department of Prevention,
Rehabilitation and Sports Medicine, Germany. andi@msm1.ukl.uni-freiburg.de
Autonomic dysreflexia presents a special situation in high-lesion spinal cord
injury, however, intentionally or self-induced autonomic dysreflexia directly
before or during competition to increase performance, so called 'boosting', is
also being reported. In order to examine the influence of autonomic dysreflexia
on plasma catecholamines, cardiocirculatory and metabolic parameters, 6 spinal
cord injured wheelchair athletes with high-level lesions underwent wheelchair
ergometry without (ST1) and with (ST2) autonomic dysreflexia. At the point of
exhaustion significantly higher values for norepinephrine and epinephrine were
observed in ST2 than in ST1. During autonomic dysreflexia a significantly higher
peak performance (77.5 vs. 72.5 watt), higher peak heart rate (161 vs. 149 x
min(-1)), and peak oxygen consumption (1.96 vs. 1.85 l x min(-1)), with
comparable peak lactate (7.11 vs. 7.00 mmol x l(-1)) were reached on average.
The blood pressure values in ST2 were partially hypertensive and higher than in
ST1. In conclusion, autonomic dysreflexia, as a sympathetic spinal reflex, leads
to a higher release of catecholamines during exercise. This results in higher
peak performance, peak heart rate, peak oxygen consumption, and higher blood
pressure values. The peak lactate, as an indicator of the anaerobic lactate
metabolism, was unchanged. However, autonomic dysreflexia presents an
unpredictable risk, caused predominantly by hypertensive blood pressure values,
for high-lesion spinal cord injured persons at rest and more so during exercise;
it is seen as a prohibited manipulation by the doping guidelines of the
International Paralympic Committee.
Publication Types:
Case Reports
PMID: 11258636 [PubMed]
311: Biometrics. 2001 Mar;57(1):294-301.
Statistical evaluation of the regulatory guidelines for use of furosemide in
race horses.
Chu KK, Wang N, Stanley S, Cohen ND.
Department of Statistics, Texas A&M University, College Station 77843-3143, USA.
kchu@stat.tamu.edu
The pharmacokinetic behavior of furosemide concentrations in performance horses
is of great interest to the equine industry and equine researchers.
Specifically, such information is useful for the evaluation of the existing
guidelines in several racing jurisdictions and for the possible development of
new guidelines for varying time periods after administration. We studied several
approaches within the framework of nonlinear mixed effects models to increase
the accuracy of evaluating these guidelines. Theoretical properties of the
proposed methods were examined and the variances of the resulting estimators
compared. Their numerical performances were further evaluated through
simulations. Finally, we applied these methods to a furosemide concentration
profile data set and used our findings to address certain important practical
issues.
PMID: 11252613 [PubMed]
312: Clin Chim Acta. 2001 Mar;305(1-2):1-17.
Correlations of growth hormone (GH) and insulin-like growth factor I (IGF-I):
effects of exercise and abuse by athletes.
De Palo EF, Gatti R, Lancerin F, Cappellin E, Spinella P.
Clinical Biochemistry Section, Department of Medical Diagnostic Sciences and
Special Therapies, University of Padua Medical School, Padua, Italy.
depalo@ux1.unipd.it
The importance of hormones on body metabolism when physical exercise is carried
out has been established for a long time. Growth hormone (GH) is crucial in
energy metabolism as well as in body anabolism. Recent studies have increased
our knowledge of GH's mechanisms of action. In particular, insulin-like growth
factor I (IGF-I), the main hormone mediating the principal GH effects and other
protein structures (i.e. the binding proteins related to these two hormones),
has been recognized as playing a crucial role. The biochemical aspects relating
to the molecules of the GH/IGF-I axis have been described here. Furthermore, the
belief that GH and IGF-I enhance performance has induced an 'abuse' of GH (and
possibly of IGF-I) by competitive sports athletes and amateurs. The present
study outlines the best methods available to uncover abuse, as well as a series
of potential research projects to recognize doping. The review also underlines
the principal variables measurable in the laboratory and summarizes published
reference ranges of these parameters. These biochemical and laboratory profiles
describe principal experimental approaches, with the hope that this will
stimulate new ideas on the subject of detecting doping practices.
Publication Types:
Review
Review, Tutorial
PMID: 11249917 [PubMed]
313: J Pharm Biomed Anal. 2001 Mar;24(5-6):1125-30.
Doping control for nandrolone using hair analysis.
Kintz P, Cirimele V, Dumestre-Toulet V, Ludes B.
Institut de Medecine Legale, Universite Louis Pasteur, 11 rue Humann, F-67000
Strasbourg, France. pascal.kintz@wanadoo.fr
A sensitive, specific and reproducible method for the quantitative determination
of nandrolone in human hair has been developed. The sample preparation involved
a decontamination step of the hair with methylene chloride. The hair sample
(about 100 mg) was solubilized in 1 ml NaOH IN, 15 min at 95 degrees C, in
presence of 10 ng nandrolone-d(3) used as an internal standard. The homogenate
was neutralized and extracted using consecutively a solid phase (Isolute C18)
and a liquid--liquid (pentane) extraction. The residue was derivatized by adding
50 microl MSTFA/NH4I/2-mercaptoethanol (1000:2:5; v/v/v), then incubated for 20
min at 60 degrees C. A 4-microl aliquot of the derivatized extract was injected
into the column (HP5-MS capillary column, 5% phenyl--95% methylsiloxane, 30 m x
0.25 mm i.d. x 0.25 mm film thickness) of a Hewlett Packard (Palo Alto, CA) gas
chromatograph (6890 Series) via a Hewlett Packard (7673) autosampler. The assay
was capable of detecting 0.5 pg of nandrolone per mg of hair when approximately
100 mg of hair were processed. Linearity was observed for nandrolone
concentrations ranging from 1 to 50 pg/mg with a correlation coefficient of
0.997. Intra-day and between-day precisions at 10 pg/mg were 11.2 and 15.1%,
respectively, with an extraction recovery of 81.7%. The analysis of three
strands of hair, obtained from three bodybuilders, revealed the presence of
nandrolone at the concentration of 1, 3.5 and 7.5 pg/mg.
PMID: 11248508 [PubMed]
314: Ann Endocrinol (Paris). 2001 Feb;62(1 Pt 1):33-41.
[Doping: effectiveness, consequences, prevention]
[Article in French]
Guezennec CY.
Institut de Medecine Aerospatiale du Service de Sante des Armees, BP 73, 91223
Bretigny-sur-Orge Cedex.
The use of doping is linked with the history of sports. Doping abuse escalated
until the mid sixties when government and sports authorities responded with
antidoping laws and drug testing. Today, the details of substances detected in
controls give a good indication on the importance of doping use. Three classes
of pharmaceuticals account for most of the positive controls. They are anabolic
steroids, stimulants and narcotics. Their use can be related with the goal of
the athletes. Anabolic steroids are mainly used in sports such as bodybuilding
or weight lifting in order to develop strength. Stimulants are used in sports
were speed favors performance. All the products that enhance blood oxygen
transportation are used in endurance sports, their efficacy is not
scientifically demonstrated, but their use does result in real risks. Several
studies have evidenced the medical problems resulting from prolonged doping.
Doping control is impaired by the fact that many products now used, e.g. EPO or
rhGH, are not detectable. Regular medical examination of athletes could help
prevent use of doping.
Publication Types:
Review
Review, Tutorial
PMID: 11240405 [PubMed]
315: J Sci Med Sport. 2000 Dec;3(4):339-59.
Sir William Refshauge Lecture 1999. Drugs and nutrition.
Corrigan B.
Sports Medicine Australia.
Publication Types:
Lectures
PMID: 11235001 [PubMed]
316: J Clin Endocrinol Metab. 2001 Jan;86(1):146-50.
Urinary nandrolone metabolites of endogenous origin in man: a confirmation by
output regulation under human chorionic gonadotropin stimulation.
Reznik Y, Dehennin L, Coffin C, Mahoudeau J, Leymarie P.
Service d'Endocrinologie, Laboratoire de Biochimie B, Centre Hospitalier
Universitaire Cote de Nacre 14033 Caen, France.
19-Nortestosterone (nandrolone) is an anabolic steroid compound widely used as a
doping agent by athletes. The analysis of its urinary metabolites,
19-norandrosterone (NA) and 19-noretiocholanolone (NE) glucuronides, allows the
detection of surreptitious administration of nandrolone in sport. A threshold
concentration at 2 microgram/L urinary nandrolone metabolites is advocated by
the International Olympic Committee for the detection of doping, but some
controversy concerning the validity of this threshold arose from the
demonstration of endogenous production of nandrolone in mammals, including
humans. The regulation of human nandrolone production and its contribution in
vivo to the process of aromatization remain unknown. In the present study 10
healthy men were successively submitted to insulinic stress and gonadal
stimulation by hCG administration. Urinary NA and NE concentrations were
quantified by gas chromatography-mass spectrometry. NA was detected in basal
urine samples from all subjects, with a mean urinary excretion rate (UER) of
3.17 +/- 0.35 ng/h, whereas NE was detected in 4 of 10 (UER range, 0.8-4.7
ng/h). Insulinic hypoglycemia did not significantly modify mean NA UER despite
random intraindividual variations between timed urine collections. After hCG
administration, NA UER increased by 250% (P < 0.01) and estradiol (E(2)) UER by
260% (P < 0.001). The maximum NA concentration obtained after stimulation was
0.43 microgram/L. NA UER, plasma E(2), and E(2)/T ratio peaked on day 1 after
hCG administration, whereas plasma T peaked later on day 3. NA UER correlated
with plasma E(2) (r = 0.61; P < 0.001) and E(2)/T (r = 0.51; P < 0.001), but not
with plasma T. In conclusion, insulinic stress did not significantly alter
nandrolone metabolism, whereas the effect of hCG was a stimulation of NA
excretion in all subjects, which constitutes strong support for the endogenous
origin of low basal NA excretion. The comparative kinetics of NA UER, plasma
E(2), and E(2)/T ratio suggest a contribution of the aromatase process to
nandrolone biosynthesis in man.
PMID: 11231992 [PubMed]
317: Practitioner. 2000 Dec;244(1617):1003.
Drugs in sport: a new approach.
Dawson RT.
Publication Types:
Editorial
PMID: 11220167 [PubMed]
318: Haematologica. 2001 Feb;86(2):128-37.
Detection of recombinant human erythropoietin abuse in athletes utilizing
markers of altered erythropoiesis.
Parisotto R, Wu M, Ashenden MJ, Emslie KR, Gore CJ, Howe C, Kazlauskas R, Sharpe
K, Trout GJ, Xie M.
Department of Physiology, Australian Institute of Sport, P.O. Box 176, Belconnen
ACT 2616, Australia. robin.parisotto@ausport.gov.au
BACKGROUND AND OBJECTIVES: The detection of recombinant human erythropoietin
(r-HuEPO) abuse by athletes remains problematic. The main aim of this study was
to demonstrate that the five indirect markers of altered erythropoiesis
identified in our earlier work were reliable evidence of current or recently
discontinued r-HuEPO use. A subsidiary aim was to refine weightings of the five
markers in the initial model using a much larger data set than in the pilot
study. A final aim was to verify that the hematologic response to r-HuEPO did
not differ between Caucasian and Asiatic subjects. DESIGN AND METHODS:
Recreational athletes resident in Sydney, Australia (Sydney, n = 49; 16 women,
33 men) or Beijing, China (Beijing, n=24; 12 women, 12 men) were randomly
assigned to r-HuEPO or placebo groups prior to a 25 day administration phase.
Injections of r-HuEPO (or saline) were administered double-blind at a dose of 50
IU/kg three times per week, with oral iron (105 mg) or placebo supplements taken
daily by all subjects. Blood profiles were monitored during and for 4 weeks
after drug administration for hematocrit (Hct), reticulocyte hematocrit
(RetHct), percent macrocytes (%Macro), serum erythropoietin (EPO) and soluble
transferrin receptor (sTfr), since we had previously shown that these five
variables were indicative of r-HuEPO use. RESULTS. The changes in Hct, RetHct,
%Macro, EPO and sTfr in the Sydney trial were qualitatively very similar to the
changes noted in our previous administration trial involving recreational
athletes of similar genetic origin. Statistical models developed from Fisher's
discriminant analysis were able to categorize the user and placebo groups
correctly. The same hematologic response was demonstrated in Beijing athletes
also administered r-HuEPO. INTERPRETATION AND CONCLUSIONS: This paper confirms
that r-HuEPO administration causes a predictable and reproducible hematologic
response. These markers are disturbed both during and for several weeks
following r-HuEPO administration. This work establishes an indirect blood test
which offers a useful means of detecting and deterring r-HuEPO abuse. Ethnicity
did not influence the markers identified as being able to detect athletes who
abuse r-HuEPO.
Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial
PMID: 11224480 [PubMed]
319: Nephrol Dial Transplant. 2001 Jan;16(1):163-5.
End-stage renal disease in a bodybuilder: a multifactorial process or simply
doping?
Hartung R, Gerth J, Funfstuck R, Grone HJ, Stein G.
Department of Internal Medicine IV, Friedrich-Schiller-University of Jena,
Germany.
Publication Types:
Case Reports
PMID: 11209014 [PubMed]
320: Ann Emerg Med. 2001 Feb;37(2):147-53.
Comment in:
Ann Emerg Med. 2001 Nov;38(5):605-7.
Ann Emerg Med. 2001 Sep;38(3):345-6.
Gamma-hydroxybutyrate withdrawal syndrome.
Dyer JE, Roth B, Hyma BA.
California Poison Control System, San Francisco Division, San Francisco General
Hospital, CA 94110, USA. jodyer@itsa.ucsf.edu
STUDY OBJECTIVE: Gamma-hydroxybutyrate (GHB) withdrawal syndrome is increasingly
encountered in emergency departments among patients presenting for health care
after discontinuing frequent GHB use. This report describes the characteristics,
course, and symptoms of this syndrome. METHODS: A retrospective review of poison
center records identified 7 consecutive cases in which patients reporting
excessive GHB use were admitted for symptoms consistent with a sedative
withdrawal syndrome. One additional case identified by a medical examiner was
brought to our attention. These medical records were reviewed extracting
demographic information, reason for presentation and use, concurrent drug use,
toxicology screenings, and the onset and duration of clinical signs and
symptoms. RESULTS: Eight patients had a prolonged withdrawal course after
discontinuing chronic use of GHB. All patients in this series were psychotic and
severely agitated, requiring physical restraint and sedation. Cardiovascular
effects included mild tachycardia and hypertension. Neurologic effects of
prolonged delirium with auditory and visual hallucinations became episodic as
the syndrome waned. Diaphoresis, nausea, and vomiting occurred less frequently.
The onset of withdrawal symptoms in these patients was rapid (1 to 6 hours after
the last dose) and symptoms were prolonged (5 to 15 days). One death occurred on
hospital day 13 as withdrawal symptoms were resolving. CONCLUSION: In our
patients, severe GHB dependence followed frequent ingestion every 1 to 3 hours
around-the-clock. The withdrawal syndrome was accompanied initially by symptoms
of anxiety, insomnia, and tremor that developed soon after GHB discontinuation.
These initial symptoms may progress to severe delirium with autonomic
instability.
Publication Types:
Case Reports
PMID: 11174231 [PubMed]
321: J Am Acad Orthop Surg. 2001 Jan-Feb;9(1):61-70.
Use of ergogenic aids by athletes.
Silver MD.
Department of Orthopaedics and Rehabilitation, Yale University School of
Medicine, New Haven, CT 06511, USA.
"Ergogenic aid" is defined as any means of enhancing energy utilization,
including energy production, control, and efficiency. Athletes frequently use
ergogenic aids to improve their performance and increase their chances of
winning in competition. It is estimated that between 1 and 3 million male and
female athletes in the United States alone have used anabolic steroids. In
response to the problem of drug use, many athletic organizations have
established policies prohibiting the use of certain pharmacologic, physiologic,
and nutritional aids by athletes and have implemented drug testing programs to
monitor compliance. Therefore, it is important for physicians to be
knowledgeable about the available ergogenic aids so they can appropriately treat
and counsel the athletic patient.
Publication Types:
Review
Review, Tutorial
PMID: 11174164 [PubMed]
322: Anal Biochem. 2001 Feb 15;289(2):116-23.
Changes in androgenic steroid profile due to urine contamination by
microorganisms: a prospective study in the context of doping control.
de la Torre R, de la Torre X, Alia C, Segura J, Baro T, Torres-Rodriguez JM.
Pharmacology Research Unit, Institut Municipal d'Investigacio Medica (IMIM),
Doctor Aiguader 80, E-08003 Barcelona, Spain. rtorre@imim.es
Urine contamination by microorganisms may affect the interpretation of
urinalysis in different areas of clinical diagnosis. This is particularly
relevant in doping control. A prospective study was designed to assess the
effects of urine contamination by selected pathogens on the endogenous
androgenic steroid profile. Pooled urine from a healthy male volunteer with
standard steroid profile compared with reference values for the Caucasian
population was sterilized by filtration and stored in sterile glass tubes.
Aliquots were inoculated with known amounts of 15 different organisms (bacteria,
fungi, and moulds) and incubated at 37 degrees C for 2 weeks. Different markers
of urine contamination, such as pH, deconjugation of steroids, and metabolic
by-products, were determined. Alkalization of urinary pH was not a reliable
indicator of urine contamination as several organisms grew in this medium and no
alteration of this parameter was found. In uncontaminated urine, less than 10%
of steroid glucuronide conjugates were spontaneously hydrolyzed. Higher rates of
hydrolysis for sulfate conjugates were found. An unconjugated fraction higher
than 10% of the total amount of testosterone was a reliable indicator of urine
contamination. However, microbial production of testosterone or epitestosterone
was not detected. In contrast, a few organisms were able to synthesize
5alpha-androstanedione, 5beta-androstanedione, and androstenedione using
endogenous steroids as substrates. Copyright 2001 Academic Press.
PMID: 11161304 [PubMed]
323: Clin Chem. 2001 Feb;47(2):292-300.
Performance characteristics of a carbon isotope ratio method for detecting
doping with testosterone based on urine diols: controls and athletes with
elevated testosterone/epitestosterone ratios.
Aguilera R, Chapman TE, Starcevic B, Hatton CK, Catlin DH.
UCLA Olympic Analytical Laboratory, Department of Molecular and Medical
Pharmacology, University of California at Los Angeles, Los Angeles, CA 90025,
USA. rodrigoa@ucla.edu
Background: Carbon isotope ratio methods are used in doping control to determine
whether urinary steroids are endogenous or pharmaceutical. METHODS: Gas
chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS) was used
to determine the delta(13)C values for 5 beta-androstane-3 alpha,17 beta-diyl
diacetate (5 beta A), 5 alpha-androstane-3 alpha,17 beta-diyl diacetate (5 alpha
A), and 5 beta-pregnane-3 alpha,20 alpha-diyl diacetate (5 beta P) in a control
group of 73 healthy males and 6 athletes with testosterone/epitestosterone
ratios (T/E) >6. RESULTS: The within-assay precision SDs for 5 beta A, 5 alpha
A, and 5 beta P were +/- 0.27 per thousand, +/- 0.38 per thousand, and +/- 0.28
per thousand, respectively. The between-assay precision SDs ranged from +/- 0.40
per thousand to +/- 0.52 per thousand. The system suitability and batch
acceptance scheme is based on SDs. For the control group, the mean delta(13)C
(SD) values were -25.69 per thousand (+/- 0.92 per thousand), -26.35 per
thousand (+/- 0.68 per thousand), and -24.26 per thousand (+/- 0.70 per
thousand), for 5 beta A, 5 alpha A, and 5 beta P, respectively. 5 beta P was
greater than 5 beta A and 5 alpha A (P <0.01), and 5 beta A was greater than 5
alpha A (P <0.01). The means - 3 SD were -28.46 per thousand, -28.39 per
thousand, and -26.37 per thousand for 5 beta A, 5 alpha A, and 5 beta P,
respectively. The maximum difference between 5 beta P and 5 beta A was 3.2 per
thousand, and the maximum 5 beta A/5 beta P was 1.13. Three athletes with
chronically elevated T/Es had delta(13)C values consistent with testosterone
administration and three did not. CONCLUSIONS: This GC-C-IRMS assay of urine
diols has low within- and between-assay SDs; therefore, analysis of one urine
sample suffices for doping control. The means, SDs, +/-3 SDs, and ranges of
delta(13)C values in a control group are established. In comparison,
testosterone users have low 5 beta A and 5 alpha A, large differences between 5
beta A or 5 alpha A and 5 beta P, and high 5 beta A/5 beta P and 5 alpha A/5
beta P ratios.
PMID: 11159778 [PubMed]
324: Scand J Med Sci Sports. 2000 Apr;10(2):98-102.
Changes in hemoglobin values in elite cross-country skiers from 1987-1999.
Videman T, Lereim I, Hemmingsson P, Turner MS, Rousseau-Bianchi MP, Jenoure P,
Raas E, Schonhuber H, Rusko H, Stray-Gundersen J.
The Medical Committee of the International Ski Federation and KIHU-Research
Institute for Olympic Sports, Jyvaskyla, Finland.
Hemoglobin data have been available from ski teams beginning from 1987, and from
1989 to 1999 we have followed hemoglobin values in elite cross-country skiers in
international competitions. The mean values at the 1989 World Nordic Ski
Championships were lower than population reference values, as would be expected
from plasma volume expansion associated with endurance training. However, an
increase, particularly in the maximal values, became obvious in 1994 and rose
further in 1996. These extreme values provide both a health risk to the
individual athlete and unfair competition. After a rule limiting hemoglobin
values was introduced, the drop of the highest values was remarkable: among men
15 g/l (0.23 mmol/l) and among women 42 g/l (0.65 mmol/l). It would appear that
the rule had achieved its goal of limiting extreme hemoglobin values. Yet the
mean hemoglobin concentrations in men and women have continued to rise,
suggesting the continued use of artificial methods to increase total hemoglobin
mass.
PMID: 10755280 [PubMed]
325: Rev Assoc Med Bras. 1999 Oct-Dec;45(4):364-70.
[Abuse of anabolic-androgenic steroids in sports]
[Article in Portuguese]
Lise ML, da Gama e Silva TS, Ferigolo M, Barros HM.
Fundacao Faculdade Federal de Ciencias Medicas de Porto Alegre, RS.
Publication Types:
Review
Review Literature
PMID: 10752246 [PubMed]
326: Am J Kidney Dis. 2001 Jan;37(1):157-159.
Comment on:
Am J Kidney Dis. 2001 Jan;37(1):73-78.
Win, place, show: creatine consumption and the price of winning.
Sabatini S.
Publication Types:
Comment
Editorial
PMID: 11136183 [PubMed]
327: Comb Chem High Throughput Screen. 2000 Dec;3(6):467-80.
Screening procedures for simultaneous detection of several drug classes used for
high throughput toxicological analyses and doping control. A review.
Maurer HH.
Department of Toxicology, Institute of Pharmacology and Toxicology, University
of Saarland, D-66421 Homburg (Saar), Germany. hans.maurer@med-rz.uni-saarland.de
This paper reviews high throughput screening procedures for the simultaneous
detection of several drug classes relevant to clinical and forensic toxicology
or doping control in urine or blood using gas chromatography-mass spectrometry
(GC-MS), liquid chromatography coupled with a diode-array detector (LC-DAD) or
mass spectrometry (LC-MS). Basic information describing these systematic
toxicological analysis (STA) procedures such as the analytes, the biosample,
work-up, separation column, mobile phase or separation buffer, detection mode
and detection limits are summarized in tables arranged according to the
analytical method. Examples of typical applications are presented in 2 figures.
Analysis of alternative matrices, like sweat, saliva, nails or hair, was not
reviewed.
Publication Types:
Review
Review, Tutorial
PMID: 11121516 [PubMed]
328: Haematologica. 2000;85(E-letters):E04.
Erythropoietin doping. A comment.
Remacha AF.
Publication Types:
Letter
PMID: 11114819 [PubMed]
329: J Mass Spectrom. 2000 Nov;35(11):1285-94.
Derivatization procedures for the detection of beta(2)-agonists by gas
chromatographic/mass spectrometric analysis.
Damasceno L, Ventura R, Ortuno J, Segura J.
Unitat de Farmacologia, Institut Municipal d'Investigaci o M edica, E-08003
Barcelona, Spain.
An evaluation of derivatization procedures for the detection of beta(2)-agonists
is presented. The study was performed with the beta(2)-agonists bambuterol,
clenbuterol, fenoterol, formoterol, salbutamol, salmeterol and terbutaline.
Different derivatizating agents were employed, aiming to obtain derivatives with
high selectivity to be used in the gas chromatographic/mass spectrometric
analysis of beta(2)-agonists in biological samples. Trimethylsilylation was
compared with different agents and the role of some catalysts was evaluated.
Acylation, combined trimethylsilylation and acylation, and the formation of
cyclic methylboronates were also studied. Sterical hindrance caused by different
substituents at the nitrogen atom of the beta-ethanolamine lateral chain of
beta(2)-agonist molecules is mainly responsible for differences in the
abundances of the derivatives obtained. The use of catalysts produces an
increase in the derivatization yield, especially for compounds with low steric
hindrance (substituents with primary and secondary carbon atoms). The formation
of trimethylsilyl (TMS) ethers is not influenced by structural molecular
differences when only hydroxy groups are involved in derivatization. Combined
trimethylsilylation and acylation showed that compounds with a secondary carbon
atom linked to the nitrogen atom form mainly N-TFA-O-TMS derivatives, with a
small amount of N-TMS-O-TMS derivatives. Compounds with tert-butyl substituents
at the amino group (bambuterol, salbutamol and terbutaline) formed O-TMS
derivatives as the main products, although a limited amount of
trifluoroacylation at the nitrogen atom also occurred. Cyclic methylboronates
were formed with bambuterol, clenbuterol, formoterol, salbutamol and salmeterol.
Owing to hydroxy substituents in unsuitable positions for ring formation, this
procedure was not effective for fenoterol and terbutaline. Mass spectra of
different derivatives and tentative fragmentation profiles are also shown. For
screening purpose (e.g. sports drug testing), derivatization with MSTFA or BSTFA
alone is recommended as a comprehensive derivatization technique for
beta(2)-agonists owing to minimal by-product formation; formation of cyclic
methylboronates can be useful for confirmation purposes. Detection limits were
obtained for the TMS and cyclic methylboronate derivatives using the
derivatizing reagents MSTFA and trimethylboroxine, respectively. For most of the
compounds, lower detection limits were found for the TMS derivatives. Copyright
2000 John Wiley & Sons, Ltd.
PMID: 11114086 [PubMed]
330: Rapid Commun Mass Spectrom. 2000;14(24):2343-7.
Detection of exogenous intake of natural corticosteroids by gas
chromatography/combustion/isotope ratio mass spectrometry: application to misuse
in sport.
Bourgogne E, Herrou V, Mathurin JC, Becchi M, de Ceaurriz J.
Laboratoire National de Depistage du Dopage, 143 avenue R. Salengro, 92290
Chatenay Malabry, France.
A detailed procedure for the analysis of exogenous hydrocortisone and cortisone
in urine by gas chromatography/combustion/isotope ratio mass spectrometry
(GC/C/IRMS) is proposed. As urinary levels of hydrocortisone are rather low for
GC/C/IRMS analysis, the focus is on the main corticosteroid metabolites,
tetrahydrocortisone (THE) and tetrahydrocortisol (THF). Following different
solid phase extraction purifications, THE and THF are oxidized to
5beta-androstanetrione before analysis by GC/C/IRMS. Significant differences in
delta(13)C per thousand values of synthetic natural corticosteroids and
endogenous human corticosteroids have been observed. Therefore, a positive
criterion, to detect exogenous administration of synthetic corticosteroids in
anti-doping control, is proposed. Copyright 2000 John Wiley & Sons, Ltd.
PMID: 11114048 [PubMed]
331: Clin Chem. 2000 Dec;46(12):2020-2.
Discrimination of the nature of doping with 19-norsteroids through hair
analysis.
Kintz P, Cirimele V, Ludes B.
Publication Types:
Letter
PMID: 11106346 [PubMed]
332: Nippon Rinsho. 2000 Sep;58 Suppl:162-6.
[Doping]
[Article in Japanese]
Kawahara T.
Japan Institute of Sports Sciences.
Publication Types:
Review
Review, Tutorial
PMID: 11085108 [PubMed]
333: Clin Hemorheol Microcirc. 2000;22(4):287-303.
The paradox of hematocrit in exercise physiology: which is the "normal" range
from an hemorheologist's viewpoint?
Brun JF, Bouchahda C, Chaze D, Benhaddad AA, Micallef JP, Mercier J.
Service Central de Physiologie Clinique, Centre d'Exploration et de Readaptation
des Anomalies du Metabolisme Musculaire (CERAMM), CHU Lapeyronie, Montpellier,
France. drjfbrun@aol.com
The paradox of hematocrit in exercise physiology is that artificially increasing
it by autotransfusion or erythropoietin doping improves VO2 max and performance,
while in normal conditions there is a strong negative correlation between
hematocrit and fitness, due to a training-induced "autohemodilution". We aimed
at investigating: (a) which is the physiological range of hematocrit in highly
trained professional footballers; (b) what are the characteristics of athletes
with high vs low hematocrit? We determined in 77 healthy male footballers the
physiological range (mean +/- sd) of hematocrit: 42.3+/-2.74, (range
-2sigma/+2sigma = 36.8-47.8%) thus defining boundaries of quintiles of
distribution for this parameter: 40, 41.6, 42.9, 44.6. In another sample of 42
male footballers we compared three groups: lowest quintile (n = 8), highest
quintile (n = 5) and the three middle quintiles considered together (n = 29).
Athletes in the lowest quintile compared to those in the four other quintiles
had a lower value of blood viscosity (-8%, p < 0.01) but this difference
disappeared after correction for hematocrit. These subjects with low hematocrit
had also higher values of the following parameters: aerobic working capacity (p
< 0.01); isometric adductor strength (p = 0.02); crossover point of carbohydrate
oxidation (70% carbohydrates/30% lipids) (p < 0.05); insulin like growth factor
binding protein 1 (p < 0.0001). Athletes in the highest quintile had higher red
cell aggregability (Myrenne index "M1" 8.45+/-0.38 vs 6.82+/-0.62, p < 0.04) and
a higher disaggregability threshold gammaD (72.6+/-22.63 vs 44.49+/-1.37, p <
0.01) and a lower percentage of water in fat-free mass (p < 0.02). On the whole
sample hematocrit was negatively correlated with aerobic working capacity (W170
r = -0.329, p = 0.007; Wmax (% of expected value) r = -0.552, p = 0.008; VO2 max
(% of expected value) r = -0.543, p = 0.009) and with ferritin (r = -0.33, p =
0.031), and positively correlated with the overtraining score (r = 0.352, p =
0.019) which was in turn negatively correlated with ferritin r = -0.312, p =
0.02). Besides, hematocrit behaves as a major determinant of blood viscosity
(correlation with blood viscosity r = 0.997, p < 10(-7)) and erythrocyte
disaggregability gammaD (r = 0.384, p = 0.03), but the hematocrit/viscosity
ratio (h/eta index of O2 delivery) remains maintained almost constant over the
range of values studied. These results show that (a) physiological values of
hematocrit in these athletes are comprised between 36 and 48%; (b) "low"
hematocrit (<40%) was associated with a higher aerobic capacity; (c) subjects
with the higher hematocrits (>44.6%) were frequently overtrained and/or
iron-deficient, and their blood viscosity (and red cell disaggregability) tended
to be increased.
PMID: 11081466 [PubMed]
334: Int J Sports Med. 2000 Oct;21(7):471-9.
Reticulocyte parameters as potential discriminators of recombinant human
erythropoietin abuse in elite athletes.
Parisotto R, Gore CJ, Hahn AG, Ashenden MJ, Olds TS, Martin DT, Pyne DB,
Gawthorn K, Brugnara C.
Department of Physiology and Applied Nutrition, Australian Institute of Sport,
Canberra.
This study investigated using reticulocyte (retic) parameters as indirect
markers of human recombinant erythropoietin (r-HuEPO) abuse in elite athletes.
Absolute reticulocyte count (# retic), the per cell haemoglobin content of
reticulocytes (CHr), reticulocyte haemoglobin mass per litre of blood (RetHb)
and red blood cell:reticulocyte haemoglobin (RBCHb:RetHb) ratio were assessed
using flow cytometry. Venous blood was drawn from 155 elite athletes from six
sports during regular training to establish reference ranges (95% confidence
interval) for these parameters. The reference ranges were compared with those of
a non-athletic population (n = 23), four groups of athletes (n = 24) before and
after exposure to simulated altitudes (2,500-3,000 m for 11-23 nights), two
groups of elite cyclists (n = 13) before and after four weeks of training at
natural altitude (1,780 and 2,690 m), and with those of non-athletic subjects
from a separate study (n =24) before and 1-2 days after they were injected with
1,200 U x kg(-1) r-HuEPO over a 9-10 day period. Generally the changes induced
by r-HuEPO injection exceeded by approximately 100% the magnitude of the changes
associated with natural altitude exposure. Simulated altitude exposure did not
significantly alter the reticulocyte parameters. From the sample of 155
non-users and 24 r-HuEPO users, the population mean and variance, as well as the
95% confidence limits for the population mean and population variance, were
estimated. Relative to arbitrarily chosen cut-off levels, the confidence limits
for the rate of true positives and rate of true negatives were also calculated.
Based on the lowest rate of false positives and highest rate of true positives,
the best discriminator between r-HuEPO users and non-users was # retic,
marginally superior to RBCHb: RetHb ratio and RetHb. At a cut-off for # retic of
221 x 10(9)x L(-1) we could be 95% sure that we would find no more than 7 false
positives in every 100,000 tests. We would expect to pick up 51.8% of users, and
could be 95% sure of picking up at least 38% of current or recent users. This
result highlights the potential power of retic parameters for detecting r-HuEPO
abuse among athletes. However, the efficacy of these cut-offs for detecting
r-HuEPO abuse is unknown if an athlete is a chronic user or stops using r-HuEPO
several weeks before being tested.
PMID: 11071048 [PubMed]
335: Newsweek. 2000 Sep 11;136(11):42-5.
The drug charade.
Begley S, Clifton T.
PMID: 11067259 [PubMed]
336: Time. 2000 Sep 11;156(11):90-2.
Are drugs winning the games?
Sullivan R, Song S.
PMID: 11067230 [PubMed]
337: Med J Aust. 2000 Sep 18;173(6):314-7.
Comment in:
Med J Aust. 2001 Feb 19;174(4):203-4.
Newer drugs used to enhance sporting performance.
Kennedy MC.
Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital,
Sydney, NSW. drmkenn@ozemail.com.au
Controversy surrounding drug use in sport makes this a difficult area for
rigorous research. However, it is striking that what data there are on drugs
currently used for performance enhancement rarely indicate any clear benefit.
Publication Types:
Review
Review, Tutorial
PMID: 11061403 [PubMed]
338: Med J Aust. 2000 Sep 18;173(6):312-3.
Comment in:
Med J Aust. 2001 Feb 19;174(4):203-4.
Med J Aust. 2001 Feb 19;174(4):204.
Drug testing at the Sydney Olympics.
Corrigan B, Kazlauskas R.
Institute of Sport, Concord Hospital, Sydney, NSW. abc@southernx.com.au
With pre-Olympic and out-of-competition testing, as well as a new, validated
test for erythropoietin, athletes will be exposed to more comprehensive drug
testing at the Sydney Olympics.
PMID: 11061402 [PubMed]
339: Sci Am. 2000 May;282(5):20, 22.
All doped up--and going for the gold.
Zorpette G.
Publication Types:
News
PMID: 11056980 [PubMed]
340: Lancet. 2000 Sep 16;356(9234):1008.
Past, present, and future of drug abuse at the Olympics.
Birchard K.
Publication Types:
News
PMID: 11041409 [PubMed]
341: Lancet. 2000 Sep 30;356(9236):1171.
Olympic committee bans doctor after doping case.
Birchard K.
Publication Types:
News
PMID: 11030305 [PubMed]
342: Postgrad Med. 2000 Sep 15;108(4):103-6, 109-12.
Sports supplements. Can dietary additives boost athletic performance and
potential?
Rubinstein ML, Federman DG.
Department of Medicine, Yale University School of Medicine, New Haven,
Connecticut, USA.
Nutritional sports supplements, many of which are endorsed by professional
athletes, are increasing in popularity among casual and adolescent sports
enthusiasts, bodybuilders, and weight lifters. Because many people consider
nutritional additives to be "natural" and therefore "safe," patients may not
consider the possible effects of those substances when taken in high doses or in
combination with medications. Drs Rubinstein and Federman present an interesting
overview of several sports supplements and examine the consequences and caveats
of their use, as well as the reasons for their popularity.
Publication Types:
Review
Review, Tutorial
PMID: 11021262 [PubMed]
343: US News World Rep. 2000 Aug 14;129(6):40-1.
Positive on testing. But will the Olympic Games get clean this year--or ever?
Clark K.
Publication Types:
News
PMID: 11010048 [PubMed]
344: J Mass Spectrom. 2000 Sep;35(9):1100-4.
Negative ion chemical ionization for the determination of methylphenidate in
human plasma by stable isotope dilution gas chromatography/mass spectrometry.
Leis HJ, Fauler G, Raspotnig G, Windischhofer W.
University Children's Hospital, Department of Analytical Biochemistry and Mass
Spectrometry, Auenbruggerplatz 30, A-8036 Graz, Austria.
hans.leis@kfunigraz.ac.at
A sensitive and specific method for the determination of methylphenidate in
human plasma is presented. Methylphenidate was extracted from plasma by solvent
extraction with hexane at pH 9.3 and derivatized to its heptafluorobutyrate
derivative. The derivative was measured by gas chromatography/negative ion
chemical ionization mass spectrometry without any further purification. Using
this detection mode, a diagnostically useful fragment ion at m/z 369 was
obtained at high relative abundance. (18)O(2)-labelled methylphenidate was used
as an internal standard and its rapid and facile preparation from the unlabeled
compound is described. Calibration graphs were linear within the range
0.14-18.25 ng ml(-1). The inter-assay precision was 8.7% (0.14 ng ml(-1)) and
3.1% (4.56 ng ml(-1)) and the intra-assay variability was 1.3% (0.14 ng ml(-1))
and 0.4% (4.56 ng ml(-1)). Accuracy determinations showed deviations of +0.7%
(0.14 ng ml(-1)) and -2.5% (4.56 ng ml(-1)). The method is rugged, rapid and
robust and has been applied to the batch analysis of methylphenidate during
pharmacokinetic profiling of the drug. Copyright 2000 John Wiley & Sons, Ltd.
PMID: 11006603 [PubMed]
345: Rapid Commun Mass Spectrom. 2000;14(19):1835-40.
Measurement of 19-nortestosterone and its esters in equine plasma by
high-performance liquid chromatography with tandem mass spectrometry.
Kim JY, Choi MH, Kim SJ, Chung BC.
Racing Laboratory, Korea Racing Association, Kwachon 427-070, Korea.
A high-performance liquid chromatographic-tandem mass spectrometric (HPLC/MS/MS)
method for the determination of 19-nortestosterone and its esters
(cyclopentanepropionate, phenylpropionate, and decanoate) in equine plasma is
achieved using an atmospheric pressure chemical ionization (APCI) interface in
selected reaction monitoring (SRM) mode. The two internal standards used were
16,16, 17-(2)H(3)-19-nortestosterone for 19-nortestosterone and methenolone
acetate for its esters. The steroids studied were extracted from plasma samples
with a mixture of diethyl ether/n-hexane (9:1, v/v). The quantification limits
for 19-nortestosterone, 19-nortestosterone cyclopentanepropionate,
19-nortestosterone phenylpropionate, and 19-nortestosterone decanoate were 0.16,
5.0, 0.1, and 2.0 ng/mL, respectively, when 2 mL of plasma were used. The
recoveries of most of the steroids were 71.6-101.0% except for the decanoate,
which could be recovered to about 39.8%. The responses were linear, with
correlation coefficients varying from 0.9897 to 0.9999 in the concentration
range of 0.1 to 50.0 ng/mL for the steroids studied. When applied to equine
(mare) plasma samples, the present method allowed detection of
19-nortestosterone up to 23 days after an intra-muscular injection of 400 mg as
the decanoate. Copyright 2000 John Wiley & Sons, Ltd.
PMID: 11006593 [PubMed]
346: Nature. 2000 Sep 14;407(6801):124-7.
Erratum in:
Nature 2000 Oct 26;407(6807):following 936.
What price the Olympian ideal?
Abbott A.
Publication Types:
News
PMID: 11001030 [PubMed]
347: Nature. 2000 Sep 14;407(6801):115.
A nut to crack a sledgehammer.
[No authors listed]
Publication Types:
Editorial
PMID: 11001019 [PubMed]
348: J Chromatogr B Biomed Sci Appl. 2000 Jul 21;744(2):345-50.
Detection of the plasma volume expander hydroxyethyl starch in human urine.
Thevis M, Opfermann G, Schanzer W.
Institute of Biochemistry, German Sports University Cologne, Germany.
mario@biochem.dshs-koeln.de
The plasma volume expander hydroxyethyl starch (HES) is usually administered in
cases of hypovolaemic shocks but in 1998 the press reported its misuse in
endurance sports. Since January 2000, it has been put on the list of prohibited
substances of the International Olympic Committee (IOC) and its misuse is to ban
by doping controls. Therefore, a rapid method enabling the screening for HES in
human urine was developed which can be easily adopted by IOC laboratories to
analyse routine urine samples for this remedy. Excretion study urine samples
obtained from patients treated with HES, blank urine specimen and reference
standards, were hydrolysed with hydrochloric acid and without any further
purification of the resulting monosaccharides their per-timethylsilylated
derivatives were performed. By means of gas chromatography-mass spectrometry the
products were separated and the alpha- and beta-isomers of glucose, 2-, 3- and
6-hydroxyethyl glucose derivatives were identified. Typical ion traces of 2- and
3-substituted glucose (m/z 248, m/z 261 and m/z 235, m/z 248, respectively)
support the fast determination of the substances whose electron impact mass
spectra are presented and discussed.
PMID: 10993523 [PubMed]
349: Growth Horm IGF Res. 1998 Feb;8(1):1-2.
Research on growth hormone (GH) and the insulin-like growth factors (IGFs)
Le Roith D, Sonksen PH.
Publication Types:
Editorial
PMID: 10990438 [PubMed]
350: Bull Acad Natl Med. 2000;184(2):431-44; discussion 444-6.
[Assessment of physical and sports aptitudes, overtraining prevention, and
prevention of doping]
[Article in French]
Menier R, Laplaud D, Dalmay F, Talmud J.
CHRU Dupuytren-Centre Regional de Medecine du Sport, Limoges.
Present levels of training loads--which can exceed thirty hours a week for high
level sportsmen--expose to overwork then to overtraining syndrome and finally to
temptation of doping. At the same time testing techniques improve, particularly
exercise tests with a linearly increasing load, and the follow-up of training
effects on physical fitness provides more accurate data. The specialized
literature has developed the notions of cardiac frequency reserve and of oxygen
intake reserve within the last ten years. These notions, as those of produced
power reserve, were applied here to assess the ventilatory threshold of 104
sportsmen (51 cyclists with high endurance and 53 team sportsmen with lower
endurance) and of 223 sedentary witnesses. They allow, when completed with
absolute level of aerobic endurance, to appreciate physical fitness of sportsmen
all along sports season, to predict their capabilities to progress by an
increase of training load or to reinforce the hypothesis of an over-working
onset.
PMID: 10989549 [PubMed]
351: Clin Pharmacokinet. 2000 Aug;39(2):127-53.
Clinically significant pharmacokinetic interactions between dietary caffeine and
medications.
Carrillo JA, Benitez J.
Department of Pharmacology and Psychiatry, Medical School, University of
Extremadura, Badajoz, Spain. carrillo@unex.es
Caffeine from dietary sources (mainly coffee, tea and soft drinks) is the most
frequently and widely consumed CNS stimulant in the world today. Because of its
enormous popularity, the consumption of caffeine is generally thought to be safe
and long term caffeine intake may be disregarded as a medical problem. However,
it is clear that this compound has many of the features usually associated with
a drug of abuse. Furthermore, physicians should be aware of the possible
contribution of dietary caffeine to the presenting signs and symptoms of
patients. The toxic effects of caffeine are extensions of their pharmacological
effects. The most serious caffeine-related CNS effects include seizures and
delirium. Other symptoms affecting the cardiovascular system range from moderate
increases in heart rate to more severe cardiac arrhythmia. Although tolerance
develops to many of the pharmacological effects of caffeine, tolerance may be
overwhelmed by the nonlinear accumulation of caffeine when its metabolism
becomes saturated. This might occur with high levels of consumption or as the
result of a pharmacokinetic interaction between caffeine and over-the-counter or
prescription medications. The polycyclic aromatic hydrocarbon-inducible
cytochrome P450 (CYP) 1A2 participates in the metabolism of caffeine as well as
of a number of clinically important drugs. A number of drugs, including certain
selective serotonin reuptake inhibitors (particularly fluvoxamine),
antiarrhythmics (mexiletine), antipsychotics (clozapine), psoralens,
idrocilamide and phenylpropanolamine, bronchodilators (furafylline and
theophylline) and quinolones (enoxacin), have been reported to be potent
inhibitors of this isoenzyme. This has important clinical implications, since
drugs that are metabolised by, or bind to, the same CYP enzyme have a high
potential for pharmacokinetic interactions due to inhibition of drug metabolism.
Thus, pharmacokinetic interactions at the CYP1A2 enzyme level may cause toxic
effects during concomitant administration of caffeine and certain drugs used for
cardiovascular, CNS (an excessive dietary intake of caffeine has also been
observed in psychiatric patients), gastrointestinal, infectious, respiratory and
skin disorders. Unless a lack of interaction has already been demonstrated for
the potentially interacting drug, dietary caffeine intake should be considered
when planning, or assessing response to, drug therapy. Some of the reported
interactions of caffeine, irrespective of clinical relevance, might
inadvertently cause athletes to exceed the urinary caffeine concentration limit
set by sports authorities at 12 mg/L. Finally, caffeine is a useful and reliable
probe drug for the assessment of CYP1A2 activity, which is of considerable
interest for metabolic studies in human populations.
Publication Types:
Review
Review Literature
PMID: 10976659 [PubMed]
352: Clin Chem. 2000 Sep;46(9):1365-75.
Discrimination of prohibited oral use of salbutamol from authorized inhaled
asthma treatment.
Berges R, Segura J, Ventura R, Fitch KD, Morton AR, Farre M, Mas M, de La Torre
X.
Pharmacology Research Unit, Institut Municipal d'Investigacio Medica (IMIM),
Doctor Aiguader 80, 08003 Barcelona, Spain.
BACKGROUND: The administration of salbutamol is permitted only by inhalation by
the International Olympic Committee (IOC) for the management of asthma and
exercise-induced asthma in athletes. The establishment of criteria to
distinguish between the (IOC) authorized use (inhaled) and the (IOC) prohibited
use (oral) of salbutamol appeared possible using simultaneous evaluation of
variables based on the concentration of nonconjugated enantiomers of salbutamol
excreted in urine. METHODS: Urine was collected from asthmatic and nonasthmatic
swimmers who had received various preexercise doses of oral (five doses of 4 mg)
or inhaled (two doses of 100 microgram) salbutamol. Urine was also obtained from
subjects who had received the maximum dosage of inhaled salbutamol advisable for
competing athletes to provide protection from exercise-induced asthma and
treatment of asthma (1600 microgram in 24 h, 800 microgram being in the last 4
h). All samples were analyzed to determine the total amount of unchanged
salbutamol excreted in urine and the ratio between the S: and R: enantiomers.
RESULTS: The discriminant function D = -3.776 + 1.46 x 10(-3) ([S:(+)] +
[R:(-)]) + 1.012 ([S:(+)]/[R(-)]) can be used to classify data into two groups,
inhaled and oral. The confirmatory criterion suggested (cutoff at D = 1.06, 4 SD
from the mean D value of the inhaled distribution) has been verified in
different sets of samples showing suspicious concentrations by conventional
screening procedures in doping control. An 11.8% false-negative (oral classified
as inhaled) rate is assumed with the confirmatory criterion proposed, but
virtually no false positives (inhaled classified as oral) are obtained (<1 in 33
000). CONCLUSIONS: The overall procedure recommended is to screen all samples
and to apply the confirmation criterion proposed to samples showing free racemic
salbutamol concentrations >500 microgram/L by gas chromatography-mass
spectrometry or free + conjugated racemic salbutamol concentrations >1400
microgram/L by ELISA.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 10973867 [PubMed]
353: Ann Thorac Surg. 2000 Aug;70(2):658-60.
Ventricular thrombosis and systemic embolism in bodybuilders: etiology and
management.
McCarthy K, Tang AT, Dalrymple-Hay MJ, Haw MP.
Department of Cardiac Surgery, Wessex Cardiac & Thoracic Unit, Southampton
General Hospital, United Kingdom.
Increased thrombogenicity and acute embolism are well-recognized complications
of chronic anabolic steroid abuse. The following cases highlight such dangers in
steroid-enhanced bodybuilders who developed intracardiac thrombosis that
subsequently embolized. Systemic anticoagulation and surgical thrombectomy
constituted the mainstay treatment. This represents the first report of such
devastating cardiovascular complications after anabolic steroid abuse and their
management.
Publication Types:
Case Reports
PMID: 10969698 [PubMed]
354: Int J Sports Med. 2000 Jul;21(5):380-5.
Haemoglobin, haematocrit and red blood cell indices in elite cyclists. Are the
control values for blood testing valid?
Schumacher YO, Grathwohl D, Barturen JM, Wollenweber M, Heinrich L, Schmid A,
Huber G, Keul J.
Department Rehabilitation, Prevention and Sports Medicine, University of
Freiburg, Germany. olaf@msm1.ukl.uni-freiburg.de
BACKGROUND: In international cycling and cross-country skiing competitions,
blood tests are used to unmask the performance enhancing misuse of
erythropoietin. Haematocrit (cycling) and haemoglobin (cross-country skiing)
limits have been set by international sporting federations (haematocrit 50%,
haemoglobin 18.5 g/dl). Athletes tested above these cut-off values are declared
unfit for competition. To investigate the validity of these regulations, we
studied haemoglobin, haematocrit and red blood cell indices of elite cyclists
before erythropoietin became commercially available. MATERIAL AND METHODS: We
investigated 523 blood samples of 92 male elite cyclists (age 16-31 years) from
1978 to 1987. Haematocrit, haemoglobin and red blood cell count were analysed
automatically, erythrocyte indices were calculated. RESULTS: Haemoglobin (-0.3
+/- 1 g/dl), haematocrit (-1.2 +/- 2.8%) and red blood cell count (-0.2 +/- 0.4
x 10(6)/mm3) decreased significantly (p < 0.05) with increasing training
workload. The erythrocyte indices showed no significant change. Fifty-four blood
samples (10.3%) showed a haematocrit above 50%, one sample presented a
haemoglobin mass higher than 18.5 g/dl. During periods of increased workload,
less athletes tested above the haematocrit limit. CONCLUSION: The current
haematocrit limit used in blood tests might lead to a high number of false
positive tests.
Publication Types:
Validation Studies
PMID: 10950450 [PubMed]
355: Growth Horm IGF Res. 2000 Jun;10(3):107-10.
The Growth Hormone Research Society.
Sonksen P.
Publication Types:
Editorial
PMID: 10942630 [PubMed]
356: Presse Med. 2000 Jul 8-15;29(24):1365-72.
[Doping: epidemiological studies]
[Article in French]
Laure P.
patrick.laure@wanadoo.fr
PREVALENCE: Whatever method is used (observation, interviews, questionnaire,
laboratory tests), it is difficult to collect epidemiological data on doping.
Particularly difficult problems are related to the definitions of sports players
and the drugs involved as well as the often illicit nature of drug use. RESULTS:
The prevalence of doping in children and adolescents participating in sports is
estimated at 3% to 5% with higher percentages in boys, older adolescents and
those playing at a competition level. Use of anabolic steroids, as early as 8
years of age, has increased since 1990, especially in girls. All studies have
emphasized how easy it is for adolescents to procure any prohibited drug. In
adults participating in amateur sports, the prevalence of doping would be 5% to
15%. All sports are involved with higher prevalence in men, age ranges 20-25
years and 35-39 years, and competitive level players. The main drugs used are
stimulants, narcotics, corticosteroids and anabolic steroids. Combination of at
least 2 drugs is frequent with an increase of mean daily dose over the last 15
years. According to users, the drugs are obtained with a medical prescription,
on the underground market, or from other participants. Few data are available on
doping outside sports activities. In the French department Meurthe-et-Moselle,
15% of the inhabitants use drugs to improve their occupational performance.
CONCLUSIONS: Doping is more widespread than would be expected from antidoping
control data. Other studies are needed to acquire more precise epidemiological
data.
PMID: 10938696 [PubMed]
357: Presse Med. 2000 Jul 8-15;29(24):1356.
[Doping: indispensible public education]
[Article in French]
Garnier A.
Publication Types:
Editorial
PMID: 10938693 [PubMed]
358: Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Mar;14(1):147-65.
Techniques for analytical testing of unconventional samples.
Rivier L.
Institute of Legal Medicine of the University, Lausanne, Switzerland.
Forensic scientists have long detected the presence of drugs and their
metabolites in biological materials using body fluids such as urine, blood
and/or other biological liquids or tissues. For doping analysis, only urine has
so far been collected. In recent years, remarkable advances in sensitive
analytical techniques have encouraged the analysis of drugs in unconventional
biological samples such as hair, saliva and sweat. These samples are easily
collected, although drug levels are often lower than the corresponding levels in
urine or blood. This chapter reviews recent studies in the detection of doping
agents in hair, saliva and sweat. Sampling, analytical procedures and
interpretation of the results are discussed in comparison with those obtained
from urine and blood samples.
Publication Types:
Review
Review, Tutorial
PMID: 10932817 [PubMed]
359: Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Mar;14(1):135-45.
Erythropoietin test methods.
Breymann C.
Department of Obstetrics and Gynaecology, University Hospital of Zurich,
Switzerland.
Recombinant human erythropoietin (rhEPO), which increases red cell mass, is one
of the most abused substances in sport. Abuse is currently undetectable by the
only direct routine method, immunoassay, since blood and urine rhEPO are
immunologically indistinguishable from endogenous EPO. Elevated EPO levels are
only detectable several days after rhEPO administration. Indirect parameters
have therefore been introduced, primarily the haematocrit level, but also
markers of functional iron deficiency during or after rhEPO administration
(hypochromic red cells and reticulocytes, serum transferrin receptors, ferritin
levels) and, in the urine, fibrin degradation products. Although iron status
indices have yielded promising results, athletes are currently banned solely on
the basis of their haematocrit. Yet various factors can cause false positive
haematocrit results with potentially fatal consequences to athletes' careers.
Until new direct assays such as liquid chromatography-mass spectrometry have
been evaluated and introduced, efforts must be directed at using a battery of
tests to increase the sensitivity and specificity and reduce the number of false
positives and false negatives.
Publication Types:
Review
Review, Tutorial
PMID: 10932816 [PubMed]
360: Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Mar;14(1):111-33.
Test methods: anabolics.
Saugy M, Cardis C, Robinson N, Schweizer C.
Laboratoire Suisse d'analyse du Dopage, Institut de Medecine Legale, Universite
de Lausanne, Switzerland.
In the International Olympic Committee (IOC) accredited laboratories, specific
methods have been developed to detect anabolic steroids in athletes' urine. The
technique of choice to achieve this is gas-chromatography coupled with mass
spectrometry (GC-MS). In order to improve the efficiency of anti-doping
programmes, the laboratories have defined new analytical strategies. The final
sensitivity of the analytical procedure can be improved by choosing new
technologies for use in detection, such as tandem mass spectrometry (MS-MS) or
high resolution mass spectrometry (HRMS). A better sample preparation using
immuno-affinity chromatography (IAC) is also a good tool for improving
sensitivity. These techniques are suitable for the detection of synthetic
anabolic steroids whose structure is not found naturally in the human body. The
more and more evident use, on a large scale, of substances chemically similar to
the endogenous steroids obliges both the laboratory and the sports authorities
to use the steroid profile of the athlete in comparison with reference ranges
from a population or with intraindividual reference values.
Publication Types:
Review
Review, Tutorial
PMID: 10932815 [PubMed]
361: Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Mar;14(1):99-109.
Test method: GH.
Bidlingmaier M, Wu Z, Strasburger CJ.
Department of Internal Medicine, Klinikum Innenstadt,
Ludwig-Maximilians-University, Munich, Germany.
The abuse of recombinant human growth hormone in sports is considered to be a
widespread phenomenon, but until today all our knowledge thereof is based on
rumor, anonymous surveys or accidental observations by customs officers.
Although growth hormone (GH) is listed as a prohibited class E substance by the
International Olympic Committee (IOC) no official test for the detection of GH
abuse is implemented. Because of the high degree of identity in the amino acid
sequence between recombinant and endogenous GH and because of the pulsatile
nature of GH secretion, as well as inter-individual variations, it was believed
to be undetectable. Recently, new proposals have been made to overcome this
problem. On the basis of differential immunoassays it is possible to determine
the relative content of GH isoforms in the circulation and thus to detect the
application of recombinant GH. Furthermore, changes in GH dependent parameters
after the administration of recombinant GH have been shown to be a possible
indicator of GH abuse.
Publication Types:
Review
Review, Tutorial
PMID: 10932814 [PubMed]
362: Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Mar;14(1):89-98.
Blood boosting and sport.
Ekblom BT.
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm,
Sweden.
Reinfusion of whole blood or packed red blood cells (RBCs) increasing the
haemoglobin concentration ([Hb]) above the individual's normal values increases
VO2max and enhances physical performance. During submaximal exercise heart rate
and blood lactate concentration ([Hla]) are reduced, while arterial blood
pressure remains unchanged despite increased haematocrit (Hct). There is no
method available for detecting this type of blood 'doping'. Seven weeks of
injection with recombinant human erythropoietin (rhEPO) (20-40 IU per kg body
weight) increased [Hb] and Hct, maximal oxygen uptake (VO2max) and physical
performance were increased. The change in VO2max per gram change in [Hb] is the
same after reinfusion of blood and after rhEPO injections. During submaximal
exercise arterial blood pressure is increased, which despite a reduced heart
rate, puts greater stress on the circulation even in trained athletes. An
electrophoretic method is available to detect the use of rhEPO but it is costly
and slow and therefore it can not be used in sport. Indirect markers of
increased erythopoiesis may be used. However, further research in this field is
necessary.
Publication Types:
Review
Review, Tutorial
PMID: 10932813 [PubMed]
363: Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Mar;14(1):79-88.
Central nervous system stimulants.
George AJ.
School of Pharmacy and Chemistry, Liverpool John Moores University, UK.
Three major types of CNS stimulant are currently abused in sport: amphetamine,
cocaine and caffeine. Each drug type has its own characteristic mechanism of
action on CNS neurones and their associated receptors and nerve terminals.
Amphetamine is widely abused in sports requiring intense anaerobic exercise
where it prolongs the tolerance to anaerobic metabolism. It is addictive, and
chronic abuse causes marked behavioural change and sometimes psychosis. Major
sports abusing amphetamine are cycling, American football, ice-hockey and
baseball. Cocaine increases tolerance to intense exercise, yet most of its
chronic effects on energy metabolism are negative. Its greatest effects seem to
be as a central stimulant and the enhancement of short-term anaerobic exercise.
It is highly addictive and can cause cerebral and cardiovascular fatalities.
Caffeine enhances fatty acid metabolism leading to glucose conservation, which
appears to benefit long-distance endurance events such as skiing. Caffeine is
also addictive, and chronic abuse can lead to cardiac damage. Social abuse of
each of the three drugs is often difficult to distinguish from their abuse in
sport.
Publication Types:
Review
Review, Tutorial
PMID: 10932812 [PubMed]
364: Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Mar;14(1):71-7.
Growth hormone abuse.
Ehrnborg C, Bengtsson BA, Rosen T.
Department of Internal Medicine, Sahlgrenska University Hospital, Goteborg,
Sweden.
Doping with growth hormone (GH) has become an increasing problem in sports
during the last 10 years. GH has a reputation of being fairly effective among GH
users, although the effectiveness is not undisputed, and the few controlled
studies that have been performed with supraphysiological GH doses to athletes
have shown no significant positive effects of GH in the aspect of a doping
agent. There is no method yet to discover GH doping, but current intensive
research in this matter will hopefully produce a method in the years to come.
This article describes the GH physiology, the clinical use of GH, the athlete's
view, administration regimens and side effects.
Publication Types:
Review
Review, Tutorial
PMID: 10932811 [PubMed]
365: Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Mar;14(1):55-69.
Anabolic steroids.
Mottram DR, George AJ.
School of Pharmacy and Chemistry, Liverpool John Moores University, UK.
Anabolic steroids are synthetic derivatives of testosterone modified to enhance
the anabolic rather than the androgenic actions of the hormone. The anabolic
effects are considered to be those promoting protein synthesis, muscle growth
and crythopoiesis. There are numerous side-effects to anabolic steroids,
including hypertension and atherosclerosis, blood clotting, jaundice, hepatic
carcinoma, tendon damage, psychiatric and behavioural effects and, in males,
reduced fertility and gynaccomastia. Anabolic steroids were added to the
International Olympic Committee's list of banned substances in 1975. The
majority of 'evidence' concerning the efficacy of anabolic steroids as
performance enhancing agents is anecdotal. In the main, experimental
investigations have been poorly designed scientifically, clinically and
statistically. The percentage of positive test results from IOC accredited
laboratories has remained consistently low. However, athletes take their
steroids during training and out-of-competition testing is not conducted in all
countries, although international co-operation is now under consideration.
Despite the lack of conclusive evidence, steroids users will continue to hold
the view that their effects are efficacious and they are therefore unlikely to
be persuaded to curtail their use.
Publication Types:
Historical Article
Review
Review, Tutorial
PMID: 10932810 [PubMed]
366: Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Mar;14(1):25-35.
Doping among adolescent athletes.
Yesalis CE, Bahrke MS.
Department of Health Policy and Administration, Pennsylvania State University,
University Park 16802, USA.
The use of drugs to enhance physical performance and appearance has been
observed for thousands of years. Today individuals, including adolescents,
continue to employ a wide variety of drugs in the hope of improving their
athletic performance and looking better. Unfortunately, beyond the assessment of
anabolic-androgenic steroid (AAS) use, very little is known regarding the use,
safety and efficacy of other performance-enhancing drugs and nutritional
supplements among adolescents. Most studies report that 3-12% of adolescent
males admit to using an AAS at some time during their life. Among adolescent
females, studies find that 1-2% report having used steroids. The current
strategy for dealing with performance-enhancing drug use by adolescents is
multi-faceted and primarily involves education and prevention strategies,
interdiction and drug testing programmes. However, the demand for
performance-enhancing drugs has been created by our societal fixation on winning
and physical appearance. In order to alter the current use of
performance-enhancing drugs by adolescents, we as a society must come to grips
with our addiction to sport and the importance we place on winning and
appearance. We must change our values.
Publication Types:
Review
Review, Tutorial
PMID: 10932808 [PubMed]
367: Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Mar;14(1):1-23.
Drug use and abuse in sport.
Verroken M.
Ethics and Anti-Doping, UK Sport, London, UK.
This chapter describes evolving patterns of drug misuse in sport, and reciprocal
systems for defining and detecting doping, across the late twentieth century.
The International Olympic Committee's list of prohibited substances and methods
is presented as a primary tool for developing and administering such systems.
Developments in the list since its introduction have been stimulated both by
increasingly sophisticated detection methods, and by the imperative to recognise
and anticipate trends in doping. The historical argument that doping is
incompatible with the ethical nature of sport, and relates to pressures and
inducements to misuse drugs, particularly at the elite level, is also addressed.
Finally, recent developments in international collaboration between governments
and the sporting community are covered, and continued efforts to harmonize
standards in anti-doping policies and practices are advocated.
Publication Types:
Historical Article
Review
Review, Tutorial
PMID: 10932807 [PubMed]
368: J Anal Toxicol. 2000 Jul-Aug;24(5):381-2.
Ephedrine abuse for doping purposes as demonstrated by hair analysis.
Dumestre-Toulet V, Kintz P.
Publication Types:
Letter
PMID: 10926364 [PubMed]
369: Med Sci Sports Exerc. 2000 Jul;32(7):1361-2.
Comment on:
Med Sci Sports Exerc. 1999 Apr;31(4):497-501.
The ethics of not testing in athletic competition.
Videman T, Forsythe K.
Publication Types:
Comment
Letter
PMID: 10912904 [PubMed]
370: Med Sci Sports Exerc. 2000 Jul;32(7):1238-43.
Effect of rhEPO administration on serum levels of sTfR and cycling performance.
Birkeland KI, Stray-Gundersen J, Hemmersbach P, Hallen J, Haug E, Bahr R.
Hormone Laboratory, Aker University Hospital and Norwegian University of Sport
and Physical Education, Oslo. kare.birkeland@ioks.uio.no
PURPOSE: We assessed the possibility of using soluble transferrin receptor
(sTfR) as an indicator of doping with recombinant erythropoietin (rhEPO).
METHODS: A double-blind, placebo-controlled study was conducted with the
administration of 5,000 U of rhEPO (N = 10) or placebo (N = 10) three times
weekly (181-232 U x kg(-1) x wk-1) for 4 wk to male athletes. We measured
hematocrit and the concentration of hemoglobin, sTfR, ferritin, EPO, and
quantified the effects on performance by measuring time to exhaustion and
maximal oxygen uptake (VO2max) on a cycle ergometer. RESULTS: Hematocrit
increased from 42.7 +/- 1.6% to 50.8 +/- 2.0% in the EPO group, and peaked 1 d
after treatment was stopped. In the EPO group, there was an increase in sTfR
(from 3.1 +/- 0.9 to 6.3 +/- 2.3 mg x L(-1) , P < 0.001) and in the ratio
between sTfR and ferritin (sTfR-ferritin(-1)) (from 3.2 +/- 1.6 to 11.8 +/- 5.1,
P < 0.001). The sTfR increase was significant after 1 wk of treatment and
remained so for 1 wk posttreatment. Individual values for sTfR throughout the
study period showed that 8 of 10 subjects receiving rhEPO, but none receiving
placebo, had sTfR levels that exceeded the 95% confidence interval for all
subjects at baseline (= 4.6 mg x L(-1)). VO2max increased from 63.6 +/- 4.5 mL x
kg(-1) x min(-1) before to 68.1 +/- 5.4 mL x kg(-1) x min(-1) 2 d post rhEPO
administration (7% increase, P = 0.001) in the EPO group. Hematocrit, sTfR,
sTfR-ferritin(-1), and VO2max did not change in the placebo group. CONCLUSION:
Serum levels of sTfR may be used as an indirect marker of supranormal
erythropoiesis up to 1 wk after the administration of rhEPO, but the effects on
endurance performance outlast the increase in sTfR.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 10912888 [PubMed]
371: J Pharm Biomed Anal. 2000 Aug 1;23(1):211-21.
Detection of beta-blockers in human urine by GC-MS-MS-EI: perspectives for the
antidoping control.
Amendola L, Molaioni F, Botre F.
Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome.
We have developed a general method for the detection of beta-blockers and/or of
their metabolites in human urine. The method comprises a pretreatment procedure
(enzymatic hydrolysis, liquid/liquid extraction and derivatization by
pentafluoropropionic anhydride, PFPA), carried out on an initial aliquot of
2.5-5.0 ml of urine, and the instrumental analysis of the derivatives, performed
by GC-MS-MS (ion trap) with electronic impact ionization (EI). The GC-MS-MS
analysis allows to isolate and to characterize specific fragments of the
original molecular structure, and particularly the fragments originating from
parent ion clusters specific for all beta blocking drugs, giving rise to m/z =
366 and 202 ions respectively. MS-MS analysis of the parent ion allows checking
for the presence of the above-mentioned peaks in the GC-MS chromatogram. The
proposed method is capable of detecting a great variety of known (and possibly
also of newly synthesized) beta-blockers, with an average sensitivity limit of
20 ng/ml of drug/metabolite in urine. The method is presently being evaluated as
a general screening protocol to be followed by an antidoping laboratory to
detect illicit beta-blockers administration to the athletes.
PMID: 10898172 [PubMed]
372: Med Health R I. 2000 Jun;83(6):169-72.
Sports and drugs in primary care.
Puerini AJ Jr, Gorey K.
Providence College, USA. year100@home.com
PMID: 10893928 [PubMed]
373: Sports Med. 2000 Jun;29(6):387-96.
Perspectives in the utilisation of Fourier-transform infrared spectroscopy of
serum in sports medicine: health monitoring of athletes and prevention of
doping.
Petibois C, Deleris G, Cazorla G.
INSERM Unit 443, Bio-Organic Chemistry Group, University Victor Segalen/Bordeaux
2, France.
Doping prevention is mainly directed to providing information on the dangers of
doping to young athletes and to every profession concerned with athletic
performance. Unfortunately, repression is also necessary in the fight against
doping. Measurement of performance-enhancing drugs is complex, partly because of
the large number of prohibited substances. A number of sophisticated analytical
techniques are increasingly being used to provide the maximum detection time
window. However, the effectiveness of methods to separate exogenous from
endogenous biological molecules and the cost of antidoping analyses makes
controls invalid or impossible. Moreover, most athletes, because of the
metabolic and psychological stresses caused, legitimately refuse blood testing.
It is becoming crucial to introduce new methods in the form of longitudinal
health monitoring, since this is probably the most effective tool to prevent the
use of doping agents when athletes become overtrained and/or overstressed. This
paper describes new methods using Fourier-transform infrared spectroscopy to
analyse serum from 50 microl samples of capillary blood. This technique has been
shown to allow determination of the concentration of a wide range of biological
molecules in a single microsample with clinically useful accuracy, and to
provide a 'discriminatory biomolecular profile' to differentiate individuals on
the basis of their physiological status. A specific application of this
methodology is to perform longitudinal health monitoring in athletes, allowing
prevention of overtraining. It is proposed to apply such methods in longitudinal
studies for health monitoring and prevention of doping.
Publication Types:
Review
Review, Tutorial
PMID: 10870865 [PubMed]
374: Haematologica. 2000 Jun;85(6):564-72.
A novel method utilising markers of altered erythropoiesis for the detection of
recombinant human erythropoietin abuse in athletes.
Parisotto R, Gore CJ, Emslie KR, Ashenden MJ, Brugnara C, Howe C, Martin DT,
Trout GJ, Hahn AG.
Department of Physiology, Australian Institute of Sport, P.O. Box 176, Belconnen
ACT 2616, Australia. robin.parisotto@ausport.gov.au.
BACKGROUND AND OBJECTIVE: The use of recombinant human erythropoietin (r-HuEPO)
to enhance athletic performance is prohibited. Existing tests cannot readily
differentiate between exogenous and endogenous EPO. Therefore the aim of our
study was to investigate possible indirect detection of r-HuEPO use via blood
markers of altered erythropoiesis. DESIGN AND METHODS: Twenty-seven recreational
athletes were assigned to three groups prior to a 25 day drug administration
phase, with the following protocols: EPO+IM group (n = 10), 50 Ukg(-1) r-HuEPO
at a frequency of 3wk(-1), 100 mg intramuscular (IM) iron 1wk(-1) and a sham
iron tablet daily; EPO+OR group (n = 8), 50 U.kg(-1) r-HuEPO 3wk(-1), sham iron
injection 1wk(-1) and 105 mg of oral elemental iron daily; placebo group (n =
9), sham r-HuEPO injections 3wk(-1), sham iron injections 1wk(-1) and sham iron
tablets daily. Each group was monitored during and for 4 weeks after drug
administration. RESULTS: Models incorporating combinations of the variables
reticulocyte hematocrit (RetHct), serum EPO, soluble transferrin receptor,
hematocrit (Hct) and % macrocytes were analyzed by logistic regression. One
model (ON-model) repeatedly identified 94-100% of r-HuEPO group members during
the final 2 wk of the r-HuEPO administration phase. One false positive was
recorded from a possible 189. Another model (OFF-model) incorporating RetHct,
EPO and Hct was applied during the wash-out phase and, during the period of
12-21 days after the last r-HuEPO injection, it repeatedly identified 67-72% of
recent users with no false positives. INTERPRETATION AND CONCLUSIONS: Multiple
indirect hematologic and biochemical markers used simultaneously are potentially
effective for identifying current or recent users of r-HuEPO.
Publication Types:
Clinical Trial
Multicenter Study
PMID: 10870111 [PubMed]
375: Haematologica. 2000 Jun;85(6):561-3.
A global strategy for prevention and detection of blood doping with
erythropoietin and related drugs.
Cazzola M.
Publication Types:
Editorial
PMID: 10870110 [PubMed]
376: Nature. 2000 Jun 8;405(6787):635.
Recombinant erythropoietin in urine.
Lasne F, de Ceaurriz J.
National Anti-Doping Laboratory, Chatenay-Malabry, France.
PMID: 10864311 [PubMed]
377: Aust Fam Physician. 2000 Jun;29(6):611-3.
Putting together a medical team for the Olympic and Paralympic games.
Crichton K.
PMID: 10863820 [PubMed]
378: Rapid Commun Mass Spectrom. 2000;14(12):1058-65.
Consequence of boar edible tissue consumption on urinary profiles of nandrolone
metabolites. I. Mass spectrometric detection and quantification of
19-norandrosterone and 19-noretiocholanolone in human urine.
Le Bizec B, Gaudin I, Monteau F, Andre F, Impens S, De Wasch K, De Brabander H.
LDH-LNR, Ecole Nationale Veterinaire, BP 50707, F-44087 Nantes Cedex 03, France.
For the first time in the field of steroid residues in humans, demonstration of
19-norandrosterone (19-NA: 3alpha-hydroxy-5alpha-estran-17-one) and
19-noretiocholanolone (19-NE: 3alpha-hydroxy-5beta-estran-17-one) excretion in
urine subsequent to boar consumption is reported. Three male volunteers agreed
to consume 310 g of tissues from the edible parts (meat, liver, heart and
kidney) of a boar. The three individuals delivered urine samples before and
during 24 h after meal intake. After deconjugation of phase II metabolites,
purification and specific derivatisation of target metabolites, the urinary
extracts were analysed by mass spectrometry. Identification was carried out
using measurements obtained by gas chromatography/high resolution mass
spectrometry (GC/HRMS) (R = 7000) and liquid chromatography/tandem mass
spectrometry (LC/MS/MS) (positive electrospray ionisation (ESI+)).
Quantification was realised using a quadrupole mass filter. 19-NA and 19-NE
concentrations in urine reached 3.1 to 7.5 microg/L nearby 10 hours after boar
tissue consumption. Levels returned to endogenous values 24 hours after. These
two steroids are usually exploited to confirm the exogenous administration of
19-nortestosterone (19-NT: 17beta-hydroxyestr-4-en-3-one), especially in the
antidoping field. We have thus proved that eating tissues of non-castrated male
pork (in which 17beta-nandrolone is present) might induce some false accusations
of the abuse of nandrolone in antidoping. Copyright 2000 John Wiley & Sons, Ltd.
PMID: 10861987 [PubMed]
379: Sportverletz Sportschaden. 2000 Mar;14(1):1-11.
[Dangers and risks of black market anabolic steroid abuse in sports --gas
chromatography-mass spectrometry analyses]
[Article in German]
Ritsch M, Musshoff F.
Anabolic steroids have become increasingly popular among athletes even at
subcompetitive or recreational level instead of extensive doping tests,
educational campaigns and lethal incidents. Nowadays, the fitness boom has also
produced a population of steroid users at high school level and also under
non-sports practicing children. After opening the borders to East Europe an
explosion of the black-market for anabolic steroids occurred. Beside the
well-known side effects of anabolic steroids new problems and risks occurred due
to fake drugs from the black market. This review ist subdivided into two parts:
We provide a detailed review of the literature an anabolic steroids to the
reader the information needed to make an informed decision an the relative risks
and benefits of anabolic steroids. Secondly, we evaluated 40 "anabolic steroids"
obtained from the black market using mass spectrometry or gas chromatography
analysis to evaluate the real pharmacological compounds. As the results of this
analysis, we found that 15 (37.5%) these drugs contained different or any
pharmacological compounds as labeled. From the external packing, a
differentiation between original and the fake drugs was impossible. Therefore, a
large information and credibility gap concerning anabolic steroids particular
those from the black market exists between the athletes and the medical and
scientific communities. We believe that this gap can only be closed if both
groups are be better informed about anabolic steroids.
Publication Types:
Editorial
Review
Review, Tutorial
PMID: 10859788 [PubMed]
380: Ann Med Interne (Paris). 2000 Apr;151 Suppl A:A18-26.
[Physical and sports activities in the history of patients treated for
addictions. Report 1999 of the study sponsored by the Ministry of Youth and
Sports (France)]
[Article in French]
Lowenstein W, Arvers P, Gourarier L, Porche AS, Cohen JM, Nordmann F, Prevot B,
Carrier C, Sanchez M.
Centre Monte-Cristo, Service de Medecine Interne, Hopital Laennec, Paris.
Early February 1999, the French Ministere de la Jeunesse et des Sports (Youth
and Sports Ministry) sponsored three different studies, aiming to prevent
harmful behavior in the area of sport practices among youth. Two years earlier,
our health care team working with drug users published reports on the
meaningfulness of intensive sports activities in the history of our patients.
The present work was performed to highlight the midterm results of one of these
studies, to better understand and quantify the importance of physical training
in the history of a group of outpatients seen for addictive disorders and
comorbid pathologies. For 20 consecutive weeks, 3,040 self-administered
questionnaires were available for persons consulting 20 health centers, 2
self-help groups and a general practitioner network working in the field of
alcohol or heroine abuse. One thousand one hundred and eleven questionnaires
were filled out (36.1%) and returned by mail for complete analysis: 86% of the
answering persons had practiced at least one sports activity or participated in
physical training, 10.5% had participated in a national or international level
competition, and 10.6% reported stress fractures. In the intensive sports group,
36% had used illicit drugs intravenously and 16.4% said they had already used
doping substances. Only 28.4% said they experienced dependence during their
period of intensive sports activities compared with 15.2% before this time, and
a majority (56.4%) thereafter. Intensive sports or physical training should not
be seen as a protective factor nor as a way of improving addictive behaviors.
More studies are needed to evaluate individual vulnerability factors and
specific harm of overtraining and to determine the exact periods when men and
women participating in sports activities are likely to abuse drugs, especially
at the end of their career.
PMID: 10855373 [PubMed]
381: Br J Sports Med. 2000 Jun;34(3):159-60.
Cloning of local growth factors involved in the determination of muscle mass.
Goldspink G.
Department of Anatomy and Developmental Biology, The Royal Free and University
College Medical School, University of London, United Kingdom.
chaplin@rfhsm.ac.uk
PMID: 10854011 [PubMed]
382: Ther Drug Monit. 2000 Jun;22(3):277-82.
Distinction of inhaled and oral salbutamol by urine analysis using conventional
screening procedures for doping control.
Ventura R, Segura J, Berges R, Fitch KD, Morton AR, Berruezo S, Jimenez C.
Pharmacology Research Unit, Institut Municipal d'Investigacio Medica, and
Universitat Pompeu Fabra, Barcelona, Spain.
Salbutamol administration in athletes is permitted only by inhalation, for the
management of asthma. The authors discuss different criteria for suspecting oral
use of salbutamol, taking into account the data obtained by application of two
conventional screening procedures for doping control: gas chromatography/mass
spectrometry (GC/MS) and enzyme-linked immunosorbent assay (ELISA). Urine
samples obtained after administration of oral and inhaled salbutamol to
asthmatic and nonasthmatic swimmers were analyzed using both analytical
approaches. As expected, concentrations obtained by the ELISA test (detection of
total salbutamol) were higher than those obtained using the GC/MS procedure
(detection of nonsulfated salbutamol). After oral administration, the ELISA test
detected significantly higher salbutamol concentrations than those detected
after inhalation, reflecting the greater doses administered orally. Urine
samples with total salbutamol greater than 1400 ng/mL were obtained after oral
doses, but no sample reached this value after inhaled doses. Higher
concentrations of nonsulfated salbutamol have also been detected after oral
intake, although there is an overlap between the distributions of concentrations
after oral and inhaled doses. A cut-off concentration of 500 ng/mL can be used
for nonsulfated salbutamol to select suspicious samples, giving 11.8% false
negative results and 4.3% false positive results. An additional criterion
evaluated was the androsterone-salbutamol peak height ratio, which was lower
after oral doses because of the higher concentrations of salbutamol in urine.
This ratio was lower than 2 for all the samples collected after oral
administration, although 6.8% false positive samples resulted because of low
concentrations of androsterone in female urine. Several possibilities for
detecting suspicious samples from athletes who have taken prohibited oral
salbutamol are available with conventional screening procedures in doping
control.
PMID: 10850394 [PubMed]
383: J Sci Med Sport. 2000 Mar;3(1):79-83.
Beta-hydroxy beta-methylbutyrate (HMB) supplementation does not influence the
urinary testosterone: epitestosterone ratio in healthy males.
Slater GJ, Logan PA, Boston T, Gore CJ, Stenhouse A, Hahn AG.
Department of Physiology and Applied Nutrition, Australian Institute of Sport,
Canberra.
Six healthy, recreationally active, males undertook two weeks supplementation
with beta-Hydroxy beta-Methylbutyrate (HMB). Supplementation was in capsule form
with 3 g consumed each day in three even doses of 1 g at main meals. Mid stream
urine samples were collected prior to, as well as, after one and two weeks of
supplementation and subsequently analysed for testosterone and epitestosterone.
The testosterone: epitestosterone ratio was not affected by 2 weeks of HMB
supplementation (mean +/- SD baseline 1.02 +/- 0.68; week one 0.98 +/- 0.61;
week two 0.92 +/- 0.62). Our results support the claim that supplementation with
HMB at the doses recommended will not influence the urinary testosterone:
epitestosterone ratio and thus not breach doping policies of the International
Olympic Committee for exogenous testosterone or precursor administration.
PMID: 10839231 [PubMed]
384: Int J Sports Med. 2000 Apr;21(3):228-30.
Comment on:
Int J Sports Med. 1999 Nov;20(8):538-41.
Hemoglobin and packed-cell volume in endurance athletes prior to rhEPO.
Kujala UM, Peltonen JE, Elovainio RO.
Publication Types:
Comment
Letter
PMID: 10834359 [PubMed]
385: Int J Sports Med. 2000 Apr;21(3):225-7.
Increased premature mortality of competitive powerlifters suspected to have used
anabolic agents.
Parssinen M, Kujala U, Vartiainen E, Sarna S, Seppala T.
National Public Health Institute, Laboratory of Substance Abuse, Helsinki,
Finland. miia.parssinen@ktl.fi
Misuse of supraphysiological doses of anabolic steroids is claimed to have
serious side effects. The aim of the study was to determine the mortality, and
the cause of premature deaths among a group of subjects who are strongly
suspected to have used anabolic steroids for a non-medical purpose over several
years. The mortality of 62 male powerlifters placed 1st-5th in weight series
82.5-125 kg in Finnish championships during 1977-1982 was compared with the
mortality of population controls. The mortality during the 12-year follow-up was
12.9% for the powerlifters compared to 3.1% in the control population. By 1993
eight of 62 powerlifters and 34 of 1094 population controls had died, thus the
risk of death among the powerlifters was 4.6 times higher (95% CI 2.04-10.45; p
= 0.0002). The causes of premature death among the powerlifters were suicide
(3), acute myocardial infarction (3), hepatic coma (1) and non-Hodgkin's
lymphoma (1). These findings add to the growing amount of evidence of an
association between anabolic steroid abuse and premature death, and support the
view that measures to decrease AAS misuse among both competitive and amateur
athletes are justified.
PMID: 10834358 [PubMed]
386: J Sports Med Phys Fitness. 2000 Mar;40(1):71-9.
Caffeine use in sports. A pharmacological review.
Sinclair CJ, Geiger JD.
Department of Pharmacology and Therapeutics, Faculty of Medicine, University of
Manitoba, Winnipeg, Canada.
Caffeine is the most widely ingested psychoactive drug in the world. As many
know, chronic use of caffeine leads to dependence, tolerance, drug craving, and
upon abrupt cessation unpleasant withdrawal symptoms. Thus, caffeine fulfills
pharmacological criteria by which agents are classified as drugs of abuse.
Nevertheless, its use is legal and only at high, but readily attainable, levels
is it banned from sport. Its use is widespread by athletes as young as 11 years
of age who are seeking athletic advantage over fellow competitors. It is likely
that its use will not decline any time soon because it is inexpensive, readily
available, medically quite safe, socially acceptable, and by most measures
legal. However, at levels allowed in sport, caffeine through its wide-ranging
physiological and psychological effects increases endurance in well-trained
athletes. If the goal of drug-testing and education programs in sport is to
protect the health of athletes, prevent unfair advantage (cheating) and
encourage ethical behavior then it seems obvious that the allowable levels of
caffeine ingestion should be decreased. The alternative is to continue with
policies designed largely to punish only those that get caught.
Publication Types:
Review
Review, Academic
PMID: 10822912 [PubMed]
387: J Chromatogr B Biomed Sci Appl. 2000 Apr 14;740(2):265-71.
Testing of the anabolic stanozolol in human hair by gas chromatography-negative
ion chemical ionization mass spectrometry.
Cirimele V, Kintz P, Ludes B.
Institut de Medecine Legale, Strasbourg, France.
vincent.cirimele@medecine.u-strasbg.fr
A sensitive, specific and reproducible method for the quantitative determination
of stanozolol in human hair has been developed. The sample preparation involved
a decontamination step of the hair with methylene chloride and the sonication in
methanol of 100 mg of powdered hair for 2 h. After elimination of the solvent,
the hair sample was solubilized in 1 ml 1 M NaOH, 15 min at 95 degrees C, in the
presence of 10 ng stanozolol-d3 used as internal standard. The homogenate was
neutralized and extracted using consecutively a solid-phase (Isolute C18) and a
liquid-liquid (pentane) extraction. After evaporation of the final organic
phase, the dry extract was derivatized using 40 microl MBHFA-TMSI (1000:20,
v/v), incubated for 5 min at 80 degrees C, followed by 10 microl of MBHFBA,
incubated for 30 min at 80 degrees C. The derivatized extract was analyzed by a
Hewlett-Packard GC-MS system with a 5989 B Engine operating in the negative
chemical ionization mode of detection. Linearity of the detector response was
observed for stanozolol concentrations ranging from 5 to 200 pg/mg with a
correlation coefficient of 0.998. The assay was capable of detecting 2 pg of
stanozolol per mg of hair when approximately 100 mg hair material was processed,
with a quantification limit set at 5 pg/mg. Intra-day precision was 5.9% at 50
pg/mg and 7.8% at 25 pg/mg with extraction recoveries of 79.8 and 75.1%,
respectively. The analysis of a 3-cm long hair strand, obtained from a young
bodybuilder (27 year old) assuming to be a regular user of Winstrol (stanozolol,
2 mg), revealed the presence of stanozolol at the concentration of 15 pg/mg.
Publication Types:
Case Reports
PMID: 10821413 [PubMed]
388: J Chromatogr B Biomed Sci Appl. 2000 Apr 14;740(2):227-36.
Analysis of corticosteroids in hair by liquid chromatography-electrospray
ionization mass spectrometry.
Bevalot F, Gaillard Y, Lhermitte MA, Pepin G.
Laboratoire d'Expertises TOXLAB, Paris, France. bevalot@aol.com
The present study describes a confirmatory method for the quantitative
determination in hair of the most common corticosteroids illegaly used as doping
agents by athletes. Corticosteroids are extracted from 50 mg of powdered hairs
by methanolic extraction follows by a solid-phase extraction on C18 cartridge.
After extraction, the dried residue is reconstituted with 50 microl acetonitrile
and injected in a liquid chromatograph. Liquid chromatography separation is
performed on a reversed-phase C18 column with a binary gradient of formiate
buffer pH 3-acetonitrile as mobile phase. Detection is performed with an
electrospray ionization mass spectrometer in negative ion and selected-ion
monitoring mode. The limits of sensitivity achieved is 0.1 ng/mg in hair.
Application to hair sample collected during an antidoping control and comparison
to results obtain on urines, collected on the same athletes at the same time,
shows the interest and the complementarity of both matrices. Hair analysis could
allow the detection of corticosteroids on a large period preceding the control,
and the detection of natural corticosteroids administered as pro-drug, like
hydrocortisone acetate.
Publication Types:
Clinical Trial
PMID: 10821409 [PubMed]
389: Thorax. 2000 May;55(5):441-2.
Comment on:
Thorax. 1999 Nov;54(11):1041-6.
Athletes and fenoterol.
Henze MK.
Publication Types:
Comment
Letter
PMID: 10819688 [PubMed]
390: Cancer. 2000 May 1;88(9):2195-7.
Comment on:
Cancer. 1999 Oct 15;86(8):1571-5.
Intratesticular leiomyosarcoma in a young man after high dose doping with
oral-turinabol. A case report.
Renshaw A.
Publication Types:
Case Reports
Comment
Letter
PMID: 10813736 [PubMed]
391: Rev Clin Esp. 2000 Mar;200(3):133-8.
[43 cycles of anabolic steroid treatment studied in athletes: the uses and
secondary effects]
[Article in Spanish]
Inigo MA, Arrimadas E, Arroyo D.
Servicio de Analisis Clinicos, Hospital del Servicio Andaluz de Salud de La
Linea, Cadiz.
OBJECTIVE: To know the actual abuse of anabolic steroids by amateur athletes in
our environment as well as actions and secondary effects resulting from such
abuse. METHODS: Analytical observational study from May 1997 to November 1998.
Forty-three therapy courses with anabolic steroids among 39 male athletes were
studied. Diet and training were standardized for all participants. A
verification was made that the test group started from a basal state. RESULTS:
Duration of therapy was 6 weeks and the mean total dose was 2,928 mg.
Significant differences were found in the test group regarding basal and
post-therapy values for: transaminases (AST: 29.8 vs 45.0 IU/l, p < 0.001. ALT:
32.9 vs 51.4 IU/l, p < 0.01), cholesterol, HDL-cholesterol (31.4 vs 19.7 mg/dl,
p < 0.01), LDL-cholesterol (145.9 vs 173.5 mg/dl, p < 0.01), LH (2.1 vs 0.2 U/l,
p < 0.001), FSH (3.3 vs 0.4 U/l, p < 0.001), free testosterone (14.4 vs 34.0
pg/ml, p < 0.001), 17-beta-estradiol and arm muscular section (98.8 vs 103.7
cm2, p < 0.001). The inclusion of testosterone in therapy introduced a
significant difference with respect to the use of synthetic anabolic agents
alone, in total testosterone (4.5 vs 0.9 ng/ml, p < 0.001) and
17-beta-oestradiol, but neither with respect to free testosterone nor arm
muscular section. An 84.6% of individuals in the problem group stated to
complete two therapy courses in a year. CONCLUSIONS: The use of anabolic
steroids increases the lean muscular mass. The most relevant secondary effects
included: increased transaminase serum levels, change in the lipid profile and
suppression of the hypothalamus-pituitary gland-gonad axis. The inclusion of
testosterone did not increase the lean muscular mass.
PMID: 10804758 [PubMed]
392: Gastroenterol Clin Biol. 2000 Mar;24(3):375-6.
[Hepatitis C and parenteral use of doping substances: an unknown route of
transmission?]
[Article in French]
Coton T, Lightburn E, Faure P, Rey P, Dembele B, Debonne JM.
Publication Types:
Case Reports
Letter
PMID: 10804354 [PubMed]
393: Br J Haematol. 2000 Mar;108(4):883-4.
'Blood doping' with recombinant erythropoietin (rhEPO) and assessment of
functional iron deficiency in healthy volunteers.
Breymann C, Rohling R, Krafft A, Huch A, Huch R.
Publication Types:
Clinical Trial
Controlled Clinical Trial
Letter
PMID: 10792301 [PubMed]
394: Br J Sports Med. 2000 Apr;34(2):154.
Performance enhancing drugs; damned if you do, and damned if you don't.
Dean C.
Publication Types:
Letter
PMID: 10786878 [PubMed]
395: Clin Chem Lab Med. 2000 Jan;38(1):13-9.
Laboratory screening for erythropoietin abuse in sport: an emerging challenge.
Lippi G, Guidi G.
Istituto di Chimica e Microscopia Clinica, Universita degli Studi di Verona,
Italy.
The growing diffusion of banned practice to improve the athletic performances is
forcing clinical laboratories to identify and standardize reliable assays to
detect potential unfairness. Among the doping practices, the use of recombinant
human erythropoietin is becoming fairly popular, due to simplicity and safeties
of administration and troublesome detection. The heterogeneous response rate,
the presence of a little but significant amount of naturally occurring hormone,
the short half-life exhibited by recombinant human erythropoietin and the lack
of standardization of commercial assays appear the main problems to overcome.
Aim of the present article is to provide a critical review of some of the more
widespread laboratory techniques currently available for the screening for
erythropoietin abuse in sport.
Publication Types:
Review
Review, Tutorial
PMID: 10774956 [PubMed]
396: Dtsch Tierarztl Wochenschr. 2000 Mar;107(3):107-9.
[Veterinary service and supervision of equine competitions]
[Article in German]
Schule E.
Because of the growing interest in animal health and welfare in breeding and
sport--specially in the horse--the regulation of the German Riding Association
(FN) was updated. The result--the LPO 2000--refer more functions to the
veterinarian. At first the permanent presence of the vet is necessary, at second
he controls the correct, new installed vaccination against influenza-virus. The
functions of vet-check, general horse-control and doping are wide up in number
and consultation. For this the veterinarian must decree about much experience
and good preparation. The organisations of the veterinarians of the countries
and the FN work together to develop the knowledge and competence in horse-sport
for a better protection.
PMID: 10774069 [PubMed]
397: Med J Aust. 2000 Mar 6;172(5):220-4.
Erratum in:
Med J Aust 2000 Apr 3;172(7):334.
Use, misuse and abuse of androgens. The Endocrine Society of Australia consensus
guidelines for androgen prescribing.
Conway AJ, Handelsman DJ, Lording DW, Stuckey B, Zajac JD.
Endocrine Society of Australia, Sydney, NSW.
Androgen replacement therapy (ART) is usually life-long, and should only be
started after androgen deficiency has been proven by hormone assays. The
therapeutic goal is to maintain physiological testosterone levels. Testosterone
rather than synthetic androgens should be used. Oral 17 alpha-alkylated
androgens are hepatotoxic and should not be used for ART. There is no indication
for androgen therapy in male infertility. Although androgen deficiency is an
uncommon cause of erectile dysfunction, all men presenting with erectile
dysfunction should be evaluated for androgen deficiency. If androgen deficiency
is confirmed, investigation for the underlying pathological cause is required.
Contraindications to androgen therapy are prostate and breast cancer.
Precautions include using lower starting doses for older men and induction of
puberty. Intramuscular injections should be avoided in men with bleeding
disorders. Androgen-sensitive epilepsy, migraine, sleep apnoea, polycythaemia or
fluid overload need to be considered. Competitive athletes should be warned
about the risks of disqualification. ART should be initiated with intramuscular
injections of testosterone esters, 250 mg every two weeks [corrected].
Maintenance requires tailoring treatment modality to the patient's convenience.
Modalities currently available include testosterone injections, implants, or
capsules. Choice depends on convenience, cost, availability and familiarity.
There is no convincing evidence that, in the absence of proven androgen
deficiency, androgen therapy is effective and safe for older men per se, in men
with chronic non-gonadal disease, or for treatment of non-specific symptoms.
Until further evidence is available, such treatment cannot be recommended.
Publication Types:
Guideline
Practice Guideline
PMID: 10776394 [PubMed]
398: J Clin Endocrinol Metab. 2000 Apr;85(4):1505-12.
Growth hormone (GH) effects on bone and collagen turnover in healthy adults and
its potential as a marker of GH abuse in sports: a double blind,
placebo-controlled study. The GH-2000 Study Group.
Longobardi S, Keay N, Ehrnborg C, Cittadini A, Rosen T, Dall R, Boroujerdi MA,
Bassett EE, Healy ML, Pentecost C, Wallace JD, Powrie J, Jorgensen JO, Sacca L.
Department of Clinical Medicine and Cardiovascular Sciences, University Federico
II, Naples, Italy.
The effects of GH on bone remodeling in healthy adults have not been
systematically investigated. An analysis of these effects might provide insights
into GH physiology and might yield data useful for the detection of GH doping in
sports. The aim of this study was to evaluate the effects of GH administration
on biochemical markers of bone and collagen turnover in healthy volunteers.
Ninety-nine healthy volunteers of both sexes were enrolled in a multicenter,
randomized, double blind, placebo-controlled study and assigned to receive
either placebo (40 subjects) or recombinant human GH (0.1 IU/kg day in 29
subjects and 0.2 IU/kg x day in 30 subjects). The treatment duration was 28
days, followed by a 56-day wash-out period. The biochemical markers evaluated
were the bone formation markers osteocalcin and C-terminal propeptide of type I
procollagen, the resorption marker type I collagen telopeptide, and the soft
tissue marker procollagen type III. All variables increased on days 21 and 28 in
the two active treatment groups vs. levels in both the baseline (P < 0.01) and
placebo (P < 0.01) groups. The increment was more pronounced in the 0.2
IU/kg-day group and remained significant on day 84 for procollagen type III
(from 0.53 +/- 0.13 to 0.61 +/- 0.14 kU/L; P < 0.02) and osteocalcin (from 12.2
+ 2.9 to 14.6 +/- 3.6 UG/L; P < 0.02), whereas levels of C-terminal propeptide
of type I procollagen and type I collagen telopeptide declined after day 42 and
were no longer significantly above baseline on day 84 (from 3.9 +/- 1.2 to 5.1
+/-1.5 microg/L and from 174 +/- 60 to 173 +/- 53 microg/L, respectively).
Gender-related differences were observed in the study; females were less
responsive than males to GH administration with respect to procollagen type III
and type I collagen telopeptide (P < 0.001). In conclusion, exogenous GH
administration affects the biochemical parameters of bone and collagen turnover
in a dose- and gender-dependent manner. As GH-induced modifications of most
markers, in particular procollagen type III and osteocalcin, persist after GH
withdrawal, they may be suitable markers for detecting GH abuse.
Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial
PMID: 10770189 [PubMed]
399: J Am Vet Med Assoc. 2000 Apr 15;216(8):1258-61.
Who speaks for the horse--the sport of endurance riding and equine welfare.
Frazier DL.
Terra Veterinary Services Inc, Lebanon, MO 65536, USA.
PMID: 10767965 [PubMed]
400: J Am Vet Med Assoc. 2000 Apr 15;216(8):1243-6.
Equine welfare. Racing.
Mundy GD.
PMID: 10767961 [PubMed]
401: Clin Chem. 2000 Apr;46(4):515-22.
Oral testosterone administration detected by testosterone glucuronidation
measured in blood spots dried on filter paper.
Peng SH, Segura J, Farre M, de la Torre X.
Institut Municipal d'Investigacio Medica, E-08003 Barcelona, Spain.
BACKGROUND: Blood sampling is not a common practice for sports drug testing. Our
aim was to investigate whether dried blood spots on filter paper could be an
alternative to plasma samples for monitoring steroid profiles in dope testing.
METHODS: We collected dried blood spots and plasma from six healthy Caucasian
subjects after an oral 120-mg dose of testosterone undecanoate (TU).
Nonconjugated testosterone, testosterone glucuronide (TG), androsterone
glucuronide (AG), and etiocholanolone glucuronide (EtG) were measured by gas
chromatography-mass spectrometry in both matrices. 17alpha-Hydroxyprogesterone
(17alphaOHP) and luteinizing hormone (LH) also were measured in the plasma
samples. For comparison, similar measurements were done on samples obtained from
the same subjects given 25 mg of testosterone propionate (TP) plus 110 mg of
testosterone enanthate (TE) intramuscularly after a wash-out period. RESULTS:
After oral TU intake, TG, AG, and EtG increased sharply, whereas nonconjugated
testosterone did not change significantly. Results on dried blood spots
correlated well with those on plasma. The TG/testosterone ratio in blood or
plasma was verified to be a sensitive and specific marker (significantly
increased for up to 8 h after intake; P <0.05) for oral TU intake but not for
intramuscular administration of TP plus TE. Little suppression of plasma LH and
17alphaOHP was observed after a single oral dose of TU. One subject did not show
a significant increase of blood TG after oral TU intake. CONCLUSIONS: The
measurement of glucuronide conjugates in blood and plasma samples is relevant
for sports drug testing when analyzing the steroid profile. Dried blood spots
collected on filter paper are a suitable alternative to plasma for detecting
testosterone abuse.
PMID: 10759475 [PubMed]
402: J Anal Toxicol. 2000 Mar;24(2):102-15.
Evaluation of testosterone/epitestosterone ratio influential factors as
determined in doping analysis.
van de Kerkhof DH, de Boer D, Thijssen JH, Maes RA.
Utrecht Institute of Pharmaceutical Sciences, Department of Human Toxicology,
University of Utrecht, The Netherlands. D.H.vandeKerkhof@pharm.uu.nl
The ratio of the concentration of testosterone glucuronide to the concentration
of epitestosterone glucuronide (T/E ratio) as determined in urine is the most
frequently used method to prove testosterone abuse by athletes. A T/E ratio
higher than 6 has been considered as proof of abuse in the past; however, cases
of naturally occurring higher T/E ratios have been described. Since the
introduction of the T/E ratio in doping analysis, the parameters that may or may
not influence the T/E ratio, possibly leading to false-positive results, have
been debated. To achieve more insight on the influencing circumstances, an
overview is given to obtain an objective view on the merits of the urinary T/E
ratio. Relevant analytical aspects of the T/E ratio, potential parameters of
endogenous and exogenous origins, as well as some alternative methods to
determine testosterone abuse, such as the urinary testosterone/luteinizing
hormone ratio, gas chromatography-combustion-isotope-ratio mass spectrometry,
hair analysis, and high-performance liquid chromatography-mass spectrometry, are
discussed.
Publication Types:
Review
Review, Academic
PMID: 10732948 [PubMed]
403: Isr Med Assoc J. 1999 Oct;1(2):79-82.
Drug testing in elite athletes--the Israeli perspective.
Epstein S, Eliakim A.
Ribstein Center for Sports Medicine and Science, Wingate Institute, Natanya,
Israel.
BACKGROUND: The use of performance-enhancing drugs by athletes, in particular
anabolic steroids, is probably one of the major problems in sports today. During
the early 1990s the Israeli Sports Federation and Olympic Committee established
the Israeli Sports Anti-Doping Committee. OBJECTIVES: To present a follow-up on
tests for use of performance-enhancing drugs among elite Israeli athletes from
1993 until the present. METHODS: Since 1993, 273 drug tests (urine samples) were
performed in elite Israeli athletes. These tests were done during major
competitions, and at random during the regular training season without prior
notice to the athletes. The urine samples were sent for analysis to an official
drug laboratory of the Olympic Committee in Cologne, Germany. RESULTS: Since
1993, seven (2.7%) male Israeli elite athletes (5 weight lifters, a javelin
thrower, and a sprinter) tested positive for performance-enhancing drugs--all of
them for anabolic steroids, and two for diuretics as well. DISCUSSION: These
findings suggest that the phenomenon of performance-enhancing drug use by elite
athletes has also entered Israeli sports, and probably represent the tip of the
iceberg among Israeli sportsmen. Therefore, more drug tests should be performed,
especially at random without prior notice and during the regular season.
Athletes in the most popular sports such as soccer and basketball should also be
tested. The concern over the use of these agents is both medical and ethical.
PMID: 10731300 [PubMed]
404: Int J Sports Med. 2000 Feb;21(2):133-8.
How valid is the determination of hematocrit values to detect blood
manipulations?
Schmidt W, Biermann B, Winchenbach P, Lison S, Boning D.
Abteilung Sportmedizin/Sportphysiologie, Universitat Bayreuth, Deutschland,
Germany. walter.schmidt@uni-bayreuth.de
The aim of this paper is a critical reflection of the practice in competitive
cycling to use the hematocrit value (Hct) as an indirect control measure for
doping with erythropoietin. To demonstrate the individual physiological
variation of Hct values, five different studies were performed: 1) Eight
subjects were observed (i) during 23 h after a 1 h lasting bout of cycle
exercise at 60% of maximum performance and (ii) during 24h under control
conditions. 2) Seven subjects were exposed to a 20 min period of -7 head down
tilt (HDT), which was followed by 15 min in sitting position. 3) From four
subjects blood samples were taken in a sitting position up to 60 min after they
had ingested 1 liter isotonic saline solution. 4) Ten subjects performed a vita
maxima test on a cycle ergometer, starting at 100W and increasing the workload
by 17W every minute. 5) Four elite cyclists participated in a 10 days
competition (1,700 km). RESULTS: 1) During the 24h observation period Hct
decreased during the night from 45.3+/-3.1 % to 42.9+/-1.5% and returned to the
initial values in the morning. This diurnal variation was even more pronounced
after submaximal exercise (-4.1 %). 2) Due to fluid shifts from the interstitial
into the intravasal compartment, HDT was accompanied by a 3.1+/-0.5% lower Hct.
3) Drinking of the isotonic saline solution also reduced the hematocrit by
3.3+/-0.5% after one hour. 4) Maximum cycle exercise increased the Hct from
46.8+/-2.4 % to 51.3+/-1.9% which was due to a 15 % decrease in plasma volume.
5) Repeated bouts of cycle-exercise reduced the Hct from 46.4+/-1.5% to
41.3+/-1.6%. CONCLUSIONS: All experiments demonstrate that the Hct is not a
constant value but can be considerably changed by physiological measures.
Clinical studies show that brain oxygen supply decreases with increasing
Hct-values, which are also associated with a higher risk of stroke accidents. We
therefore recommend to use a Hct-limit solely under strongly controlled
standardized conditions to protect professional cyclists from hazardous
manoeuvre until more appropriate methods to detect EPO-doping are developed.
PMID: 10727075 [PubMed]
405: Nippon Hoigaku Zasshi. 1999 Nov;53(3):318-21.
[Present status of forensic analyses and possible approach for a rapid
identification of toxins]
[Article in Japanese]
Ueki M.
Doping Control Laboratory, Mitsubishi Kagaku Bio-Clinical Laboratories, Inc.,
Tokyo, Japan.
Frequency of public harm that associated with hazardous chemicals has been
increasing in the last several years. These incidents involve nerve gas attacks
on Matsumoto-city and on the subways in central Tokyo, doping in sports,
amphetamines abuse problem among adolescent boys and girls, potential health
risks due to a contamination of environment by endocrine disrupters, and
scheduled contamination of foods and drinks by several toxic compounds. US
government has learnt from unexpected Sarin-affairs in Japan, and fast-track
defensive action has been taken in the USA for a better safe of general public.
The Japanese system for forensic analyses consists of a number of
in-organizational laboratories that founded in each individual universities,
hospitals and police offices etc. Such system allows laboratories to fit
regional requirements and to achieve highly professional outcome on a specific
area depending on their scientific interests. On the other hand, such situation
sometime can cause difficulty in timely identification of certain compounds,
which are not frequently analyzed in their laboratories. This paper refers to
the possible bottlenecks, critical points and key success factors for a rapid
identification of toxins. Two stage testing systems, namely, a) simple rapid
examination such as one-step specific immunoassays for on-site emergency
testing, and b) following conclusive identification of the compounds in the
nearest expert laboratories seemed to be effective and practical corrective
measures for the problems that were focused in the recent crises. Documentation
of the course of action to be taken in case of emergency, improved supply system
of reference standards, circulation of information through the Internet mailing
list or other communication infrastructures, use of quality control program, and
financial supporting of other educational programs for analyses, may improve the
situation.
Publication Types:
Review
Review, Tutorial
PMID: 10723965 [PubMed]
406: Minerva Med. 1999 Sep;90(9):345-57.
[Doping and sports]
[Article in Italian]
Lippi G, Guidi G.
Istituto di Chimica e Microscopia Clinica, Universita degli Studi, Verona.
Doping is widely known as the use of banned substances and practices by athletes
in an attempt to improve sporting performances. The term doping likely derives
from "dope", an ancient expression referred to a primitive alcoholic drink that
was used as a stimulant in South African ceremonial dances; gradually, the term
was extended and finally adopted his current significance. There are at least
two essential reasons to support the fight against doping: the potential harmful
effects on athletes and the depth corruption of the fair competition. An
exhaustive list of banned substances and methods has been drawn by the
International Olympic Committee and further accepted by other International
Sport Authorities and Federations. This list, regularly updated, is basically
divided into doping substances (stimulants, narcotic analgesics, anabolic
agents, diuretics, peptide and glycoprotein hormones and analogues), doping
methods (blood doping, pharmacological, chemical and physical manipulation) and
drugs subjected to certain restrictions (alcohol, marijuana, local anesthetics,
corticosteroids and beta-blockers). Although there might be some medical
conditions, which could legitimate the need of these substances or methods,
there is no place for their use in sport. Thus, an athlete's consume of any of
these substances or methods will result in disqualification. Aim of the present
review is to provide a synthetic description of both the desirable effects and
the potentially harmful consequences of the use of some of the major doping
substances and methods.
Publication Types:
Historical Article
Review
Review, Tutorial
PMID: 10719440 [PubMed]
407: Clin J Sport Med. 2000 Jan;10(1):7-8.
Comment on:
Clin J Sport Med. 2000 Jan;10(1):1-6.
Drugs, sport, and the new millennium.
Pipe A.
Publication Types:
Comment
Editorial
PMID: 10695843 [PubMed]
408: Clin J Sport Med. 2000 Jan;10(1):1-6.
Comment in:
Clin J Sport Med. 2000 Jan;10(1):7-8.
Societal alternatives to anabolic steroid use.
Yesalis CE, Bahrke MS, Wright JE.
Publication Types:
Editorial
PMID: 10695842 [PubMed]
409: Forensic Sci Int. 2000 Jan 10;107(1-3):361-79.
Compared interest between hair analysis and urinalysis in doping controls.
Results for amphetamines, corticosteroids and anabolic steroids in racing
cyclists.
Gaillard Y, Vayssette F, Pepin G.
Laboratoire TOXLAB, Paris, France.
In France during a famous bicycle race, the newspapers documented the degree in
which doping seemed to be supervised in some teams by managers and doctors. Use
of anabolic steroids and other substances was officially banned in the
mid-seventies by sports authorities. This policy has been enforced through urine
testing before competition. It is well known, however, that a latency period is
all that is necessary to defeat these tests. Nevertheless, hair analysis could
be a promising tool when testing for periods that are not accessible to
urinalysis any more. We have developed different sensitive methods for testing
hair for amphetamines, a