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
act