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Magnolini R, Falcato L, Cremonesi A, Schori D, Bruggmann P. Fake anabolic androgenic steroids on the black market - a systematic review and meta-analysis on qualitative and quantitative analytical results found within the literature. BMC Public Health 2022; 22:1371. [PMID: 35842594 PMCID: PMC9288681 DOI: 10.1186/s12889-022-13734-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Supraphysiologic doses of anabolic androgenic steroids (AAS) are widely used to improve body image and sport performance goals. These substances can easily be acquired over the internet, leading to a substantial black market. We reviewed literature that assessed the quality and quantity of AAS found on the black market. Methods We searched PubMed/Medline, Embase and Google Scholar for articles published before March 2022. Additional hand searches were conducted to obtain studies not found in the primary literature search. Studies were included if they report on qualitative and/or quantitative analytical findings of AAS from the black market. Primary outcomes were proportions of counterfeit or substandard AAS. Eligible articles were extracted; quality appraisal was done using the ToxRTool for in-vitro studies. We used random-effects models to calculate the overall mean estimates for outcomes. The review protocol has been published and registered in INPLASY. Results Overall, 19 studies, which in total comprised 5,413 anabolic samples, met the inclusion criteria, and passed the quality appraisal from two WHO world regions that reported findings, the Americas and Europe. Most studies were nonclinical laboratory studies (95%) and provided samples seized by authorities (74%). In 18 articles, proportions of counterfeit substances and in eight articles, proportions of substandard substances were presented. The overall mean estimate for counterfeit anabolic steroids found on the black market was 36% (95% CI = 29, 43). An additional 37% (95% CI = 17, 63) were of substandard quality. We also demonstrate that these drugs could contain no active ingredient, or in another amount than that labeled, a wrong active ingredient, as well as not all or more active ingredients than were labeled. High heterogeneity among all analyses and significant differences between geographical subgroups were found. Conclusion With this systematic review and meta-analysis, we demonstrate that substantial mean proportions of black-market AAS are counterfeit and of substandard quality. These products pose a considerable individual and public health threat, and the very wide range in proportions of fake black-market AAS puts the user in a situation of unpredictable uncertainty. There is a great need for future prevention and harm-reduction programs to protect users from these substances. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13734-4.
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Affiliation(s)
- Raphael Magnolini
- Arud Centre for Addiction Medicine, Schützengasse 31, 8001, Zurich, Switzerland. .,Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
| | - Luis Falcato
- Arud Centre for Addiction Medicine, Schützengasse 31, 8001, Zurich, Switzerland
| | - Alessio Cremonesi
- Division of Clinical Chemistry and Biochemistry, University Children's Hospital Zurich - Eleonore Foundation, Zurich, Switzerland
| | - Dominique Schori
- Department of Social Welfare, Drug Information Centre 'DIZ', City of Zurich, Zurich, Switzerland
| | - Philip Bruggmann
- Arud Centre for Addiction Medicine, Schützengasse 31, 8001, Zurich, Switzerland.,Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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2
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Chemical and cytotoxicity evaluation of apprehended formulations of anabolic androgenic steroids. TALANTA OPEN 2022. [DOI: 10.1016/j.talo.2022.100101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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3
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Abstract
PURPOSE OF REVIEW To summarize the most recent evidence regarding nonprescribed androgen use among women and trans men. RECENT FINDINGS Fourteen heterogeneous studies met inclusion criteria. Three provided lifetime prevalence estimates among particular subgroups (from 0.5 to 8%), whereas one longitudinal study found adverse childhood experiences predicted later nonprescribed androgen use. Mental health and substance problems appear to correlate with severity of use, but evidence is mixed as to whether female users had lower or equal mental health burdens compared to male users. Studies that discuss motivation highlighted the dynamic risk management that underlies decisions to continue use; benefits have to outweigh undesired effects, whereas some sexual side effects are re-framed to be positive. Finally, a theme among qualitative studies is the gendered experiences of nonprescribed androgen use, and the search for knowledge and communities created by women. SUMMARY Prevalence, side effects, and trajectories of use appear to be different for women than men. Women users need gender-specific information, although some are able to navigate male-dominated knowledge sources and are creating a female ethnopharmacology that privileges women's experiences. Health research, including epidemiology, gravely needs a gender perspective when examining nonprescribed androgen use, and one that is inclusive of transgender people.
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4
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Coimbra MA, Barbosa FS, Scheid C, Macedo SMD, Yonamine M, Merib JO, Oliveira TF, Eller S. Mass spectrometry determination of seized oil-based anabolic-androgenic steroids products. Forensic Sci Int 2021; 328:111012. [PMID: 34587560 DOI: 10.1016/j.forsciint.2021.111012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/11/2021] [Accepted: 09/18/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The presence of anabolic-androgenic steroids (AAS) in illegal commercial products has been pointed as a global threat for public health. Due the correlation with adverse toxicological effects, there is a growing interest in the implementation of straightforward methods for the determination of AAS in seized products. This work exploited the development of a mass spectrometry approach to characterize the illegal oil formulations containing AAS. METHODS The optimization of sample preparation was performed through a simplex-centroid design and the best condition was described as follow: an aliquot of 5 μL of sample were added with 995 μL of acetonitrile and water (75:25, v/v). The solution was vortexed and centrifuged. After that, 10 μL of supernatant were added with 35 μL of acetonitrile and water and internal standard (testosterone-d3, 1.25 ng). An aliquot of 5 μL was injected into the analytical system. RESULTS The method developed was validated and successfully applied in 115 seized samples. Testosterone and its esters had the highest incidence, found in more than 50% of the samples. Besides that, drugs such as boldenone, methandienone, and trenbolone have also been found, where the low quality of the samples was evidenced by the wide variation in the concentration of the drugs, always quantified in sub-doses. Finally, at least one AAS was detected in each sample analyzed. The statistical results were grouped by principal components analysis, to better understand the profile of the seized samples. CONCLUSION This work successfully established a fast and simple method for determination of AAS and can be applied to verify the profile of seized samples.
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Affiliation(s)
- Masurquede A Coimbra
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Fábio S Barbosa
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Camila Scheid
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Sandra M D Macedo
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil; Instituto Nacional de Ciência e Tecnologia Forense (INCT Forense), Porto Alegre, Brazil
| | - Mauricio Yonamine
- School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil
| | - Josias O Merib
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Tiago F Oliveira
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
| | - Sarah Eller
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
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5
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Abstract
Androgens are potent drugs requiring prescription for valid medical indications but are misused for invalid, unproven, or off-label reasons as well as being abused without prescription for illicit nonmedical application for performance or image enhancement. Following discovery and first clinical application of testosterone in the 1930s, commercialization of testosterone and synthetic androgens proliferated in the decades after World War II. It remains among the oldest marketed drugs in therapeutic use, yet after 8 decades of clinical use, the sole unequivocal indication for testosterone remains in replacement therapy for pathological hypogonadism, organic disorders of the male reproductive system. Nevertheless, wider claims assert unproven, unsafe, or implausible benefits for testosterone, mostly representing wishful thinking about rejuvenation. Over recent decades, this created an epidemic of testosterone misuse involving prescription as a revitalizing tonic for anti-aging, sexual dysfunction and/or obesity, where efficacy and safety remains unproven and doubtful. Androgen abuse originated during the Cold War as an epidemic of androgen doping among elite athletes for performance enhancement before the 1980s when it crossed over into the general community to become an endemic variant of drug abuse in sufficiently affluent communities that support an illicit drug industry geared to bodybuilding and aiming to create a hypermasculine body physique and image. This review focuses on the misuse of testosterone, defined as prescribing without valid clinical indications, and abuse of testosterone or synthetic androgens (androgen abuse), defined as the illicit use of androgens without prescription or valid indications, typically by athletes, bodybuilders and others for image-oriented, cosmetic, or occupational reasons.
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Affiliation(s)
- David J Handelsman
- ANZAC Research Institute, University of Sydney, Sydney, Australia.,Andrology Department, Concord Hospital, Sydney, Australia
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6
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Lemos VF, Ortiz RS, Limberger RP. Forensic analysis of anabolic steroids tablets composition using attenuated total reflection Fourier transform infrared microspectroscopy (µATR-FTIR) mapping. J Forensic Sci 2021; 66:837-845. [PMID: 33502006 DOI: 10.1111/1556-4029.14671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/21/2020] [Accepted: 01/05/2021] [Indexed: 11/27/2022]
Abstract
The use of falsified and unregistered drugs is a worldwide public health problem. Because these global market products usually do not follow the Good Manufacturing Practices required by health legislation, its composition may be completely different from the original or may contain relevant concentrations of impurities and toxic contaminants. Since anabolic steroids are among the main irregular therapeutic classes seized in Brazil, here we propose a new methodology for analyzing these products, in tablets form, using Attenuated Total Reflection Fourier Transform Infrared Microspectroscopy (µATR-FTIR) mapping. Spectra were acquired from solid tablets by attenuated total reflection, through point mapping methodology. In data processing, a characteristic absorption band for each Active Pharmaceutical Ingredient (API) was integrated and plotted to create its distribution map. This technique was applied in an unprecedented way for the forensic analysis of anabolic steroids and proved to be effective in distinguishing falsified products based on the detection of their APIs. It was possible to detect APIs in 26 out of 30 samples, five of which were classified as falsified only through µATR-FTIR analysis. We were able to create distribution maps of the detected substances associating the microspectroscopic results with characteristic band integration method, which can be used to detect substances and to study samples' homogeneity. We concluded that this methodology is promising for the analysis of anabolic steroid tablets, and can be used in a complementary way with techniques already consolidated in forensic laboratory routine for a better classification of questioned samples between authentic and falsified ones.
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Affiliation(s)
- Vanessa Ferreira Lemos
- General Institute of Forensics of Rio Grande do Sul - IGP-RS, Porto Alegre, RS, Brazil.,Department of Analysis, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Rafael Scorsatto Ortiz
- Rio Grande do Sul Superintendence, Brazilian Federal Police, Porto Alegre, RS, Brazil.,Brazilian National Institute of Forensic Science and Technology - INCT FORENSE, Porto Alegre, RS, Brazil
| | - Renata Pereira Limberger
- Department of Analysis, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil.,Brazilian National Institute of Forensic Science and Technology - INCT FORENSE, Porto Alegre, RS, Brazil
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7
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Berneira LM, da Silva CC, Passos LF, Poletti T, Dos Santos MAZ, de Pereira CMP. Analytical approaches applied to the analysis of apprehended formulations of anabolic androgenic steroids. Drug Test Anal 2020; 12:1264-1273. [PMID: 32537903 DOI: 10.1002/dta.2877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/20/2020] [Accepted: 06/09/2020] [Indexed: 11/08/2022]
Abstract
Anabolic androgenic steroids (AASs) comprise a class of synthetic androgens resulting from chemical modifications of testosterone, known for their illicit consumption, which can result inextensive side effects. Extraction procedures applied to the analysis of their formulations are still limited to a few methodologies, despite the increasing numbers of confiscations of AASs. In this sense, the aims of this work were to evaluate the extraction of active ingredients from formulations of anabolic agents using solid-liquid or liquid-iquid, ultrasonic bath, ultrasonicprobe, and microwave-assisted extraction. The results indicated that the extraction procedures influenced the detected concentration of AASs, as the use of ultrasonic probe and microwave irradiation increased the overall extraction of anabolic agents compared with solid-liquid, liquid-liquid, and ultrasonic bath. Regarding oxymetholone, for instance, the microwave-assisted extraction and ultrasonic probe extracted, respectively, 37.46 ± 1.36 and 35.69 ± 0.98 mg/tablet, while solid-liquid extracted 29.63 ± 0.40 mg/tablet of the activeingredient. Therefore, alternative methods such as microwave-assisted extraction or theultrasonic probe could be used for the analysis of formulations of AASs assisting with the identification of illicit and toxic components.
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Affiliation(s)
- Lucas M Berneira
- Center of Chemical, Pharmaceutical and Food Sciences, Lipidomic and Bio-Organic Laboratory, Bioforensic Research Group, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Caroline C da Silva
- Center of Chemical, Pharmaceutical and Food Sciences, Lipidomic and Bio-Organic Laboratory, Bioforensic Research Group, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Luan F Passos
- Center of Chemical, Pharmaceutical and Food Sciences, Lipidomic and Bio-Organic Laboratory, Bioforensic Research Group, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Tais Poletti
- Center of Chemical, Pharmaceutical and Food Sciences, Lipidomic and Bio-Organic Laboratory, Bioforensic Research Group, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Marco A Z Dos Santos
- Center of Chemical, Pharmaceutical and Food Sciences, Lipidomic and Bio-Organic Laboratory, Bioforensic Research Group, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Claudio M P de Pereira
- Center of Chemical, Pharmaceutical and Food Sciences, Lipidomic and Bio-Organic Laboratory, Bioforensic Research Group, Federal University of Pelotas, Pelotas, RS, Brazil
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8
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Frude E, McKay FH, Dunn M. A focused netnographic study exploring experiences associated with counterfeit and contaminated anabolic-androgenic steroids. Harm Reduct J 2020; 17:42. [PMID: 32532347 PMCID: PMC7291737 DOI: 10.1186/s12954-020-00387-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/03/2020] [Indexed: 02/17/2023] Open
Abstract
Background A primary consequence of illicit drug markets and the absence of regulation is the variable quality or purity of the final product. Analysis of anabolic-androgenic steroid seizures shows that these products can contain adulterated products, product not included on the label, or product of unsatisfactory standard. While the potential negative effects of counterfeit anabolic-androgenic steroids (AAS) use is a recognised risk associated with use, no study has explored personal experiences associated with use. The aim of the present study was to use online discussion forums to investigate and explore the experiences associated with the purchase and consumption of counterfeit AAS among consumers. Methods An online search was conducted to identify online forums that discussed counterfeit or contaminated AAS; three were deemed suitable for the study. The primary source of data for this study was the ‘threads’ from these online forums, identified using search terms including ‘counterfeit’, ‘tampered’, and ‘fake’. Threads were thematically analysed for overall content, leading to the identification of themes. Results Data from 134 threads (2743 posts from 875 unique avatars) was included. Two main themes were identified from the analysis: (1) experiences with counterfeit product and (2) harms and benefits associated with counterfeit product. Conclusions The use of counterfeit or contaminated substances represents a public health concern. Those who report using performance and image enhancing drugs such as AAS for non-medical purposes report consuming these substances and experiencing harm as a result. Consumers take steps to limit coming into contact with counterfeit or contaminated product, though recognise that many of these have limitations. The implementation of accessible drug safety checking services may provide an opportunity to provide consumers with information to assist them with making healthier choices.
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Affiliation(s)
- Evelyn Frude
- School of Health and Social Development, Deakin University, Geelong Waterfront Campus, Locked Bag 20000, Geelong, Victoria, 3220, Australia
| | - Fiona H McKay
- School of Health and Social Development, Deakin University, Geelong Waterfront Campus, Locked Bag 20000, Geelong, Victoria, 3220, Australia
| | - Matthew Dunn
- School of Health and Social Development, Deakin University, Geelong Waterfront Campus, Locked Bag 20000, Geelong, Victoria, 3220, Australia. .,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
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9
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Mullen C, Whalley BJ, Schifano F, Baker JS. Anabolic androgenic steroid abuse in the United Kingdom: An update. Br J Pharmacol 2020; 177:2180-2198. [PMID: 31989581 PMCID: PMC7174889 DOI: 10.1111/bph.14995] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/03/2019] [Accepted: 01/07/2020] [Indexed: 12/11/2022] Open
Abstract
Anabolic androgenic steroids (AASs) are prescribed for medical conditions related to low testosterone. Abuse of AASs has surged as they become recognised as potent image enhancement drugs. The primary goal of most abusers is to obtain a more attractive outward appearance. Abuse is complex. There are a vast range of AAS substances illegally available, the nature of their true composition is difficult to evaluate. Users follow dosing patterns which incorporate a number of different AASs, in addition to other pharmaceutical substances believed to complement the desired physical effects or manage unwanted effects. Animal work and medical case reports suggest potential to cause serious hepatotoxicity, plus possible neurotoxicity, nephrotoxicity and damage to the cardiovascular and reproductive systems. As the long-term AASs users reach maturity, further controlled experimentation, with larger sample sizes, is required. Data gathering should be directed towards the most vulnerable group of AAS users, females and adolescent boys.
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Affiliation(s)
- Carrie Mullen
- School of Computing, Engineering and Physical SciencesUniversity of the West of ScotlandPaisleyUK
| | - Benjamin J. Whalley
- School of Chemistry, Food and Nutritional Sciences, and PharmacyThe University of ReadingReadingUK
| | - Fabrizio Schifano
- School of Life and Medical SciencesUniversity of HertfordshireHatfieldUK
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and HealthHong Kong Baptist UniversityKowloon TongHong Kong
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10
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Anabolic-androgenic steroids (AAS) users on AAS use: Negative effects, ‘code of silence’, and implications for forensic and medical professionals. J Forensic Leg Med 2019; 68:101871. [DOI: 10.1016/j.jflm.2019.101871] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/11/2019] [Accepted: 09/16/2019] [Indexed: 11/23/2022]
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11
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Pereira E, Moyses SJ, Ignácio SA, Mendes DK, da Silva DS, Carneiro E, Hardy AMTG, Rosa EAR, Bettega PVC, Johann ACBR. Anabolic steroids among resistance training practitioners. PLoS One 2019; 14:e0223384. [PMID: 31618245 PMCID: PMC6795452 DOI: 10.1371/journal.pone.0223384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/02/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To compare the use of anabolic steroids (AS), the motivation to use them, their side effects, the source of information and the form in which AS were obtained, the medical follow-up, and the periodic examinations in resistance training practitioners who are either current or former users of AS. METHODS A prevalence survey was performed in the gyms of the city of Curitiba, including 719 current and former AS users who self-administered a questionnaire. The chi-square and z of proportions (p <0.05) statistical tests were conducted. RESULTS Esthetics was the main motivation associated with AS intake, leading to satisfactory results. The information about the form in which to use AS was provided by doctors and AS were either purchased at the pharmacy with a prescription or illegally. Current users reported a higher number of cycles and doses, a longer duration of use, as well as larger economical investments into AS. This shows a higher consumption of such drugs, regardless of the medical follow-up and post-cycle therapy. CONCLUSION Given that a change in the usage pattern was observed when increasing the AS consumption, this should be considered in the elaboration of public policies to inhibit such a trend.
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Affiliation(s)
- Ericson Pereira
- Department of Physical Education, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Samuel Jorge Moyses
- Department of Dentistry, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Sérgio Aparecido Ignácio
- Department of Dentistry, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Daniel Komarchewski Mendes
- Department of Physical Education, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Diego Sgarbi da Silva
- Department of Dentistry, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Everdan Carneiro
- Department of Dentistry, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Ana Maria Trindade Grégio Hardy
- Department of Pharmacology, College of Pharmacy and Pharmaceutical Sciences, The University of Toledo, Toledo, Ohio, United States of America
| | - Edvaldo Antônio Ribeiro Rosa
- Department of Dentistry, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Patrícia Vida Cassi Bettega
- Department of Physical Education, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
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12
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Immunodeficiency as a side effect of anabolic androgenic steroid abuse: a case of necrotizing myofasciitis. Forensic Sci Med Pathol 2019; 15:616-621. [PMID: 31359306 DOI: 10.1007/s12024-019-00144-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2019] [Indexed: 12/11/2022]
Abstract
Even if there are well-known consequences of anabolic androgenic steroid (AAS) abuse, their full pathway of action is still being investigated. In this context, the presented case report aims to discuss and provide evidence of unusual adverse effects linked to immunodeficiency in an AAS abuser. In fact, this kind of chronic complication, even if not usually considered, may lead sudden death. In this case a 31-year-old aesthetic weightlifter, who presented to the emergency department due to an accidental fall that resulted in left thigh trauma. This subsequently developed into left thigh necrotizing myofasciitis in the following few days. Although surgery and hyperbaric therapy were carried out, the man died. An autopsy with complete biological sampling for toxicological studies was performed. This case highlights the close relationship between AAS abuse and immunodeficiency and highlights it's importance for further studies. However, it should be considered that of all the dangerous effects produced by AAS use, necrotizing fasciitis is not such an unusual consequence.
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13
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Berneira LM, de Freitas SC, da Silva CC, Machado ADM, de Pereira CMP, dos Santos MAZ. Application of differential scanning calorimetry in the analysis of apprehended formulations of anabolic androgenic steroids. Forensic Sci Int 2019; 296:15-21. [DOI: 10.1016/j.forsciint.2018.12.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 12/22/2018] [Accepted: 12/31/2018] [Indexed: 11/16/2022]
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14
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Park M, Sim J, Jeon Y, Yeon S, Lee J, In S. Determination of boldenone in postmortem specimens including blood and urine samples using LC-MS/MS. J Pharm Biomed Anal 2019; 169:111-115. [PMID: 30851513 DOI: 10.1016/j.jpba.2019.02.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 11/19/2022]
Abstract
Boldenone (BOLD), one of androgenic anabolic steroids (AAS), although banned in humans, is still available illegally. AAS abuse has previously been associated with various cardiovascular adverse events including acute myocardial infarction, arrhythmia, and sudden death. In this study, the concentration of BOLD was determined in postmortem specimens from the corpse of a human male who intentionally injected BOLD undecylenate into his shoulder muscle. In addition, the endogenous levels of BOLD in the blood and urine samples of young human males have been reported. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method with solid-phase extraction (SPE) was developed and validated for the analysis of BOLD in blood, muscular tissue and urine samples. The validation parameters including linearity, accuracy, precision, matrix effect, and recovery were satisfactory. The concentrations of BOLD in the blood of 20 young human males who didn't take BOLD were under the limit of quantitation (LOQ, 0.5 ng/mL). Additionally, the mean level of BOLD in the urine samples was 3.19 ± 1.65 ng/mL (range: 0.37˜6.02 ng/mL). The concentrations of BOLD in the victim's blood from the femoral vein and heart were 140.44 and 25.74 ng/mL, respectively. On the other hand, those in the muscular tissue from the injection site and the urine sample were 142.3 ng/g and 3474 ng/mL, respectively.
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Affiliation(s)
- Meejung Park
- Forensic Toxicology Division, National Forensic Service, Wonju 26430, Republic of Korea.
| | - Juhyun Sim
- Forensic Toxicology Division, National Forensic Service, Wonju 26430, Republic of Korea
| | - Youngjoon Jeon
- Forensic Toxicology Division, National Forensic Service, Wonju 26430, Republic of Korea
| | - Seonghoon Yeon
- Forensic Toxicology Division, National Forensic Service, Wonju 26430, Republic of Korea
| | - Jaesin Lee
- Forensic Toxicology Division, National Forensic Service, Wonju 26430, Republic of Korea
| | - Sangwhan In
- Forensic Toxicology Division, National Forensic Service, Wonju 26430, Republic of Korea
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15
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Fink J, Schoenfeld BJ, Hackney AC, Matsumoto M, Maekawa T, Nakazato K, Horie S. Anabolic-androgenic steroids: procurement and administration practices of doping athletes. PHYSICIAN SPORTSMED 2019; 47:10-14. [PMID: 30247933 DOI: 10.1080/00913847.2018.1526626] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Performance enhancing substances are becoming increasingly popular amongst bodybuilders and people who want to enhance their physiques. However, due to the rise of the Internet and laws prohibiting sales of these substances without prescription, the route of procurement and administration practices have become more and more dangerous. Prior to the mid-1970's, anabolic steroids were not regulated and easily available from physicians and pharmacies in several countries. In 1990, the United States enacted the Anabolic Steroid Control Act, leading to the proliferation of black markets and underground laboratories. The shift from pharmacy to underground online sites for the procurement of anabolic steroids led to an increase of fake products with low purity and the ability to potentially endanger the health of anabolic steroid users. Underground laboratories emerged both locally and in countries with lax legal regulations. 'Anabolic steroid tourism' and large networks of online resellers emerged, leading to the banalisation of the illegal procurement of anabolic steroids. Furthermore, the increase of anecdotal information spreading on the internet among anabolic steroid user forums nourishes the rampant misinformation and dangerous practices that currently exist. The dosages and ways of administration recommended on these forums can be false and misleading to those who lack a medical background and cannot go to their physician to seek advice because of the fear of repercussions. This review aims to elucidate and describe current practices of the anabolic-androgenic steroids black market and draw attention to potential dangers for users.
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Affiliation(s)
- Julius Fink
- a Graduate School of Medicine, Department of Metabolism and Endocrinology , Juntendo University , Tokyo , JAPAN
| | | | - Anthony C Hackney
- c Department of Exercise & Sport Science; Department of Nutrition - School of Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Masahito Matsumoto
- d Advanced Diabetic Therapeutics, Department of Metabolic Endocrinology , Juntendo University , Tokyo , Japan
| | - Takahiro Maekawa
- e Department of Rehabilitation for the Movement Functions Research Institute , National Rehabilitation Center for Persons with Disabilities , Saitama , Japan
| | - Koichi Nakazato
- f Graduate Schools of Health and Sport Science , Nippon Sport Science University , Tokyo , JAPAN
| | - Shigeo Horie
- g Graduate School of Medicine, Department of Urology , Juntendo University , Tokyo Japan
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16
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Tircova B, Bosakova Z, Kozlik P. Development of an ultra-high performance liquid chromatography-tandem mass spectrometry method for the determination of anabolic steroids currently available on the black market in the Czech Republic and Slovakia. Drug Test Anal 2018; 11:355-360. [DOI: 10.1002/dta.2541] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/05/2018] [Accepted: 11/06/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Barbora Tircova
- Department of Chemistry, Faculty of Natural Science; Matej Bel University in Banska Bystrica; Banska Bystrica Slovakia
| | - Zuzana Bosakova
- Department of Analytical Chemistry, Faculty of Science; Charles University; Prague Czech Republic
| | - Petr Kozlik
- Department of Analytical Chemistry, Faculty of Science; Charles University; Prague Czech Republic
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17
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Jacka B, Peacock A, Degenhardt L, Bruno R, Clare P, Kemp R, Dev A, Larance B. Trends in PIEDs use among male clients of needle-syringe programs in Queensland, Australia; 2007-2015. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017. [PMID: 28651113 DOI: 10.1016/j.drugpo.2017.05.048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- B Jacka
- National Drug and Alcohol Research Centre, UNSW, Sydney, NSW, Australia; Kirby Institute, UNSW, Sydney, NSW, Australia
| | - A Peacock
- National Drug and Alcohol Research Centre, UNSW, Sydney, NSW, Australia; School of Medicine (Psychology), University of Tasmania, Tasmania Australia
| | - L Degenhardt
- National Drug and Alcohol Research Centre, UNSW, Sydney, NSW, Australia
| | - R Bruno
- School of Medicine (Psychology), University of Tasmania, Tasmania Australia
| | - P Clare
- National Drug and Alcohol Research Centre, UNSW, Sydney, NSW, Australia
| | - R Kemp
- Communicable Diseases Branch, Queensland Health, QLD, Australia
| | - A Dev
- Chief Medical Officer and Healthcare Regulation Branch, Queensland Health, QLD Australia
| | - B Larance
- National Drug and Alcohol Research Centre, UNSW, Sydney, NSW, Australia.
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18
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Neves DBDJ, Caldas ED. GC–MS quantitative analysis of black market pharmaceutical products containing anabolic androgenic steroids seized by the Brazilian Federal Police. Forensic Sci Int 2017; 275:272-281. [DOI: 10.1016/j.forsciint.2017.03.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/10/2017] [Accepted: 03/22/2017] [Indexed: 11/25/2022]
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19
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Weber C, Krug O, Kamber M, Thevis M. Qualitative and Semiquantitative Analysis of Doping Products Seized at the Swiss Border. Subst Use Misuse 2017; 52:742-753. [PMID: 28156209 DOI: 10.1080/10826084.2016.1263665] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Substances developed for therapeutic use are also known to be misused by athletes as doping agents and, outside of regulated sport, for image-enhancement. This has generated a market for counterfeit doping substances. Counterfeit doping agents may be of poor pharmaceutical quality and therefore constitute health risks to consumers. OBJECTIVES This study aims to investigate the pharmaceutical quality of 1,190 doping products seized at the Swiss border. METHODS Swiss customs authorities seize incoming shipments potentially containing doping agents. Qualitative and semiquantitative analyses were performed in order to test for prohibited doping substances. The main analytical methods utilized for characterizing confiscated compounds were liquid chromatography-high resolution mass spectrometry, polyacrylamide gel electrophoresis with subsequent in-gel tryptic digestion and identification of peptidic compounds using nanoliquid chromatography-tandem mass spectrometry, and electrochemiluminescence immuno assay. RESULTS For 889 (75%) of the analyzed products, the label suggested the content of anabolic agents, for 146 samples (12%) peptide hormones or growth factors, and for 113 items (9%) antiestrogens, aromatase inhibitors or other metabolic modulators. For the majority of the investigated products, the pharmaceutical quality was an unsatisfactory standard: nonapproved substances were detected and less than 20% of the products contained the claimed substance in the respective amount. CONCLUSION A comprehensive sample of confiscated doping products was analyzed, allowing for monitoring of developments regarding the use of doping substances in Switzerland and for anticipating future trends and challenges in sports drug testing. An alarming number of tested products was of substandard pharmaceutical quality.
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Affiliation(s)
| | - Oliver Krug
- b Center for Preventive Doping Research/Institute of Biochemistry , German Sport University Cologne , Cologne , Germany.,c European Monitoring Center for Emerging Doping Agents , Cologne/Bonn , Germany
| | | | - Mario Thevis
- b Center for Preventive Doping Research/Institute of Biochemistry , German Sport University Cologne , Cologne , Germany.,c European Monitoring Center for Emerging Doping Agents , Cologne/Bonn , Germany
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20
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Povzun SA. [Artificial illness as a result of non-medical use of anabolic androgenic steroids: A case report and a review of literature]. Arkh Patol 2017; 78:48-53. [PMID: 27600782 DOI: 10.17116/patol201678448-53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A 42-year-old female body builder who had used anabolic androgenic steroids (AASs) for 18 years to build up muscle mass died from liver rupture. The cause of the latter was multiple abscesses caused by Actinomyces, which developed in the presence of immunodeficiency. The postmortem changes in different organs were due to hormonal imbalance. The paper gives the data available in the literature pertaining to the analysis of the effects of AASs taken in supraphysiological doses on the body and their non-medical application.
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Affiliation(s)
- S A Povzun
- Department of Pathology and Clinical Expertise, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care, St.-Petersburg
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21
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Abrahin O, Félix Souza NS, de Sousa EC, Santos AM, Bahrke MS. Anabolic–androgenic steroid use among Brazilian women: an exploratory investigation. JOURNAL OF SUBSTANCE USE 2016. [DOI: 10.1080/14659891.2016.1179806] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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22
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Chemometrics and the identification of counterfeit medicines-A review. J Pharm Biomed Anal 2016; 127:112-22. [PMID: 27133184 DOI: 10.1016/j.jpba.2016.04.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 03/31/2016] [Accepted: 04/14/2016] [Indexed: 11/20/2022]
Abstract
This review article provides readers with a number of actual case studies dealing with verifying the authenticity of selected medicines supported by different chemometric approaches. In particular, a general data processing workflow is discussed with the major emphasis on the most frequently selected instrumental techniques to characterize drug samples and the chemometric methods being used to explore and/or model the analytical data. However, further discussion is limited to a situation in which the collected data describes two groups of drug samples - authentic ones and counterfeits.
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23
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Cho SH, Park HJ, Lee JH, Do JA, Heo S, Jo JH, Cho S. Determination of anabolic-androgenic steroid adulterants in counterfeit drugs by UHPLC-MS/MS. J Pharm Biomed Anal 2015; 111:138-46. [PMID: 25880245 DOI: 10.1016/j.jpba.2015.03.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/17/2015] [Accepted: 03/19/2015] [Indexed: 11/29/2022]
Abstract
Anabolic-androgenic steroids (AASs) have been illegally used in counterfeit drugs to improve the performance of athletes. In addition, AASs have been used for cosmetic purpose by non-athletes. To determine the presence of 26 AASs, an analysis method using ultra-liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) was developed and validated. The validated method was applied to 19 counterfeit drugs collected from the Internet and off-line markets during 2014. Nearly 50% (9/19) of the samples contained one of these 26 AASs. In addition, the concentration ranges of the AASs ranged from 0.09 to 119,228.57 mg/kg in the suspected samples. The determined AASs primarily consisted of testosterone and testosterone 17-propionate (26%) followed by boldenone (21%). These results indicate the adulteration of over-the-counter counterfeit drugs, and the continuous monitoring of counterfeit drugs or dubious dietary supplements containing anabolic steroids is warranted.
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Affiliation(s)
- So-Hyun Cho
- Advanced Analysis Team, Toxicological Evaluation and Research Department, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Chungcheongbuk-do 363-700, Republic of Korea
| | - Hyoung Joon Park
- Advanced Analysis Team, Toxicological Evaluation and Research Department, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Chungcheongbuk-do 363-700, Republic of Korea
| | - Ji Hyun Lee
- Advanced Analysis Team, Toxicological Evaluation and Research Department, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Chungcheongbuk-do 363-700, Republic of Korea
| | - Jung-Ah Do
- Advanced Analysis Team, Toxicological Evaluation and Research Department, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Chungcheongbuk-do 363-700, Republic of Korea
| | - Seok Heo
- Advanced Analysis Team, Toxicological Evaluation and Research Department, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Chungcheongbuk-do 363-700, Republic of Korea
| | - Jeong Hwa Jo
- Advanced Analysis Team, Toxicological Evaluation and Research Department, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Chungcheongbuk-do 363-700, Republic of Korea
| | - Sooyeul Cho
- Advanced Analysis Team, Toxicological Evaluation and Research Department, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju-si, Chungcheongbuk-do 363-700, Republic of Korea.
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24
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Doué M, Dervilly-Pinel G, Pouponneau K, Monteau F, Le Bizec B. Direct analysis in real time - high resolution mass spectrometry (DART-HRMS): a high throughput strategy for identification and quantification of anabolic steroid esters. Drug Test Anal 2014; 7:603-8. [DOI: 10.1002/dta.1727] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 08/28/2014] [Accepted: 09/02/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Mickael Doué
- LUNAM Université, Oniris; Laboratoire d'Etude des Résidus et Contaminants dans les Aliments (LABERCA); Atlanpole-La-Chantrerie, CS 50707 Nantes F-44307 France
| | - Gaud Dervilly-Pinel
- LUNAM Université, Oniris; Laboratoire d'Etude des Résidus et Contaminants dans les Aliments (LABERCA); Atlanpole-La-Chantrerie, CS 50707 Nantes F-44307 France
| | - Karinne Pouponneau
- LUNAM Université, Oniris; Laboratoire d'Etude des Résidus et Contaminants dans les Aliments (LABERCA); Atlanpole-La-Chantrerie, CS 50707 Nantes F-44307 France
| | - Fabrice Monteau
- LUNAM Université, Oniris; Laboratoire d'Etude des Résidus et Contaminants dans les Aliments (LABERCA); Atlanpole-La-Chantrerie, CS 50707 Nantes F-44307 France
| | - Bruno Le Bizec
- LUNAM Université, Oniris; Laboratoire d'Etude des Résidus et Contaminants dans les Aliments (LABERCA); Atlanpole-La-Chantrerie, CS 50707 Nantes F-44307 France
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25
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Coomber R, Pavlidis A, Santos GH, Wilde M, Schmidt W, Redshaw C. The supply of steroids and other performance and image enhancing drugs (PIEDs) in one English city: Fakes, counterfeits, supplier trust, common beliefs and access. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.peh.2015.10.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Abrahin OSC, Sousa ECD, Santos AM. Prevalence of the use of anabolic-androgenic steroids in Brazil: a systematic review. Subst Use Misuse 2014; 49:1156-62. [PMID: 24766401 DOI: 10.3109/10826084.2014.903750] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The use of anabolic-androgenic steroids (AAS) is increasing among practitioners of recreational physical activity. The aim of this research was to evaluate the prevalence of AAS in practitioners of recreational physical activity in Brazil. After systematic review of four databases, 14 articles were included. The results indicate that the prevalence of AAS varied between 2.1% and 31.6%, according to the region analyzed and the sample characteristics. The study's limitations are noted.
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27
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Doué M, Dervilly-Pinel G, Gicquiau A, Pouponneau K, Monteau F, Le Bizec B. High Throughput Identification and Quantification of Anabolic Steroid Esters by Atmospheric Solids Analysis Probe Mass Spectrometry for Efficient Screening of Drug Preparations. Anal Chem 2014; 86:5649-55. [DOI: 10.1021/ac501072g] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Mickael Doué
- LUNAM Université, Oniris, Laboratoire d’Etude des Résidus
et Contaminants dans les Aliments (LABERCA), Atlanpole-La Chantrerie, CS 50707, Nantes, F-44307, France
| | - Gaud Dervilly-Pinel
- LUNAM Université, Oniris, Laboratoire d’Etude des Résidus
et Contaminants dans les Aliments (LABERCA), Atlanpole-La Chantrerie, CS 50707, Nantes, F-44307, France
| | - Audrey Gicquiau
- LUNAM Université, Oniris, Laboratoire d’Etude des Résidus
et Contaminants dans les Aliments (LABERCA), Atlanpole-La Chantrerie, CS 50707, Nantes, F-44307, France
| | - Karinne Pouponneau
- LUNAM Université, Oniris, Laboratoire d’Etude des Résidus
et Contaminants dans les Aliments (LABERCA), Atlanpole-La Chantrerie, CS 50707, Nantes, F-44307, France
| | - Fabrice Monteau
- LUNAM Université, Oniris, Laboratoire d’Etude des Résidus
et Contaminants dans les Aliments (LABERCA), Atlanpole-La Chantrerie, CS 50707, Nantes, F-44307, France
| | - Bruno Le Bizec
- LUNAM Université, Oniris, Laboratoire d’Etude des Résidus
et Contaminants dans les Aliments (LABERCA), Atlanpole-La Chantrerie, CS 50707, Nantes, F-44307, France
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