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Berger K, Schiefner F, Rudolf M, Awiszus F, Junne F, Vogel M, Lohmann CH. Long-term effects of doping with anabolic steroids during adolescence on physical and mental health. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:608-616. [PMID: 38653791 DOI: 10.1007/s00132-024-04498-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/13/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Systematic doping programs like in the GDR were applied in adolescent competitive athletes to induce supramaximal athletic performance. The substances had adverse somatic and psychological effects. The psychological development of the young athletes was impaired and they suffered in adulthood from long-term effects and secondary diseases even years after the doping period. METHOD The study compared three groups: competitive athletes with doping (I), competitive athletes without doping (II) and persons with no sports activities (III). Somatic and psychological diseases were analyzed to identify the adverse effects of doping in the most vulnerable phase of development in adolescence. Participants were asked to supply a patient history and completed a questionnaire with standardized psychological tests. RESULTS The doping cohort had a higher rate of somatic diseases, psychological disorders and social and professional difficulties. The differences were gender-specific with males more often having impaired liver function, depression, tumors and difficulties associated with the workplace . The doping group reported more emotional and physical neglect during childhood. They proved to be less optimistic but more pessimistic, to perceive less social support and to be more depressive. The study identified less extraversion and more neuroticism. Posttraumatic stress disorder (PTSD) occurred in a small number of participants in the doping group. Doping is associated with psychiatric variables. Predictors were the subscale identifying feelings of the Toronto alexithymia scale 20 (TAS-20), the sense of coherence and the Beck depression inventory 2 (BDI-II) and the Beck depression inventory (BDI). CONCLUSION Physical and psychosocial effects imply correlation with the application of doping substances but might not only be due to the side effects of these substances but also caused by the system, which exerts great psychological pressure and stress during adolescence, a highly vulnerable phase.
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Affiliation(s)
- K Berger
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany.
| | - F Schiefner
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - M Rudolf
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - F Awiszus
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - F Junne
- Department for Psychosomatic and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - M Vogel
- Department for Psychosomatic and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - C H Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
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Furukawa R, Tozaki T, Kikuchi M, Ishige T, Takahashi Y, Fukui E, Kakoi H. A method for detecting gene doping in horse sports without DNA extraction. Drug Test Anal 2024. [PMID: 38853330 DOI: 10.1002/dta.3745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/09/2024] [Accepted: 05/27/2024] [Indexed: 06/11/2024]
Abstract
Gene doping is prohibited in horse sports and can involve the administration of exogenous genes, called transgenes, to postnatal animals. Quantitative polymerase chain reaction (qPCR) methods have been developed to detect gene doping; however, these generally require DNA extraction from the plasma prior to qPCR. In this study, we developed two methods, direct droplet digital PCR (ddPCR) and nested ddPCR, to detect the equine erythropoietin (EPO) transgene without DNA extraction. Direct ddPCR used pretreated plasma and PCR to detect the EPO transgene spiked at 10 copies/μL. Nested ddPCR utilised pre-amplification using nontreated plasma, purification of PCR products and PCR to detect the EPO transgene spiked at 1 copy/μL in plasma. These methods successfully detected the EPO transgene after intramuscular injection into horses. Since each method has different detection sensitivity, the combined use of direct ddPCR for screening and nested ddPCR for confirmation may complement each other and prevent the occurrence of false positives, allowing the reliable detection of gene-doped substances. One advantage of these methods is the small amount of sample required, approximately 2.2-5.0 μl, owing to the lack of a DNA extraction step. Therefore, these tests could be applied to small volume samples as an alternative to conventional gene doping tests.
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Affiliation(s)
- Risako Furukawa
- Genetic Analysis Department, Laboratory of Racing Chemistry, Utsunomiya, Tochigi, Japan
| | - Teruaki Tozaki
- Genetic Analysis Department, Laboratory of Racing Chemistry, Utsunomiya, Tochigi, Japan
| | - Mio Kikuchi
- Genetic Analysis Department, Laboratory of Racing Chemistry, Utsunomiya, Tochigi, Japan
| | - Taichiro Ishige
- Genetic Analysis Department, Laboratory of Racing Chemistry, Utsunomiya, Tochigi, Japan
| | - Yuji Takahashi
- Equine Research Institute, Japan Racing Association, Shimotsuke, Tochigi, Japan
| | - Emiko Fukui
- School of Agriculture, Utsunomiya University, Utsunomiya, Tochigi, Japan
| | - Hironaga Kakoi
- Genetic Analysis Department, Laboratory of Racing Chemistry, Utsunomiya, Tochigi, Japan
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3
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Colangelo J, Smith A, Hachen S, Liebrenz M. Exploring the scope and applications of anti-doping measures in ultramarathon: an analysis of the positions of ultramarathon race organizers. Front Sports Act Living 2024; 6:1406638. [PMID: 38840955 PMCID: PMC11150625 DOI: 10.3389/fspor.2024.1406638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction With ultramarathon attracting burgeoning interest, evidence has emerged about doping behaviors. However, currently, research into the anti-doping policy landscape and the adoption of testing and athlete surveillance is limited, including the applicability of rubric from the World Anti-Doping Agency (WADA) and National Anti-Doping Organizations (NADOs). Consequently, it remains unclear if anti-doping provisions have been developed and enforced in ultramarathon, which is a timely consideration given growth in the sport. Methods This study gathered perspectives on anti-doping and testing procedures from ultramarathon race organizers (UMROs). To that end, a sample of n = 35 prominent competitions was compiled using web materials and community engagement, encompassing elite and amateur entrants, diverse course designs, and prize money opportunities. Data-gathering was conducted across two phases between November and December 2023, with an initial review of UMRO web resources. Subsequently, UMROs were contacted via email to validate or ascertain their anti-doping and testing policies. Insights from UMRO respondents were reviewed and coded. UMROs who did not reply were excluded from the analysis. Results Based on this methodology, the positions of n = 17 UMROs were captured, covering 159 ultramarathon races and approximately 96,500 annual participants. Of these, n = 8 UMROs did not have a self-developed policy and their rubric was pursuant to external authorities like WADA and NADOs. n = 4 had created a specific proprietary policy, which often incorporated WADO or NADO materials. The remaining n = 5 UMROs reported no anti-doping controls were in place at the time of the study. There was also notable heterogeneity in testing and surveillance, ranging from rigorous procedures to an absence of protocols. Interestingly, none of the included UMROs explicitly reported that they had enacted anti-doping measures against athletes. Discussion Various determinants could inform these regulatory inconsistencies across UMROs, such as financial constraints, infrastructural and logistical barriers, cultural factors, and the lack of a unifying international federation in ultramarathon. Given the disparate approaches identified in our results, greater cooperation and education may be necessary to enhance understanding about the implications of doping and advance cohesive frameworks. This should involve collaborations with WADA and NADOs to promote best-practices and evidence-based exchanges within the community.
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Affiliation(s)
- Jill Colangelo
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
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4
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Garcia JF, Seco-Calvo J, Arribalzaga S, Díez R, Lopez C, Fernandez MN, Garcia JJ, Diez MJ, de la Puente R, Sierra M, Sahagún AM. Online information and availability of three doping substances (anabolic agents) in sports: role of pharmacies. Front Pharmacol 2023; 14:1305080. [PMID: 38111382 PMCID: PMC10725911 DOI: 10.3389/fphar.2023.1305080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/22/2023] [Indexed: 12/20/2023] Open
Abstract
Background: The Internet has become an important source for easy access to doping substances, where people and athletes may acquire, outside pharmacies and without a (medical) prescription. These online websites do not always offer quality-assured products, and are outside the regular distribution channels of medicines. The aim of this study was to estimate the availability and accessible information on the Internet about the sale of three doping substances (oxandrolone, DHEA, androstenedione). Methods: Cross-sectional exploratory study, being an observation at a point in time of the online availability of these three doping substances (WADA S1 category: anabolic agents), purchased from Spain, Puerto Rico, Canada, United States, Ukraine and Russia. The characteristics of the websites, the countries the webs sold to, the pharmaceutical forms offered and the recommendations for its use were analyzed by using a computer tool designed ad hoc. Results: There were significant differences between countries in the number of webpages that sold the products (Chi-square test, p < 0.05). Oxandrolone was available for purchase mainly when buying from Spain (27.12%) and Ukraine (26.58%), in websites dedicated to sports (77.26%). For DHEA, most of the pages offered it if the search was done from Canada (23.34%) and Russia (21.44%). Products containing androstenedione or DHEA are claimed to enhance sports performance or for sports use without providing details. Compared to the total number of websites checked, the proportion of pharmacies offering these products was low, ranging from 4.86% for DHEA to 15.79% for androstenedione. Conclusion: The three substances selected are easily available without control through the Internet. Only a small number of websites offering them were online pharmacies, and requested a prescription. Most of the doping substances are purchased from the country where they are requested. Product information described benefits for sports performance, but did not do the same with their side effects. It would be advisable for these products to be sold through pharmacies, to guarantee their quality and provide evidence-based information on their safe use, benefits and risks, and only with a prescription. Athletes should be encouraged to consult health professionals about those supplements suitable for their type of training and sports objectives.
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Affiliation(s)
- Juan F. Garcia
- Department of Mechanical, Informatics, and Aerospatiale Engineering, University of Leon, Leon, Spain
| | - Jesús Seco-Calvo
- Physiotherapy Department, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
- Psychology Department, Faculty of Medicine, Basque Country University, Leioa, Spain
| | - Soledad Arribalzaga
- Physiotherapy Department, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Raquel Díez
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Cristina Lopez
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - M. Nelida Fernandez
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Juan J. Garcia
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - M. Jose Diez
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Raul de la Puente
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Matilde Sierra
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Ana M. Sahagún
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
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5
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Barkoukis V, Harris PR, Rowe R, Lazuras L. Self-Affirmation and Image/Performance Enhancing Drug Use in Recreational Exercise. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:698-706. [PMID: 35452365 DOI: 10.1080/02701367.2022.2046253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 02/18/2022] [Indexed: 06/14/2023]
Abstract
Objectives: The use of image and performance enhancement drugs (IPEDs) in recreational sport represents an emerging public health and societal problem. The present study investigated whether self-affirmation changed exercisers' intentions to use IPEDs, via the effects of mental construal and message acceptance. Method: Sixty-eight exercisers who self-reported IPEDs use participated in the study and were randomly assigned to either a self-affirmation or a control group. All participants read a health-related message about the 10 consequences of IPEDs and subsequently completed a survey measuring message acceptance, mental construal, doping intentions and IPEDs-related social cognitive variables. Results: There were no significant differences between the self-affirmed and the control groups. Hierarchical linear regression analysis further showed that message acceptance, subjective norms, and situational temptation were significantly associated with intentions to use IPEDs. Conclusion: Our findings raise the possibility that for recreational exercisers IPED's use is seen mostly as a health-related matter than a socio-moral transgression.
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Gameli PS, Taoussi O, Basile G, Carlier J, Busardò FP. Metabolism Study of Anamorelin, a GHSR1a Receptor Agonist Potentially Misused in Sport, with Human Hepatocytes and LC-HRMS/MS. Metabolites 2023; 13:949. [PMID: 37623892 PMCID: PMC10456928 DOI: 10.3390/metabo13080949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023] Open
Abstract
Anamorelin, developed for the treatment of cancer cachexia, is an orally active medication that improves appetite and food intake, thereby increasing body mass and physical functioning. It is classified as a growth hormone secretagogue and strictly monitored by the World Anti-Doping Agency (WADA), owing to its anabolic enhancing potential. Identifying anamorelin and/or metabolite biomarkers of consumption is critical in doping controls. However, there are currently no data available on anamorelin human metabolic fate. The aim of this study was to investigate and identify biomarkers characteristic of anamorelin intake using in silico metabolite predictions with GLORYx, in vitro incubation with 10-donor-pooled human hepatocytes, liquid chromatography-high-resolution tandem mass spectrometry (LC-HRMS/MS) analysis, and data processing with Thermo Scientific's Compound Discoverer. In silico prediction resulted in N-acetylation at the methylalanyl group as the main transformation (score, 88%). Others including hydroxylation at the indole substructure, and oxidation and N-demethylation at the trimethylhydrazino group were predicted (score, ≤36%). Hepatocyte incubations resulted in 14 phase I metabolites formed through N-demethylation at the trimethylhydrazino group, N-dealkylation at the piperidine ring, and oxidation at the indole and methylalanyl groups; and two phase II glucuronide conjugates occurring at the indole. We propose four metabolites detected as specific biomarkers for toxicological screening.
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Affiliation(s)
- Prince Sellase Gameli
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (P.S.G.); (O.T.); (F.P.B.)
| | - Omayema Taoussi
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (P.S.G.); (O.T.); (F.P.B.)
| | - Giuseppe Basile
- Department of Trauma Surgery, IRCCS Galeazzi Orthopedic Institute, Via Riccardo Galeazzi 4, 20161 Milan, Italy;
| | - Jeremy Carlier
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (P.S.G.); (O.T.); (F.P.B.)
| | - Francesco Paolo Busardò
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (P.S.G.); (O.T.); (F.P.B.)
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7
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Liu Y, Dong T, Yan K, Wang Z, He G, Zhang Y, Ma C, Liu L, Chang W, Zhang L. A comprehensive and high-throughput screening method for multiple prohibited substances by UPLC-QE Plus-HRMS and HPLC-QQQ-MS in human urine for doping control. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2023; 15:3206-3224. [PMID: 37341547 DOI: 10.1039/d3ay00424d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Since the World Anti-Doping Agency's (WADA) Prohibited List is updated on an annual basis, screening methods must be continually adapted to align with these changes. In accordance with Technical Document-MRPL 2022, a newly combined, comprehensive, rapid and high-throughput doping control screening method has been developed for the analysis of 350 substances with different polarities in human urine using ultra-high performance liquid chromatography coupled with Q Exactive Plus Hybrid Quadrupole-Orbitrap mass spectrometer (UPLC-QE Plus-HRMS) and ultra-high performance liquid chromatography coupled with triple quadrupole mass spectrometer (UPLC-QQQ-MS). The limits of detection were in the range of 0.12-50 ng mL-1 for beta-2 agonists, hormone and metabolic modulators, narcotics, cannabinoids and glucocorticoids, 0.1-14 ng mL-1 for the manipulation of blood and blood components, beta blockers, anabolic agents and hypoxia-inducible factor (HIF) activating agents, and 2.5-100 000 ng mL-1 for substances of Appendix A, diuretics & masking agents and stimulants. The sample preparation consisted of two parts: one is the dilute & shoot part analyzed in UPLC-QQQ-MS, another is a mixture of the dilute & shoot part and a liquid-liquid extraction part of hydrolyzed human urine analyzed in UPLC-QE Plus-HRMS in full scan mode with polarity switching and parallel reaction monitoring (PRM) mode. The method has been fully validated for doping control purposes. All the substances were compliant with WADA's required 1/2 minimum requirement performance level (MRPL) or minimum reporting level (MRL), and this method was successfully used in the 2022 Beijing Winter Olympic Games and Winter Paralympic Games for anti-doping purpose.
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Affiliation(s)
- Yunxi Liu
- Beijing Anti-Doping Laboratory, Beijing Sport University, No. 1 Anding Road, ChaoYang District, 100029 Beijing, People's Republic of China.
| | - Tianyu Dong
- Beijing Anti-Doping Laboratory, Beijing Sport University, No. 1 Anding Road, ChaoYang District, 100029 Beijing, People's Republic of China.
| | - Kuan Yan
- Beijing Anti-Doping Laboratory, Beijing Sport University, No. 1 Anding Road, ChaoYang District, 100029 Beijing, People's Republic of China.
| | - Zhanliang Wang
- Beijing Anti-Doping Laboratory, Beijing Sport University, No. 1 Anding Road, ChaoYang District, 100029 Beijing, People's Republic of China.
| | - Genye He
- Beijing Anti-Doping Laboratory, Beijing Sport University, No. 1 Anding Road, ChaoYang District, 100029 Beijing, People's Republic of China.
| | - Yufeng Zhang
- Beijing Anti-Doping Laboratory, Beijing Sport University, No. 1 Anding Road, ChaoYang District, 100029 Beijing, People's Republic of China.
| | - Congcong Ma
- Beijing Anti-Doping Laboratory, Beijing Sport University, No. 1 Anding Road, ChaoYang District, 100029 Beijing, People's Republic of China.
| | - Lu Liu
- Beijing Anti-Doping Laboratory, Beijing Sport University, No. 1 Anding Road, ChaoYang District, 100029 Beijing, People's Republic of China.
| | - Wei Chang
- Beijing Anti-Doping Laboratory, Beijing Sport University, No. 1 Anding Road, ChaoYang District, 100029 Beijing, People's Republic of China.
| | - Lisi Zhang
- Beijing Anti-Doping Laboratory, Beijing Sport University, No. 1 Anding Road, ChaoYang District, 100029 Beijing, People's Republic of China.
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8
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Moreillon B, Salamin O, Krumm B, Iannella L, Molaioni F, Kuuranne T, Nicoli R, Saugy JJ, Botrè F, Faiss R. Variability of the urinary and blood steroid profiles in healthy and physically active women with and without oral contraception. Drug Test Anal 2023; 15:324-333. [PMID: 36414566 DOI: 10.1002/dta.3412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022]
Abstract
The steroidal module of the athlete biological passport (ABP) targets the use of pseudo-endogenous androgenous anabolic steroids in elite sport by monitoring urinary steroid profiles. Urine and blood samples were collected weekly during two consecutive oral contraceptive pill (OCP) cycles in 15 physically active women to investigate the low urinary steroid concentrations and putative confounding effect of OCP. In urine, testosterone (T) and epitestosterone (E) were below the limit of quantification of 1 ng/ml in 62% of the samples. Biomarkers' variability ranged between 31% and 41%, with a significantly lesser variability for ratios (except for T/E [41%]): 20% for androsterone/etiocholanolone (p < 0.001) and 25% for 5α-androstane-3α,17β-diol/5ß-androstane-3α,17β-diol (p < 0.001). In serum, markers' variability (testosterone: 24%, androstenedione: 23%, dihydrotestosterone: 19%, and T/A4: 16%) was significantly lower than in urine (p < 0.001). Urinary A/Etio increased by >18% after the first 2 weeks (p < 0.05) following withdrawal blood loss. In contrast, serum T (0.98 nmol/l during the first week) and T/A4 (0.34 the first week) decreased significantly by more than 25% and 17% (p < 0.05), respectively, in the following weeks. Our results outline steroidal variations during the OCP cycle, highlighting exogenous hormonal preparations as confounder for steroid concentrations in blood. Low steroid levels in urine samples have a clear negative impact on the subsequent interpretation of steroid profile of the ABP. With a greater analytical sensitivity and lesser variability for steroids in healthy active women, serum represents a complementary matrix to urine in the ABP steroidal module.
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Affiliation(s)
- Basile Moreillon
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Olivier Salamin
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Bastien Krumm
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Loredana Iannella
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Francesco Molaioni
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Raul Nicoli
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jonas J Saugy
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Francesco Botrè
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Raphael Faiss
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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9
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Shao H, Ren Y, Lei C, Xu G. Electron beam degradation of the cardiovascular drug salbutamol: Mechanisms and degradation pathways. CHEMOSPHERE 2023; 318:137939. [PMID: 36702419 DOI: 10.1016/j.chemosphere.2023.137939] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/20/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
With the increasing incidence and mortality of cardiovascular diseases, high consumption of the cardiovascular drug salbutamol (SAL) has made this compound an emerging pollutant in natural water and a challenge for traditional wastewater treatment. In this paper, an efficient advanced oxidation process was used to degrade SAL by electron beam (EB) irradiation. The results revealed that 100 mg L-1 of SAL could be nearly completely removed (95.1%) at 10 kGy and the degradation kinetic well followed pseudo first-order kinetic model. Different factors, including pH, inorganic ions and water matrix, had varying effects on the degradation of SAL owing to their important influence on the formation of reactive species in the aqueous solution. And it was found that eaq- played a major role in the degradation of SAL parent. Moreover, the addition of K2S2O8 (20 mM) increased the SAL mineralization rate from 2.9% to 64.2%, suggesting that oxidation free radicals could greatly improve the mineralization rate of SAL. Combining with the theoretical calculations and determined degradation by-products, four possible degradation pathways of SAL by EB irradiation were proposed, including H•, •OH and eaq- all participated in the degradation of SAL. Finally, toxicity evaluation suggested that the toxicity of SAL aqueous solution reduced after EB irradiation, indicating that it is an effective method to degrade SAL.
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Affiliation(s)
- Haiyang Shao
- School of Environmental and Chemical Engineering, Shanghai University, 99 Shangda Road, Shanghai, 200444, PR China
| | - Yingfei Ren
- School of Environmental and Chemical Engineering, Shanghai University, 99 Shangda Road, Shanghai, 200444, PR China
| | - Chen Lei
- School of Environmental and Chemical Engineering, Shanghai University, 99 Shangda Road, Shanghai, 200444, PR China
| | - Gang Xu
- School of Environmental and Chemical Engineering, Shanghai University, 99 Shangda Road, Shanghai, 200444, PR China; Key Laboratory of Organic Compound Pollution Control Engineering, Ministry of Education, Shanghai, 200444, PR China.
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10
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Prokhorov DA, Kutyshenko VP, Tarahovsky YS, Kukushkin NI, Khrenov MO, Kovtun AL, Zakharova NM. Solid Xenon Carrier Based on α-Cyclodextrin: Properties, Preparation, and Application. J Pharm Sci 2023; 112:344-349. [PMID: 35995207 DOI: 10.1016/j.xphs.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 11/30/2022]
Abstract
The inert gas xenon (Xe) is increasingly used in medicine as a universal anesthetic, a regulator of cellular metabolism, and a broad-spectrum organoprotector. Commonly utilized Xe inhalation requires expensive equipment that is not universally available. Here we describe the production process and physical characteristics of a solid, highly stable xenon carrier based on α-cyclodextrin (α-CD), developed for oral administration. It was found, that the interaction of α-CD with Xe in an aqueous solution and elevated pressure leads to precipitation of the α-CD-Xe complex. We have discovered three new properties of the resulting complex that promote long-term storage and oral delivery of Xe. (i) At temperatures below 0 °C, the precipitated α-CD-Xe complex containing water is so stable that it allows the removal of water by vacuum freeze-drying (lyophilization). (ii). Lyophilized α-CD-Xe remains stable for months at room temperature. (iii) Upon contact with water, α-CD-Xe rapidly releases gaseous Xe. As revealed in the forced swim test, after oral administration of lyophilized α-CD-Xe to rats, the duration of swimming was significantly increased. The obtained data open up prospects for the development of drugs based on the lyophilized α-CD-Xe complex suitable for storage, transportation, and medical use, including outside the hospital.
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Affiliation(s)
- Dmitry A Prokhorov
- Institute of Theoretical and Experimental Biophysics, RAS, Pushchino, Moscow Region, 142290, Russia; Institute of Cell Biophysics, RAS, Pushchino, Moscow Region, 142290, Russia
| | - Victor P Kutyshenko
- Institute of Theoretical and Experimental Biophysics, RAS, Pushchino, Moscow Region, 142290, Russia; Institute of Cell Biophysics, RAS, Pushchino, Moscow Region, 142290, Russia
| | - Yury S Tarahovsky
- Institute of Theoretical and Experimental Biophysics, RAS, Pushchino, Moscow Region, 142290, Russia; Institute of Cell Biophysics, RAS, Pushchino, Moscow Region, 142290, Russia.
| | | | - Maxim O Khrenov
- Institute of Cell Biophysics, RAS, Pushchino, Moscow Region, 142290, Russia
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Gómez-Guerrero N, González-López N, Zapata-Velásquez JD, Martínez-Ramírez JA, Rivera-Monroy ZJ, García-Castañeda JE. Synthetic Peptides in Doping Control: A Powerful Tool for an Analytical Challenge. ACS OMEGA 2022; 7:38193-38206. [PMID: 36340120 PMCID: PMC9631397 DOI: 10.1021/acsomega.2c05296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Peptides are very diverse molecules that can participate in a wide variety of biological processes. In this way, peptides are attractive for doping, since these molecules can activate or trigger biological processes that can improve the sports performance of athletes. Peptide molecules are found in the official World Anti-Doping Agency lists, mainly in sections S2, S4, and S5. In most cases, these molecules have a very short half-life in the body and/or are identical to natural molecules in the body, making it difficult to analyze them as performance-enhancing drugs. This article reviews the role of peptides in doping, with special emphasis on the peptides used as reference materials, the pretreatment of samples in biological matrices, the instrumentation, and the validation of analytical methodologies for the analysis of peptides used in doping. The growing need to characterize and quantify these molecules, especially in complex biological matrices, has generated the need to search for robust strategies that allow for obtaining sensitive and conclusive results. In this sense, strategies such as solid phase peptide synthesis (SPPS), seeking to obtain specific peptides, metabolites, or isotopically labeled analogs, is a key tool for adequate quantification of different peptide molecules in biological matrices. This, together with the use of optimal methodologies for sample pretreatment (e.g., SPE or protein precipitation), and for subsequent analysis by high-resolution techniques (mainly hyphenated LC-HRMS techniques), have become the preferred instrumentation to meet the analytical challenge involved in the analysis of peptides in complex matrices.
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Affiliation(s)
- Néstor
Alejandro Gómez-Guerrero
- Chemistry
Department, Universidad Nacional de Colombia, Bogotá, Carrera 45 No 26-85,
Building 451, 11321 Bogotá, Colombia
- Doping
Control Laboratory, Ministerio del Deporte,
Bogotá, Carrera
68 No 55-65, 111071 Bogotá, Colombia
| | - Nicolás
Mateo González-López
- Pharmacy
Department, Universidad Nacional de Colombia, Bogotá, Carrera 45 No 26-85,
Building 450, 11321 Bogotá, Colombia
| | - Juan Diego Zapata-Velásquez
- Pharmacy
Department, Universidad Nacional de Colombia, Bogotá, Carrera 45 No 26-85,
Building 450, 11321 Bogotá, Colombia
| | - Jorge Ariel Martínez-Ramírez
- Pharmacy
Department, Universidad Nacional de Colombia, Bogotá, Carrera 45 No 26-85,
Building 450, 11321 Bogotá, Colombia
| | - Zuly Jenny Rivera-Monroy
- Chemistry
Department, Universidad Nacional de Colombia, Bogotá, Carrera 45 No 26-85,
Building 451, 11321 Bogotá, Colombia
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12
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Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21 st century. Dis Mon 2022:101482. [PMID: 36100481 DOI: 10.1016/j.disamonth.2022.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.
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13
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Siegmund LA. Appearance and Performance Enhancing Drugs and Substances: The Role of the School Nurse. NASN Sch Nurse 2022; 37:263-269. [PMID: 35466806 DOI: 10.1177/1942602x221093938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this article is to provide the school nurse with the ability to recognize performance and appearance enhancing substance use and understand treatment and prevention strategies to reduce associated health risks. The use of appearance and performance enhancing drugs and substances, also known as "doping," has been an ethical and health issue in sports for many years. It is vital that school nurses learn to recognize performance and appearance enhancing substance use to ensure student athletes and exercisers receive the care and education they need. Commonly used performance and appearance enhancing substances include anabolic-androgenic steroids, stimulants, diuretics, growth hormone, and supplements. Signs and symptoms that may look similar to other health concerns include palpitations, stunted growth, acne, severe headaches, muscle cramps, dizziness, and dehydration, but some long-term severe complications occur as well. Doping can lead to severe and sometimes permanent organ damage, including liver, kidney, and heart disease. The school nurse can play a key role by working with parents, coaches, school counselors, and educators to foster an anti-doping culture.
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14
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Zhu T, Jin Y, Zhao J, Jing J, Tian T, Shan Y, Xu X, Wang Y. Qualitative and quantitative analysis of ephedrine stimulants in urine by ultra-performance liquid chromatography-tandem mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2022; 36:e9229. [PMID: 34854506 DOI: 10.1002/rcm.9229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/01/2021] [Accepted: 11/24/2021] [Indexed: 06/13/2023]
Abstract
RATIONALE Ephedrine analogues are stimulants that are explicitly required to be quantified and characterized in the Anti-Doping Prohibited List of the World Anti-Doping Agency. Given the difficulty of distinguishing diastereoisomers, the qualitative and quantitative analyses of ephedrine diastereoisomers are difficult. METHODS An ultra-performance liquid chromatography-tandem mass spectrometry (UHPLC/MS/MS) method was developed to detect five ephedrine analogues, and two pairs of diastereoisomers were identified using this method. The samples were analyzed qualitatively and quantitatively using a tandem mass spectrometer with an electrospray ionization source in multiple reaction detection mode after one-step dilution. RESULTS The effective detection limits of this method were below 0.5 ng/mL. A matrix effect (range: 83.4% to 102%) was observed in quality control samples. The intra- and inter-day precision was lower than 9.16% and 8.60%, respectively, and the accuracy was within ±8.0%. CONCLUSIONS The method is efficient, accurate, stable and sensitive, and fully meets the requirements for the detection of ephedrine substances in stimulants.
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Affiliation(s)
- Ting Zhu
- Shanghai University of Sport, Shanghai, China
| | - Yao Jin
- Shanghai University of Sport, Shanghai, China
| | | | - Jing Jing
- Shanghai University of Sport, Shanghai, China
| | - Tian Tian
- Shanghai University of Sport, Shanghai, China
| | | | - Xin Xu
- Shanghai University of Sport, Shanghai, China
| | - Yang Wang
- Shanghai University of Sport, Shanghai, China
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15
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Daher J, El Khoury D, Dwyer JJM. Education Interventions to Improve Knowledge, Beliefs, Intentions and Practices with Respect to Dietary Supplements and Doping Substances: A Narrative Review. Nutrients 2021; 13:nu13113935. [PMID: 34836190 PMCID: PMC8618302 DOI: 10.3390/nu13113935] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/24/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022] Open
Abstract
The misuse of dietary supplements and doping substances is commonly associated with toxicity, nutritional imbalances, and health and psychological consequences. This is alarming especially in light of the increasing prevalence of the use of dietary supplements and doping, particularly among young adults including athletes. There is evidence that education interventions can lead to improved knowledge, intentions, and practices. However, no review has summarized and evaluated the effectiveness of such interventions. The aim of this article is to review the characteristics, contents and effects of education interventions that were designed and implemented to improve knowledge, attitudes, beliefs and intentions with respect to the use of dietary supplements and doping agents in different populations. PubMed, Scopus, CINAHL, PsycInfo and Google Scholar were searched for English-language education interventions targeting dietary supplements and doping substances. A total of 20 articles were identified and have generally provided consistent findings. Most interventions reported a significant improvement in knowledge on dietary supplements and doping agents. Unfortunately, the heavy reliance on self-reported assessment tools limits the validity of these interventions, with almost all articles targeting athletes and adolescents.
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16
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Lara B, Aguilar-Navarro M, Salinero JJ, Muñoz-Guerra J, Del Mar Plata M, Del Coso J. Study of frequency and type of adverse analytical findings in the different disciplines of aquatics. Bioanalysis 2021; 13:1467-1476. [PMID: 34617450 DOI: 10.4155/bio-2021-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022] Open
Abstract
We aimed to analyze the number and distribution of doping control tests in which a banned substance was reported (i.e., adverse analytical finding) in aquatics. The analysis was performed by using the data provided by the WADA Testing Figure Reports from 2015 to 2019. A total of 79,956 doping control tests were analyzed. Sprint swimming, middle-distance swimming and water polo were the disciplines with the highest number of doping control tests. However, there were no differences in the frequency of adverse findings among disciplines (overall, ∼0.56%, from 0.13 in artistic swimming to 0.76% in sprint swimming). Sprinters and long-distance swimmers presented a higher frequency of beta-2-agonists than the remaining aquatic disciplines (p < 0.05). These results indicate that the type of prohibited substances employed is strongly influenced by the intrinsic characteristics of each aquatic discipline.
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Affiliation(s)
- Beatriz Lara
- Camilo José Cela University, Exercise Physiology Laboratory, Madrid, 28692, Spain
| | - Millán Aguilar-Navarro
- Francisco de Vitoria University, Exercise & Sport Sciences, Faculty of Health Sciences, Madrid, 28223, Spain
| | - Juan José Salinero
- Camilo José Cela University, Exercise Physiology Laboratory, Madrid, 28692, Spain
| | - Jesús Muñoz-Guerra
- Department for Doping Control, Spanish Agency for Health Protection in Sport, Madrid, 28016, Spain
| | - María Del Mar Plata
- Department of Education, Spanish Agency for Health Protection in Sport, Madrid, 28016, Spain
| | - Juan Del Coso
- Rey Juan Carlos University, Centre for Sport Studies, Madrid, 28943, Spain
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17
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Nijholt KT, Meems LMG, Ruifrok WPT, Maass AH, Yurista SR, Pavez-Giani MG, Mahmoud B, Wolters AHG, van Veldhuisen DJ, van Gilst WH, Silljé HHW, de Boer RA, Westenbrink BD. The erythropoietin receptor expressed in skeletal muscle is essential for mitochondrial biogenesis and physiological exercise. Pflugers Arch 2021; 473:1301-1313. [PMID: 34142210 PMCID: PMC8302562 DOI: 10.1007/s00424-021-02577-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/16/2021] [Accepted: 05/05/2021] [Indexed: 12/13/2022]
Abstract
Erythropoietin (EPO) is a haematopoietic hormone that regulates erythropoiesis, but the EPO-receptor (EpoR) is also expressed in non-haematopoietic tissues. Stimulation of the EpoR in cardiac and skeletal muscle provides protection from various forms of pathological stress, but its relevance for normal muscle physiology remains unclear. We aimed to determine the contribution of the tissue-specific EpoR to exercise-induced remodelling of cardiac and skeletal muscle. Baseline phenotyping was performed on left ventricle and m. gastrocnemius of mice that only express the EpoR in haematopoietic tissues (EpoR-tKO). Subsequently, mice were caged in the presence or absence of a running wheel for 4 weeks and exercise performance, cardiac function and histological and molecular markers for physiological adaptation were assessed. While gross morphology of both muscles was normal in EpoR-tKO mice, mitochondrial content in skeletal muscle was decreased by 50%, associated with similar reductions in mitochondrial biogenesis, while mitophagy was unaltered. When subjected to exercise, EpoR-tKO mice ran slower and covered less distance than wild-type (WT) mice (5.5 ± 0.6 vs. 8.0 ± 0.4 km/day, p < 0.01). The impaired exercise performance was paralleled by reductions in myocyte growth and angiogenesis in both muscle types. Our findings indicate that the endogenous EPO-EpoR system controls mitochondrial biogenesis in skeletal muscle. The reductions in mitochondrial content were associated with reduced exercise capacity in response to voluntary exercise, supporting a critical role for the extra-haematopoietic EpoR in exercise performance.
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Affiliation(s)
- Kirsten T Nijholt
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Laura M G Meems
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Willem P T Ruifrok
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Alexander H Maass
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Salva R Yurista
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Mario G Pavez-Giani
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Belend Mahmoud
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Anouk H G Wolters
- Department of Cell Biology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Dirk J van Veldhuisen
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Wiek H van Gilst
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Herman H W Silljé
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Rudolf A de Boer
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - B Daan Westenbrink
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands.
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18
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Aguilar-Navarro M, Salinero JJ, Muñoz-Guerra J, Plata MDM, Del Coso J. Frequency and type of adverse analytical findings in athletics: Differences among disciplines. Drug Test Anal 2021; 13:1561-1568. [PMID: 33982423 DOI: 10.1002/dta.3058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 04/26/2021] [Accepted: 05/01/2021] [Indexed: 11/11/2022]
Abstract
Athletics is a highly diverse sport that contains a set of disciplines grouped into jumps, throws, races of varying distances, and combined events. From a physiological standpoint, the physical capabilities linked to success are quite different among disciplines, with varying involvements of muscle strength, muscle power, and endurance. Thus, the use of banned substances in athletics might be dictated by physical dimensions of each discipline. Thus, the aim of this investigation was to analyse the number and distribution of adverse analytical findings per drug class in athletic disciplines. The data included in this investigation were gathered from the Anti-Doping Testing Figure Report made available by the World Anti-Doping Agency (from 2016 to 2018). Interestingly, there were no differences in the frequency of adverse findings (overall,~0.95%, range from 0.77 to 1.70%) among disciplines despite long distance runners having the highest number of samples analysed per year (~9812 samples/year). Sprinters and throwers presented abnormally high proportions of adverse analytical findings within the group of anabolic agents (p < 0.01); middle- and long-distance runners presented atypically high proportions of findings related to peptide hormones and growth factors (p < 0.01); racewalkers presented atypically high proportions of banned diuretics and masking agents (p = 0.05). These results suggest that the proportion of athletes that are using banned substances is similar among the different disciplines of athletics. However, there are substantial differences in the class of drugs more commonly used in each discipline. This information can be used to effectively enhance anti-doping testing protocols in athletics.
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Affiliation(s)
- Millán Aguilar-Navarro
- Exercise and Sport Sciences, Faculty of Health Sciences, Francisco de Vitoria University, Madrid, Spain
| | - Juan J Salinero
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | - Jesús Muñoz-Guerra
- Department for Doping Control, Spanish Agency for Health Protection in Sport, Madrid, Spain
| | - María Del Mar Plata
- Department of Education, Spanish Agency for Health Protection in Sport, Madrid, Spain
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, Madrid, Spain
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19
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Jokipalo I, Khudayarov A. A Netnography and a Survey on Doping Use among Competitive Doping-untested Strength-sport Athletes. Int J Sports Med 2021; 42:645-650. [PMID: 33506442 DOI: 10.1055/a-1342-7312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Doping-untested strength-sport athletes (powerlifters, strongmen, armlifters, etc.,) are infamous for their doping use, but their exact doping regimens are not known. The purpose of this study was to provide a reasonable portrait of doping history in this specific athlete group for medical practitioners. Seventy-five athletes were selected by netnography of the social media community around the Finnish doping-untested strength-sport federations on the basis of their activity in doping-related discussions, and the athletes were invited to answer a detailed doping-related anonymous survey. Fifty respondents completed the survey. 100% of the respondents reported use of anabolic androgenic steroids, 66% reported use of stimulants, and 80% use of non-steroidal anabolic substances. The doses of both testosterone products and human growth hormone were notably larger than reported in previous studies of gym users (mostly non-competitive athletes). The subjects reported simultaneous use of an average 5.66 illegal substances, and lifetime use of 16.78 illegal substances. The doses of illicit drugs, as well as polypharmacy, among competitive doping-untested strength-sport athletes are higher than previously reported among recreational gym users, and side effects are likely in this specific population.
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Affiliation(s)
- Iiro Jokipalo
- Department of Nursing Science, Mikkeli University of Applied Sciences, Mikkeli, Finland
| | - Anna Khudayarov
- Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland
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20
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Aguilar-Navarro M, Muñoz-Guerra J, Del Mar Plara M, Del Coso J. Analysis of doping control test results in individual and team sports from 2003 to 2015. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:160-169. [PMID: 32099724 PMCID: PMC7031807 DOI: 10.1016/j.jshs.2019.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/27/2019] [Accepted: 04/02/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND Determining the prevalence of doping in sport might be useful for anti-doping authorities to gauge the effectiveness of anti-doping policies implemented to prevent positive attitudes toward doping. Using questionnaires and personal interviews, previous investigations have found that the prevalence of doping might be different among different sports disciplines; however, there is no sport-specific information about the proportion of adverse and atypical findings (AAF) in samples used for doping control. The aim of the present investigation was to assess the differences in the frequency of adverse analytical and atypical findings among sports using the data made available by the World Anti-Doping Agency. METHODS The data included in this investigation were gathered from the Testing Figures Reports made available annually from 2003 to 2015 by the World Anti-Doping Agency. These Testing Figures Reports include information about the number of samples analyzed, the number of AAFs reported, and the most commonly found drugs in the urine and blood samples analyzed. A total of 1,347,213 samples were analyzed from the individual sports selected for this investigation, and 698,371 samples were analyzed for disciplines catalogued as team sports. RESULTS In individual sports, the highest proportions of AAF were 3.3% ± 1.0% in cycling, 3.0% ± 0.6% in weightlifting, and 2.9% ± 0.6% in boxing. In team sports, the highest proportions of AAF were 2.2% ± 0.5% in ice hockey, 2.0% ± 0.5% in rugby, and 2.0% ± 0.5% in basketball. Gymnastics and skating had the lowest proportions at (≤1.0%) for individual sports, and field hockey, volleyball and football had the lowest proportions for team sports (≤1.4%). CONCLUSION As suggested by the analysis, the incidence of AAF was not uniform across all sports disciplines, with the different proportions pointing to an uneven use of banned substances depending on the sport. This information might be useful for increasing the strength and efficacy of anti-doping policies in those sports with the highest prevalence in the use of banned substances.
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Affiliation(s)
- Millán Aguilar-Navarro
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, 28692, Spain; Faculty of Education, Francisco de Vitoria University, Madrid, 28223, Spain
| | - Jesús Muñoz-Guerra
- Department for Doping Control, Spanish Agency for Health Protection in Sport, Madrid, 28016, Spain
| | - María Del Mar Plara
- Department of Education, Spanish Agency for Health Protection in Sport, Madrid, 28016, Spain
| | - Juan Del Coso
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, 28692, Spain.
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21
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Husen M, Jäger M. [Doping in elite and popular sport : What orthopedic and trauma surgeons should know]. DER ORTHOPADE 2019; 48:711-724. [PMID: 31346643 DOI: 10.1007/s00132-019-03780-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The spectacular doping raid during the Nordic World Ski Championships in Seefeld in winter this year is not the first time that illegal performance enhancement by taking drugs is in the spotlight of public interest. Kicked off by the so-called Festina scandal of the 1998 Tour de France, the serial exposure of further doping offences continues up to the present day. Less well-known to the general public is the high prevalence of doping under hobby and amateur athletes. Physicians are confronted by this group of patients in the practice much more frequently than by elite athletes, who are mostly treated in closed medical networks. The aim of the article is to provide an overview of the medical aspects including the most frequent substance classes and the current legal foundations of the anti-doping movement. Furthermore, the official definition of doping and the structure of the anti-doping agencies are presented.
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Affiliation(s)
- Martin Husen
- Zentrum für Orthopädie und Unfallchirurgie, Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinik Essen, Universitätsmedizin Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
| | - Marcus Jäger
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinik für Orthopädie und Unfallchirurgie, Universität Duisburg-Essen, Universitätsmedizin Essen, Hufelandstr. 55, 45147, Essen, Deutschland
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22
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Heuberger JAAC, Cohen AF. Review of WADA Prohibited Substances: Limited Evidence for Performance-Enhancing Effects. Sports Med 2019; 49:525-539. [PMID: 30411235 PMCID: PMC6422964 DOI: 10.1007/s40279-018-1014-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The World Anti-Doping Agency is responsible for maintaining a Prohibited List that describes the use of substances and methods that are prohibited for athletes. The list currently contains 23 substance classes, and an important reason for the existence of this list is to prevent unfair competition due to pharmacologically enhanced performance. The aim of this review was to give an overview of the available evidence for performance enhancement of these substance classes. We searched the scientific literature through PubMed for studies and reviews evaluating the effects of substance classes on performance. Findings from double-blind, randomized controlled trials were considered as evidence for (the absence of) effects if they were performed in trained subjects measuring relevant performance outcomes. Only 5 of 23 substance classes show evidence of having the ability to enhance actual sports performance, i.e. anabolic agents, β2-agonists, stimulants, glucocorticoids and β-blockers. One additional class, growth hormone, has similar evidence but only in untrained subjects. The observed effects all relate to strength or sprint performance (and accuracy for β-blockers); there are no studies showing positive effects on reliable markers of endurance performance. For 11 classes, no well-designed studies are available, and, for the remaining six classes, there is evidence of an absence of a positive effect. In conclusion, for the majority of substance classes, no convincing evidence for performance enhancement is available, while, for the remaining classes, the evidence is based on a total of only 266 subjects from 11 studies.
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Affiliation(s)
| | - Adam F Cohen
- Centre for Human Drug Research, Zernikedreef 8, 2333 CL, Leiden, The Netherlands
- Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands
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23
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Calcaterra V, Clerici E, Ceolin V, Regalbuto C, Larizza D. Gynecomastia after euthyroidism restoration in a patient with type 1 diabetes and Graves' disease. Clin Case Rep 2018; 6:1481-1484. [PMID: 30147887 PMCID: PMC6099052 DOI: 10.1002/ccr3.1565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 03/30/2018] [Accepted: 04/14/2018] [Indexed: 11/06/2022] Open
Abstract
In patients with autoimmune disease, gynecomastia should not be considered as 1 of the first signs of hyperthyroidism, rather it is a breast pathology that can be present even when euthyroidism restoration is achieved. It is unknown whether the autoimmune nature of thyroid disorders or simply the hyperthyroidism effects breast changes.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric Endocrinology UnitDepartment of Maternal and Children's HealthFondazione IRCCS Policlinico S. Matteo and University of PaviaPaviaItaly
| | - Edoardo Clerici
- Pediatric Endocrinology UnitDepartment of Maternal and Children's HealthFondazione IRCCS Policlinico S. Matteo and University of PaviaPaviaItaly
| | - Valeria Ceolin
- Pediatric Endocrinology UnitDepartment of Maternal and Children's HealthFondazione IRCCS Policlinico S. Matteo and University of PaviaPaviaItaly
| | - Corrado Regalbuto
- Pediatric Endocrinology UnitDepartment of Maternal and Children's HealthFondazione IRCCS Policlinico S. Matteo and University of PaviaPaviaItaly
| | - Daniela Larizza
- Pediatric Endocrinology UnitDepartment of Maternal and Children's HealthFondazione IRCCS Policlinico S. Matteo and University of PaviaPaviaItaly
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Loland S. Performance-Enhancing Drugs, Sport, and the Ideal of Natural Athletic Performance. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:8-15. [PMID: 29852101 DOI: 10.1080/15265161.2018.1459934] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The use of certain performance-enhancing drugs (PED) is banned in sport. I discuss critically standard justifications of the ban based on arguments from two widely used criteria: fairness and harms to health. I argue that these arguments on their own are inadequate, and only make sense within a normative understanding of athletic performance and the value of sport. In the discourse over PED, the distinction between "natural" and "artificial" performance has exerted significant impact. I examine whether the distinction makes sense from a moral point of view. I propose an understanding of "natural" athletic performance by combining biological knowledge of training with an interpretation of the normative structure of sport. I conclude that this understanding can serve as moral justification of the PED ban and enable critical and analytically based line drawing between acceptable and nonacceptable performance-enhancing means in sport.
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Overbye M. An (un)desirable trade of harms? How elite athletes might react to medically supervised ‘doping’ and their considerations of side-effects in this situation. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 55:14-30. [DOI: 10.1016/j.drugpo.2017.12.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 11/24/2017] [Accepted: 12/22/2017] [Indexed: 11/16/2022]
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Abstract
Abuse of substances or methods to enhance the performance is becoming very common in the sports, which often destroys the spirit of competition. The regulatory bodies for sports have reported rates ranging from 5% to 31% for the use of performance-enhancing substances among athletes. Athletes can have serious injuries and morbidities, leading to poor health with the use of such substances. Commonly abused agents in sports include anabolic-androgenic steroids and its analogs, blood, erythropoietin, growth hormone and its derivatives, nutritional supplements, creatine, amphetamines, beta-hydroxy-beta-methylbutyrate (HMB), stimulants, and analgesics. Health-care professionals need to be careful while prescribing medicines to sportspersons. Knowledge of exercise physiology, pharmacology of the commonly used agents for sports-related injuries, and agents used for doping could help the sportspersons and health-care professionals to avoid the embarrassment arising because of misuse of these agents. Sports pharmacology includes study of the various aspects of the drug use and abuse in sports and treatment of sports-related injuries. Focusing on sports pharmacology in the medical curriculum can help the upcoming health-care professionals to support the sportspersons to improve the quality of their life by using various drugs and other substances within the standardized limits and avoid embarrassment of doping.
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Affiliation(s)
- Harshad O Malve
- Lead Medical Advisor, Medical Affairs, Novartis Healthcare Private Limited, Mumbai
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27
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Al OM, Elshatarat RA. Influence of knowledge and beliefs on consumption of performance enhancing agents in north-western Saudi Arabia. Ann Saudi Med 2017; 37:317-325. [PMID: 28761032 PMCID: PMC6150593 DOI: 10.5144/0256-4947.2017.317] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Consumption of performance enhancing agents (PEAs) has a wide range of negative health consequences, but knowledge of these consequences among gym users of PEAs in Saudi Arabia is not well understood. OBJECTIVES Identify the knowledge, awareness, beliefs and attitudes of gym users about negative health consequences of using PEAs, and the relationship between these factors and use of these agents. DESIGN Cross-sectional study. SETTING Five gyms in Madinah city, Saudi Arabia. SUBJECTS AND METHODS Convenience sampling was used to recruit gym users. An electronic self-administered questionnaire was used to collect data. MAIN OUTCOME MEASURE(S) Level of knowledge about the negative health consequences of PEAs among gym users. RESULTS About 70% of 316 participants had used one or more of PEAs over the last six months. Of those, about 68.4% used protein powder supplements and 48.1% used energy drinks. Participants who believed that protein powder supplements (c2=52.3, P < .01) and energy drinks (c2=35.2, P < .01) had health hazards used these agents less often than others during the six months preceding data collection. Participants who had less knowledge about the negative health consequences were more likely to use protein powder supplement (t=2.38, P=.018). On the other hand, those who were more knowledgeable about the negative health consequences of insulin, were more likely to use insulin (t=2.45, P=.015). CONCLUSION Misuse of PEAs is widespread among gym users in Saudi Arabia. Improving the level of knowledge and awareness of possible serious health consequences would hopefully lead to reduced PEA consumption. LIMITATIONS The temporal sequence of cause and effect could not be determined in a cross sectional study. Convenience sampling in a single city limited the generalizability of the findings to all regions of Saudi Arabia.
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Affiliation(s)
- Omar Mansour Al
- Dr. Omar Mansour Al Nozha, Department of Internal Medicine,, Taibah University,, PO Box 30088, Madinah 41477,, Saudi Arabia, T: 966-55534992, F: 014-8484800, , ORCID: http://orcid.org/0000-0002-9238-4683
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Birzniece V, Ho KKY. Sex steroids and the GH axis: Implications for the management of hypopituitarism. Best Pract Res Clin Endocrinol Metab 2017; 31:59-69. [PMID: 28477733 DOI: 10.1016/j.beem.2017.03.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Growth hormone (GH) regulates somatic growth, substrate metabolism and body composition. Sex hormones exert profound effect on the secretion and action of GH. Estrogens stimulate the secretion of GH, but inhibit the action of GH on the liver, an effect that occurs when administered orally. Estrogens suppress GH receptor signaling by stimulating the expression proteins that inhibit cytokine receptor signaling. This effect of estrogens is avoided when physiological doses of estrogens are administered via a non-oral route. Estrogen-like compounds, such as selective estrogen receptor modulators, possess dual properties of inhibiting the secretion as well as the action of GH. In contrast, androgens stimulate GH secretion, driving IGF-1 production. In the periphery, androgens enhance the action of GH. The differential effects of estrogens and androgens influence the dose of GH replacement in patients with hypopituitarism on concomitant treatment with sex steroids. Where possible, a non-oral route of estrogen replacement is recommended for optimizing cost-benefit of GH replacement in women with GH deficiency. Adequate androgen replacement in conjunction with GH replacement is required to achieve the full anabolic effect in men with hypopituitarism.
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Affiliation(s)
- Vita Birzniece
- School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia; Garvan Institute of Medical Research, Sydney, NSW 2010, Australia; School of Medicine, University of New South Wales, NSW 2052, Australia.
| | - Ken K Y Ho
- Garvan Institute of Medical Research, Sydney, NSW 2010, Australia; Centres for Health Research, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD 4102, Australia
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30
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Zhou L, Wang Q, Zhang Y, Ji Y, Yang X. Aquatic photolysis of β2-agonist salbutamol: kinetics and mechanism studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:5544-5553. [PMID: 28028708 DOI: 10.1007/s11356-016-8207-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 12/05/2016] [Indexed: 06/06/2023]
Abstract
Salbutamol (SAL) has been widely used as medicine both in treating asthma and in animal primary production; an increasing number of reports have detected SAL in natural waters. The photolysis kinetic and pathway of SAL in aquatic system were studied, as well as the effect of several natural water constituents, such as nitrate, dissolved oxygen (DO) and ferric ions. According to our research, the direct photolysis of SAL followed pseudo-first-order reaction kinetics. Alkaline condition could promote the degradation of SAL; the increase of solution pH would simultaneously increase the fraction of the deprotonated forms of SAL (including the deprotonated and zwitterionic species), which were easier to be excited, and result in the bathochromic shift of the UV-Vis spectrum and, finally, accelerate the degradation rate of SAL. The presence of nitrate could enhance the removal rate of SAL via generation hydroxyl radical (·OH) under irradiation. In addition, the absence of oxygen in the reaction solution could decrease the photolysis. Moreover, Fe(III) was able to chelate with SAL to form an octahedral complex, which was photochemically reactive. The octahedral complex could generate ·OH to oxidize SAL itself in turn. The pathways of SAL photolysis were also investigated by means of the solid phase extraction (SPE)-LC-MS method. The major pathways of SAL photodegradation included oxidation and side-chain cleavage.
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Affiliation(s)
- Lei Zhou
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210023, People's Republic of China.
- Univ Lyon, Université Claude Bernard Lyon 1, CNRS, IRCELYON, 69626, Villeurbanne, France.
| | - Qi Wang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210023, People's Republic of China
| | - Ya Zhang
- Nanjing Institute of Environmental Sciences, Ministry of Environmental Protection of the People's Republic of China, Nanjing, 210042, China
| | - Yuefei Ji
- College of Resources and Environmental Science, Nanjing Agricultural University, Nanjing, 210095, People's Republic of China
| | - Xi Yang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210023, People's Republic of China.
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31
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Sansone A, Romanelli F, Sansone M, Lenzi A, Di Luigi L. Gynecomastia and hormones. Endocrine 2017; 55:37-44. [PMID: 27145756 DOI: 10.1007/s12020-016-0975-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 04/26/2016] [Indexed: 12/28/2022]
Abstract
Gynecomastia-the enlargement of male breast tissue in men-is a common finding, frequently observed in newborns, adolescents, and old men. Physiological gynecomastia, occurring in almost 25 % of cases, is benign and self-limited; on the other hand, several conditions and drugs may induce proliferation of male breast tissue. True gynecomastia is a common feature often related to estrogen excess and/or androgen deficiency as a consequence of different endocrine disorders. Biochemical evaluation should be performed once physiological or iatrogenic gynecomastia has been ruled out. Non-endocrine illnesses, including liver failure and chronic kidney disease, are another cause of gynecomastia which should be considered. Treating the underlying disease or discontinuing medications might resolve gynecomastia, although the psychosocial burden of this condition might require different and careful consideration.
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Affiliation(s)
- Andrea Sansone
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza, University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Francesco Romanelli
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza, University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Massimiliano Sansone
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza, University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza, University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Luigi Di Luigi
- Department of Movement, Human and Health Sciences, Unit of Endocrinology, University of Rome "Foro Italico", Largo Lauro de Bosis 15, 00135, Rome, Italy
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Uxoricide and dismemberment in a case of illicit anabolic steroid use: A case report and literature review. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2016. [DOI: 10.1016/j.ejfs.2016.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Miller DJ, Blum AB, Levine WN, Ahmad CS, Popkin CA. Preparticipation Evaluation of the Young Athlete: What an Orthopaedic Surgeon Needs to Know. Am J Sports Med 2016; 44:1605-15. [PMID: 26330569 DOI: 10.1177/0363546515598994] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The preparticipation evaluation (PPE) is a widely used tool for detecting health conditions that may delay or disqualify athletic participation. The medical interview is the most valuable tool for identifying athletes who may be at increased risk for injury. Physical examination is tailored to identifying cardiac abnormalities or factors that may place an athlete at increased risk for injury. Although practiced in Europe, universal cardiac screening with electrocardiography is not currently recommended in the United States largely due to the high rate of false-positive results. Neuropsychological testing for management of concussion and laboratory testing for sickle cell trait may be indicated in select groups of athletes. Health care providers should view the PPE as a chance for anticipatory guidance and athlete-directed health counseling. Despite widespread acceptance of the PPE, the quality of such examinations varies significantly, which is an area for possible improvement and further research.
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Affiliation(s)
- Daniel J Miller
- Center for Shoulder, Elbow and Sports Medicine, Department of Orthopedic Surgery, Columbia University, New York, New York, USA
| | | | - William N Levine
- Center for Shoulder, Elbow and Sports Medicine, Department of Orthopedic Surgery, Columbia University, New York, New York, USA
| | - Christopher S Ahmad
- Center for Shoulder, Elbow and Sports Medicine, Department of Orthopedic Surgery, Columbia University, New York, New York, USA
| | - Charles A Popkin
- Center for Shoulder, Elbow and Sports Medicine, Department of Orthopedic Surgery, Columbia University, New York, New York, USA
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Ribeiro S, Garrido P, Fernandes J, Vala H, Rocha-Pereira P, Costa E, Belo L, Reis F, Santos-Silva A. Impaired renal endothelial nitric oxide synthase and reticulocyte production as modulators of hypertension induced by rHuEPO in the rat. Life Sci 2016; 151:147-156. [PMID: 26924494 DOI: 10.1016/j.lfs.2016.02.088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/12/2016] [Accepted: 02/24/2016] [Indexed: 01/15/2023]
Abstract
Our aim was to study the effect of a broad range of recombinant human erythropoietin (rHuEPO) doses on hematological and biochemical parameters, blood pressure (BP), renal function and damage in the rat, focusing on endothelial nitric oxide synthase (eNOS) and hypoxia-inducible factors (HIFs). Male Wistar rats were divided in 5 groups receiving different doses of rHuEPO (100, 200, 400 and 600IU/kg body weight (BW)/week) and saline solution (control), during 3weeks. Blood and 24h urine were collected to perform hematological and biochemical analysis. BP was measured by the tail-cuff method. Kidney tissue was collected to mRNA and protein expression assays and to characterize renal lesions. A dose-dependent increase in red blood cells count, hematocrit and hemoglobin levels was found with rHuEPO therapy, in rHuEPO200, rHuEPO400 and rHuEPO600 groups. Increased reticulocyte count was found in rHuEPO400 and rHuEPO600 groups. BP raised in all groups receiving rHuEPO. The rHuEPO200 and rHuEPO600 groups presented increased kidney protein levels of HIF2α, a reduction in kidney protein levels of eNOS, and the highest grade of vascular and tubular renal lesions. Our study showed that rHuEPO-induced hypertension is present before significant hematological changes occur and, therefore, might involve direct (renal) and indirect (hematological) effects, which varies according to the dose used. The presence of renal hypoxia reduces eNOS activity. Excessive erythrocytosis increases blood hyperviscosity, which can be modulated by an increase in reticulocytes. Hypertension leads to early renal damage without alterations in traditional markers of renal function, thus underestimating the serious adverse effects and risks.
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Affiliation(s)
- Sandra Ribeiro
- Research Unit on Applied Molecular Biosciences (UCIBIO), REQUIMTE, Department of Biological Sciences, Laboratory of Biochemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Patrícia Garrido
- Laboratory of Pharmacology & Experimental Therapeutics, Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Fernandes
- Laboratory of Pharmacology & Experimental Therapeutics, Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Center for Neuroscience and Cell Biology-Institute for Biomedical Imaging and Life Sciences (CNC.IBILI) Research Unit, University of Coimbra, Coimbra, Portugal
| | - Helena Vala
- Center for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB) and Center for Studies in Education and Health Technologies (CI&DETS), Agrarian School of Viseu, Polytechnic Institute of Viseu, Viseu, Portugal
| | - Petronila Rocha-Pereira
- Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Elísio Costa
- Research Unit on Applied Molecular Biosciences (UCIBIO), REQUIMTE, Department of Biological Sciences, Laboratory of Biochemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Luís Belo
- Research Unit on Applied Molecular Biosciences (UCIBIO), REQUIMTE, Department of Biological Sciences, Laboratory of Biochemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Flávio Reis
- Laboratory of Pharmacology & Experimental Therapeutics, Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Center for Neuroscience and Cell Biology-Institute for Biomedical Imaging and Life Sciences (CNC.IBILI) Research Unit, University of Coimbra, Coimbra, Portugal
| | - Alice Santos-Silva
- Research Unit on Applied Molecular Biosciences (UCIBIO), REQUIMTE, Department of Biological Sciences, Laboratory of Biochemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal.
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35
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Thevis M, Kuuranne T, Walpurgis K, Geyer H, Schänzer W. Annual banned-substance review: analytical approaches in human sports drug testing. Drug Test Anal 2016; 8:7-29. [PMID: 26767774 DOI: 10.1002/dta.1928] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 11/10/2015] [Accepted: 11/10/2015] [Indexed: 12/30/2022]
Abstract
The aim of improving anti-doping efforts is predicated on several different pillars, including, amongst others, optimized analytical methods. These commonly result from exploiting most recent developments in analytical instrumentation as well as research data on elite athletes' physiology in general, and pharmacology, metabolism, elimination, and downstream effects of prohibited substances and methods of doping, in particular. The need for frequent and adequate adaptations of sports drug testing procedures has been incessant, largely due to the uninterrupted emergence of new chemical entities but also due to the apparent use of established or even obsolete drugs for reasons other than therapeutic means, such as assumed beneficial effects on endurance, strength, and regeneration capacities. Continuing the series of annual banned-substance reviews, literature concerning human sports drug testing published between October 2014 and September 2015 is summarized and reviewed in reference to the content of the 2015 Prohibited List as issued by the World Anti-Doping Agency (WADA), with particular emphasis on analytical approaches and their contribution to enhanced doping controls.
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Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.,European Monitoring Center for Emerging Doping Agents, Cologne/Bonn, Germany
| | - Tiia Kuuranne
- Doping Control Laboratory, United Medix Laboratories, Höyläämötie 14, 00380, Helsinki, Finland
| | - Katja Walpurgis
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Hans Geyer
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Wilhelm Schänzer
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
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36
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Yang S, Lu J, Xu Y, Wang X. New oxymesterone metabolites in human by gas chromatography-tandem mass spectrometry and their application for doping control. Drug Test Anal 2015. [PMID: 26197789 DOI: 10.1002/dta.1836] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Oxymesterone (17α-methyl-4, 17β-dihydroxy-androst-4-ene-3-one) is one of the anabolic androgenic steroids (AAS) banned by the World Anti-Doping Agency (WADA). The biotransformation of oxymesterone is performed in vitro by human heptocytes and human urinary metabolic profiles are investigated after single dose of 20 mg to two adult males as well. Cell cultures and urine samples were hydrolyzed by β-glucuronidase, extracted, and reacted with N-Methyl-N-trimethylsilyltrifluoroacetamide (MSTFA), ammonium iodide (NH4 I), and dithioerythritol. After derivatization, a gas chromatography triple quadruple tandem mass spectrometry (GC-MS/MS) using full scan and MS/MS modes was applied. The total ion chromatographs of the blank and the positive samples are compared, and 7 new metabolites were found. In addition to the well-known 17-epioxymesterone, oxymesterone is metabolized by 4-ene-reduction, 3-keto-reduction, 11β-hydroxylation, and 16ξ-hydroxylation. Based on the behavior of the MS/MS results of product ion and precursor ion modes, a GC-MS/MS method has been developed monitoring these metabolites. The structures of metabolite 2 and 4 are tentatively identified as 17α-methyl-3β, 17β-dihydroxy-5α-androstane-4-one and 17α-methyl-3α, 4ξ, 17β-trihydroxy-5α-androstane, respectively. Detection of oxymesterone using new metabolites M2 and M4 can extend the detection window up to 4 days since the parent steroid was not detectable. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Sheng Yang
- National Anti-doping Laboratory, China Anti-Doping Agency, 1st Anding Road, ChaoYang District, Beijing, 100029, P. R. China
| | - Jianghai Lu
- National Anti-doping Laboratory, China Anti-Doping Agency, 1st Anding Road, ChaoYang District, Beijing, 100029, P. R. China
| | - Youxuan Xu
- National Anti-doping Laboratory, China Anti-Doping Agency, 1st Anding Road, ChaoYang District, Beijing, 100029, P. R. China
| | - Xiaobing Wang
- National Anti-doping Laboratory, China Anti-Doping Agency, 1st Anding Road, ChaoYang District, Beijing, 100029, P. R. China
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Vázquez-Mourelle R, Carracedo-Martínez E, Ces Gens E, Cadórniga Valiño L, Álvaro Esteban P, Pose Reino JM. [Control measures for anabolic androgenic steroid medicines]. GACETA SANITARIA 2015; 29:304-7. [PMID: 25778637 DOI: 10.1016/j.gaceta.2015.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/05/2015] [Accepted: 02/09/2015] [Indexed: 11/30/2022]
Abstract
Anabolic androgenic steroids (AAS) can cause serious adverse effects when used without a therapeutic purpose. This article aims to show that the AAS are susceptible to being sold on the black market. We also aim to describe how certain limitations on the health inspection services of the Galician health service to pursue these illegal actions prompted a regulatory initiative demanding that additional actions be granted to community pharmacies when dispensing AAS. Four pharmacy inspections detected the diversion of a total of 3118 packages of AAS, which led to the opening of four disciplinary proceedings. In two of these, specialized police forces were called in as there was sufficient evidence of possible diversion to gymnasiums, resulting in a police operation called Operation Fitness.
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Affiliation(s)
- Raquel Vázquez-Mourelle
- Gerencia de Gestión Integrada, Servizo Galego de Saúde, Xunta de Galicia, Santiago de Compostela, A Coruña, España.
| | - Eduardo Carracedo-Martínez
- Gerencia de Gestión Integrada, Servizo Galego de Saúde, Xunta de Galicia, Santiago de Compostela, A Coruña, España
| | - Eugenio Ces Gens
- Subdirección General de Inspección, Auditoría y Acreditación de Servicios Sanitarios, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, A Coruña, España
| | - Luis Cadórniga Valiño
- Jefatura Territorial Sanidade, Servicio de Inspección de Servicios Sanitarios, Pontevedra, España
| | - Pilar Álvaro Esteban
- Jefatura Territorial Sanidade, Servicio de Inspección de Servicios Sanitarios, A Coruña, España
| | - José Manuel Pose Reino
- Subdirección General de Inspección, Auditoría y Acreditación de Servicios Sanitarios, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, A Coruña, España
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