Doping in Sports Research Papers (original) (raw)

To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes... more

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- Metabolism, Health Care, Body Image, Sports
- by Josko Osredkar
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- Forecasting, Doping, Olympic Games, Clinical Sciences

Blood doping represents one main trend in doping strategies. Blood doping refers to the practice of boosting the number of red blood cells (RBCs) in the bloodstream in order to enhance athletic performance, by means of blood transfusions, administration of erythropoiesis-stimulating substances, blood substitutes, natural or artificial altitude facilities, and innovative gene therapies. While detection of recombinant EPO and homologous transfusion is already feasible through electrophoretic, mass spectrometry or flow cytometry-based approaches, no method is currently available to tackle doping strategies relying on autologous transfusions. We exploited an in vitro model of autologous transfusion through a 1:10 dilution of concentrated RBCs after 30 days of storage upon appropriate dilution in freshly withdrawn RBCs from the same donor. Western blot towards membrane Prdx2 and Percoll density gradients were exploited to assess their suitability as biomarkers of transfusion. Membrane Pr...

- by Angelo D'Alessandro
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- Biological markers, Erythrocyte Membrane, Erythrocytes, Doping in Sports

THE SCIENCE OF fluid replacement in athletic training, particularly with regard to American football players, has advanced during the past 3 decades. This advance has resulted in substantial decreases in heatstroke-related deaths during summer training sessions. Recent trends in football heatstroke fatalities toward significant increases may, in part, be attributable to or aggravated by the use of dietary supplements. Credible scientific evidence has been found that amphetamine derivatives and the ergonomic aid creatine may contribute to subclinical dehydration and heatstroke in selected individuals. Caution is urged in the education and evaluation of football players who train during the hot summer months.

- by Richard Kreider
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- Neurosurgery, Health Education, Creatine, Medicine

Mesterolone (1␣-methyl-5␣-androstan-17␤-ol-3-one) is a synthetic anabolic androgenic steroid (AAS) with reported abuses in human sports. As for other AAS, mesterolone is also a potential doping agent in equine sports. Metabolic studies on mesterolone have been reported for humans, whereas little is known about its metabolic fate in horses. This paper describes the studies of both the in vitro and in vivo metabolism of mesterolone in racehorses with an objective to identify the most appropriate target metabolites for detecting mesterolone administration.

- by David Leung
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- Analytical Chemistry, Metabolism, Mass Spectrometry, Comparative Study
- by Christian Strasburger
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- Doping, Human Growth Hormone, Clinical Sciences, Time Factors
- by Christian Reichel
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- Engineering, Education, Sports, Consensus
- by Babette Pluim
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- Engineering, Education, Doping in Sports
- by Costantino Balestra
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- Skeletal muscle biology, Antioxidants, Erythropoietin, Anoxia

Doping with natural steroids can be detected by evaluating the urinary concentrations and ratios of several endogenous steroids. Since these biomarkers of steroid doping are known to present large inter-individual variations, monitoring of individual steroid profiles over time allows switching from population-based towards subject-based reference ranges for improved detection. In an Athlete Biological Passport (ABP), biomarkers data are collated throughout the athlete's sporting career and individual thresholds defined adaptively. For now, this approach has been validated on a limited number of markers of steroid doping, such as the testosterone (T) over epitestosterone (E) ratio to detect T misuse in athletes. Additional markers are required for other endogenous steroids like dihydrotestosterone (DHT) and dehydroepiandrosterone (DHEA). By combining comprehensive steroid profiles composed of 24 steroid concentrations with Bayesian inference techniques for longitudinal profiling, a selection was made for the detection of DHT and DHEA misuse. The biomarkers found were rated according to relative response, parameter stability, discriminative power, and maximal detection time. This analysis revealed DHT/E, DHT/5β-androstane-3α,17β-diol and 5α-androstane-3α,17β-diol/5β-androstane-3α,17β-diol as best biomarkers for DHT administration and DHEA/E, 16α-hydroxydehydroepiandrosterone/E, 7β-hydroxydehydroepiandrosterone/E and 5βandrostane-3α,17β-diol/5α-androstane-3α,17β-diol for DHEA. The selected biomarkers were found suitable for individual referencing. A drastic overall increase in sensitivity was obtained.

- by Martial Saugy
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- Analytical Chemistry, Biomarkers, STEROIDS, Bayesian Inference

Physicians should possess specific diagnostic and pharmacotherapeutic skills in order to recognize symptoms associated with doping use. It is important to be on the alert in athletes and fitness enthusiasts for physical and psychological changes due to use of anabolic steroids such as acne, stretch marks, gynecomastia, signs of acromegaly, irascibility and lethargy. Stimulants such as amphetamines, ephedrine and cocaine lead to fat loss and increased alertness; their main side effects are cardiac problems, behavioural changes and addiction. In addition to anabolic steroids and stimulants, erythropoietin, growth hormone, diuretics and glucocorticoids are regularly used to improve sport performance. In cycling, a biological passport will be used in an attempt to detect doping use. In future, the Olympic motto 'citius, altius, fortius' (faster, higher, stronger) will have ground-breaking consequences for the performance and health of top athletes.

- by Toine Pieters
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- Athletes, Biological markers, Performance Enhancing Substances, Doping in Sports

Glycerol is prohibited as a masking agent by the World Anti-Doping Agency and a urinary threshold has recently been recommended. However, little is known about urinary glycerol excretion after exercise, when (1) exogenous glycerol is metabolized increasingly and (2) endogenous glycerol levels are elevated. The purpose of the placebo-controlled cross-over study was to determine the effects of pre-exercise glycerol administration on glycerol metabolism, urinary excretion, and selected blood parameters. After administration of glycerol (G; 1.0 g/kg body weight (BW) + 25 ml fluid/kg BW) or placebo (P; 25 ml fluid/kg), 14 cyclists exercised 90 min at 60% VO 2max. Samples were taken at 0 h (before administration), 2.5 h (before exercise), 4 h (after exercise) and 6.5 h and additional urine samples were collected until 24 h. Exercise increased endogenous plasma glycerol (0.51 AE 0.21 mmol/l) but peak concentrations were much higher in G (2.5 h: 15.6 AE 7.8 mmol/l). Urinary glycerol increased rapidly (58,428 AE 71,084 mg/ ml after 2.5 h) and was significantly higher than in P until 13.6 AE 0.9 h (p < 0.01). In comparison with placebo administration, G caused significantly greater changes in plasma volume and haemoglobin concentrations after 2.5 h. BW and urine production were significantly different between P and G after 2.5 h and post-exercise. Despite exercise-induced increases in endogenous glycerol in the control group, urinary excretion remained well below the previously recommended threshold. In addition, exercise-related glycerol degradation did not appear to negatively affect the detection of exogenously administered glycerol.

- by Karsten Köhler
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- Analytical Chemistry, Doping, Young Adult, Exercise

No reliable estimate of the prevalence of doping in elite sports has been published. Since 2001, the international governing body for athletics has implemented a blood-testing program to detect altered hematological profiles in the... more

- by Martial Saugy
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- Biochemistry, Epidemiology, Molecular Biology, Doping

as the dependent variable, and trainer and horse nested within trainer as random effects. Results: Sex, class and distance of race, frusemide administration and cloudy weather conditions were significantly (P<0.001) associated with pre-race TCO 2 concentration. Horses that finished in the top 3 positions had values that were slightly (0.2 mmol/l) but significantly (P<0.001) greater than horses not finishing in the top 3. There were significant effects of trainer on pre-race TCO 2 concentration. Conclusions: A variety of factors may influence pre-race TCO2 concentration in horses. Horses with better performance tend to have higher pre-race TCO 2 concentrations. Potential relevance: TCO 2 concentration is associated with improved performance although the magnitude of effect was quite small. Regulatory programmes based on monitoring should consider the influence of other factors on TCO 2 concentration.

- by Noah Cohen
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- Carbon Dioxide, Medicine, Biological Sciences, Sports

Administration studies of levamisole in horses were carried out using two different levamisole preparations, namely, levamisole hydrochloride oral bolus and levamisole phosphate injectable solution. These preparations were analysed in detail for the presence of aminorex-like impurities. Both levamisole preparations were found to contain 1-(2-mercaptoethyl)-4-phenyl-2-imidazolidinone (I) and 4-phenyl-2imidazolidinone (II) as degradation impurities, but neither aminorex nor rexamino was detected in these preparations. After the administration of these preparations to horses, aminorex, rexamino, in addition to levamisole and compound II, were detected in post-administration urine and plasma samples, among which compound II was found to have the longest detection time. Administration study of compound II was then performed on another horse to investigate whether it could be a metabolic precursor of aminorex and/or rexamino. However, no aminorex and rexamino was detected in the post-administration samples, suggesting that compound II was not a metabolic precursor of aminorex or rexamino. A metabolite (III) of compound II, tentatively identified to be a hydrolysis product of compound II, was observed instead.

- by David Leung
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- Analytical Chemistry, Metabolism, Mass Spectrometry, Drug metabolism

This study investigated substance use and misuse among 16 female and 9 male Croatian ballet professionals in 2008 using an original questionnaire. We analyzed social, personal, activity-and training-related, and educational factors, and criteria such as: binge alcohol drinking, cigarette smoking, appetite suppressant consumption, analgesic use, and actual and potential "doping" habits. Frequency tables and rank-order correlation were calculated. More than one third of the male dancers reported binge drinking, while 20% of the females smoked more than a box of cigarettes per day. Almost 25% of these dancers will use "doping" if it will ensure successful ballet performance, regardless of negative health consequences. In males, the risk of potential "doping" behavior increased with age. In females, education level was negatively related to cigarette smoking, but positively correlated to potential "doping" habits and behavior. In both genders, religiousness was the factor negatively related to the following: (1) potential "doping" behavior and (2) belief that "doping" exists in professional ballet. Results suggest that there is evident need for more specific medical and/or psychological services in professional ballet. The study's limitations are noted.

- by Mia Peric
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- Psychology, Dancing, Substance Use, Alcoholism

The applicability of LC-MS/MS in precursor ion scan mode for the detection of urinary stanozolol metabolites has been studied. The product ion at m/z 81 has been selected as specific for stanozolol metabolites without a modification in A-or N-rings and the product ions at m/z 97 and 145 for the metabolites hydroxylated in the N-ring and 4-hydroxy-stanozolol metabolites, respectively. Under these conditions, the parent drug and up to 15 metabolites were found in a positive doping test sample. The study of a sample from a chimeric uPA-SCID mouse collected after the administration of stanozolol revealed the presence of 4 additional metabolites. The information obtained from the product ion spectra was used to develop a SRM method for the detection of 19 compounds. This SRM method was applied to several doping positive samples. All the metabolites were detected in both the uPA-SCID mouse sample and positive human samples and were not detected in none of the blank samples tested; confirming the metabolic nature of all the detected compounds. In addition, the application of the SRM method to a single human excretion study revealed that one of the metabolites (4,16-dihydroxy-stanozolol) could be detected in negative ionization mode for a longer period than those commonly used in the screening for stanozolol misuse (3 -hydroxy-stanozolol, 16␤-hydroxy-stanozolol and 4␤-hydroxy-stanozolol) in doping analysis. The application of the developed approach to several positive doping samples confirmed the usefulness of this metabolite for the screening of stanozolol misuse. Finally, a tentative structure for each detected metabolite has been proposed based on the product ion spectra measured with accurate masses using UPLC-QTOF MS.

- by Christian Reichel
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- Mass Spectrometry, Bioanalysis, Erythropoietin, Anemia

The glycoprotein hormone erythropoietin is an essential viability and growth factor for the erythrocytic progenitors in the bone marrow. Tissue hypoxia is the main stimulus for the synthesis of the hormone in the kidneys and the liver. Endogenous erythropoietin and recombinant human erythropoietin (rHu-EPO) are similar with respect to their biological and chemical properties except for some microheterogeneities in their 4 carbohydrate chains. Generic products and alternatives to rHu-EPO are in development. Renal anemia can be corrected by rHu-EPO in a dose-dependent and predictable way without major side effects apart from a possible increase in arterial blood pressure. The optimal target hematocrit still needs to be defined. There are rare reports of antibody formation towards rHu-EPO in humans. Patients suffering from non-renal anemias may also benefit from the prescription of rHu-EPO. The drug has been approved for treatment of tumor patients with platinum-induced anemia. The cost-effectiveness and medical justification of the administration of rHu-EPO in tumor patients with respect to its positive effects on tumor oxygenation, tumor growth inhibition and support of chemo-and radiotherapy is still a matter of debate. In surgical patients, the pharmacological application of rHu-EPO can increase the yield of blood units in autologous blood donation programs and lower the severity and duration of postoperative anemia, if applicated some days prior to surgery. While rHu-EPO is a godsend in medical practice, its abuse as an performance enhancing drug by athletes in endurance sports is an unethical and potentially dangerous procedure. Unequivocal methods for detection of rHu-EPO doping still need to be established. studies of the pathophysiology and pharmacology of EPO . In all likelihood, rHu-EPO is today the best selling drug in the world (estimated sales 5,000 millions US $ per year).

- by Zeland Schwartz (Muccio)
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- Chemistry, Analytical Chemistry, Forensic Science, Chromatography
- by Martial Saugy
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- Genetics, Forensic Science, Multidisciplinary, Case Study

In the present study, toremifene urinary excretion studies were evaluated in order to examine main metabolic reactions and to select target metabolites in doping control analysis. Urine samples from three female subjects were collected every 3 h for at least 15 days after the oral administration of a single dose of Fareston® (60 mg). The elemental compositions of the compounds detected were determined by liquid chromatography-mass spectrometry using a time-of-flight system with accurate mass measurement. More detailed structure elucidation was obtained by monitoring the presence or absence of structure-specific ions, using product ion scan and neutral loss acquisition modes, whereas the metabolites urinary profiles were evaluated in selected reaction monitoring acquisition mode. The results showed that the main routes of phase-I modifications involved carboxylation of the chlorinated side chain, N-demethylation and hydroxylation in different positions. Fifteen metabolites were found in all subjects studied, most of them were detected for more than 10 days in the free, glucuronide and sulphate fractions, with a maximum of excretion generally after 9–22 and 34–47 h from drug administration. These metabolites can be divided in two groups: metabolites with the characteristic chlorine isotope pattern and metabolites without the characteristic chlorine isotope pattern. The most abundant and long-term compounds were the carboxylated metabolites followed by the hydroxylated metabolites. Their product ions originating after collision-induced dissociation were observed to occur prevalently in the dimethylaminoethoxy and in the chlorinated side chains. These structure-specific ions were used to design screening and confirmation procedures to positively identify toremifene administration in doping control analysis. Figure Suggested main metabolic routes of toremifene, as postulated by excretion studies followed by both LC-MS/MS assays with different acquisition modes and LC-QTOF

- by Monica Mazzarino
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- Engineering, Design, Mass Spectrometry, Doping

Doping use is an ongoing problem in contemporary sports. Despite efforts to detect and control doping, research on its etiology is limited, especially among elite-level athletes. The present study used an integrated social cognition model to examine the predictors of doping intentions. Structured anonymous questionnaires were completed by 1075 Greek adult elite-level athletes (M age = 25 years, SD = 5.89, 36.1% females) from both team and individual sports. Multiple regression and mediation analyses showed that attitudes, normative beliefs, situational temptation, and behavioral control significantly predicted doping intentions. A normative process was identified whereby situational temptation mediated the effects of normative beliefs on intentions. The findings provide the basis for future social cognition research in doping use, and set the framework for the development of evidence-based preventive interventions.

- by Lambros Lazuras
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- Education, Cognition, Beliefs, Intention

Background:: Anabolic ergogenic substance use, in particular the use of anabolic androgenic steroids, is a serious problem in general. Nevertheless, it is subject to debate whether ergogenic substance users exhibit similar features as multiple substance users or whether they constitute a discrete group. Methods:: One thousand eight hundred and two standardized, anonymous questionnaires were distributed among visitors of 113 fitness centers. Questions were asked concerning biometric parameters, social indicators, physical fitness, use of natural stimulants, general illicit drugs and ergogenic substances. With logistic regression analysis, multivariate odds ratios were estimated to investigate the association of anabolic ergogenic substance or general illicit drug use with other parameters. Results:: 13.5% of all participants confessed to having used anabolic ergogenic substances at some point in time. Anabolic ergogenic substance use was positively related with cocaine use, training years, training frequency, negatively related to the level of education, alcohol intake and less frequently used by Germans than by non-Germans. General illicit drug use, however, was positively related with alcohol intake, smoking and a university degree and negatively with having children. In addition, anabolic ergogenic substance use was significantly related with the use of general illicit drugs based on the strong relation with the use of cocaine, which is an ergogenic substance itself. The health care system supplies 48.1% of the anaolic ergogenic substance users with their substances and 32.1% are even monitored by a physician. Conclusions:: The results of this study strengthen the notion that anabolic ergogenic substance users constitute a specific body-oriented substance user group. Uncommon for general illicit drug use, the health care system is a major sponsor of anabolic ergogenic substance users. These findings suggest the need for alternative approaches for successful prevention and intervention programs.

- by Rolf Ulrich
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- Sports Medicine, Health Care, Prevention, Comorbidity

Drugs and methods to improve physical performance among athletes have been used since the beginning of sport history, but the use of performance enhancing drugs has not always been regarded as cheating. In short, the motives for doping are improving and maintaining physical functioning, coping with the social/psychological pressures and striving for social and psychological goals, including economic benefits. Factors such as, &amp;quot;doping dilemma&amp;quot;, &amp;quot;win at all costs&amp;quot;, cost versus benefit, and the specificity of some specific doping agents, also play major roles. It seems that action on the athletes&amp;#39; attitude about the achievement of physical improvement and creating effective methods to reveal the drug abuse, are two main ways in winning the struggle against doping.

- by Thord Rosén
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- Physiology, Ethics, Adolescent, Motivation

The use of performance-enhancing and social drugs by athletes raises a number of ethical and health concerns. The World Anti-Doping Agency was constituted to address both of these issues as well as publishing a list of, and testing for, banned substances in athletes. Despite continuing methodological developments to detect drug use and associated punishments for positive dope tests, there are still many athletes who choose to use performance and image enhancing drugs. Of primary concern to this review are the health consequences of drug use by athletes. For such a large topic we must put in place delimitations. Specifically, we will address current knowledge, controversies and emerging evidence in relation to cardiovascular (CV) health of athletes taking drugs. Further, we delimit our discussion to the CV consequences of anabolic steroids and stimulant (including amphetamines and cocaine) use. These drugs are reported in the majority of adverse findings in athlete drug screenings and thus are more likely to be relevant to the healthcare professionals responsible for the wellbeing of athletes. In detailing CV health issues related to anabolic steroid and stimulant abuse by athletes we critique current research evidence, present exemplar case studies and suggest important avenues for on-going research. Specifically we prompt the need for awareness of clinical staff when assessing the potential CV consequences of drug use in athletes.

- by Gregory Whyte
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- Engineering, Education, Health Education, Electrocardiography

Unified metabolism schemes of anabolic androgenic steroids (AAS) in human urine based on structure classification of parent molecules are presented in this paper. Principal components analysis (PCA) was applied to AAS molecules referred in the World Anti-Doping Agency (WADA) list of prohibited substances, resulting to their classification into six distinct groups related to structure features where metabolic alterations usually occur. The metabolites of the steroids participating to these six groups were treated using the Excel©classification filters showing that common metabolism routes are derived for each of the above PCA classes, leading to the proposed metabolism schemes of the present study. This rule-based approach is proposed for the prediction of the metabolism of unknown, chemically modified steroids, otherwise named as designer steroids. The metabolites of three known, in the literature, AAS are estimated using the proposed metabolism schemes, confirming that their use could be a useful tool for the prediction of metabolic pathways of unknown AAS.

- by A. Fragkaki and +1
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- Metabolism, Principal Component Analysis, STEROIDS, Androgens

The female reproductive life cycle is one of the most important biological rhythms. From prepuberty through to menarche, conception, pregnancy, the postpartum period, menopause, and beyond, the female athlete is exposed to a constantly shifting kaleidoscope of endogenous sex steroid hormones. Although estrogen and progesterone are the most important in terms of their actions on the various body systems, more recent research has explored the effects of other hormones, such as testosterone, relaxin, and leptin, to name just a few. Oral contraceptives and hormone replacement therapy further introduce exogenous synthetic hormones (in varying proportions) to the equation.

- by Wolfgang Jelkmann
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- Erythropoietin, Blood, Gene transfer techniques, Cyclic peptides

Unification of the screening protocols for a wide range of doping agents has become an important issue for doping control laboratories. This study presents the development and validation of a generic liquid chromatography/time-of-flight mass spectrometry (LC/TOFMS) screening method of 241 small molecule analytes from various categories of prohibited substances (stimulants, narcotics, diuretics, b 2 -agonists, b-blockers, hormone antagonists and modulators, glucocorticosteroids and anabolic agents). It is based on a single-step liquid-liquid extraction of hydrolyzed urine and the use of a rapid-resolution liquid chromatography/high-resolution time-of-flight mass spectrometric system acquiring continuous full scan data. Electrospray ionization in the positive mode was used. Validation parameters consisted of identification capability, limit of detection, specificity, ion suppression, extraction recovery, repeatability and mass accuracy. Detection criteria were established on the basis of retention time reproducibility and mass accuracy. The suitability of the methodology for doping control was demonstrated with positive urine samples. The preventive role of the method was proved by the case where full scan acquisition with accurate mass measurement allowed the retrospective reprocessing of acquired data from past doping control samples for the detection of a designer drug, the stimulant 4-methyl-2-hexanamine, which resulted in re-reporting a number of stored samples as positives for this particular substance, when, initially, they had been reported as negatives.

- by David McDuff
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- Mechanical Engineering, Sports Medicine, Alcoholism, United States

Exercise is integral to the life of T1DM subjects. Several factors influence the metabolic response to exercise in these patients. Despite physical and psychological benefits of exercise, its hypo- and hyperglycemic effects may cause discouragement from participation in sports and games. To use existing evidence from literature to provide practical indications for the management of insulin therapy in subjects with T1DM who practice sports or physical activities. Bibliographic research was performed on PubMed and the main Systematic Review and Guidelines database were also searched. Existing guidelines are useful but the exact adjustments of insulin dose must be made on an individual basis and these adjustments can be made only by "trial and error" approach. These clinical indications may be a starting point from which health care providers can find practical advices for each patient.

- by Lorenzo Lenzi
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- Adolescent, Exercise therapy, Biological Sciences, Sports

Anabolic steroids are widely used for doping, in professional and domestic sports. The mechanism of action is not completely understood. It may differ somewhat depending on the specific molecule due to structural differences that influence the specificity of binding with steroid receptors. When used by athletes in training, they can improve performance to levels that cannot be attained by almost any combination of sophisticated nonchemical support by modern sport science. The severity of the undesired effects of anabolic steroids depends on a variety of factors, from the type and combination of them, the dose and duration of administration, as well as the gender of the person taking the drug. Younger individuals and women show greater effects caused by anabolic steroids in terms of performance, but are also at greater risk of side effects. This paper presents a review of the literature concerning the major adverse effects of anabolic steroids, focusing the attention on possible situations of addiction from this category of drugs.

- by Fabio Lugoboni
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- Side Effect, Mechanism of action, Substance-Related Disorders, Doping in Sports

Athletes are among the groups of people who are interested in the effects of caffeine on endurance and exercise capacity. Although many studies have investigated the effect of caffeine ingestion on exercise, not all are suited to draw conclusions regarding caffeine and sports performance. Characteristics of studies that can better explore the issues of athletes include the use of well-trained subjects, conditions that reflect actual practices in sport, and exercise protocols that simulate real-life events. There is a scarcity of field-based studies and investigations involving elite performers. Researchers are encouraged to use statistical analyses that consider the magnitude of changes, and to establish whether these are meaningful to the outcome of sport. The available literature that follows such guidelines suggests that performance benefits can be seen with moderate amounts (~3 mgÁkg -1 body mass) of caffeine. Furthermore, these benefits are likely to occur across a range of sports, including endurance events, stop-and-go events (e.g., team and racquet sports), and sports involving sustained high-intensity activity lasting from 1-60 min (e.g., swimming, rowing, and middle and distance running races). The direct effects on single events involving strength and power, such as lifts, throws, and sprints, are unclear. Further studies are needed to better elucidate the range of protocols (timing and amount of doses) that produce benefits and the range of sports to which these may apply. Individual responses, the politics of sport, and the effects of caffeine on other goals, such as sleep, hydration, and refuelling, also need to be considered.

- by Louise Burke
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- Doping, Biological Sciences, Sport, Caffeine

Anabolic androgenic steroids are synthetic derivatives of testosterone, which is the primary male sex hormone. Anabolic androgenic steroids are used to enhance athletic performance and appearance. Adverse effects include those on the liver, serum lipids, psyche/behavior and reproductive system. Androstenedione is an anabolic androgenic steroid used to increase blood testosterone levels for the purposes of increasing strength, lean body mass and sexual performance. However, there is no research indicating that androstenedione, or its related compounds, significantly increases strength and/ or lean body mass in humans by increasing testosterone levels. The long-term health effects of prolonged androstenedione supplementation are unknown. Dehydroepiandrosterone (DHEA) is a weak androgen also used to elevate testosterone levels, and is advertised as an anti-obesity and anti-aging supplement capable of improving libido, vitality and immunity levels. However, research demonstrates that DHEA supplementation does not increase serum testosterone concentrations or increase strength in men, and may acutely increase testosterone levels in women, thus producing a virilizing effect.

- by Charles Yesalis
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- Health, STEROIDS, Androgens, Exercise
- by Mai Mansour
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- Gene Therapy, Clinical Biochemistry, Sports, Erythropoietin
- by Martial Saugy
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- Erythropoietin, Red blood cell, Blood Transfusion, Athletic performance

to stimulate further adaptation toward a specific training goal(s), progression in the type of resistance training protocol used is necessary. The optimal characteristics of strength-specific programs include the use of both concentric and eccentric muscle actions and the performance of both single-and multiple-joint exercises. It is also recommended that the strength program sequence exercises to optimize the quality of the exercise intensity (large before small muscle group exercises, multiple-joint exercises before single-joint exercises, and higher intensity before lower intensity exercises). For initial resistances, it is recommended that loads corresponding to 8 -12 repetition maximum (RM) be used in novice training. For intermediate to advanced training, it is recommended that individuals use a wider loading range, from 1-12 RM in a periodized fashion, with eventual emphasis on heavy loading (1-6 RM) using at least 3-min rest periods between sets performed at a moderate contraction velocity (1-2 s concentric, 1-2 s eccentric). When training at a specific RM load, it is recommended that 2-10% increase in load be applied when the individual can perform the current workload for one to two repetitions over the desired number. The recommendation for training frequency is 2-3 d·wk Ϫ1 for novice and intermediate training and 4 -5 d·wk Ϫ1 for advanced training. Similar program designs are recommended for hypertrophy training with respect to exercise selection and frequency. For loading, it is recommended that loads corresponding to 1-12 RM be used in periodized fashion, with emphasis on the 6 -12 RM zone using 1-to 2-min rest periods between sets at a moderate velocity. Higher volume, multiple-set programs are recommended for maximizing hypertrophy. Progression in power training entails two general loading strategies: 1) strength training, and 2) use of light loads (30 -60% of 1 RM) performed at a fast contraction velocity with 2-3 min of rest between sets for multiple sets per exercise. It is also recommended that emphasis be placed on multiple-joint exercises, especially those involving the total body. For local muscular endurance training, it is recommended that light to moderate loads (40 -60% of 1 RM) be performed for high repetitions (Ͼ 15) using short rest periods (Ͻ 90 s). In the interpretation of this position stand, as with prior ones, the recommendations should be viewed in context of the individual's target goals, physical capacity, and training status.

- by Carol Garber
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- Management, Sports Medicine, Technology, Health Behavior

The list of prohibited substances in sports includes a group of masking agents that are forbidden in both in- and out-of-competition doping tests. This group consists of a series of compounds that are misused in sports to mask the administration of other doping agents, and includes: diuretics, used to reduce the concentration in urine of other doping agents either by increasing the urine volume or by reducing the excretion of basic doping agents by increasing the urinary pH; probenecid, used to reduce the concentration in urine of acidic compounds, such as glucuronoconjugates of some doping agents; 5alpha-reductase inhibitors, used to reduce the formation of 5alpha-reduced metabolites of anabolic androgenic steroids; plasma expanders, used to maintain the plasma volume after misuse of erythropoietin or red blood cells concentrates; and epitestosterone, used to mask the detection of the administration of testosterone. Diuretics may be also misused to achieve acute weight loss before ...

- by Rosa Ventura
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- Mass Spectrometry, Doping, Masking, Erythropoietin

R ÉSUMÉ : Sport, dopage et addictions. Délimitations conceptuelles et approche épidémiologique à partir des données de la littérature. Contexte. -La prise de connaissance récente par le public et le milieu médical non-sportif de l'importance des pratiques de dopages chez certains sportifs a fait évoquer que ceux-ci puissent être, en fait, dans une situation de dépendance. La pratique du sport pourrait, elle-même, être une pratique addictive ? Objectif. -L'objectif principal était de répondre à la question : le dopage sportif relève-t-il d'une pratique addictive ? Méthodologie. -Dans une première partie nous présentons et discutons les définitions du dopage et les critères diagnostiques de dépendance à une substance psychoactive tels qu'ils font actuellement consensus, et leurs facteurs de vulnérabilité éventuellement communs. Dans une deuxième partie, nous examinons les données épidémiologiques de la littérature suivant trois approches : a) études épidémiologiques sur la consommation de substances chez les adolescents et jeunes adultes sportifs et non-sportifs ; b) études de la prévalence de la dépendance aux substances dopantes chez les sportifs usagers de substances dopantes ; c) étude des antécédents de pratiques sportives des sujets dépendants en traitement. Résultats. -La consommation de substance visant à améliorer la performance est une réalité préoccupante chez les adolescents car elle est associée à des prises de risque pour la santé (échange et partage de seringues), et paraît être en augmentation. Les taux ne sont pas négligeables, et si les sportifs, notamment ceux évoluant en compétition, sont les plus concernés (20 % selon certains auteurs), l'usage de substances telles que les stéroïdes ana-Correpondance et tirés à part : M. A URIACOMBE , Service du Pr.

- by Marc Auriacombe
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- Adolescent, France, Child, Risk factors

Rogerson, S., R.P. Weatherby, G.B. Deakin, R.A. Meir, R.A. Coutts, S. Zhou, and S.M. Marshall-Gradisnik. The effect of short-term use of testosterone enanthate on muscular strength and power in healthy young men. J. Strength Cond. Res. 21 : 354-361. 2007.-Use of testosterone enanthate has been shown to significantly increase strength within 6-12 weeks of administration (2, 9), however, it is unclear if the ergogenic benefits are evident in less than 6 weeks. Testosterone enanthate is classified as a prohibited substance by the World Anti-Doping Agency (WADA) and its use may be detected by way of the urinary testosterone/epitestosterone (T/E) ratio (16). The two objectives of this study were to establish (a) if injection of 3.5 mg·kg Ϫ1 testosterone enanthate once per week could increase muscular strength and cycle sprint performance in 3-6 weeks; and (b) if the WADA-imposed urinary T/E ratio of 4:1 could identify all subjects being administered 3.5 mg·kg Ϫ1 testosterone enanthate. Sixteen healthy young men were match-paired and were assigned randomly in a double-blind manner to either a testosterone enanthate or a placebo group. All subjects performed a structured heavy resistance training program while receiving either testosterone enanthate (3.5 mg·kg Ϫ1 ) or saline injections once weekly for 6 weeks. One repetition maximum (1RM) strength measures and 10-second cycle sprint performance were monitored at the pre (week 0), mid (week 3), and post (week 6) time points. Body mass and the urinary T/E ratio were measured at the pre (week 0) and post (week 6) time points. When compared with baseline (pre), 1RM bench press strength and total work during the cycle sprint increased significantly at week 3 (p Ͻ 0.01) and week 6 (p Ͻ 0.01) in the testosterone enanthate group, but not in the placebo group. Body mass at week 6 was significantly greater than at baseline in the testosterone enanthate group (p Ͻ 0.01), but not in the placebo group. Despite the clear ergogenic effects of testosterone enanthate in as little as 3 weeks, 4 of the 9 subjects in the testosterone enanthate group (ϳ44%) did not test positive to testosterone under current WADA urinary T/E ratio criteria.

- by Rudi Meir and +2
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- Strength & Conditioning, Skeletal muscle biology, Muscle strength, Testosterone

This review summarises the physiological and pharmacological effects of the anabolic steroids used to enhance performance in sports. The anabolic steroids promote muscle growth and protein synthesis. Side-effects of anabolic steroids include cardiomyopathy, atherosclerosis, hypercoagulopathy, hepatic dysfunction, and psychiatric and behavioural disturbances. It is therefore appropriate that the anaesthetist be familiar with the abuse of anabolic steroids, their potential adverse effects, and the peri-operative risk associated with the use of these drugs.

- by Peter Kam
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- Drug interactions, Anaesthesia, Anesthesia, Clinical Sciences

- by Jordi Segura
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- Mass Spectrometry, Doping, Masking, Erythropoietin
- by John W Stiller
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- Mechanical Engineering, Sports Medicine, Sports, Melatonin
- by Martial Saugy
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- Forensic Science, Mass Spectrometry, Multidisciplinary, Sample Preparation
- by Geoffrey Verrall and +1
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- Engineering, Sports Medicine, Education, Skeletal muscle biology

The misuse of medicines for performance enhancement in sport (doping) is not approved by regulatory agencies, and is illegal in many countries. In addition to the 'traditional' doping agents such as steroids, β-blockers and blood transfusions, the list of agents and techniques used in doping is increasing and now includes newer medicines such as erythropoiesis-stimulating agents and growth hormones. Innovative new medicines are of particular interest as would-be dopers may believe them to be undetectable by current methods. Close collaboration between the biopharmaceutical industry and anti-doping agencies such as the World Anti-Doping Agency is critical to a successful anti-doping strategy. Industry is ideally placed to identify the doping potential of new medicines at early stages and to support early development of detection assays. A strong, united front between the biopharmaceutical industry and anti-doping agencies is essential to counter the misuse of medicines for pe...

- by Steve Elliott
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- Bioanalysis, Government Agencies, Drug Industry, Performance Enhancing Substances