Effects of erythropoietin administration in training athletes and possible indirect detection in doping control / M. Audran, R. Gareau, S. Matecki, F. Durand, C. Chenard, M.T. Sicart, B. Marion, F. Bressolle. - (Medicine & Science in Sports & Exercise 31 (1999) 5 (May); p. 639-645)

• PMID: 10331881
• DOI: 10.1097/00005768-199905000-00003

Abstract

Purpose: This study investigated the effects of repeated subcutaneous injection of rHuEpo (50 IU x kg(-1)) in athletes and proposes a method based on the measurement in blood samples of the sTfR/serum protein ratio to determine if the observed values of this marker are related to rHuEpo abuse.

Methods: Serum erythropoietin concentrations, and hematological and biochemical parameters were evaluated, during treatment and for 25 d posttreatment in nine training athletes. Moreover, the effect of rHuEpo administrations on the maximum oxygen uptake (VO2max) and ventilatory threshold (VT) of these athletes was also studied. Threshold values for sTfr and the sTfr/serum protein ratio were determined from 233 subjects (185 athletes, 15 athletes training at moderately high altitude, and 33 subjects living at >3000 m).

Results: Significant changes in reticulocytes, hemoglobin (Hb) concentration, hematocrit (Hct), sTfr, and sTfr/serum proteins were observed during and after rHuEpo treatment. The maximal heart rate of 177 beats x min(-1) at the beginning of the study was significantly higher than the value of 168 beats x min(-1) after 26 d of rHuEpo administration. Compared with the values measured at baseline, the VT measured after rHuEpo administration occurred at a statistically significant high level of oxygen uptake.

Conclusions: When oxygen uptake measured at the VT was expressed as a percentage of V02 max, the values obtained were also significantly higher. The increased values of Tfr and sTfr/serum proteins, respectively, above 10 microg x mL(-1) and 153, indicated the probable intake of rHuEpo.

Perceptions Of Benefits and Losses Associated With The Use and Discontinuance Of Anabolic-Androgenic Steroids Among Male Bodybuilders / Olrich, Tracy W. - (Journal of Personal and Interpersonal 4 (1999) 3; p. 231-242)

• DOI: 10.1080/10811449908409732

Abstract

Research has shown the mesomorphic physique to be the most preferred body type among males. Specifically, the hypermesomorphic physique, which displays extreme muscularity and definition, is the most desired (Tucker, 1983). Mishkind, Rodin, Silberstein, and Streigel-Moore (1987) concluded that multiple reasons exist for this preference, most notably the intimate ties that exist among societal conceptions of masculinity, the male sex role, and the mesomorphic physique. Bodybuilding has been perceived as an avenue by which males attempt to develop the preferred mesomorphic physique, and, at times, anabolic-androgenic steroids (AAS) have been ingested as a means for further development. This study entailed in-depth interviews with 10 male bodybuilders, all of whom had taken, or were currently taking, AAS. This article presents the findings of the interviews concerning the perceived benefits of and psychological dependency on AAS. The data, particularly responses concerning psychological dependency, are noted within Mishkind et al.'s framework as a mechanism to avoid loss of muscle strength, muscle mass, and masculinity.

TAS 98/203 Union Cycliste Internationale (UCI) / F. & Federazione Ciclistica Italiana (FCI)

• Cycling
• Doping (testosterone and metenolone)
• Double infringement

1.) When an athlete tested positive for the same substance or method several times in a short period of time and it is decided that these positive test results are caused by one anti-doping violation, these cases will be joined into one imposed sanction and into one imposed fine. On the other hand, when the athlete tested positive for two different substances and that these positive tests are the result from different doping acts, there is a double infringement. In both cases disqualification will be applied on all competition events where the athlete tested positive.

2.) The CAS summary proceedings is a guarantee of double degree of jurisdiction. Therefore, and provided that there is a domestic legal remedy in de legislation of the country in question, the UCI considers that CAS is the only court of appeal.

In August 1997 the International Cycling Union (UCI) reported an anti-doping rule violation against the Italian Athlete F. after his 2 samples provided at the Tour of Switzerland in June 1997 tested positive for the prohibited substances metenolone and testosterone with a T/E ratio above the threshold.

Also in October 1997 the UCI reported a second anti-doping rule violation against the Athlete after his sample provided at the Tour of Poland in September 1997 tested positive for methyltestosterone.

On 12 January 1998 the Italian Cycling Federation, Federazione Ciclistica Italiana (FCI), decided to impose a 6 month period of ineligibility and a CHF 2.000,- fine on the Athlete including 50 points loss.

On 8 April 1998 the FCI decided for the Athlete’s second violation to impose an additional 1 year period of ineligibility and a CHF 4.000,- fine including including 75 points loss. Here the Athlete admitted that he had used doping during the Tour of Switzerland but denied the use of doping during the Tour of Poland.

The Athlete appealed the FCI decision of 8 April 1998 and on 16 May 1998 the FCI Appeal Commission concluded that no double infringement occurred and decided to set aside the challenged sanctions and to impose on the Athlete a 8 month period of ineligibility and a CHF 3.500,- fine including 70 points loss.

Hereafter the UCI appealed the FCI Appeal Commission decision of 16 May 1998 with the Court of Arbitration for Sport (CAS). The UCI requested the Panel to set aside the decision of the FCI decision and to uphold the FCI decisions of 12 January and 8 April 1998.

Considering the evidence and statements in this case the Panel concludes that the Athlete has committed two anti-doping violations for the use of the substances testosterone and metenolone during the 1997 Tour of Switzerland and for methyltestosterone during the 1997 Tour of Poland.

Therefore the Court of Arbitration for Sport decides on 20 November 1998:

• To set aside the decision of the FCI Appeal Commission of 16 May 1998;
• To uphold the FCI decision of 12 January 1998 (1997 Tour of Switzersland);
• To disqualify the Athlete’s results obtained at the 1997 Tour of Poland;
• To impose a 1 year period of ineligibility, including 5 months as suspended sanction, for the Athlete’s second violation (1997 Tour of Poland); and
• CHF 4.000,- fine.

A case of anabolic steroid abuse / John H. Porcerelli, Bruce A. Sandler. - (Psychiatric Clinics of North America 21 (1998) 4 (1 December); p. 829-833)

Abstract

This case report is of a young man who developed significant psychiatric symptomatology, which warranted brief hospitalization, as a result of anabolic-androgenic steroid abuse. His symptoms included hostility, agitation, and homicidal and paranoid thinking. The initiation of steroid use was motivated by efforts to master an adult trauma (being shot with a shotgun). Individual (outpatient) psychotherapy helped the patient to understand his fears and to discover and work through the meanings that the shooting and injuries had for him. Cessation of steroid use eliminated his presenting symptoms. However, the major depressive symptoms, indicative of steroid dependence, developed and were treated successfully on an outpatient basis with antidepressant medication.

Anabolic-androgenic steroid abuse and psychopathology / John H. Porcerelli, Bruce A. Sandler. - (Psychiatric Clinics of North America 21 (1998) 4 (1 December); p. 829-833)

• PMID: 9890124
• DOI: 10.1016/s0193-953x(05)70043-5

Abstract

Anabolic steroid abuse is a significant public health problem. There is evidence from both case reports and empirical studies that abuse of these drugs causes significant psychiatric and medical effects. There appears to be a relationship between increased dosages and severity of psychiatric symptomatology. Research is needed on the role of pathologic personality traits in the initiation and maintenance of anabolic steroid abuse.

CAS A9/98 Australian Olympic Committee (AOC) vs. Sarah Rockell

In May 1998 the Australian Olympic Committee (AOC) has reported an anti-doping rule violation against the minor cyclist (14) Sarah Rockell after her A and B samples tested positive for the prohibited substance pseudoephedrine in a concentration above the threshold. After notification the Athlete filed a statement in her defence and she was heard for the Court of Arbitration (CAS) Oceania Division.

The Athlete accepted the test results and denied the intentional use of the substance. She explained that she suffered from exercise induced asthma and that she used Demazin recommended by the family doctor. Also when the minor Athlete was selected for Doping Control her father as her coach was not notified while he was on site and could have been notified at any time.

She and her father testified that at the time of the test Demazin was used and that they were not aware that Demazin was prohibited. They had never received the banned substance list from the Australian Sports Drug Agency (ASDA) or from their Cycling Federations, nor did they receive any anti-doping advice.

The Sole Arbitrator accepts the Athlete’s explanation and establish that extenuating circumstances exist for a reduced sanction. The Arbitrator concludes that the Athlete clearly didn’t know that she had used a prohibited substance and that she acted reasonably in all the circumstances.
Further the Arbitrator establish that the Doping Control was not conducted in accordance with the Rules as the minor Athlete’s father was not notified about the sample collection while on site.

Considering the circumstances in this case the Arbitrator decides on 22 December 1998 that the Athlete should not be sanctioned for the reported anti-doping rule violation.
In addition recommendations were made to sporting organisations to ensure that they have anti-doping policies and anti-doping education programmes provided to athletes.

CAS 98/208 N., J., Y., W. / Fédération Internationale de Natation (FINA)

• Swimming
• Doping (Triamterene)
• (Non-) discrimination
• Burden of proof
• Strict liability

1. The burden of proof lay upon FINA to establish that an offence had been committed. This flows from the language of the doping control provisions as well as general principles of Swiss Law. The presumption of innocence operates in the athlete’s favour until FINA discharged that burden. The standard of proof required of FINA is high: less than criminal standard, but more than the ordinary civil standard.

2. It is the presence of a prohibited substance in a competitor's bodily fluid which constitutes the offence under the FINA rules, irrespective of whether or not the competitor intended to ingest the prohibited substance.

3. If the presence of a prohibited substance is established to the high degree of satisfaction required by the seriousness of the allegation, then the burden of proof shifts to the competitor to show why the maximum sanction should not be imposed. It is only at the level of sanction, not of finding of innocence or guilt, that the concept of shifting burden becomes relevant at all. And it is only at this juncture that questions of intent become relevant.

In January 1998 the International Swimming Federation (FINA) has reported anti-doping rule violations against the four Chinese Athlete’s N., J. Y. and W after their A and B samples tested positive for the prohibited substance triamterene.

Consequently and on 24 July 1998 the FINA Doping Panel decided to impose a 2 year period of ineligibility on the four Athletes. Hereafter in August 1998 the Athletes appealed the FINA decision of 24 July 1998 with the Court of Aribitration for Sport (CAS).

The CAS Panel finds that there was no evidence that ingestion of six tablets a day (paying all due regard to the contention that Actovegin tablets are not chemically formulated and can vary from tablet to tablet) since 22 December 1997 (the Athletes unchallenged evidence as to their own consumption) would produce the results shown in the “A” and “B” samples. The Athletes accordingly failed to discharge the burden that lies upon them.

In reaching the conclusion that the offence was committed, and that the Athletes had not discharged the burden which lay upon them to mitigate the maximum sanction of two years, the Panel have borne in mind that all the swimmers have denied on affidavit that they took Triamterene. The Panel has treated that evidence as if it had been given on oath. However, it is regrettable that the currency of such denial is devalued by the fact that it is the common coin of the guilty as well as of the innocent.

The Court of Arbitration for Sport decides on 22 December 1998:

1.) The appeal filed by the Athletes N., J., Y., W. on 18 August 1998 is dismissed.

2.) The decision issued by the FINA Doping Panel on 24 July 1998 is confirmed.

(...)

Growth Hormone Secretagogues : Physiological Role and Clinical Utility / Felipe F. Casanueva, Carlos Dieguez

• Trends in Endocrinology & Metabolism 10 (1999) 1 (1 January), p. 30-38
• PMID: 10322392
• DOI: 10.1016/s1043-2760(98)00116-7

Abstract

Growth hormone secretagogues (GHSs) are artificial compounds developed to release GH in vitro. GHSs mimic an unknown endogenous factor that activates the GHS receptor in the pituitary and the hypothalamus. With the cloning of the human GHS receptor it has been demonstrated that GHS is a new physiological system that regulates GH secretion along with growth hormone-releasing factor (GHRH) and somatostatin. GHSs administered alone or in combination with GHRH are the most potent and reproducible GH releasers, and are useful tools for the diagnosis of GH deficiency when tested in a variety of pathological conditions, both in children and in adults. As therapeutic agents, they show clinical effectiveness in enhancing GH release after short-term treatment.

Does growth hormone therapy in conjunction with resistance exercise increase muscle force production and muscle mass in men and women aged 60 years or older? / J.J. Zachwieja, K.E. Yarasheski. -  (Physical Therapy & Rehabilitation Journal 79 (1999) 1 (1 January); p. 76-82)

• PMID: 9920193
• DOI: 10.1093/ptj/79.1.76

Abstract

Improved muscle protein mass and increments in maximum voluntary muscle force have rarely been observed in men and women aged 60 years and older who were treated with rhGH. Although rhGH administration has been reported to increase lean body mass in older men and women, it is doubtful that this increase is localized to skeletal muscle contractile proteins. When rhGH administration was combined with 16 weeks of resistance exercises, increases in muscle mass, muscle protein synthesis, and muscle force were not greater in the rhGH-treated group than in a weight training group that received placebo injections. Side effects of rhGH treatment in elderly people are prevalent, not trivial, and further limit its usefulness as an effective anabolic agent for promoting muscle protein accretion in men and women. In particular, the induction of insulin resistance and carpal tunnel compression reduces the efficacy of rhGH replacement therapy in elderly individuals. The evidence for a GH-induced increase in human skeletal muscle protein and maximum voluntary muscle force is weak. The optimum dose and GH-replacement paradigm (GHRH, GH-secretagogues) have not been identified. Whether rhGH therapy improves muscle protein mass and force in individuals with severe cachexia associated with major trauma, burns, surgery, or muscular dystrophy is controversial and under investigation.

Enquête onder topsporters over doping, dopingcontroles en medicijngebruik in de sport : evaluatie van de kennis en houding van topsporters over doping, dopingcontroles en medicijngebruik in de sport, alsmede hun oordeel over het voorlichtingsprogramma hieromtrent / S. de Groot, F. Hartgens, M.F. Zweers. – Rotterdam : Nederlands Centrum voor Dopingvraagstukken (NeCeDo), 1999. – 40 p. : fig.. – (NeCeDo praktijkpublikaties). – Uitg. in samenw. met Nationaal Olympisch Comité*Nationale Sport Federatie (NOC*NSF)
Met lit. opg. – Met samenvatting in het Engels
ISSN 1383-6730 ; 2

Het doel van deze enquete was voor het Nederlands Centrum voor Dopingvraagstukken (NeCeDo) tweeledig. Ten eerste was de enquete bedoeld om inzicht te krijgen in de huidige kennis en houding van topsporters over doping, dopingcontroles en medicijngebruik in de'sport. Ten tweede wilde het NeCeDo evalueren welke mening de topsporters over het voorlichtingsprogramma omtrent doping hebben, hoe de naamsbekendheid van het NeCeDo is en hoe de topsporters de dopingwaaier beoordelen.

Inhoud:
1. Samenvatting
2. Summary
3. Inleiding
4. Methoden
5. Resultaten
6. Discussie
7. Conclusie
8. Aanbevelingen

Summary:

Aim of the study:
For this study two main goals were set. Firstly, the study was performed to determine the knowledge and attitude of elite athletes about doping, doping tests and drug use. In the second place this investigation was pointed towards the opinion of the elite athletes regarding the education program of doping. Therefore, the following questions were formulated: a) How do elite athletes evaluate the doping education program? b) Are the elite athletes familiar with the Netherlands Centre for Doping Affairs (NeCeDo) and the doping guide and how do they assess this guide? c) Which groups (e.g. age, level of sport) need extra education concerning doping?

Methods:
The study was performed by means of a questionnaire. A total number of 1332 elite athletes, registered in the files of the Dutch Olympic Committee (NOC*NSF), received a questionnaire.

Results:
Subjects: A response rate of 44.7% was obtained. Most of the subjects were aged between 18 and 25 years (56.8%). The cooperating elite athletes performed their sport mainly at the A- (40.2%) or B2- level (44.8%). The majority of the respondents was supported by a national coach (59.8%), the individual/club trainer (55.5%), the individual/club coach (54.6%), the parents (44.5%) and a physical therapist (44.0%). A great part of the respondents (53.2%) had never experienced a doping test.
Knowledge: 69.7% of the respondents did not know that, even if the athlete doesn't agree with the doping test, he or she always has to sign the doping test form. 21.2% of the athletes were not aware that a refusal of a doping test may lead to a ban of the athlete. A majority did not know that dietary supplements (37.5%), cough mixture (19.2%), natural food products (41.4%) and drugs on doctors prescription (27.9%)
may contain substances of doping.
Attitude: Sixteen subjects (2.7%) admitted to have used a doping substance in the past. Nineteen respondents (3.2%) admitted to consider the use of performance enhancing drugs. One third of the respondents did not examine their own drugs with respect to doping regulations. A vast majority of the respondents (87.2%) indicated that there were no pressures present to use performance-enhancing drugs. In addition, a large majority (72.4%) indicated that there was no pressure concerning not using doping in the Netherlands. Most elite athletes advocated an increase in the number of doping tests (54.5%), of out-of-competition doping tests (46.2%) and of doping tests during important competitions (68.3%). To the opinion of, most respondents (67,9%) the punishments after a positive test result had to be more severe.
Education: Most elite athletes had received information of doping, doping tests and drug use from the NOC*NSF (51.3%), the national sport association (36.6%) and the NeCeDo (33.8%). The respondents were not well informed about the doping rules in the sport (52.1%), the procedure of doping tests (49.7%), use of drugs (64.2%) and about dietary supplements (74.2%). The youngest athletes (younger than 18 years) admitted to feel informed badly. For information about doping related subjects, the majority consulted to the doctor of their national team (44.2%). Older athletes (31 years and older) consulted their general practitioner about doping more frequently. The elite athletes appreciated to receive more information about doping regularly.
NeCeDo/Doping guide: Half of the respondents had never heard of the NeCeDo before they received the questionnaire. Those who knew the NeCeDo before, were made familiar by the NOC*NSF (75.1%). A majority of the athletes (53.4%) did not know how to contact the NeCeDo. Almost 55% of the respondents were familiar with the NeCeDo doping guide in a fan-shaped formation. 84% of them had received this doping guide, mainly via the NOC*NSF. Three quarter of the cooperating athletes was satisfied with the quality of the doping guide. Again the youngest athletes were less familiar with the NeCeDo and the doping guide.

Conclusions:
Overall, it can be concluded that the general knowledge of elite athletes concerning doping is not optimal and needs to be improved. Most of the athletes supported the idea of a more severe doping policy regarding the number of doping tests and penalties. Not all the respondents felt well informed about doping. Certain items, like dietary supplements and the use of drugs, need more attention. The NeCeDo was not very well known in the group of athletes. Not everybody knew how to contact the NeCeDo. The doping guide was evaluated rather well although several topics should be added or extended. Especially, the youngest group of elite athletes (below 18 years) requires more education.

Recommendations:
To increase the response rate of the survey it will be better to send the questionnaire to the elite athletes in the months November/December. Those months are quieter concerning competition or tournaments.
A great part of the athletes supported a more severe doping policy. The NOC*NSF and Dutch government have started a more sever doping policy. The youngest athletes (younger than 18) and the athletes of the lowest sport category are not well informed. Those groups need more information about doping. This might be realized by informing these groups about doping as soon as they receive their official B/C license of the NOC*NSF. An important way to inform the athletes seems to be via the sports associations (e.g. the associations magazine), at training hours and tournaments. Up to date information can be provided by a newsletter for the athletes supported by the NOC*NSF. The education program has to be objective and practical. The NeCeDo doping guide in a fan-shaped form provides a lot of information. According to the respondents the guide has to contain up to date information. This may be realized by releasing a new edition every year or by releasing some pages with the latest developments, which can be added to the doping guide. The terminology should be simple and unequivocal. Because the athletes would like to receive a lot of information about doping and the fan-shaped doping guide should stay handy-sized, it might be an interesting idea to release a more detailed book besides the doping guide. Furthermore, a number of athletes indicated interest in improving their knowledge about doping by means of a symposium or course. The education program should also be directed towards coaches, doctors et cetera.
Most of the athletes will first contact these persons with questions about doping. The NeCeDo is not very well known by the athletes. Therefore, the name and address of the NeCeDo should be written more prominent on the distributed information.