Pitch-side Acute Severe Pain Management Decisions in European Elite football

16 Aug 2021

Pitch-side Acute Severe Pain Management Decisions in European Elite football / Maeve Claire Doheny, Gerard Bury. - (International Journal of Sports Medicine (2021) 9 (16 August))

  • PMID: 34399429
  • DOI: 10.1055/a-1588-7931


Abstract

This is the first study on acute severe pain management involving sport and exercise medicine Doctors who are leaders in football medicine in their respective countries. An online survey was designed describing the management of acute severe pain in this expert cohort. The survey captured participant sex, age, years working in sports medicine, core specialty and use of clinical practice guidelines (CPGs). Finally, three clinical vignettes exploring the management of acute pain were presented. Forty-four senior team doctors across 55 European countries completed the survey. There were no consistent guidelines proposed, with 33 (75%) participants indicating they did not use any. Methoxyflurane was proposed by 14 (32%) and 13 (30%) participants for female anterior cruciate ligament rupture and male ankle fracture, respectively. Strong opioids were not used in 17 (39%) and 6 (14%) participants regarding female cruciate injuries and male fractures, respectively. Despite 75% of participants having paediatric life support training, eight (18%) participants expressed uncertainty administering medications in this population, and 15 (34%) would avoid using strong opioids altogether. There is a tendency to undertreat pain and avoid strong opioids for reasons including lack of monitoring equipment, anti-doping concerns and lack of comfort treating paediatric patients with opioids.

Proof of Gene Doping in a Mouse Model with a Human Erythropoietin Gene Transferred Using an Adenoviral Vector

16 Aug 2021

Proof of Gene Doping in a Mouse Model with a Human Erythropoietin Gene Transferred Using an Adenoviral Vector / Takehito Sugasawa, Takuro Nakano, Shin-Ichiro Fujita, Yuki Matsumoto, Genki Ishihara, Kai Aoki, Koki Yanazawa, Seiko Ono, Shinsuke Tamai, Lev Manevich, Haruna Ueda, Noriyo Ishibashi, Kenshirou Tamai, Yasuharu Kanki, Yasuko Yoshida, Koichi Watanabe, Tohru Takemasa, Yasushi Kawakami, Kazuhiro Takekoshi. - (Genes 12 (2021) 8 (16 August); 1249)

  • PMID: 34440425
  • PMCID: PMC8392868
  • DOI: 10.3390/genes12081249


Abstract

Despite the World Anti-Doping Agency (WADA) ban on gene doping in the context of advancements in gene therapy, the risk of EPO gene-based doping among athletes is still present. To address this and similar risks, gene-doping tests are being developed in doping control laboratories worldwide. In this regard, the present study was performed with two objectives: to develop a robust gene-doping mouse model with the human EPO gene (hEPO) transferred using recombinant adenovirus (rAdV) as a vector and to develop a detection method to identify gene doping by using this model. The rAdV including the hEPO gene was injected intravenously to transfer the gene to the liver. After injection, the mice showed significantly increased whole-blood red blood cell counts and increased expression of hematopoietic marker genes in the spleen, indicating successful development of the gene-doping model. Next, direct and potentially indirect proof of gene doping were evaluated in whole-blood DNA and RNA by using a quantitative PCR assay and RNA sequencing. Proof of doping could be detected in DNA and RNA samples from one drop of whole blood for approximately a month; furthermore, the overall RNA expression profiles showed significant changes, allowing advanced detection of hEPO gene doping.

Testosterone, identity and the body: Exploring cultural definitions of disorder

17 Aug 2021

Testosterone, identity and the body : Exploring cultural definitions of disorder / Kyle J.D. Mulrooney, Rick Collins, Jack Darkes. - (International Journal of Drug Policy 95 (2021) September; 103366)

  • PMID: 34412937
  • DOI: 10.1016/j.drugpo.2021.103366


Abstract

Medically-sanctioned testosterone administration has seen increasingly widespread application in the treatment of gender dysphoria (GD). Yet, by comparison, this approach is not medically accepted for those who are experiencing muscle dysmorphia (MD), a specifier of body dysmorphic disorder (BDD), despite both conditions reflecting incongruences between self-perception, identity and phenotype, and both currently being classified as mental health disorders. Rather, by stark contrast, those with MD are largely treated with psychological intervention to accept themselves as they physically are and the illicit use of testosterone for muscle-related body perception purposes is generally subject to criminal justice enforcement actions. In this commentary, we examine attempts to distinguish between the use of testosterone for gender-affirming hormone therapy in the case of GD and for aesthetic (muscle enhancement) use in the case of MD, as well as explore the implications of this disparity. Moreover, we consider how such disparity in policy and practice may be understood, in part, as an example of a bias reflecting the selective pathologizing of anabolic-androgenic steroid (AAS) use, socio-cultural evolutions in gender identity and expression and, more broadly, the manner in which culture defines disorder and its appropriate response.

Me, myself, and my muscles: associations between narcissism and muscle dysmorphia

17 Aug 2021

Me, myself, and my muscles: associations between narcissism and muscle dysmorphia / Matt W. Boulter, Sebastian S. Sandgren. - (Eating Disorders (2021) 17 August; p. 1-7)

  • PMID: 34402405
  • DOI: 10.1080/10640266.2021.1930348


Abstact

The conceptualisation and measurement of the associations between narcissism and muscle dysmorphia (MD) are poorly understood in the literature. It is recognised that narcissism features two broad dimensions: vulnerable and grandiose. Studying both narcissism dimensions is important given their differences in etiology and health-related outcomes. Therefore, the aim of this study was to investigate the associations between MD, vulnerable and grandiose narcissism. A total of 336 participants (48% male; Mage = 26.4 years) completed measures of MD and narcissism. Hierarchical regression analysis revealed that vulnerable narcissism was significantly, positively associated with MD, whilst grandiose narcissism was not. Practitioners should be aware that vulnerable narcissism may be a potential risk factor of MD.

World Athletics 2021 WA vs Racheal Mutgaa

17 Aug 2021

In August 2021 the Athletics Integrity Unit (AIU) of World Athletics has reported an an anti-doping rule violation against the Kenyan Athlete Racheal Mutgaa after her sample tested positive for the prohibited substances 3α-hydroxy-5α-androstan-17-one (androsterone), 5β-androstane-3α,17β-diol and Testosterone.

After notification the Athlete gave a prompt admission, waived her right for a hearing, accepted a provisional suspension and the sanction proposed by AIU. 

Therefore the AIU decides on 17 August 2021 to impose a 3 year period of ineligibility on the Athlete starting on the date of the provisional suspension, i.e. on 3 August 2021.

World Athletics 2021 WA vs Yousef Karam

18 Aug 2021

In March 2021 the Athletics Integrity Unit (AIU) of World Athletics has reported an an anti-doping rule violation against the Kuwaiti Athlete Yousef Karam after his sample tested positive for the prohibited substance Ibutamoren.

After notification the Athlete gave a prompt admission, waived his right for a hearing, accepted a provisional suspension and the sanction proposed by AIU. 

Therefore the AIU decides on 18 August 2021 to impose a 3 year period of ineligibility on the Athlete starting on the date of the provisional suspension, i.e. on 30 March 2021.

BHA 2021 BHA vs Joe Colliver

19 Aug 2021

In April 2021 the British Horseracing Authority (BHA) reported that the Jockey Joe Colliver had tested positive for the prohibited substance Cocaine.

After notification a provisional suspension was ordered. The Jockey admitted the violation ans he was heard for the BHA Judicial Panel.

The BHA Judicial Panel decides on 19 August 2021 to impose a suspension of the Jockey's license for 6 months.

Controlled Administration of Dehydrochloromethyltestosterone in Humans: Urinary Excretion and Long-Term Detection of Metabolites for Anti-Doping Purpose

19 Aug 2021

Controlled Administration of Dehydrochloromethyltestosterone in Humans: Urinary Excretion and Long-Term Detection of Metabolites for Anti-Doping Purpose / Steffen Loke, Xavier de la Torre, Michele Iannone, Giuseppe La Piana, Nils Schlörer, Francesco Botrè, Matthias Bureik, Maria Kristina Parr. - (The Journal of Steroid Biochemistry and Molecular Biology (2021) 19 August; 105978)

  • PMID: 34418529
  • DOI: 10.1016/j.jsbmb.2021.105978


Abstract

Dehydrochloromethyltestosterone (DHCMT) is an anabolic-androgenic steroid that was developed by Jenapharm in the 1960s and was marketed as Oral Turinabol®. It is prohibited in sports at all times; nevertheless, there are several findings by anti-doping laboratories every year. New long-term metabolites have been proposed in 2011/12, which resulted in adverse analytical findings in retests of the Olympic games of 2008 and 2012. However, no controlled administration trial monitoring these long-term metabolites was reported until now. In this study, DHCMT (5 mg, p.o.) was administered to five healthy male volunteers and their urine samples were collected for a total of 60 days. The unconjugated and the glucuronidated fraction were analyzed separately by gas chromatography coupled to tandem mass spectrometry. The formation of the described long-term metabolites was verified, and their excretion monitored in detail. Due to interindividual differences there were several varieties in the excretion profiles among the volunteers. The metabolite M3, which has a fully reduced A-ring and modified D-ring structure, was identified by comparison with reference material as 4α-chloro-17β-hydroxymethyl-17α-methyl-18-nor-5α-androstan-13-en-3α-ol. It was found to be suitable as long-term marker for the intake of DHCMT in four of the volunteers. In one of the volunteers, it was detectable for 45 days after single oral dose administration. However, in two of the volunteers M5 (already published as long-term metabolite in the 1990s) showed longer detection windows. In one volunteer M3 was undetectable but another metabolite, M2, was found as the longest detectable metabolite. The last sample clearly identified as positive was collected between 9.9 and 44.9 days. Furthermore, the metabolite epiM4 (partially reduced A-ring and a modified D-ring structure which is epimerized in position 17 compared to M3) was identified in the urine of all volunteers with the help of chemically synthesized reference as 4-chloro-17α-hydroxymethyl-17β-methyl-18-nor-androsta-4,13-dien-3β-ol. It may serve as additional confirmatory metabolite. It is highly recommended to screen for all known metabolites in both fractions, glucuronidated and unconjugated, to improve identification of cheating athletes. This study also offers some deeper insights into the metabolism of DHCMT and of 17α-methyl steroids in general.

World Rugby 2021 WR vs Luciano Daniel Torres

19 Aug 2021

In May 2021 World Rugby has reported an anti-doping rule violation against the Argentine rugby player Luciano Daniel Torres after his A and B samples tested positive for the prohibited substance 19-norandrosterone (Nandrolone).

After notification the Athlete gave a prompt admission, waived his right for a hearing, accepted a provisional suspension and the sanction proposed by World Rugby.

Because of the Athlete's early admission and acceptance of sanction World Rugby decides on 19 August 2021 to impose a reduced 3 year period of ineligibility on the Athlete, starting on the date of the provisional suspension, i.e. on 7 May 2021.

The accreditation of the anti-doping laboratory: science and politics in the fight against doping in sport

20 Aug 2021

O credenciamento do laboratório antidopagem : ciência e política na luta contra o doping no esporte = The accreditation of the anti-doping laboratory : science and politics in the fight against doping in sport =  La acreditación del laboratorio antidopaje : ciencia y política en la lucha contra el dopaje en el deporte / Daniel Giordani Vasques, Ekain Zubizarreta Zuzuarregi, Marco Paulo Stigger

  • Revista Brasileira de Ciências do Esporte 43 (202), e006321
  • DOI: 10.1590/rbce.43.e006321


RESUMO

A pesquisa social sobre doping e a luta contra ele cresceu nos últimos anos, porém sua distribuição é desigual. O objetivo é descrever como os interesses da WADA e do governo brasileiro para ter o laboratório preparado para os Jogos de 2016 afetaram a luta antidopagem. Adotamos procedimentos etnográficos para analisar a suspensão, descredenciamento e recredenciamento do LBCD (2013-2015). Com ajuda da sociologia pragmática, visualizaram-se associações e interesses dos atores. Especificamente, retratou-se como a WADA conseguiu pressionar o governo por meio do descredenciamento de 2013 e, a partir das ações e associações do governo, como ela foi flexível para recredenciar um laboratório em condições inadequadas, a fim de mantê-lo atuante para os Jogos de 2016.

ABSTRACT

Social research on doping and anti-doping has grown in recent years. However, its distribution is uneven. The objective is to study how WADA and Brazilian government for having an operational laboratory affected anti-doping. We adopted an ethnographic approach to describe the processes of suspension, revocation and re-accreditation of LBCD (2013-2015). Using pragmatic sociology concepts, it is possible to identify actors’ associations and interests. Specifically, the paper will show that WADA managed to pressure the government through the 2013 revocation – forcing it to act and to associate with other actors − but it was then flexible to re-accredit a laboratory in inadequate conditions, in order to have it operational for 2016 Games.

RESUMEN

La investigación social sobre antidopaje ha crecido en los últimos años, sin embargo, la repartición es desigual. El objetivo es describir cómo los intereses de AMA y del gobierno brasileño de tener un laboratorio para los JJOO de 2016 afectaron la lucha antidopaje. Adoptamos métodos etnográficos para analizar los procesos de suspensión, desacreditación y reacreditación del LBCD (2013-2015). Es posible identificar las asociaciones e intereses de los actores. Específicamente, se relata cómo AMA logró presionar al gobierno con la desacreditación y que, tras las acciones y asociaciones posteriores del gobierno, cómo fue flexible a la hora de volver a acreditar el laboratorio en condiciones inadecuadas, a fin de mantener el laboratorio operativo para los Juegos.

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