Reticulocytes in Sports Medicine: An Update / Giovanni Lombardi, Alessandra Colombini, Patrizia Lanteri, Giuseppe Banfi. – Advances in clinical chemistry 59 (2013) Chapter 5; p. 125–153)

• DOI: 10.1016/B978-0-12-405211-6.00005-X

Reticulocytes are young red blood cells which develop from erythroblasts and circulate in the bloodstream for about 1-4 days before maturing into erythrocytes. With the introduction of reticulocyte count in equations and statistical models for detecting suspected blood doping, its application to sports medicine has attracted growing interest in reticulocyte behavior during training and competition seasons in athletes and experimental blood doping treatment in healthy volunteers. An update on recent publications is therefore needed to improve the interpretation of reticulocyte analysis and its variability in sportsmen. Reticulocyte count constitutes a robust parameter during the preanalytical phase, but cell stability can be assured only if blood samples are kept at constantly cold temperatures (4 degrees C) and test results will differ depending on the blood analyzer system used. Marked intra individual variability is the principal finding to be evaluated when exercise-induced changes are observed or illicit procedures suspected. Furthermore, reticulocyte variability is greater than that of other hematological parameters such as hemoglobin or hematocrit. Ideally, any variation should be interpreted against long-term time series for the individual athlete: values obtained from large athlete cohorts ought to be used only for extrapolating outliers that deserve further examination. Reticulocyte distribution in athletes is similar to that found in the general population, and a gender effect in some sports disciplines or selected athlete groups may be seen. Reticulocyte variability is strongly influenced by seasonal factors linked to training and competition schedules and by the type of sports discipline. Published experimental data have confirmed the high sensitivity of reticulocyte analysis in identifying abnormal bone marrow stimulation by either erythropoietin administration or blood withdrawal and reinfusion.

The role of banned substance residue analysis in the control of dietary supplement contamination / Catherine Judkins, Philip Teale and David J. Hall . – In: Drug testing and analysis 2 (2010) vol. 9 (September), p. 417–420

The potential for contaminated dietary supplements to result in a failed doping test remains a concern for athletes, trainers, and sporting authorities despite improvements to regulatory guidelines. Previous surveys of readily available supplements confirm that many are contaminated with steroids and stimulants prohibited for use in elite sport. Suggested responses to this issue include the complete avoidance of all supplements. Many athletes, however, use nutritional supplements to achieve effective training and also to ensure that daily nutritional requirements are met (e.g. recommended levels of vitamins and minerals). This ensures that the use of supplements is and will remain the norm for a range of sports. As a result, an alternative approach of rigorous testing of materials destined for use by elite athletes has been introduced in several countries. While the testing of final product for banned substances may help mitigate the problem, it will not help to remove the underlying issue of contamination. In this article we describe an alternative approach that uses appropriate quality assurance procedures backed up by testing to remove sources of contamination. The decrease in the incidence of contamination amongst supplement companies adopting such a system is explained, and contrasted with the relatively high incidences of contamination found in products that are not part of a quality system. These findings are of key importance to both supplement manufacturers and those involved in advising athletes about supplement use.

Gezondheidsrisico's illegale doping via internet / Hans Wassink, Bart Coumans, Olivier de Hon. - Capelle a/d IJssel : Dopingautoriteit, 2010

Abstract:

Health Risks of Illegal Doping Trade over the Internet. In the Netherlands it is estimated that there are 160,000 doping users who take these substances particularly for cosmetic purposes, i.e. more muscle and less body fat. It is suspected that a significant proportion of these users purchase doping over the internet. The purpose of this research is to better understand the doping trade over the internet and the associated (additional) health and other risks.

An overview of research in the Netherlands on illegal doping trade over the internet was done. In addition, during the period November 2009 to February 2010 sites were reviewed in particular those selling anabolic steroids and human growth hormone. A selection of these websites was made followed by a qualitative analysis of the (additional) health risks based on the information and advices on these websites. Based on the research overview it can be concluded that it seems that the trade of illicit doping over the internet increases. There are some indications that these substances are more often counterfeited than the 'regular' doping trade. The most recent estimate indicates that approximately 30% of the doping buyers buy the substances over the internet. Internet plays a distinct role in information even when only looking for buying opportunities. Besides health risks, there are also financial and legal risks of buying these products over the internet.

The analysis of websites offering illegal doping brings various risks to the fore. Besides the fact that the use of doping already gives substantial health risks and that 50-60% of illegal doping is counterfeited, users run additional risks following the advices given. Large doses are almost standard advice to beginners, and on websites the tone of voice about doping use is frivolous and the information given is very unbalanced (risks are minimized; risk groups like minors and women are seldom specifically warned).

The findings from this research will be used in the prevention and education activities of the Anti-Doping Authority of the Netherlands mainly focused on athletes and fitness instructors in gyms. To better map trends, future prevalence studies should include doping trade over the internet. It is known that ordinary drug sales over the internet can vary considerably in quality. It is recommended that the quality and risks of the illicit doping trade over the internet should be monitored. Finally, cooperation and exchange with the national Health Campaign "The dangers of internet medication’ and the Trimbos Institute (centre on mental health and drug addiction) are recommended.

Facts
The Canadian Centre for Ethics in Sport (CCES) alleges Socholotiuk for a violation of the Canadian Anti-Doping Program (CADP). On March 31, 2010, at the specific request of the University of Waterloo, the Canadian Centre for Ethics in Sport (CCES) attended at the university campus to conduct out-of-competition drug testing on the entire football team. The athlete was tested as a player on the team and provided both a urine sample and a blood sample. His urine sample tested positive on testosterone and his bloods sample tested positive on the presence of recombinant Growth Hormone.

History
The Athlete replies in writing, regarding the testerone, that the substance he was using was not a banned substance. For the presence of recombinant Growth Hormone: the athlete replies in writing: the blood test for Human Growth Hormone is very unreliable. The athlete neither signed a waiver of hearing nor requested an arbitration hearing. It was not possible to get in touch with the athlete and he didn't attend the hearing.
On March 31, 2010, the CCES attended at the university campus and conducted drug tests on the entire football team at the request of the university’s administration. This unprecedented request was generated by criminal charges laid previously by local police against a member of the team for possession and trafficking in substances which also are banned in sport. The CCES tested 61 athletes and collected 61 urine samples and 20 blood samples. It is currently managing potential anti-doping rule violations involving 9 of these athletes. These 9 athletes do not include the two who were criminally charged, since the CCES has decided to postpone their consideration pending the conclusion of the criminal proceedings against them. The large number of athletes from the same team who tested positive is also unprecedented.

Decision
As stated in the decision issued on August 23, 2010, an anti-doping rule violation by the Athlete has been established. The sanction imposed is a period of ineligibility of three years commencing on June 4, 2010.

NIDA (National Institute of Drug Abuse)

Throughout much of the last century, scientists studying drug abuse labored in the shadows of powerful myths and misconceptions about the nature of addiction. When science began to study addictive behavior in the 1930s, people addicted to drugs were thought to be morally flawed and lacking in willpower. Those views shaped society’s responses to drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punitive rather than preventative and therapeutic actions. Today, thanks to science, our views and our responses to drug abuse have changed dramatically. Groundbreaking discoveries about the brain have revolutionized our understanding of drug addiction, enabling us to respond effectively to the problem.
As a result of scientific research, we know that addiction is a disease that affects both brain and behavior. We have identified many of the biological and environmental factors and are beginning to search for the genetic variations that contribute to the development and progression of the disease. Scientists use this knowledge to develop effective prevention and treatment approaches that reduce the toll drug abuse takes on individuals, families, and communities. Despite these advances, many people today do not understand why individuals become addicted to drugs or how drugs change the brain to foster compulsive drug abuse. This booklet aims to fill that knowledge gap by providing scientific information about the disease of drug addiction, including the many harmful consequences of drug abuse and the basic approaches that have been developed to prevent and treat the disease. At the National Institute on Drug Abuse (NIDA), we believe that increased understanding of the basics of addiction will empower people to make informed choices in their own lives, adopt science-based policies and programs that reduce drug abuse and addiction in their communities, and support scientific research that improves the Nation’s well-being.

Nora D. Volkow, M.D.
Director National Institute on Drug Abuse

NIH Pub No. 10-5605 Revised August 2010

Independent Observer Report : Tour de France 2010 / Independent Observer Team. - Montreal : World Anti-Doping Agency (WADA), 2010

CAS 2008/A/1458 UCI v. Vinokourov & KCF

Related case:

CAS 2008_A_1458 UCI vs Alexandere Vinokourov & KCF - Partial Award
July 23, 2009

• Cycling
• Doping (use of a prohibited method)
• Interpretation of the wording of a Commitment signed by the rider
• Payment of a contribution as a condition for the Rider’s reinstatement

1. An athlete who used a prohibited method in the form of an homologous blood transfusion has committed an anti-doping violation (blood doping).

2. The “Rider’s commitment”, signed by the athlete, does not establish the payment of a contribution as a condition for the athlete’s reinstatement. The payment of the contribution is “in addition” to the sanction and, hence, separate and independent of the regular sanction. Furthermore, the Commitment aims at the payment of a “contribution to the fight against doping” which is supposed to be payable to the Council for the Fight Against Doping. This wording differs considerably from terms such as “fine”, as used in the later UCI Anti Doping Rules which would have clearly indicated the meaning of a sanction or even a contractual penalty.

3. In the absence of a contractual condition for a Rider’s reinstatement, an extension of the sanction making the reinstatement dependant on the prior payment of a fine could be based exclusively on the set of rules which specifically govern anti-doping rule violations and their consequences. As long as the applicable regulations do not mention a payment whatsoever as a sanction or a precondition for the reinstatement of an athlete who had served a period of ineligibility, such extension of the sanction is not applicable.

In July 2007 the International Cycling Union (UCI) has reported an anti-doping rule violation against the Kazakh cyclist Alexander Vinokourov after his A and B blood samples tested positive for blood doping. On 5 December 2007 the Kazakh Cycling Federation (KCF) decided to impose a 1 year period of ineligibility on the Athlete.

Hereafter in December 2008 the UCI appealed the KCF decision with the Court of Arbitration for Sport (CAS). The UCI requested the Panel to set aside the Appealed Decision and to impose a 2 year period of ineligibility on the Athlete including payment for costs.

Previously in January 2008 the UCI had suspended this appeal because the Athlete had declared to end his career. However in September 2008 the Athlete announced his return to competition and thereupon UCI requested CAS to reactivate the proceedings against the Athlete.

In its Partial Award the Panel on 23 July 2009 concluded that the Athlete had committed the anti-doping rule violation of blood doping. The Panel decided to set aside the Appealed Decision of 5 December 2007 and to impose a 2 year period of ineligibility on the Athlete, starting on 24 July 2007.

Although the Athlete already had admitted and accepted a 2 year period of ineligibility the UCI and the Athlete remained in a dispute about the validity and enforceability of the Athlete's commitment for contribution. In this matter the Athlete had to pay an amount equal to his annual salary from 2007 as contribution to the fight against doping.

The UCI contended that this commitment is legally valid and that the infringement of the Athlete’s personality rights is justified by his free consent and overriding public interest.

By contrast the Athlete challenged the validity of this commitment mainly because he was not free to sign or reject this commitment which was the precondition for his participation in the Tour de France 2007.

Following assessment the Panel concludes that there is no legal basis for UCI to claim the payment of a contribution under the Athlete's commitment. Accordingly, he is not obliged to make the payment requested by UCI. Against this background, further prayers for relief and further considerations of the parties are dismissed.

Therefor the Court of Arbitration for Sport decides on 30 August 2010:

1.) Paragraphs 1 to 3 of the Partial Award issued on 16 June / 23 July 2009 in the present procedure are ratified.

2.) No payment is due by Mr. Vinokourov under the “Rider's commitment for a new cycling” signed on 29 June 2007; consequently, the relief requested by the UCI in its written statement dated 4 September 2009 is dismissed.

3.) The arbitration costs incurred in the proceedings after the issuance of the Partial Award, which shall be determined and separately communicated to the parties by the CAS Court Office, shall be entirely born by UCI.

4.) Each Party shall bear its own legal expenses incurred in the proceedings until the delivery of the Partial Award.

5.) UCI is ordered to pay to Mr. Vinokourov as contribution to his legal expenses incurred in the proceedings after the issuance of the Partial Award an amount of CHF 10'000.- (ten thousand Swiss francs).

6.) All other and further prayers for relief are dismissed.

Is There an Association between the Use of Anabolic-Androgenic Steroids and Criminality? / Kurt Skårberg, Fred Nyberg, Ingemar Engström. - (European Addiction Research 16 (2010) 4 (September); p. 213–219)

• PMID: 20798542
• DOI: 10.1159/000320286

Aims:

The aim of this study was to improve our understanding
of the proposed association between anabolic-androgenic
steroids (AAS) and criminality.

Methods:

The study was based on interviews and criminality data involving 32 users of AAS who had sought treatment for AAS-related problems at a psychiatric addiction clinic in Sweden. A score derived from the number of crimes, their level of severity and the relevant time periods was computed to allow comparisons between subgroups sorted according to type and timing of drug use.

Results:

The criminal activity level increased for 69% of the individuals after having started to use drugs. This was particularly obvious in the group who had started its involvement with drugs by using AAS. Crimes of violence and weapon offences showed a great increase in incidence after drug use had been initiated. The study also showed a significant decrease in criminality after treatment, particularly among individuals who had started their drug use with AAS.

Conclusion:

The results suggest that there is an association
between the use of AAS and criminality, especially with regard to crimes of violence and weapon offences, and that this criminality may be enhanced when AAS are combined with other drugs of abuse.

2009 Adverse Analytical Findings and Atypical Findings
Reported by Accredited Laboratories / WADA (World Anti-Doping Agency). - Montreal : WADA, 2010

Facts
The Canadian Centre for Ethics in Sport (CCES) alleges Brandon Krukowoski for committing an anti-doping rule violation. The athlete failed to submit to sample collection during an out-of-competition doping control on March 31, 2010 in Waterloo, Ontario. The athlete requests subsequently to revoke the Waiver of Hearing Form send in by by the athlete, which resulted in a finding that an athlete was guilty of an anti-doping rule violation, with the result that the athlete would get a new hearing on the issue of whether he had, in fact, committed an anti-doping rule violation.

History
On 31 March 2010 a Doping Control Officer (DCO) and a Chaperone assigned by the CCES attended the Athlete’s residence at 7:14 a.m. for the purposes of conducting out-of-competition doping control testing pursuant to the CADP. The Athlete informed the DCO that he was no longer a member of the University of Waterloo football team due to injury. He refused to be tested despite being warned of the consequences of refusing. He send in a Waiver of Hearing form in which he I accepts the sanction for this violation which is four (4) years of ineligibility and waives his right to a hearing.

Decision
The request to revoke the waiver is denied. Because the waiver was validly given, the Player’s acknowledgement that he committed an anti-doping rule violation, his acceptance of the sanction proposed by the CCES, and the resulting decision of the CCES stand, a period of four (4) year ineligibility commencing on 24 May 2010 (day of sending in the waiver) till 24 May 2014.