Liquid chromatography-tandem mass spectrometry and confirmation by liquid chromatography-high-resolution mass spectrometry hair tests to evidence use of tizanidine by racing cyclists

21 Sep 2021

Liquid chromatography-tandem mass spectrometry and confirmation by liquid chromatography-high-resolution mass spectrometry hair tests to evidence use of tizanidine by racing cyclists / Pascal Kintz, Laurie Gheddar, Jean-Sébastien Raul. - (Drug Testing and Analysis (2021) 21 September)

  • PMID: 34549540
  • DOI: 10.1002/dta.3164

Abstract

Tizanidine, an imidazoline derivative close to clonidine, is a central alpha-2 adrenergic receptor agonist. Therapeutically, the drug is used as a muscle relaxant under the trade names Sirdalud™ or Zanaflex™. The drug is not prohibited by the World Anti-Doping Agency but, for therapeutic purposes, can only be obtained via a nominative temporary use authorization. The French public health police requested the laboratory to test for tizanidine in head hair specimens collected from international racing cyclists. Using Liquid chromatography-tandem mass spectrometry (LC/MS-MS) and confirmation by liquid chromatography-high-resolution mass spectrometry (LC/HRMS), after pH 9.5 borate buffer overnight incubation of 20 mg and subsequent solvents extraction, tizanidine was identified in the hair of three athletes at 1.1, 3.7, and 11.1 pg/mg. This is the first evidence that tizanidine is incorporated in human hair. However, it was not possible to interpret the data in terms of doses and frequency of use due to a lack of controlled study.

An examination of the Sport Drug Control Model with elite Australian athletes

25 Apr 2011

An examination of the Sport Drug Control Model with elite Australian athletes / Daniel F. Gucciardi, Geoffrey Jalleh, Robert J. Donovan. - (Journal of Science and Medicine in Sport 14 (2011) 6 (1 November); p. 469-476)

  • PMID: 21514883
  • DOI: 10.1016/j.jsams.2011.03.009


Abstract

Objective: This study presents an opportunistic examination of the theoretical tenets outlined in the Sport Drug Control Model(1) using questionnaire items from a survey of 643 elite Australian athletes.

Design and method: Items in the questionnaire that related to the concepts in the model were identified and structural equation modelling was employed to test the hypothesised model.

Results: Morality (cheating), benefit appraisal (performance), and threat appraisal (enforcement) evidenced the strongest relationships with attitude to doping, which in turn was positively associated with doping susceptibility. Self-esteem, perceptions of legitimacy and reference group opinions showed small non-significant associations with attitude to doping. The hypothesised model accounted for 30% and 11% of the variance in attitudes to doping and doping susceptibility, respectively.

Conclusion: These present findings provide support for the model even though the questionnaire items were not constructed to specifically measure concepts contained in it. Thus, the model appears useful for understanding influences on doping. Nevertheless, there is a need to further explore individual and social factors that may influence athletes' use of performance enhancing drugs.

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.

Anabolic androgenic steroid abuse and mood disorder: a case report

1 Apr 2007

Anabolic androgenic steroid abuse and mood disorder : a case report / Georgios Papazisis, Dimitrios Kouvelas, Anastasia Mastrogianni, Anastasia Karastergiou. (International Journal of Neuropsychopharmacology 10 (2007) 2 (April); p. 291-293)

  • PMID: 16978444
  • DOI: 10.1017/S1461145706007243


The case of a young man, a long-term steroid abuser with a prior history of psychotic depression and manifestations of a current manic episode, is presented. The patient was hospitalized in the D’ Acute Ward of the Psychiatric Hospital of Thessaloniki and he was diagnosed with a substance-induced mood disorder (with manic features), attributed to the use of AAS. A few months after his brief hospitalization and under obscure circumstances the patient committed suicide.

The emergence of Exercise Addiction, Body Dysmorphic Disorder, and other image-related psychopathological correlates in fitness settings: A cross sectional study

3 Apr 2019

The emergence of Exercise Addiction, Body Dysmorphic Disorder, and other image-related psychopathological correlates in fitness settings : A cross sectional study / Ornella Corazza, Pierluigi Simonato, Zsolt Demetrovics, Roisin Mooney, Katinka van de Ven, Andres Roman-Urrestarazu, Lili Rácmolnár, Ilaria De Luca, Eduardo Cinosi, Rita Santacroce, Massimo Marini, David Wellsted, Keith Sullivan, Giuseppe Bersani, Giovanni Martinotti. - (PLoS One 14 (2019) 4 (3 April); p. 1-17)

  • PMID: 30943200
  • PMCID: PMC6447162
  • DOI: 10.1371/journal.pone.0213060


Abstract

Introduction: In a society that perpetuates the strive for a perfect appearance, a fit body has become synonymous with success, but simultaneously hard to achieve. This represents a fertile ground for the development of Exercise Addiction (EA) alongside other disorders, such as Body Dysmorphic Disorder (BDD). This study aims to explore the diffusion of EA in fitness settings in the United Kingdom, Italy, Netherlands, Hungary and the previously unexplored association with appearance anxiety, BDD, self-esteem and the use of fitness supplements.

Methods: A large cross-sectional sample (N = 1711) was surveyed in fitness settings using the Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI) and Rosenberg's Self Esteem Scale (RSE) in addition to questions surrounding the use of fitness supplements.

Results: Compulsive exercise, appearance anxiety and low self-esteem were present in this sample according to the psychometric measures used (EAI, AAI, RSE). 11.7% scored over the cut off for EA, with alarming peaks in the Netherlands (20.9%) and the United Kingdom (16.1%). 38.5% were found at risk of BDD, mainly female (47.2%). 39.8% used fitness enhancing supplements without medical consultation (95.5%). This cohort of supplement users scored higher in both EAI and AAI. The logistic regression model revealed a strong association between the consumption of sport products and the level of EA across the sample with an odds ratio (OR) of 3.03. Other co-variable factors among female were appearance anxiety (AAI; OR 1.59) and to a lesser extent self-esteem (RSE) (OR 1.08).

Conclusions: This study identified a high risk of EA, appearance anxiety and BDD amongst a cohort of gym users internationally. The previously-unexplored association between these disorders and the unsupervised use of a variety of fitness products, including illicit drugs, highlights the need for informed and integrated responses targeting such vulnerable individuals.

FIFA's approach to doping in football

23 Jun 2006

FIFA's approach to doping in football / J. Dvorak, T. Graf-Baumann, M. D'Hooghe, D. Kirkendall, H. Taennler, M. Saugy. - (British Journal of Sports Medicine 40 (2006) Suppl 1; p. i3-i12)

  • PMID: 16799099
  • PMCID: PMC2657497
  • DOI: 10.1136/bjsm.2006.027383


Abstract

Background and objectives: FIFA's anti-doping strategy relies on education and prevention. A worldwide network of physicians guarantees doping control procedures that are straightforward and leave no place for cheating. FIFA actively acknowledges its responsibility to protect players from harm and ensure equal chances for all competitors by stringent doping control regulations, data collection of positive samples, support of research, and collaboration with other organisations. This article aims to outline FIFA's approach to doping in football.

Method: Description of FIFA's doping control regulations and procedures, statistical analysis of FIFA database on doping control, and comparison with data obtained by WADA accredited laboratories as for 2004.

Results: Data on positive doping samples per substance and confederation/nation documented at the FIFA medical office from 1994 to 2005 are provided. According to the FIFA database, the incidence of positive cases over the past 11 years was 0.12%, with about 0.42% in 2004 (based on the assumption of 20,750 samples per year) and 0.37% in 2005. Especially important in this regard is the extremely low incidence of the true performance enhancing drugs such as anabolic steroids and stimulants. However, there is a need for more consistent data collection and cross checks among international anti-doping agencies as well as for further studies on specific substances, methods, and procedures. With regard to general health impairments in players, FIFA suggests that principles of occupational medicine should be considered and treatment with banned substances for purely medical reasons should be permitted to enable players to carry out their profession. At the same time, a firm stand has to be taken against suppression of symptoms by medication with the aim of meeting the ever increasing demands on football players.

Conclusion: Incidence of doping in football seems to be low, but much closer collaboration and further investigation is needed with regard to banned substances, detection methods, and data collection worldwide.

Is There Room for SERMs or SARMs as Alternative Therapies for Adult Male Hypogonadism?

21 Jan 2020

Is There Room for SERMs or SARMs as Alternative Therapies for Adult Male Hypogonadism? / Vito A Giagulli, Andrea Silvestrini, Carmine Bruno, Vincenzo Triggiani, Alvaro Mordente, Antonio Mancini. - (International Journal of Endocrinology (2020) 21 January)

  • PMID: 32411230
  • PMCID: PMC7201459
  • DOI: 10.1155/2020/9649838


Abstract

Hypogonadotropic hypogonadism (HH) can be sustained by organic or functional alterations of the hypothalamic-pituitary-testicular axis. Functional HH is related to systemic alterations, such as obesity or chronic inflammatory diseases, but could contribute to a negative course of the illness. For such situation, according to results obtained in infertile women, the administration of selective estrogen receptor modulators (SERMs) has been proposed in males too, with positive results on both metabolic and sexual function. This class of medications increases gonadotropin levels via antagonism to the estrogenic receptor; similar biological effects are also exerted by aromatase inhibitors (AIs), despite different mechanism of action. After a brief review of trials regarding SERMs and AIs use in male HH, we describe the structure and function of the androgen receptor (AR) as a basis for clinical research about compounds able to bind to AR, in order to obtain specific effects (SARMs). The tissue selectivity and different metabolic fate in comparison to testosterone can potentiate anabolic versus androgenic effects; therefore, they might be a valid alternative to testosterone replacement therapy avoiding the negative effects of testosterone (i.e., on prostate, liver, and hematopoiesis). Trials are still at an early phase of investigation and, at the moment, the application seems to be more useful for chronic disease with catabolic status while the validation as replacement for hypogonadism requires further studies.

CAS 2019_A_6530 Jeffrey Brown vs USADA | Alberto Salazar vs USADA

15 Sep 2021

CAS 2019/A/6530 Jeffrey Brown v. USADA
CAS 2019/A/6531 Alberto Salazar v. USADA

Related cases:

  • AAA 2017 No. 01 17 0003 6197 USADA vs Jeffrey Brown
    September 30, 2019
  • AAA 2017 No. 01 17 0004 0880 USADA vs Alberto Salazar
    September 30, 2019

Dr. Jeffrey Brown is a physician and a consultant from 2009-2012 for the Nike Oregon Project (NOP), the NOP Athletes and Mr. Alberto Salazar.

Mr. Alberto Salazar is an American track coach and former world-class long-distance runner and the head coach of the NOP in Portland, Oregon.

In March 2017 USADA alleged that Dr. Brown was generally involved in the prescription of Testosterone by Dr. Brown to Mr. Salazar; and Dr. Brown’s was involvement in a Testosterone experiment conducted at the NOP facilities in June and July, 2009 (the Testosterone Experiment). Dr. Brown was involved in the administration of L-carnitine infusions in 2011 and 2012; and actions taken by Dr. Brown and his counsel in connection with the investigation and adjudication of the foregoing claims.

Also in March 2017 USADA alleged that Mr. Alberto Salazar was involved in the infusions/injections of L-carnite administered to the Athlete Steve Magness and NOP athletes; possession and use of Testosterone gel and tampering together with his attorneys during the investigation and arbitration. During the proceedings USADA did not pursue the Administration or Attempted Administration of Testosterone for personal use.



On 30 September 2019 the Tribunal of the American Arbitration Association (AAA) decided to impose a 4 year period of ineligibility on Dr. Jeffey Brown and Mr. Salazar for committing multiple anti-doping rule violations:

Dr. Jeffrey Brown:

  • Complicity in trafficking of Testosterone
  • Administration of a prohibited method
  • Tampering of records

Mr. Alberto Salazar:

  • Trafficking of Testosterone
  • Administration of a prohibited method
  • Tampering

Hereafter in October 2019 both Dr. Jeffrey Brown and Mr. Alberto Salazar appealed the AAA Decisions with the Court of Arbitration for Sport (CAS) and requested for a consolidated procedure.

Dr. Jeffrey Brown and Mr. Salazar challenged the Appealed Decisions and denied they had committed any anti-doping rule violations.

USADA contended regarding Dr. Brown that:

  • Dr. Brown’s prescriptions of Testosterone to Mr. Salazar were not medically justified and his involvement in the Testosterone Experiment amounted to an ADRV.
  • Dr. Brown committed an ADRV in administering a prohibited method to Mr. Magness and committed ADRVs of administration or attempted administration in respect of NOP athletes.
  • Dr. Brown inappropriately altered Mr. Magness and NOP athletes’ patient records, elicited false testimony from witnesses and was involved in establishing a false narrative to mislead USADA into believing that NOP athletes received their L-carnitine administrations via syringes rather than infusion bags.

USADA contended regarding Mr. Salazar that:

  • Mr. Salazar’s possession of Testosterone was not medically justified and his application of Testosterone (a prohibited substance) to his sons in the Testosterone Experiment amounted to an ADRV;
  • Mr. Salazar committed an ADRV of administration, attempted administration or complicity in Dr. Brown’s administration of a prohibited method to Mr. Magness and committed ADRVs of administration or attempted administration in respect of NOP athletes;
  • Mr. Salazar committed ADRVs of tampering through a range of conduct, including giving false testimony during depositions held in relation to USADA’s anti-doping investigation, eliciting false testimony from witnesses and establishing a false narrative to mislead USADA into believing that NOP athletes received their L-carnitine administrations via syringes rather than infusion bags.

After assessment of all of the submissions and evidence presented throughout the cours of the proceedings the Panel dismissed specific charges against Mr. Salazar and Dr. Brown due to USADA had not established that they had contravened Articles of the WADC regarding Trafficking, Complicity, Possession, Administration and Tampering .

Nevertheless the Panel made the following findings:

  • Dr. Brown contravened Article 2.8 of the 2009 WADC (Complicity) by assisting, encouraging, aiding, abetting or otherwise engaging in complicity in relation to Mr. Salazar’s possession of testosterone in furtherance of the Testosterone Experiment.

  • Dr. Brown contravened Article 2.7 of the 2009 WADC (Trafficking) by sending or delivering Testosterone to Mr. Salazar in relation to the Testosterone Experiment, either by delivering Testosterone to Mr. Salazar (i) for use in the Testosterone Experiment; or (ii) to replenish Testosterone used by Mr. Salazar in the Testosterone Experiment.

  • Dr. Brown contravened Article 2.8 of the 2009 WADC (Administration) by administering a Prohibited Method to Mr. Magness on in November 2011.

  • Dr. Brown contravened Article 2.5 of the 2009 WADC (Tampering) with respect to the issue of L-carnitine infusions/syringes.

  • Mr. Salazar contravened Article 2.6.2 of the 2009 WADC (Possession) by possessing Testosterone in furtherance of the Testosterone Experiment.

  • Mr. Salazar contravened Article 2.8 of the 2009 WADC (Administration by complicity) by assisting, encouraging and otherwise being complicit in Dr. Brown’s administration of a Prohibited Method to Mr. Magness in November 2011.

  • Mr. Salazar contravened Article 2.5 of the 2009 WADC (Tampering) with respect to the issue of L-carnitine infusions/syringes.


Therefore Court of Arbitration for Sport decides on 15 September 2021 that:

1. Dr. Jeffrey Brown committed the following anti-doping rule violations:

  • a.) Complicity (2009 WADC Article 2.8) in Mr. Alberto Salazar’s possession of Testosterone in furtherance of the Testosterone Experiment;
  • b.) Trafficking (2009 WADC Article 2.7) of Testosterone to Mr. Alberto Salazar in relation to the Testosterone Experiment;
  • c.) Administration (2009 WADC Article 2.8) of a Prohibited Method, being an infusion in excess of the permitted volume, to Mr. Steve Magness;
  • d.) Tampering (2009 WADC Article 2.5) with the Doping Control Process with respect to the issue of L-carnitine infusions/syringes.

2. The appeal filed by Dr. Jeffrey Brown on 21 October 2019 and the “cross-appeal” filed by USADA on 29 April 2021 are otherwise dismissed and the period of ineligibility imposed by the Brown AAA Panel, being a period of ineligibility of four years, is upheld.

3. Mr. Alberto Salazar committed the following anti-doping rule violations:

  • a.) Possession (2009 WADC Article 2.6) of Testosterone in furtherance of the Testosterone Experiment;
  • b.) Complicity (2009 WADC Article 2.8) in Dr. Jeffrey Brown’s Administration of a Prohibited Method to Mr. Steve Magness;
  • c.) Tampering (2009 WADC Article 2.5) with the Doping Control Process with respect to the issue of L-carnitine infusions/syringes.

4. The appeal filed by Mr. Alberto Salazar on 21 October 2019 and the “cross-appeal” filed by USADA on 29 April 2021 are otherwise dismissed and the period of ineligibility imposed by the Salazar AAA Panel, being a period of ineligibility of four years, is upheld.

5. (…).
6. (…).
7. All other prayers for relief in the appeals and cross-appeals are dismissed.

JADCO 2021 JADCO vs Weston McDonald

18 Jun 2021

In April 2021 the Jamaica Anti-Doping Commission (JADCO) has reported an anti-doping rule violation against the bodybuilder Weston McDonald after his sample tested positive for the prohibited substance Mesterolone.

After notification the Athlete filed a statement in his defence, admitted the violation and waived his right for a hearing. He denied the intentional use of the substance and explained that he had used a Testosterone Booster to improve his libido.

The Panel finds that the presence of a prohibited substance has been established in the Athlete's sample and accordingly that he committed an anti-doping rule violation.

The Jamaica Independent Anti-Doping Disciplinary Panel decides on 18 June 2021 to impose a 30 month period of ineligibility on the Athlete, starting on the date of the provisional suspension, i.e. on 29 April 2021.

JADCO 2021 JADCO vs Deidre Lewis

11 May 2021

In December 2020 the Jamaica Anti-Doping Commission (JADCO) has reported an anti-doping rule violation against the bodybuilder Deidre Lewis after her A and B samples tested positive for the prohibited substance Zeranol in a low concentration.

After notification  a provisional suspension was ordered. The Athlete filed a statement in her defence and she was heard for the Jamaica Independent Anti-Doping Disciplinary Panel.

The Athlete accepted the test results and admitted the violation. She denied the intentional use of the substance wheras she could not explain how the Zeranol had entered her system.

With support of an expert witness the Athlete asserted that the substance has a long excretion time and that the low concentration found in her samples could be consistent with natural food ingestion and not the result of supplement contamination.

The Panel finds that the presence of a prohibited substance has been established in the Athlete's sample and accordingly that she committed an anti-doping rule violation. The Panel considers that that it is more likely that the violation was not intentional instead of that the violation was committed  intentionally.

Therefore the Jamaica Independent Anti-Doping Disciplinary Panel decides on 11 May 2021 to impose a 2 year period of ineligibility on the Athlete, starting on the date of the provisional suspension.

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