ISSN:1050-642X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The participation of sports physicians in the “doping” of athletes with banned drugs can be documented as far back as the 1890s. Concern about the ethics and safety of doping elite athletes appeared during the 1920s and 1930s as sport became an increasingly important form of popular culture. While organized medicine has opposed doping as a matter of policy at least since the 1950s, sports physicians have never adequately confronted the conflicts of interest that arise when they choose to work with elite athletes whose first priority is performance rather than with healing in the traditional sense.Confronted with the demands of their athlete-clients, sports physicians have divided into two factions regarding the wisdom and propriety of administering doping drugs to athletes. While most physicians are, in all likelihood, unwilling to violate laws, regulations, and medical standards by doping athletes, a significant minority of doctors has used one or more arguments to justify doping athletes: drugs are necessary to compete effectively; athletes should be free to medicate themselves as they please; drugs do not differ essentially from other performance-enhancing techniques or equipment; and medically supervised doping is safer than self-medication by athletes. Physicians can also rationalize doping as an occupational requirement of some professional athletes. In summary, physicians have played a significant, and largely unacknowledged, role in the doping of many elite athletes over the past 50 years.

ISSN:1050-642X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The International Olympic Committee, the World Anti-Doping Agency, and International Sport Federations have banned and restricted the use of many stimulants including prescription and over-the-counter medications and dietary supplements. In addition to elite athletes, people of all ages use stimulants in attempts to improve athletic performance, alter body composition, and increase levels of energy. Here we introduce a seven-stage model designed to facilitate informed decision-making by individuals taking or thinking of taking stimulants for sport, health, and/or appearance reasons. We review for amphetamines, over-the counter sympathomimetics, and caffeine their performance-enhancing and performance-degrading effects, health benefits and mechanisms of action, medical side effects, and legal, ethical, safety, and financial implications.

ISSN:1050-642X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

IntroductionThe large increase in the number of athletes who apply to use inhaled beta agonists (IBAs) at the Olympic Games is a concern to the medical community. This review will examine the use of IBAs in the asthmatic athlete, the variability that exists between countries and sport, and outline a plan to justify the use of these medications.Data SourcesMuch of this article is a result of an International Olympic Committee (IOC) Medical Commission-sponsored meeting that took place in May 2001. Records of the use of IBAs at previous Olympics were reviewed. MEDLINE Searches (PubMed interface) were performed using key words to locate published work relating to asthma, elite athletes, performance, treatment, and ergogenic aids.Main ResultsSince 1984 there have been significant increases in the use of IBAs at the Olympic Games as well as marked geographical differences in the percentage of athletes requesting the use of IBAs. There are large differences in the incidence of IBA use between sports with a trend towards increased use in endurance sports. There are no ergogenic effects of any IOC-approved IBA given in a therapeutic dose.ConclusionsIn many cases, the prescription of IBAs to this population has been made on empirical grounds. Beginning with the 2002 Winter Games, athletes will be required to submit to the IOC Medical Commission clinical and laboratory evidence that justifies the use of this medication. The eucapnic voluntary hyperpnea test will be used to assess individuals who have not satisfied an independent medical panel of the need to use an IBA.

ISSN:1050-642X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

This article examines available strategies for the detection of recombinant erythropoietin (rhEPO) abuse in sport. RhEPO was quickly recognized as an effective but hazardous performance-enhancing agent. In the absence of a valid procedure to detect rhEPO doping, at-competition health checks were introduced, which excluded athletes from competition when their hemoglobin or hematocrit values exceeded an arbitrary limit. This limited the danger to athletes, but did nothing to eliminate the use of rhEPO.Through the last decade, both direct and indirect methods for detecting rhEPO were investigated. No single indirect marker was found that satisfactorily demonstrated rhEPO use. A combination of blood and urine tests together formed the procedure and strategy approved by the International Olympic Committee (IOC) for detecting rhEPO use at the Sydney Olympics.However strategies for testing for EPO are as important as the developed laboratory analytical procedures. The use of extensive out-of-competition testing and analysis within the IOC accredited laboratory system is critical to any testing program. At-competition blood tests have merit as true health checks and will also be needed to detect acutely useful agents such as hemoglobin-based oxygen carriers. However the persistence of the “health check” rationale for on-site at-competition rhEPO testing has led to much wasted testing effort, as rhEPO use by athletes will rarely occur near to or at the time of the competition for fear of detection. Thus, direct testing methods (such as the rhEPO urine test) especially will fail due to the completed metabolism and elimination of administered rhEPO before the test, unless the international sporting federations use the information gathered to assist in targeted out-of-competition testing. This article discusses the limitations of testing at competition and proposed strategies for dealing with various phases of EPO doping in detail, concluding that no one single currently used strategy will detect all users of rhEPO.The development of strategies to diagnose rhEPO abuse may serve as a model to detect other biological agents.

ISSN:1050-642X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Dehydroepiandrosterone (DHEA), a 19-carbon steroid, is situated along the steroid metabolic pathway. It is the most abundant circulating hormone in the body and can be converted to either androgens or estrogens. It is readily conjugated to its sulphate ester DHEAS, and they are designated as DHEA(S) here when used together. Its secretion reaches a peak in early adulthood and thereafter decreases, until approximately age 70 years when it reaches a concentration of approximately 20%. Many hormonal changes may take place with aging but none is as marked as this. This “relative DHEA deficiency” resulted in DHEA being enthusiastically labelled by some as a fountain of youth or an antidote to aging that would prove to be the panacea they are seeking. Its use was also taken up enthusiastically by the athletic community and used as a prohormone in the belief or hope that it would be converted mainly to testosterone in the body.

ISSN:1050-642X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The objective of this review is to examine newer compounds coming on the market capable of boosting red blood cell concentration and thus improving aerobic activities in particular. Erythropoietin (EPO) has been used extensively in the past by the athletic community in this role. Its main disadvantages are the side effects due to increased viscosity, and the recent development of a blood test for drug testing methods. Two new methods of increasing red blood cell concentration for use in medicine are hemoglobin oxygen carriers and perfluorocarbons, each having a different structure, but which allow oxygen to be delivered to the tissues. Hemoglobin oxygen carriers physically alter the hemoglobin molecule by several methods so that complications such as renal toxicity are obviated. Perfluorocarbons belong to a group of synthetic compounds containing hydrocarbons to which fluorine is added. Evidence is available to suggest that athletes are already adapting these newer molecules for their benefit.

ISSN:1050-642X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ContextThe problems of doping in sport and the increasing use of nutritional supplements by athletes are issues that intersect to the degree that a large number of supplements may contain substances that are banned in sport. Many supplements contain substances that are associated with significant health hazards. Athletes consuming such supplement products may jeopardize their sporting status, and their health.ObjectivesTo clarify and summarize the current status of dietary supplements in general, and to describe specific problems that can be associated with supplement use so that sport physicians might be better prepared to address these issues with their athlete-patients.Data SourceAn analysis of recent and relevant literature accessed through MEDLINE, and interactions with clinicians, laboratory scientists, colleagues, and athletes.ConclusionsThe dietary supplement industry is completely unregulated in the United States; as a consequence, an abundance of supplement products of dubious value, content, and quality are now available around the world. It is known that many supplement products contain substances that are prohibited in sport—typically stimulants or anabolic steroid precursors. Many supplements contain substances (e.g., ephedrine) that have been associated with significant morbidity and mortality. Sport practitioners have particular responsibilities in addressing this issue. Athletes need to be aware of the problems that can follow supplement use, and sport authorities need to ensure that nutritional education and guidance for athletes is of the highest standard. The need for the appropriate regulation of dietary supplements is emphasized.

ISSN:1050-642X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo conduct a critical appraisal of the literature to address the question of whether human growth hormone (HGH) improves performance in trained athletes.Data SourcesUsed PubMed using the search terms of “growth hormone athletes” and the reference lists of previous reviews of the subject.Study SelectionRandomized double-blind placebo-controlled study of exogenous HGH on muscle power in trained athletes. Only one study matched the search criteria.ConclusionThere is no evidence of increased muscle strength with HGH in trained athletes.

ISSN:1050-642X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ContextRecent international developments have served to solidify the international approach to doping in sport. The development of the World Anti-Doping Agency (WADA) has resulted in new, coordinated efforts to address this important sport issue. An array of new efforts and initiatives has been initiated by the new agency. The Sydney and Salt Lake City Olympics were characterized by intensive efforts to minimize doping. The antidoping environment is evolving rapidly, and several profoundly important developments will take place in the immediate future.ObjectivesTo outline the challenges, opportunities, and changing circumstances of the current antidoping environment so that sport medicine practitioners might understand the context in which a variety of new initiatives and approaches will develop. At the same time, to ensure that practitioners understand the importance of appropriately developed and delivered antidoping policies, programs, and procedures, and the need for their harmonization. To ensure that sport medicine practitioners appreciate the need for a comprehensive approach to doping control, i.e., programs that include much more than drug testing.Data SourceA review of relevant policy documents derived from a variety of sport and antidoping organizations; selected references drawn from MEDLINE; and materials prepared by colleagues drawn from the international antidoping community.ConclusionsThe increased global effort to address doping is welcome. It will require that several critical issues be addressed that will test the resolve of all involved.

ISSN:1050-642X    

出版商:OVID    

年代:2002

数据来源: OVID