Fortnightly Review: Drugs in sport

MacAuley, Domhnall

doi:10.1136/bmj.313.7051.211

Cited by 8 publications

(5 citation statements)

References 18 publications

(15 reference statements)

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“…The current cyclists interviewed would like to be tested more often. These results follow those obtained in 1995 by the Sports Council on senior competitors from 26 winter and summer sports (MacAuley, ): “Many thought that testing should be more widespread and [occur] more often. About 70% believed that testing served as a deterrent, but a quarter believed that lack of widespread testing made the process less of a deterrent for some” (p. 215).…”

Section: Discussionsupporting

confidence: 84%

“…Cyclists who want to dope have to find other solutions. An underground market, by way of the internet, has emerged for performance‐enhancing substances (MacAuley, ; Lentillon‐Kaestner & Carstairs, ). There are a variety of websites where cyclists can easily order performance‐enhancing substances; however, their origin and purity are not guaranteed (Dumestre‐Touler, ; Binsinger & Friser, ; Pipe & Ayotte, ; Carpenter, ).…”

Section: Discussionmentioning

confidence: 99%

“…A series of doping scandals in 2006, known as the Puerto scandal or the Landis case, showed that doping is still present at the highest levels of cycling. According to MacAuley (), “Drug taking can be controlled only if detection is likely and the penalties of detection are a sufficient deterrent. Unless there is widespread testing, both in and out of competition, the risk‐to‐benefit ratio favours the drug taker” (p. 215).…”

Section: Discussionmentioning

confidence: 99%

“…Even today, cyclists use various methods (e.g. microdoses, masking agents, undetectable drugs as autologous blood transfusions, genetic doping, novel EPOs, or new doping agents) to evade detection in doping tests (MacAuley, ). For example, following the successful introduction of a urine‐based test for the presence of recombinant human EPO at the 2000 Sydney Olympics, the athletes began to evade detection by using regular, small dosages of EPO to minimize the appearance of foreign EPO in their urine.…”

Section: Discussionmentioning

confidence: 99%

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The development of doping use in high‐level cycling: From team‐organized doping to advances in the fight against doping

Lentillon‐Kaestner

2011

Scandinavian Med Sci Sports

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In 1998, the Festina scandal at the Tour de France provided the first proof of widespread doping in professional cycling. This doping scandal marked the end of team-organized doping in professional cycling and ushered in a new period marked by the increasing implementation of anti-doping measures. This article evaluates the impact of the anti-doping rules and tests instituted since the Festina scandal. We adopt a psychosocial approach to analyze the organization of doping and the development of doping attitudes and practices in high-level cycling. Sixteen cyclists were interviewed, of which eight were young, current cyclists and eight were former cyclists who became professionals before the Festina scandal. Our results show that although the fight against doping in the last decade has reduced doping use in high-level cycling, anti-doping measures have also had unexpected effects. The fight against doping in cycling is not over.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The development of doping use in high‐level cycling: From team‐organized doping to advances in the fight against doping

Lentillon‐Kaestner

2011

Scandinavian Med Sci Sports

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“…2 The use of forbidden substances in the form of human recombinant peptide hormones with ergogenic action, such as growth hormone and EPO, is currently practiced to circumvent urine doping controls. The practice of doping to enhance athletic performance is becoming a medical and public health problem because of simplicity of administration and difficulty of detection.…”

mentioning

confidence: 99%

Cyclist’s doping associated with cerebral sinus thrombosis

et al. 2002

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Erythropoietin (EPO) plays a key role in modulation of erythropoiesis and is required for the survival and proliferation of committed erythroid progenitor cells. 1 EPO has been approved for treatment of anemia in several conditions and for facilitating autologous blood donation. When used as doping agent in sport, EPO increases the ability to exercise as the result of increasing the packed-cell volume (PCV).Case report. A 26-year-old man, a professional cyclist, presented with a 2-month history of headache that had greatly increased in the previous week during a competition. There was no history of head trauma. He was referred to an institution with the diagnosis of idiopathic intracranial hypertension, which was nonresponsive to standard treatment. On admission he was cognitively normal, but reported diffuse headache with nausea, vomiting, and photophobia. Physical examination was unremarkable, except for the presence of a mild left retinal venous engorgement. A lumbar puncture disclosed an increase in CSF pressure, without abnormalities in CSF composition. Blood analysis showed a red blood cell count of 5.4 ϫ 10 12 /L (normal range, 3.5 to 5.0), hemoglobin ϭ 150 g/dL (normal range, 140 to 180), PCV ϭ 0.47 (normal range, 0.39 to 0.49), with normal values for the white cell count and platelet number. The other routine laboratory tests performed in serum and urine were within the normal range. Although the cranial CT scan examination on admission was normal, MRI of the brain revealed occlusion of the superior sagittal and the right transverse sinuses (figure). A diagnosis of cerebral sinus thrombosis was made, and anticoagulation treatment with intravenous sodium heparin infusion was started. A 400-mL phlebotomy also was performed because the PCV spontaneously increased to 0.51. Previously, a coagulation study had been performed with normal values for prothrombin time, activated partial thromboplastin time, fibrinogen, thrombin time, D-dimer, plasminogen, antithrombin III, protein C, protein S, lupus anticoagulant, and anticardiolipin antibodies. A PCR for factor V Leiden also was negative.Because EPO doping was suspected, the patient was questioned about the use of forbidden agents. He admitted to using EPO during the previous 3 months at a dose of 2000 U every 2 days, and growth hormone over the last 15 days of competition to improve his physical exercise capacity. Moreover, he reported habitual, long-lasting consumption of high doses of vitamin A and vitamin E supplements. Anticoagulation resulted in a clinical response and was continued with acenocoumarol for 3 months. A control MRI showed resolution of the thrombosis. When last seen he remained well; currently, he continues to compete.Discussion. The practice of doping to enhance athletic performance is becoming a medical and public health problem because of simplicity of administration and difficulty of detection. 2 The use of forbidden substances in the form of human recombinant peptide hormones with ergogenic action, such as growth hormone and EPO, is curr...

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Combat Sports Medicine

Kordi¹

2009

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Fortnightly Review: Drugs in sport

Cited by 8 publications

References 18 publications

The development of doping use in high‐level cycling: From team‐organized doping to advances in the fight against doping

The development of doping use in high‐level cycling: From team‐organized doping to advances in the fight against doping

Cyclist’s doping associated with cerebral sinus thrombosis

Combat Sports Medicine

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