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Abstract: Due to its considered performance enhancing effects, human growth hormone (hGH) is abused as a doping agent in sport. Its misuse also carries potentially serious side effects to a person’s health. Consequently, hGH and its releasing factors are prohibited in sport, as established in the Prohibited List which is updated and published yearly by the World Anti-Doping Agency (WADA). In order to fight the menace that hGH doping poses to the spirit of sport and to the health of athletes, the sport movement and the anti-doping authorities, initially led by the International Olympic Committee (IOC) and later by WADA, have put substantial efforts into developing tests for its detection. Currently, a primary analytical approach, the isoform differential immunoassay, has been implemented in WADA-accredited laboratories. In parallel, a second, indirect approach for the detection of hGH abuse, based on the quantification of hGH-associated biological markers, has been developed. The final aim is to combine both methodologies to improve the sensitivity and expand the time window to detect doping with hGH. In addition, novel analytical procedures, based on proteomic and genomic technologies as well as the use of mass spectrometry-based methods of detection, are being investigated for future application in hGH anti-doping tests. [Copyright &y& Elsevier]

In November 2001, the First International Symposium on Concussionin Sport was held in Vienna, Austria. This meeting was organized by theInternational Ice Hockey Federation (IIHF) in partnership with theFederation Internationale de Football (FIFA) and the InternationalOlympic Committee (IOC) Medical Commission. As part of the resultingmandate for the future, the need for leadership and updates wasidentified. To meet that mandate, the Second International Symposium onConcussion in Sport was organized by the same group and held in Prague,Czech Republic, in November 2004. The original aims of the symposia wereto provide recommendations for the improvement of safety and health ofathletes who suffer concussive injuries in ice hockey, football(soccer), as well as other sports. To this end, a range of experts wereinvited to both meetings in order to address specific issues ofepidemiology, basic and clinical science, injury grading systems,cognitive assessment, new research methods, protective equipment,management, prevention, and long-term outcome. At the conclusion of theinitial conference, a small group of experts was given a mandate by theconference delegates and organizing bodies to draft a documentdescribing the agreement position reached by those in attendance at thatmeeting. That document was copublished in the British Journal of SportsMedicine, the Clinical Journal of Sport Medicine, and The Physician andSportsmedicine.[1] The wider interest base resulting from the firstmeeting and document was reflected by the expanded representation. Newgroups at the second meeting included trauma surgeons, sportpsychologists, and others. The Concussion in Sport Group has producedthe current document as an update of the original Vienna consensusdocument and includes a sideline assessment form with a pocket-sizedsummary card for use by clinicians. This protocol represents a work inprogress and, as with all other recommendations or proposals, it must beupdated as new information is added to the current state of theliterature and understanding of this injury. [ABSTRACT FROM AUTHOR]

In November 2001, the First International Symposium on Concussion in Sport was held in Vienna, Austria. This symposium was organized by the International Ice Hockey Federation (IIHF), the Federation Internationale de Football Association Medical Assessment and Research Centre (FIFA, F-MARC), and the International Olympic Committee (IOC) Medical Commission. The aim of the symposium was to provide recommendations addressing this important topic for the improvement of safety and health of athletes who suffer concussive injuries in ice hockey, football (soccer), and other sports. To this end, a range of experts were invited to address specific issues of epidemiology, basic and clinical science, grading systems, cognitive assessment, new research methods, protective equipment, management, prevention, and long-term outcome, and to discuss a unitary model for understanding concussive injury. At the conclusion of the conference, a small group of experts was given a mandate by the conference delegates and organizing bodies to draft a document describing the agreement position reached by those in attendance at that meeting. For the purpose of this paper, this group will be called the Concussion in Sport Group. [ABSTRACT FROM AUTHOR]

Objective: To provide a clear terminology and classification of muscle injuries in order to facilitate effective communication among medical practitioners and development of systematic treatment strategies. Methods: Thirty native English-speaking scientists and team doctors of national and first division professional sports teams were asked to complete a questionnaire on muscle injuries to evaluate the currently used terminology of athletic muscle injury. In addition, a consensus meeting of international sports medicine experts was established to develop practical and scientific definitions of muscle injuries as well as a new and comprehensive classification system. Results: The response rate of the survey was 63%. The responses confirmed the marked variability in the use of the terminology relating to muscle injury, with the most obvious inconsistencies for the term strain. In the consensus meeting, practical and systematic terms were defined and established. In addition, a new comprehensive classification system was developed, which differentiates between four types: functional muscle disorders (type 1: overexertion-related and type 2: neuromuscular muscle disorders) describing disorders without macroscopic evidence of fibre tear and structural muscle injuries (type 3: partial tears and type 4: (sub)total tears/tendinous avulsions) with macroscopic evidence of fibre tear, that is, structural damage. Subclassifications are presented for each type. Conclusions: A consistent English terminology as well as a comprehensive classification system for athletic muscle injuries which is proven in the daily practice are presented. This will help to improve clarity of communication for diagnostic and therapeutic purposes and can serve as the basis for future comparative studies to address the continued lack of systematic information on muscle injuries in the literature. What are the new things: Consensus definitions of the terminology which is used in the field of muscle injuries as well as a new comprehensive classification system which clearly defines types of athletic muscle injuries.

In November 2001, the 1st International Symposium on Concussion in Sport was held in Vienna, Austria to provide recommendations for the improvement of safety and health of athletes who suffer concussive injuries in ice hockey, football (soccer), and other sports. The 2nd International Symposium on Concussion in Sport was organised by the same group and held in Prague, Czech Republic in November 2004. It resulted in a revision and update of the Vienna consensus recommendations, which are presented here. [ABSTRACT FROM AUTHOR]

Objective: To assess health problems and training environment of female golfers participating in the 2022 World Amateur Team Championships (WATC) and to compare golfers (a) with and without health problems prior the WATC and (b) living and training in countries ranking in the upper versus lower 50% of the team results at the 2022 WATC., Design: Cross-sectional cohort study using an anonymous questionnaire., Setting: International Golf Federation WATC., Participants: One hundred sixty-two female golfers from 56 countries., Interventions: N/A., Main Outcome Measures: Golfers' answers on the presence and characteristics of health problems, their training environment, and to the Oslo Sport Trauma Research Centre Questionnaire., Results: Almost all golfers (n = 162; 96%) answered the questionnaire. In the 4 weeks before the WATC, 101 golfers (63.1%) experienced 186 musculoskeletal complaints, mainly at the lumbar spine/lower back, wrist, or shoulder. Just half of the golfers (50.6%) performed injury prevention exercises always or often. More than a third (37.4%) of the golfers reported illness complaints and 32.5% mental health problems in the 4 weeks preceding the WATC. General anxiety, performance anxiety, and low mood/depression were the most frequent mental health problems. Golfers with injury complaints rated their daily training environment poorer. Golfers ranking in the lower 50% at the WATC had significantly less support staff, rated their training environment poorer, and had a higher prevalence of illness complaints and mental health problems., Conclusions: Effective illness and injury prevention programs should be implemented and better access to education and health support in the daily training environment provided., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The Youth Olympic Games (YOG) are a new format designed by the International Olympic Committee. So far no reference data are available regarding the organisation or implementation of the medical services that were needed for the Winter Youth Olympic Games that took place for the first time in Innsbruck 9-24 January 2012., Objectives: (1) To provide insight into what is needed to prepare for such a complex high level sporting event from a medical perspective, (2) to provide data on medical services for future organising committees and (3) to provide information on different National Olympic Committee (NOC) delegation structures and the consequences of registering a National Olympic Committee Team Physician., Methods: A medical information system in the form of a patient data-management system was developed with all involved parties to standardise data collection. All medical encounters occurring at any IYOGOC medical service centre (including physiotherapy and psychology facilities) were tracked and collected in daily reports. Data evaluation was prepared based on different interest groups (Athletes, National Olympic Committees, Workforce, International Olympic Committee and Media) and analysed., Results: 327 medical encounters (42.8% athletes; out of these, 57.9% were accounted to athletes with own NOC team physician) were seen during the YOG 2012. The total number of hospital transports was 27.3%, of which 8.9% were hospitalised with an average length of 1.9 nights. Physiotherapy usage was low with only 19 medical encounters resulting in a referral to physiotherapy accounting for 67 treatments during the entire YOG. Psychological care service was not used at all. The main reason for illnesses was disorders of the respiratory system (28.8%), injuries mostly affected upper extremities (49.6%) and were mostly diagnosed with lacerations and contusions (26.2%). Injury (70.7%) and illness (29.3%) incidences in athletes were slightly lower than previous studies showed. 40.0% of NOC delegations registered their own team physicians, which led to a significant difference in usage frequency of medical service (-3%, p=0.012)., Conclusions: Medical service coverage at the first Winter Youth Olympic Games seemed to be appropriate. No disaster or epidemic disease challenged the medical service plan. Future organising committees could use the provided data as a reference for their planning efforts.

In less than 10 years after the implementation of the World Anti-Doping Code and of the International Standard for Laboratories and its related Technical Documents, the analysis of human samples for the purpose of anti-doping testing has undergone a noticeable evolution. The research programs developed by the anti-doping organizations, and in particular the World Anti-Doping Agency (WADA), have created an unprecedented momentum in anti-doping science to strengthen the existing analytical methods, as well as to support the development and implementation of new and more sophisticated methodologies by the WADA-accredited laboratories. The integration of technical novelties into the analytical menus has been stimulated by the never-ending challenges posed by the adoption of more complex doping regimens by some athletes and their entourage. This increased sophistication of doping practices has also been reflected in the addition of new doping substances or methods on the WADA Prohibited Substances and Methods List. The integration of new anti-doping scientific paradigms with the development of the Athlete Biological Passport or the foreseen implementation of genomic- and proteomic-based tests constantly reshapes the environment of anti-doping analysis. This article provides a multiangle perspective on some of the key analytical challenges that anti-doping analytical science will face in 2012 and beyond.

Objective: To analyze the incidence and the variety of diseases at Olympic competition venues, non-competition venues and special control zones through the statistical analysis of medical data of Beijing 2008 Olympic Games., Methods: The proportions of people contracting diseases among different groups, i.e. non-registered people, athletes, staff, media, VIPs and others were analyzed. At different venues the incidence proportions of diseases in cardiovascular system, stomatology, gastroenterology, ENT, respiratory system, surgery, neuropsychiatry, physical injury, genitourinary system and burns were calculated. And the disease spectrum and incidence proportions at specified venues were analyzed., Results: 1. Among all groups of people involved in Beijing 2008 Olympic Games, the proportion of disease-contracting staff was the highest (44.83%) while that of VIPs the lowest (4.76%) so that the incidence proportions were different among different groups of people. 2. Chi2 = 2427.803, (P < 0.01) The statistical analysis of disease distribution indicates that people at different venues might contract different diseases. 3. The proportions of disease-contracting people at competition venues, non-competition venues, training venues and special control zones were 36.08%, 50.66%, 2.31% and 10.96% respectively, which was related to the number of people at a particular venue. 4. The incidence proportion of surgical diseases was quite high, especially maxillofacial and orthopedic diseases (orthopedic trauma) ranking as top 2 at all venues. Thus there should be surgeons at every venue, especially maxillofacial (for hockey) and orthopedic surgeons. At training venues, the number of people contracting E.N.T. diseases ranked No. 1, chi2 = 74.859 (P < 0.01), compared with that of non-competition venues at No. 2. So the incidence proportion of ENT diseases was higher at training venues than at non-competition venues. The number of people contracting respiratory diseases was the largest in special control zones and the figure of competition venues ranked at No. 2, chi2 = 123.708 (P < 0.01). Therefore the incidence proportion of respiratory diseases at special control zones was higher than that of competition venues., Conclusion: The proportions of people contracting diseases were different among different groups of people and the staff ranked the first in this regard. People contracted different diseases at different venues so that the distribution of medical resources should cater to this situation. In case of such a large-scale international competition as the Olympic Games, the patients are mainly from competition venues and non-competition venues so these two places have the largest demand for medical staff. The incidence proportion of surgical diseases is quite high and it is important to have maxillofacial and orthopedic surgeons stationed at all the venues. The ophthalmological and ENT specialists are recommended at training venues and respiratory specialists at special control zones. Meanwhile, the gastroenterologic and stomatological specialists should be present at all venues.

Objective: To gather data and examine the use by elite Olympic athletes of food supplements and pharmaceutical preparations in total and per sport, country, and gender., Design: Survey study., Setting: Athens 2004 Olympic Games (OG)., Participants: Data from 2 sources were collected: athletes' declaration of medications/supplements intake recorded on the Doping Control Official Record during sample collection for doping control, and athletes' application forms for granting of a therapeutic use exemption (TUE) and through the abbreviated TUE process (aTUE)., Main Outcome Measures: Classification of declared food supplements according to the active ingredient and medications according to therapeutic actions and active compounds., Results: 24.3% of the athletes tested for doping control declared no use of medications or food supplements. Food supplements (45.3%) continue to be popular, with vitamins (43.2%) and proteins/aminoacids (13.9%) in power sports being most widely used. Nonsteroidal antiinflammatory agents and analgesics were also commonly used by athletes (11.1% and 3.7%, respectively). The use of the hemoderivative actovegin and several nonprohibited anabolic preparations are discussed. The prevalence of medication use for asthma and the dangers of drug interactions are also presented.Laboratory analysis data reveal that of the aTUEs received for inhaled glucocorticosteroids, only budesonide was detectable in significant percentage (10.0%). Only 6.5% of the 445 athletes approved to inhale beta2-agonists led to an adverse analytical finding., Conclusions: This review demonstrates that overuse of food supplements was slightly reduced compared to previous OGs and a more rational approach to the use of medication is being adopted.

Objectives: This study reports on sudden cardiac death (SCD) in sport in the literature and aims at achieving a generally acceptable preparticipation screening protocol (PPSP) endorsed by the consensus meeting of the International Olympic Committee (IOC)., Background: The sudden death of athletes under 35 years engaged in competitive sports is a well-known occurrence; the incidence is higher in athletes (approximately 2/100,000 per year) than in non-athletes (2.5 : 1), and the cause is cardiovascular in over 90%., Methods: A systematic review of the literature identified causes of SCD, sex, age, underlying cardiac disease and the type of sport and PPSP in use. Methods necessary to detect pre-existing cardiac abnormalities are discussed to formulate a PPSP for the Medical Commission of the IOC., Results: SCD occurred in 1101 (1966-2004) reported cases in athletes under 35 years, 50% had congenital anatomical heart disease and cardiomyopathies and 10% had early-onset atherosclerotic heart disease. Forty percent occurred in athletes under 18 years, 33% under 16 years; the female/male ratio was 1/9. SCD was reported in almost all sports; most frequently involved were soccer (30%), basketball (25%) and running (15%). The PPSP were of varying quality and content. The IOC consensus meeting accepted the proposed Lausanne Recommendations based on this research and expert opinions (http://multimedia.olympic.org/pdf/en&#95;report&#95;886.pdf)., Conclusion: SCD occurs more frequently in young athletes, even those under the age of 18 years, than expected and is predominantly caused by pre-existing congenital cardiac abnormalities. Premature atherosclerotic disease forms another important cause in these young adults. A generally acceptable PPSP has been achieved by the IOC's acceptance of the Lausanne Recommendations.

More refereed publications on sports-related concussion have appeared since 2000 than in all previous years combined. Three international consensus statements, documents from the National Athletic Trainers' Association (NATA) and the American College of Sports Medicine (ACSM), and entire issues of the Clinical Journal of Sport Medicine and the Journal of Athletic Training have been devoted to this subject. The object of this article is to critique the consensus statements and NATA and ACSM documents, pointing out areas of controversy.