Some protein food supplements intended for athletes may be adulterated with pharmacologically active substances, including anabolic steroids and prohormones. The addition of these substances is aimed at enabling manufacturers to achieve rapid sales growth by promising quick increases in strength and muscle mass. However, the consumption of these products will lead to a positive result in a routine anti-doping test, along with all of the consequences that will directly affect an athlete’s career and reputation. At the same time, the illicit use of anabolic steroids continues to evolve across numerous sport disciplines. Moreover, vicious cheaters try to cover up their illegal actions by using various pharmacological agents to mask detection in anti-doping tests. This narrative review focuses on two situations—the innocent athlete and the vicious cheater. The athlete involved in inadvertent doping will suffer the consequences of doping, making close collaboration with medical staff extremely important. The analytic strategies described here address anabolic steroid doping detection and cheating using masking agents. This approach, based on biochemical changes, examines how these substances interfere with the testosterone pathway, from synthesis to elimination. Using masking agents alters the steroid profile, and the modifications produced by each agent are the subject of a detailed presentation. For most honest athletes, these findings support the initiation, development, and refinement of strategies for identifying food supplements with added illegal substances. Every athlete must have access to these approaches in order to avoid becoming vulnerable to sports fraud.
Inactivity negatively influences general health, and sedentary behaviour is known to impact the musculoskeletal system. The aim of the study was to assess the impact of time spent in active and sedentary behaviour on foot muscle strength. In this observational study, we compared the acute effects of one day of prolonged sitting and one day of low-to-moderate level of activity on ankle torque in one group of eight healthy participants. Peak ankle torque was measured using a portable custom-made electronic dynamometer. Three consecutive maximal voluntary isometric contractions for bilateral plantar flexor and dorsiflexor muscles were captured at different moments in time. The average peak torque significant statistically decreased at 6 h (p = 0.019) in both static and active behaviours, with a higher average peak torque in the active behaviour (p < 0.001). Age, gender, body mass index and average steps did not have any significant influence on the average value of maximal voluntary isometric contraction. The more time participants maintained either static or active behaviour, the less force was observed during ankle torque testation. The static behaviour represented by the sitting position was associated with a higher reduction in the average peak ankle torque during a maximal voluntary isometric contraction when compared to the active behaviour.
Background. GLASS (Global Limb Anatomic Staging System) classification is a classification proposed in 2019 by The Lower Extremity Guidelines Committee of the Society for Vascular Surgery, which aims to identify the anatomic substrate that defines the severity of a lower extremity arterial injury and predict the success rate of possible revascularization. The aim of the study is to demonstrate the usefulness of this classification and if it is a reliable tool in predicting the success of the revascularization procedures for patients with chronic limb-threatening ischemia (CLTI). Methods. A retrospective study was conducted on patients undergoing revascularization for CLTI. Glass staging was applied to angiographic data, categorizing them into GLASS 1, 2, or 3 based on the complexity of the femoropopliteal and infrapopliteal lesions. We investigated the clinical characteristics and types of endovascular treatment in correlation with GLASS classification. We also evaluated the technical success of revascularization procedures and the specificity and accuracy of the GLASS classification. Results. After the first testing, we found out that GLASS classification has a sensitivity of 63% and a specificity of 77%. After the second testing, the sensitivity was 82%. of 77% also. The follow-up of this sample was made after 1 year, with no patients lost to follow-up and with an amputation-free survival of 81.3%. Conclusions. GLASS 1 and 2 patients had significantly higher rates of success compared to GLASS 3. GLASS serves as a valuable tool in predicting revascularization success and provides a standardized approach to anatomical complexity, but further studies should integrate more data in order to enhance its predictive capability.
Introduction: Contrast-induced nephropathy (CIN) has emerged as a prevalent and serious complication associated with the administration of iodinated contrast media during diagnostic and therapeutic procedures. Given the rising global prevalence of chronic kidney disease(CKD,) it is crucial to gain a deeper understanding of the risks linked to contrast media exposure. Therefore, the aim of this study, conducted at the Vascular Surgery Clinic in a tertiary hospital in Eastern Europe (Timisoara, Romania), is to assess the incidence of CIN and identify its associated risk factors among patients undergoing endovascular interventions. Methods: This retrospective cohort study was conducted using data from patients treated at a vascular surgery clinic in Timisoara, Romania, between 1 January 2018 and 31 December 2023. The study population included adult patients who underwent scheduled endovascular procedures and had serum creatinine measurements both before and after the procedure. Results: A total of 331 patients were included in the analysis (71.42% males with a mean age of 66.79 ± 9.86 years). In total, 9.22% of the patients had CKD, while 23.8% developed CIN. The mean age was significantly higher in the CIN group (68.4 years) compared to the non-CIN group (66.32 years) with a p-value of 0.093, indicating that older age is associated with a higher risk of CIN. A multivariate logistic regression analysis was performed to assess the association between various factors and the development of CIN. Higher hemoglobin levels were associated with reduced odds of CIN (OR = 0.792, 95% CI: 0.659–0.952, p = 0.0148), indicating that anemia is a significant risk factor for CIN, while CKD significantly increased the odds of CIN by 85.8% (OR = 1.858, 95% CI: 1.105–3.125, p = 0.0023), establishing CKD as a critical risk factor for CIN. Conclusions: While anemia and CKD were found to be significant predictors of CIN, further research on a wider population is required to validate these findings and explore additional risk factors. Our study shows that, in the context of elective endovascular procedures, addressing anemia correction and stabilizing creatinine levels to baseline represents a crucial strategy for reducing the risk of CIN.
Acute limb ischemia is a limb-threatening condition that is associated with a high degree of mortality and morbidity, with the latter related to acute kidney injury and rhabdomyolysis that can rapidly lead to multiple organ failure. The aim of this study was to assess the efficacy and safety of catheter-directed arterial thrombolysis in acute lower limb ischemia in the Department of Vascular Surgery, Timișoara, Romania. A total of 158 patients (114 males—72.15% and 44 females—27.85%) with symptoms of acute lower limb ischemia were admitted and treated with catheter-directed arterial thrombolysis following our protocol. The amputation-free survival rate at 1 month after the thrombolysis was 82.3%, and at 6 months it was 77.85%. The performance of additional procedures to obtain distal perfusion was predictive of an improved outcome at 30 days. The estimated survival rate at 6 months was 84.81% (SE 0.02). The mean survival time was 158.74 days. We recommend the usage of a thrombolytic regimen in patients with a life expectancy of more than 6 months, even in Rutherford stage IIb patients, if there is no major impairment in the sensorial and mobility function of the ischemic leg.
Portable, custom-made electronic dynamometry for the foot and ankle is a promising assessment method that enables foot and ankle muscle function to be established in healthy participants and those affected by chronic conditions. Diabetic peripheral neuropathy (DPN) can alter foot and ankle muscle function. This study assessed ankle toque in participants with diabetic peripheral neuropathy and healthy participants, with the aim of developing an algorithm for optimizing the precision of data processing and interpretation of the results and to define a reference frame for ankle torque measurement in both healthy participants and those affected by DPN. This paper discloses the software chain and the signal processing methods used for voltage—torque conversion, filtering, offset detection and the muscle effort type identification, which further allowed for a primary statistical report. The full description of the signal processing methods will make our research reproducible. The applied algorithm for signal processing is proposed as a reference frame for ankle torque assessment when using a custom-made electronic dynamometer. While evaluating multiple measurements, our algorithm permits for a more detailed parametrization of the ankle torque results in healthy participants and those affected by DPN.