El archivo de Archivos: 2004

Marı́n, José Marı́a; Alonso, José

doi:10.1157/13076003

Cited by 7 publications

(3 citation statements)

References 77 publications

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“…In clinical practice, the main criterion to assess an airflow obstruction in the spirometry at rest is a reduction in FEV 1 %11–13 in such a way that an index under 70% is an indication for a bronchodilation test by administering a β-2 agonist.…”

Section: Discussionmentioning

confidence: 99%

β-2 Agonists in sport: are the anti-doping rules meeting the needs of asthmatic athletes?

Orellana¹,

Márquez²

2009

Br J Sports Med

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Objectives (a) To review the methacholine tests performed in our laboratory up until 2008; (b) to compare them with previously reported data in 2006 and (c) to examine if the anti-doping rules are meeting the needs of asthmatic athletes who really need bronchodilator treatment. Methods Between April 2004 and September 2008, 89 high-level athletes were examined in our laboratory in order to obtain an abbreviated therapeutic use exemption for β-2 agonists. Of these, 50 men (23.31 (7.05) years) and 23 women (20.68 (5.94) years) performed a methacholine inhalation test with increasing concentrations of methacholine (0.025, 0.25, 2.5, 5, 10 and 25 mg/ml) until a fall of 20% in forced expiratory volume in 1 s (FEV 1 ) was achieved. Results 31 candidates (42.5%) had a provocative concentration causing a 20% fall in FEV 1 (PC 20 ) <2 mg/ml; 12 (16.4%) were between 2 and 4 mg/ml; 8 (11%) between 4.1 and 8 mg/ml and 22 candidates (30.1%) had a PC 20 >8 mg/ml. Seven of the 73 candidates had an obstructive pattern in the spirometry at rest, demonstrated by a FEV 1 % <70% but with a FEV 1 >70% of the reference value. Conclusions The anti-doping regulations with respect to β-2 agonists need to be reviewed, and measures should be adopted to include a fall of 70% in FEV 1 % as an obstruction criterion to indicate a bronchodilation test and to extend the criterion for a positive methacholine test to a PC 20 of 8 mg/ml.

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Section: Discussionmentioning

confidence: 99%

β-2 Agonists in sport: are the anti-doping rules meeting the needs of asthmatic athletes?

Orellana¹,

Márquez²

2009

Br J Sports Med

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“…In clinical practice, other flow variables can be considered as obstructive response indicators, 8 in particular the expiratory flow between 25% and 75% of forced vital capacity and peak flow. We have found athletes who showed no fall in FEV 1 during provocation tests, but with significant changes in other flow variables measured on the flow volume curve.…”

Section: Discussionmentioning

confidence: 99%

Use of β₂agonists in sport: are the present criteria right?

Orellana

Prada²,

Márquez³

2006

Br J Sports Med

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Background: The regulations for doping control prohibit the use of b 2 agonist bronchodilators (salbutamol, salmeterol, formoterol, and terbutaline) unless the subject follows the procedure known as abbreviated therapeutic use exemption (ATUE). Objective: To highlight how the interest in discovering possible cheats may result in damage to athletes who really need bronchodilator treatment. Methods: Thirty one high level athletes (18 men and 13 women) with a previous diagnosis of asthma were examined in our laboratory in order to obtain an ATUE for b 2 agonists. All the subjects underwent spirometry at rest. If the results were normal, the subjects underwent an effort test and, if negative, a methacholine test inhaling progressive doses of methacholine until a fall of 20% in forced expiratory volume in one second (FEV 1 ) was achieved. The international anti-doping regulations require that the fall in FEV 1 occurs with a concentration of methacholine (PC20) lower than 2 mg/ml (4 mg/ml for Torino 2006). In clinical practice, a test is positive if the response occurs with a PC20 lower than 8 mg/ml. Results: Only one subject met the criterion for the bronchodilation test at rest. The remaining 30 athletes underwent an effort test, which was positive in nine of them. In 21 cases (13 men and 8 women) the effort test was negative so a methacholine test was carried out. Seven (33%) were negative for ATUE with a PC20 higher than 8 mg/ml, seven (33%) were positive for ATUE with a PC20 less than 2 mg/ml, in four (19%) the PC20 was 2-4 mg/ml, and in three (14%) it was 4-8 mg/ml. Conclusions: Strict vigilance of fair play should be pursued, but excessive control can lead to situations of inequality for asthmatic athletes such that a third of athletes cannot be treated with b 2 agonists. Therefore under current regulations, asthmatic athletes are often denied the most effective therapeutic option.

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“…CAP in institutionalized geriatric patients is considered different in terms of etiology, presentation, and prognosis. Very few Spanish studies have been done to confirm that profile, however, so Marín and Alsonso 56 made special mention of that study in their 2005 survey of publications in the 2004 volume of ARCHIVOS DE BRONCONEUMOLOGÍA. Martínez-Moragón and coworkers prospectively analyzed CAP in admitted patients over 65 years old over a period of 18 months, with special attention to functional status and comorbidity.…”

mentioning

confidence: 99%

Pneumonia Awareness Year, 2004: Scientific Impact Through Publications in Archivos de Bronconeumología

Naranjo

Marco

2006

Archivos de Bronconeumología ((English Edition))

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Pneumonia is a common and potentially serious infectious disease. Morbidity and mortality rates continue to be high in spite of major advances and steady progress in diagnosis and treatment. The economic impact of the disease is also great. It is therefore necessary to enlist the public, primary care and emergency physicians, and public policy administrators to join forces to treat and prevent pneumonia for the common good. The annual incidence of pneumonia in the population over the age of 14 years is 1.6 to 2.6 episodes/1000 inhabitants. The mortality rate is 14.1 per 100,000 inhabitants, and the associated costs are 115 million euros annually. The RESPIRA Foundation and the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) declared 2004 to be pneumonia awareness year with the aim of coordinating efforts to raise awareness, distribute information, and foster debate.

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El archivo de Archivos: 2004

Cited by 7 publications

References 77 publications

β-2 Agonists in sport: are the anti-doping rules meeting the needs of asthmatic athletes?

β-2 Agonists in sport: are the anti-doping rules meeting the needs of asthmatic athletes?

Use of β₂agonists in sport: are the present criteria right?

Pneumonia Awareness Year, 2004: Scientific Impact Through Publications in Archivos de Bronconeumología

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El archivo de Archivos: 2004

Cited by 7 publications

References 77 publications

β-2 Agonists in sport: are the anti-doping rules meeting the needs of asthmatic athletes?

β-2 Agonists in sport: are the anti-doping rules meeting the needs of asthmatic athletes?

Use of β2agonists in sport: are the present criteria right?

Pneumonia Awareness Year, 2004: Scientific Impact Through Publications in Archivos de Bronconeumología

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Product

Resources

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Use of β₂agonists in sport: are the present criteria right?