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Kenneth A Schwartz - One of the best experts on this subject based on the ideXlab platform.
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anabolic androgenic Steroid Abuse in weight lifters evidence for activation of the hemostatic system
American Journal of Hematology, 1995Co-Authors: Gary S Ferenchick, Shinchirou Hirokawa, E F Mammen, Kenneth A SchwartzAbstract:Anabolic-androgenic Steroid Abuse has recently been linked with acute vascular events in athletes. To date, the relationship between Steroid Abuse and the potential for cardiovascular disease has been considered almost exclusively in terms of lipid metabolism. However, recent reports of thrombosis in androgen abusing athletes with no evidence of atherosclerosis suggests the hypothesis that thrombosis risk in such athletes could be mediated through androgen induced abnormalities of coagulation. To determine if anabolic-androgenic Steroid Abuse in weight lifters is associated with an activation of the hemostatic system we studied forty-nine weight lifters recruited through advertisements. History of androgen use or abstinence was confirmed via urine assays. Plasma was assayed for clotting and fibrinolytic activity by measuring thrombin/ antithrombin complexes (TAT), prothrombin fragment 1 + 2 (F1 + 2), and D-dimers (D-di); markers of the endothelial based fibrinolytic components were assayed by measuring tissue plasminogen activator antigen (t-PA Ag) and its inhibitor (PAI-1); finally, the activity of antithrombin III, protein C, and protein S were measured. Abnormally high concentrations of TAT complexes were noted in 16% of our confirmed Steroid using weight lifters compared to 6% of our confirmed nonusers (P = .01). Steroid users also demonstrated abnormally high concentrations of F1 + 2 and D-dimers when compared to nonusers (44 vs. 24%, P < .001, and 9 vs. 0%, respectively). Non-steriod users were more likely to have elevated levels of t-PA Ag and PAI-1 than our Steroid using weight lifters (both P < .001). The activities of antithrombin III and protein S were more likely to be higher in users compared to nonusers (22 vs. 6%, P = .005; 19 vs. 0%, respectively). Some anabolic-androgenic Steroid using weight lifters have an accelerated activation of their hemostatic system as evidenced by increased generation of both thrombin and plasmin. These changes could reflect a thrombotic diathesis that may contribute to vascular occlusion reported in young athletes using these drugs. The predictive value of these coagulation abnormalities in terms of risk of thrombosis to individual Steroid using weight lifters or the population as a whole remains to be studied. © 1995 Wiley-Liss, Inc.
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androgenic anabolic Steroid Abuse and platelet aggregation a pilot study in weight lifters
The American Journal of the Medical Sciences, 1992Co-Authors: Gary S Ferenchick, Diane Schwartz, Michael Ball, Kenneth A SchwartzAbstract:The Abuse of anabolic-androgenic Steroids by athletes has recently been associated with the development of myocardial infarction and stroke. Because platelets play a pathogenic role in these disorders, the authors hypothesized that androgenic Steroid Abuse among weight lifters was associated with increased platelet aggregation as measured in vitro. Twenty-eight study participants were recruited. Twelve denied current androgen use. However, 8 of these 12 tested positive for urinary androgens. Nonsignificant trends toward increased platelet counts and increased platelet aggregation to adenosine diphosphate were noted when androgen users were compared to nonusers. However, when stratified by age, older (> 22 years) androgen users required lower concentrations of collagen to produce 50% aggregation of test platelets than did younger (≤ 22 years) androgen users (1.47 versus 3.35 μg/ml; p = .01). Further subgroup analysis revealed nonsignificant trends toward increased adenosine diphosphate-induced aggregability and nonsignificant trends in the platelet count in older weight lifters. Subsequent studies using collagen threshold aggregometry revealed no age-dependent effect in 17 other men (aged 18 to 46 years) not specifically selected for activity (r = .17). This study suggests an association between androgen use, age, and increased platelet sensitivity to collagen in weight lifters and may be helpful in explaining recent thrombotic disease in androgen users. It additionally calls into question the validity of subjective reporting when assessing androgen use among weight lifters.
Stan Crowder - One of the best experts on this subject based on the ideXlab platform.
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Anabolic Steroid Abuse in Public Safety Personnel - Motivations and Rationalizations
Anabolic Steroid Abuse in Public Safety Personnel, 2020Co-Authors: Brent E. Turvey, Stan CrowderAbstract:Anabolic Steroid Abusers suffer from low self-esteem, sometimes to the point of delusion and even mental illness. However, this can manifest itself in a variety of ways, and may even result in overcompensation in one form or another. Anabolic Steroid Abusers in law enforcement are prone to a number of related motivations and rationalizations, including performance enhancement, image enhancement, and the desire to frighten and intimidate others. Additionally, public safety leadership often participates in these rationalizations and fails to act, for their own reasons. None of these rationalizations make anabolic Steroid Abuse less of an addiction or a crime. None of them can protect the public safety officer from the adverse side effects of long-term Abuse. And none of them can protect the agency from the liabilities that can result from anabolic Steroid Abuse.
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Scandals and Consequence: Exploring Anabolic Steroid Abuse in Public Safety
Anabolic Steroid Abuse in Public Safety Personnel, 2020Co-Authors: Brent E. Turvey, Stan CrowderAbstract:The nature of anabolic Steroid Abuse scandals in public safety over the past decade evidence a pattern that spans all manner of agencies. They also evidence a pattern of willful negligence and criminal misconduct by not only public safety employees, but their coworkers, supervisors, and the leadership in general. There are three parts to the problem: those committing the crimes of Abuse and distribution; those willfully ignoring the crimes that they see (coworkers and family members); and those failing to hold public safety employees accountable by virtue of arrest, prosecution, and incarceration (investigators, supervisors, and the courts). Those involved in these cases must be brought to justice in a court of law by the public servants charged with upholding it, and publicly held to account for their criminal misconduct. Unfortunately, this kind of accountability is not always in the best interest of our public safety agencies. Consequently, there are those who commit these crimes, admit to them on the record, and draw maps to the crimes of others but with no real fear of any criminal charges being brought. Instead, they are merely fired, or allowed to resign, and the problem moves on to another agency to perpetuate.
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Profiles of Abuse and Addiction: Understanding the Adverse Side Effects of Anabolic Steroid Abuse
Anabolic Steroid Abuse in Public Safety Personnel, 2020Co-Authors: Brent E. Turvey, Stan CrowderAbstract:Prolonged use of anabolic Steroids, especially in high doses, can result in a host of harmful physical and psychological side effects, including death. These vary depending on the Abuser’s sex, method of application, dosage, duration of use, and synergy with other drugs. Those who Abuse anabolic Steroids will focus on short-term performance and image-enhancement benefits while denying, and concealing, any adverse side effects. However, these denials ring hollow as severe adverse side effects are often apparent to even the most casual observer. There are numerous red flags for anabolic Steroid Abuse that should be readily apparent to public safety supervisors and leaders. Failure to monitor for these indicators, and require testing when they are present, is evidence of agency negligence. Consequently, those agencies seeking to maintain the public trust and avoid liability will attend to these considerations as a routine matter.
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The Problem: Anabolic Steroids and Law Enforcement Culture
Anabolic Steroid Abuse in Public Safety Personnel, 2020Co-Authors: Brent E. Turvey, Stan CrowderAbstract:The anabolic Steroid Abuse problem within law enforcement is straightforward. Police culture embraces images of aggression and masculinity, serving up both institutional and social rewards for those that conform. Denying this reality is not reasonable. Anabolic Steroids help provide an easy path to those short-term rewards. However, these rewards are temporary, high risk, and illegal. Additionally, as with any form of illegal drug use, it doesn’t occur in a vacuum. Anabolic Steroid Abuse requires committing any number of crimes and direct association with other criminals—including those who deal other illegal drugs. Law enforcement has a professional obligation to public safety that includes employing and deploying only those officers that are fit for duty. It is not possible to use anabolic Steroids and also maintain psychological or character-related fitness for duty. However, because of related performance- and image-enhancing benefits, in combination with ignorance of the law, anabolic Steroid Abuse is tolerated by some public safety agencies and many in the legal community. This short-sighted approach, which amounts to the burying of heads in the sand, ensures that harm will be caused and that legal liability will be incurred.
Gary S Ferenchick - One of the best experts on this subject based on the ideXlab platform.
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anabolic androgenic Steroid Abuse in weight lifters evidence for activation of the hemostatic system
American Journal of Hematology, 1995Co-Authors: Gary S Ferenchick, Shinchirou Hirokawa, E F Mammen, Kenneth A SchwartzAbstract:Anabolic-androgenic Steroid Abuse has recently been linked with acute vascular events in athletes. To date, the relationship between Steroid Abuse and the potential for cardiovascular disease has been considered almost exclusively in terms of lipid metabolism. However, recent reports of thrombosis in androgen abusing athletes with no evidence of atherosclerosis suggests the hypothesis that thrombosis risk in such athletes could be mediated through androgen induced abnormalities of coagulation. To determine if anabolic-androgenic Steroid Abuse in weight lifters is associated with an activation of the hemostatic system we studied forty-nine weight lifters recruited through advertisements. History of androgen use or abstinence was confirmed via urine assays. Plasma was assayed for clotting and fibrinolytic activity by measuring thrombin/ antithrombin complexes (TAT), prothrombin fragment 1 + 2 (F1 + 2), and D-dimers (D-di); markers of the endothelial based fibrinolytic components were assayed by measuring tissue plasminogen activator antigen (t-PA Ag) and its inhibitor (PAI-1); finally, the activity of antithrombin III, protein C, and protein S were measured. Abnormally high concentrations of TAT complexes were noted in 16% of our confirmed Steroid using weight lifters compared to 6% of our confirmed nonusers (P = .01). Steroid users also demonstrated abnormally high concentrations of F1 + 2 and D-dimers when compared to nonusers (44 vs. 24%, P < .001, and 9 vs. 0%, respectively). Non-steriod users were more likely to have elevated levels of t-PA Ag and PAI-1 than our Steroid using weight lifters (both P < .001). The activities of antithrombin III and protein S were more likely to be higher in users compared to nonusers (22 vs. 6%, P = .005; 19 vs. 0%, respectively). Some anabolic-androgenic Steroid using weight lifters have an accelerated activation of their hemostatic system as evidenced by increased generation of both thrombin and plasmin. These changes could reflect a thrombotic diathesis that may contribute to vascular occlusion reported in young athletes using these drugs. The predictive value of these coagulation abnormalities in terms of risk of thrombosis to individual Steroid using weight lifters or the population as a whole remains to be studied. © 1995 Wiley-Liss, Inc.
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androgenic anabolic Steroid Abuse and platelet aggregation a pilot study in weight lifters
The American Journal of the Medical Sciences, 1992Co-Authors: Gary S Ferenchick, Diane Schwartz, Michael Ball, Kenneth A SchwartzAbstract:The Abuse of anabolic-androgenic Steroids by athletes has recently been associated with the development of myocardial infarction and stroke. Because platelets play a pathogenic role in these disorders, the authors hypothesized that androgenic Steroid Abuse among weight lifters was associated with increased platelet aggregation as measured in vitro. Twenty-eight study participants were recruited. Twelve denied current androgen use. However, 8 of these 12 tested positive for urinary androgens. Nonsignificant trends toward increased platelet counts and increased platelet aggregation to adenosine diphosphate were noted when androgen users were compared to nonusers. However, when stratified by age, older (> 22 years) androgen users required lower concentrations of collagen to produce 50% aggregation of test platelets than did younger (≤ 22 years) androgen users (1.47 versus 3.35 μg/ml; p = .01). Further subgroup analysis revealed nonsignificant trends toward increased adenosine diphosphate-induced aggregability and nonsignificant trends in the platelet count in older weight lifters. Subsequent studies using collagen threshold aggregometry revealed no age-dependent effect in 17 other men (aged 18 to 46 years) not specifically selected for activity (r = .17). This study suggests an association between androgen use, age, and increased platelet sensitivity to collagen in weight lifters and may be helpful in explaining recent thrombotic disease in androgen users. It additionally calls into question the validity of subjective reporting when assessing androgen use among weight lifters.
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anabolic androgenic Steroid Abuse and thrombosis is there a connection
Medical Hypotheses, 1991Co-Authors: Gary S FerenchickAbstract:Abstract Anabolic/adrogenic Steroid Abuse is an increasing medical and public health problem. The uncontrolled use of these agents has been associated with numerous toxic side-effects including deleterious cardiovascular changes. The most widely reported to these latter changes include the development of adverse lipid profiles and hypertension. Acute thrombosis has only recently been linked to androgen Abuse. Such a causative link has been proposed in reports of acute myocardial infarction and stroke in several athletes using androgens. Unfortunately, there exists no direct evidence that androgens are thrombogenic in humans. However, indirect experimental data suggests that androgens affect platelet aggregation, coagulation proteins and the vascular system in ways that facilitate thrombosis. Androgens also increase several anticoagulant and fibrinolytic proteins. However, they have not been shown to protect from thrombosis in high risk patients. Existing data supports a possible thrombogenic effect of exogenous androgens. Further studies are needed to clarify the hemostatic influence associated with androgen Abuse in weightlifters. The Abuse of these agents may diminish if acute thrombosis becomes clearly and scientifically associated with their uncontrolled use.
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Anabolic/androgenic Steroid Abuse and thrombosis: Is there a connection?
Medical Hypotheses, 1991Co-Authors: Gary S FerenchickAbstract:Abstract Anabolic/adrogenic Steroid Abuse is an increasing medical and public health problem. The uncontrolled use of these agents has been associated with numerous toxic side-effects including deleterious cardiovascular changes. The most widely reported to these latter changes include the development of adverse lipid profiles and hypertension. Acute thrombosis has only recently been linked to androgen Abuse. Such a causative link has been proposed in reports of acute myocardial infarction and stroke in several athletes using androgens. Unfortunately, there exists no direct evidence that androgens are thrombogenic in humans. However, indirect experimental data suggests that androgens affect platelet aggregation, coagulation proteins and the vascular system in ways that facilitate thrombosis. Androgens also increase several anticoagulant and fibrinolytic proteins. However, they have not been shown to protect from thrombosis in high risk patients. Existing data supports a possible thrombogenic effect of exogenous androgens. Further studies are needed to clarify the hemostatic influence associated with androgen Abuse in weightlifters. The Abuse of these agents may diminish if acute thrombosis becomes clearly and scientifically associated with their uncontrolled use.
Donald H Gilden - One of the best experts on this subject based on the ideXlab platform.
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disseminated vzv infection and asymptomatic vzv vasculopathy after Steroid Abuse
Journal of Clinical Virology, 2015Co-Authors: M Nagel, Daniela Lenggenhager, Teresa White, Nelly Khmeleva, Anna Heintzman, Philip J Boyer, Donald H GildenAbstract:A 60-year-old man who Abused corticoSteroids developed thoracic-distribution zoster. Varicella zoster virus (VZV) DNA was found in non-healing skin 3 months later. He died suddenly 2 months later. Skin was ulcerated and necrotic. VZV was widespread in organs and arteries, particularly coronary arteries and aorta, with VZV vasculopathy in the posterior cerebral artery.
Emanuela Turillazzi - One of the best experts on this subject based on the ideXlab platform.
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anabolic Steroid Abuse and cardiac sudden death
2009Co-Authors: Vittorio Fineschi, G Baroldi, Floriana Monciotti, Laura Paglicci Reattelli, Emanuela TurillazziAbstract:Abstract Context.—Androgenic anabolic Steroids (AAS) used for improving physical performance have been considered responsible for acute myocardial infarction and sudden cardiac death. Objective.—To establish the relationship between AAS and cardiac death. Design.—Case report. Patients.—Two young, healthy, male bodybuilders using AAS. Main Outcome Measures.—Pathologic cardiac findings associated with AAS ingestion. Results.—The autopsy revealed normal coronary arteries. In one case, we documented a typical infarct with a histologic age of 2 weeks. A segmentation of myocardial cells at the intercalated disc level was observed in the noninfarcted region. This segmentation was the only anomaly detected in the second case. No other pathologic findings in the heart or other organs were found. Urine in both subjects contained the metabolites of nortestosterone and stanozolol. Comment.—A myocardial infarct without vascular lesions is rare. To our knowledge, its association with AAS use, bodybuilding, or both lack...
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anabolic Steroid Abuse and cardiac sudden death a pathologic study
Archives of Pathology & Laboratory Medicine, 2001Co-Authors: G Baroldi, Floriana Monciotti, Paglicci Reattelli L, Emanuela TurillazziAbstract:c Context.—Androgenic anabolic Steroids (AAS) used for improving physical performance have been considered responsible for acute myocardial infarction and sudden cardiac death. Objective.—To establish the relationship between AAS and cardiac death. Design.—Case report. Patients.—Two young, healthy, male bodybuilders using AAS. Main Outcome Measures.—Pathologic cardiac findings associated with AAS ingestion. Results.—The autopsy revealed normal coronary arteries. In one case, we documented a typical infarct with a histologic age of 2 weeks. A segmentation of myocardial cells at the intercalated disc level was observed in the noninfarcted region. This segmentation was the only anomaly detected in the second case. No other pathologic findings in the heart or other organs were found. Urine in both subjects contained the metabolites of nortestosterone and stanozolol. Comment.—A myocardial infarct without vascular lesions is rare. To our knowledge, its association with AAS use, bodybuilding, or both lacks any evidence of a causeeffect relationship. The histologic findings in our 2 cases and in the few others reported in medical literature are nonspecific and do not prove the cardiac toxicity of AAS. A better understanding of AAS action on the neurogenic control of the cardiac function in relation to regional myocardial contraction and vascular regulation is required. (Arch Pathol Lab Med. 2001;125:253‐255)