Journal of Sports Medicine & Doping Studies

Hypothetico-deductive model of clinical reasoning was proposed by Mark Jones and it involves the self-reflection and informed clinical decision making process of generating and testing hypotheses in association with the patient’s presenting symptoms and signs. Sports medicine is a dynamic field with an ever-changing wealth of evidence-based information from practice, education and research. The objective of this editorial is to illustrate the application of clinical reasoning in sports medicine explained via the hypothetico-deductive model for a 23-year old female basketball player who presents with unilateral ankle pain after a twisting injury while landing on the foot. The eight hypotheses categories of dysfunction, pathobiological mechanism, and source of symptoms, contributing factors, precautions, management, prognosis and mechanisms of pain were described to illustrate the case example with emphasis on hypotheses generation and testing as an ongoing process in reflective thinking and individualized decision making in sports medicine.

The purpose of this study was to develop and validate a high-performance liquid chromatographic–tandem mass spectrometric (LC–MS/MS) method for analysis of the bromantane in human plasma. The analyte and Internal Standard (IS), selenox, were extracted from human plasma by solid-phase extraction and separated on a Zorbax SB-C18 column using methanol–0.2% formic acid as mobile phase. Detection was performed using an atmospheric pressure chemical ionization source and mass spectrometric positive Multi-Reaction-Monitoring-Mode (+MRM) at an ion voltage of +2000 V. The assay was linear over the concentration range 1–500 ng/mL with the Lowest Limit of Quantification (LLOQ) of 1 ng/mL. The method also afforded satisfactory results in terms of the sensitivity, specificity, precision (intra- and inter-day, CV<10%), accuracy, recovery as well as the stability of the analyte under various conditions. The method can be applied to pharmacokinetic and toxicological studies.

Background: Drug abuse, most notably Anabolic-Androgenic Steroid (AAS) use, in athletes is thought to be widespread. A few drug abusers and persons who express acceptance of drug abuse in sports are known to be present in Japan as well. We investigated the state of drug abuse and attitudes toward drug abuse in sports in a Japanese physical education university from the viewpoint of anti-doping.

Methods: The study sample was comprised of students attending a physical educational university in Japan. An anonymous self-completed questionnaire was given out in two classes at the beginning of the semester from 2008 until 2012, inclusive. Results for the year 2011 are given here. The questionnaire had 5 sections covering responder’s drug use, attitudes toward doping, a hypothetical situation on an athlete’s drug use, dietary supplements, and what the responder eats or drinks before playing a game.

Results: The response rate for the 2011 questionnaire was 100%. There were 2 admitted drug abusers (0.4%) and 774 (99.6%) non-abusers. The use of diuretics was admitted. In Section II, which included a question on what the responder thought of doping, 144 (19.3%) selected “good” and 592 (79.1%) selected “bad”. Section III presented a hypothetical situation whereby the respondent would use a drug undetectable by doping control, win a gold medal and have a lifespan of only 5 years thereafter. In answer to the question of whether the respondent would use the drug under those conditions, 85 (11.4%) answered “yes” and 655 (87.5%) answered “no”.

Conclusions: 20% of the students approved of drug use in sports. Furthermore, based on the response to a question in Section III, it can be speculated that 10% of the students might have used drugs in sports.