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The Next Generation of Performance-Enhancing Drugs
Gary I. Wadler, M.D., FACP, FACSM, FACPM, FCP, is an internist with special expertise in the field of drug use in sports. He is the lead author of the internationally acclaimed textbook, Drugs and the Athlete. Dr. Wadler currently serves as the Chairman of the World Anti-Doping Agency's (WADA) Prohibited List and Methods Sub-Committee and serves as an ex-officio member of WADA’s Health, Medicine, and Research Committee. Additionally, he has served as a Medical Advisor to the White House Office of National Drug Control Policy, a Trustee of the Board of the American College of Sports Medicine and of the Women’s Sports Foundation. Among his other sports medicine activities, he has served as Tournament Physician of the U.S. Open Tennis Championships.
For his groundbreaking work in the field of drug abuse in sports, Dr Wadler received the International Olympic Committee's President's Prize in 1993. He is a frequent lecturer on the subject and his opinions are widely sought by the print and electronic media nationally and internationally. In 2007, he was selected by the Institute for International Sport as “One of the 100 Most Influential Sports Educators in America” and serves Chairman of the Communications and Information Committee of the American College of Sports Medicine. In addition, he is Chairman of the American Ballet Theatre's Medical Advisory Board where he oversees the development of medical guidelines for the healthy and sound training of dancers in the United States. Dr. Wadler is the Chairman of the College Council of the State University of New York at Old Westbury. Dr. Wadler maintains a private practice in Internal Medicine and Sports Medicine in Manhasset, New York and is a Clinical Associate Professor of Medicine at the NYU School of Medicine.
Question: What does the next generation of performance-enhancing drugs look like?
Gary Wadler: Well, several things. One, if we look historically, the greatest advances have been made in medicine in the last fifty years and the drugs which we have great pride in because they really help patients are the very drugs that are being abused by athletes. If we look forward, we will continue to develop new drugs and new technologies and there’s no question that we already know factually that there are those who are already trying to get a hold of the new technologies. Now, when I graduated from medical school, we didn’t have diuretics. We had to inject people with mercury. And this sounds kind of wild, but it wasn’t that long ago. We had a very limited number of antibiotics and if you needed to get somebody’s blood count up, you had to give ‘em a lot of transfusions. Things have changed dramatically. Well, if we take several of those changes and see what’s happened; for example, for years people took anabolic steroids because they had anemia, for a variety of causes, to get their red cells up. Well, we realized that if you give them a substance called EPO, erythropoietin, you can stimulate somebody’s bone marrow to make more red cells and so there’ll be a decreased need for transfusions. And so EPO was developed. Now, it turns out, as one can anticipate, EPO was immediately abused. In fact, I reported an epidemic of deaths in four Scandinavian countries in two sports, a sport called orienteering and cycling. And it turned out that all these deaths occurred right after EPO was introduced into Europe. And although we can never prove it, all the evidence suggests it was probably related to EPO. Now EPO typically for a patient would be injected daily. However, we recognized-- or several times a week at least-- we recognized that if we can get a form of EPO that lasted longer, we’d need less injections. Well, sure enough, we developed that and comes along the Olympic Games in Salt Lake and we found that people were abusing the long-acting EPO. Now there’s technology being developed so that you wouldn’t have to inject EPO at all; that’s the gene therapy technologies. Rub a cream on that can turn on a switch in your body to make your own EPO and then turn it off by removing the cream. And, you know, we know that’s probably not too far down the road. Just like in many other forms of therapies, we try to make it easy for patients. And so that’s a good example of that kind of technology. Now, human growth hormone’s a whole other story. Human growth hormone prior to the mid 1980s for people who really needed it-- and I’ll tell you in a second who needs these things-- but people who needed human growth hormone, they were dependent on grinding up pituitary glands of cadavers. Well, it turns out that these cadavers in many cases contained a virus and produced a disease called Jakob-Creutzfeldt disease which is like akin to an Alzheimer’s dementia. Well, so obviously it couldn’t be used clinically because some of the athletes were using it, but with the development of recombinant DNA technology, the same kind of technology we used to develop EPO, they developed synthetic human growth hormone. And so we now are able to treat patients with human growth hormone safely. But as you can expect, human growth hormone has now become one of the mainstays of doping. Now, if it turns out you have a deficiency as a child, you’ll never reach your normal growth status, we treat those individuals. People with end-stage AIDS, wasting disease, we use human growth hormone to treat those people. Then there’s the people who are adults who need to legally be treated, need to have an absolute deficiency of growth hormone because their pituitary gland isn’t working because of either tumor, radiation surgery, trauma or hemorrhage in the area or whatever it might be. In fact, it’s the only drug I know of which you cannot use for off-label purposes. That is, you can only use it for the reason it was approved and it requires the approval of the Secretary of Health and Human Services; that’s how tightly regulated human growth hormone is in the United States. But that’s another example of sort of more primitive technology being replaced by a sophisticated technology and then finding that athletes are then trying to abuse those.
Recorded on: 04/25/2008
Historically, the very drugs that have helped patients are being abused by athletes, says Dr. Wadler.
Are we genetically inclined for superstition or just fearful of the truth?
- From secret societies to faked moon landings, one thing that humanity seems to have an endless supply of is conspiracy theories. In this compilation, physicist Michio Kaku, science communicator Bill Nye, psychologist Sarah Rose Cavanagh, skeptic Michael Shermer, and actor and playwright John Cameron Mitchell consider the nature of truth and why some groups believe the things they do.
- "I think there's a gene for superstition, a gene for hearsay, a gene for magic, a gene for magical thinking," argues Kaku. The theoretical physicist says that science goes against "natural thinking," and that the superstition gene persists because, one out of ten times, it actually worked and saved us.
- Other theories shared include the idea of cognitive dissonance, the dangerous power of fear to inhibit critical thinking, and Hollywood's romanticization of conspiracies. Because conspiracy theories are so diverse and multifaceted, combating them has not been an easy task for science.
A growing body of research suggests COVID-19 can cause serious neurological problems.
- The new study seeks to track the health of 50,000 people who have tested positive for COVID-19.
- The study aims to explore whether the disease causes cognitive impairment and other conditions.
- Recent research suggests that COVID-19 can, directly or indirectly, cause brain dysfunction, strokes, nerve damage and other neurological problems.
Brain images of a patient with acute demyelinating encephalomyelitis.
COVID-19 and the brain<p>A growing body of research reveals alarming neurological complications among COVID-19 patients. On Wednesday, for example, researchers from University College London published a <a href="https://academic.oup.com/brain/article/doi/10.1093/brain/awaa240/5868408" target="_blank">study</a> in the journal Brain that describes how some patients have suffered temporary brain dysfunction, strokes, nerve damage, and other neurological problems concurrent with COVID-19.</p><p>Some patients suffered brain inflammation as a result of a rare disease called acute disseminated encephalomyelitis, which can cause numbness, seizures, and confusion. One patient in the study even hallucinated monkeys and lions in her home.</p>
Photo by Mario Tama/Getty Images<p>A separate study published in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198407/" target="_blank">Journal of Clinical Neuroscience</a> notes that some COVID-19 patients have also suffered neurological complications like impaired consciousness and acute cerebrovascular disease. The study notes that past viruses like MERS and SARS also seemed to cause neurological problems.</p><p>A troubling finding among this growing body of research is that some patients seem to suffer neurological damage even when respiratory symptoms aren't obvious. Additionally, scientists aren't sure whether damage from the disease will be permanent.</p><p style="margin-left: 20px;">"Given that the disease has only been around for a matter of months, we might not yet know what long-term damage COVID-19 can cause," Dr. Ross Paterson, joint first author of the University College London study, said in a <a href="https://www.eurekalert.org/pub_releases/2020-07/ucl-iid070620.php" target="_blank">press release</a>. "Doctors needs to be aware of possible neurological effects, as early diagnosis can improve patient outcomes."</p><p>If you've been diagnosed with COVID-19 and want to enroll in the study, visit <a href="https://www.cambridgebrainsciences.com/studies/covid-brain-study" target="_blank">cambridgebrainsciences.com/studies/covid-brain-study</a>.</p>
Construction of the $500 billion dollar tech city-state of the future is moving ahead.
- The futuristic megacity Neom is being built in Saudi Arabia.
- The city will be fully automated, leading in health, education and quality of life.
- It will feature an artificial moon, cloud seeding, robotic gladiators and flying taxis.
The Red Sea area where Neom will be built:
Saudi Arabia Plans Futuristic City, "Neom" (Full Promotional Video)<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="c646d528d230c1bf66c75422bc4ccf6f"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/N53DzL3_BHA?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Coronavirus layoffs are a glimpse into our automated future. We need to build better education opportunities now so Americans can find work in the economy of tomorrow.
- Outplacement is an underperforming $5 billion dollar industry. A new non-profit coalition by SkillUp intends to disrupt it.
- More and more Americans will be laid off in years to come due to automation. Those people need to reorient their career paths and reskill in a way that protects their long-term livelihood.
- SkillUp brings together technology and service providers, education and training providers, hiring employers, worker outreach, and philanthropies to help people land in-demand jobs in high-growth industries.
Source: McKinsey Global Institute analysis [PDF]<p>Work in understanding the skills at the heart of the new digital economy is leading to novel assessments that allow individuals to prove mastery to faithfully represent their abilities—but also to give weight and stackability to the emerging ecosystem of micro-credentials that make education more seamless across time and education providers. And we are seeing the beginnings of a renewal in the liberal arts, focused on building human skills in affordable ways that are accessible to many more individuals and far more effective.</p><p>Amidst these dark times, there is much opportunity to refresh the nation's education and training solutions to support the success of individuals and society writ large.</p>