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AMHE Newsletter fall2019 october 28 Haitian Medical Association Abroad Association Medicale Haïtienne à l'Étranger Newsletter # 266 AMHE NEWSLETTER Editor in Chief: Maxime J-M Coles, MD Editorial Board: Rony Jean Mary, MD Reynald Altema, MD Technical Adviser: Jacques Arpin The hidden face of boxing Maxime Coles MD In this number - Words of the Editor, Maxime Coles,MD - APPEAL for Peace… - La chronique de Rony Jean-Mary,M.D. - AMHE Students Resident Corner - La chronique de Reynald Altéma,M.D. - Donate now to the AMHE Dorian Fund - Un cabri haïtien parle à l’Assemblée générale des Nations unies - Upcoming event - Donate now to the AMHE Foundation Dorian Fund - And more 2 which lasted 3 hours and six minutes. Both boxers were In the past, amateur boxers were found to have a exhausted, collapsed in the 99th round and could not get longer career in spite of many unsupervised bouts up. Byne won the fight but died three days later. each day, without any medical supervision. They fought with 6 oz. gloves and the ring official showed Tom Molineaux, a former slave fought in England and less willingness to stop bouts when a boxer was retired in 1815 to turn himself to drinking alcohol and overmatched. There was also no mandatory exclusion died in poverty at age 34. Many articles from the United after a knockout or a head injury. It appears that the Kingdom and Australia. have discussed the lifetime of a period of the great depression in the 1930’s was professional boxer in the ring, dropping from 19 years to responsible for the longer involvement of boxers in five years because of fear of Traumatic Brain Injuries. the ring because of financial gains. More, many The training activities looked at less interactions with professional boxers at retirement chose to become sparring partners to avoid repeated injuries to the brain, an professional sparring partners or tent/boot boxer with increase in monitoring by a medical team, with frequent their documented neurological problems. neuroimaging assessment for early detection of traumatic brain injuries. This routine has alerted the team to There is currently a false perception that professional encourage the fighter’s longevity in the ring and to boxing is decreasing in popularity around the world minimize brain injuries. especially not in the United Kingdom, Australia or the United States. The prevalence of Chronic brain What in the past was called a “punch drunk syndrome” is injury may be difficult to determine but if one has now termed “Chronic traumatic brain injury” (CTBI)!!! A expected to find in professional boxing, a “dying art”, constellation of Neurological symptoms affecting the recent statistics have proven the inverse. The sport pyramidal, cerebellar and extrapyramidal domains enjoys a popularity everywhere. A significant risk become predictable. Cognitive impairment is seen in the reduction in terms of exposure to head injury was late stages as well as neuropsychiatric and behavioral observed overtime, but unfortunately, challenged by symptoms. Amateur boxers showed the same signs at a the three recent championship fights which resulted lower incidence than the professional boxer.in spite of in the death of a boxer following knockdown blows their protective headgear and shorter bouts. to the head. There were 266 documented deaths during the era (1740- Boxing exposure, as a surrogate for repetitive 1889) before gloves were introduced in the rings. concussive head trauma is a risk factor for Chronic Between 1809 and 2019, it was found that 1876 boxers Traumatic Brain Injury. Mandatory computerized have died as a result of blows to the head. Statistics were cognitive screening, magnetic resonance scans, Apo reported by Manuel Velazquez after one of his friend, a E genotyping are now required in the United retired boxer (Pete “Kid Indian” Nebo) was confined to a Kingdom and Australia to be performed each three mental institution following multiple blows to the head years to allow a boxer to continue fighting. Neuro- and judged incompetent. His compilation of events was diagnostic methods to assess the frequency of later updated after his death by Joseph Smith. Chronic Traumatic Brain Injury are non-existent. It is difficult to understand why such sport is still Death in the ring never stopped. A 49–year-old Italian permitted by the authorities in charge of the (Christian Daghio) became a fatality in November 2018, regulations. It is true that the boxers practicing this in a World Boxing Council title fight in Thailand when he art is also aware of the risk of injury. was knocked down twice in the 12th round of the match. Taken to the hospital, he was pronounced dead two days In the past, many boxers had a rough life. They were after. It is now a pattern in boxing, when an American gang members or served time in prison. They fought boxer, of Haitian descent, Patrick Day was knocked down with different kind of gloves without any medical as well in the 4th, 7th and 10th rounds during a supervision. Knockdown on knockdown, these championship fight in Chicago and carried out on a fighters will stand up and continue to fight. Boxing stretcher with a head injury. He never recovered from a was their way of life. coma and died two days later. Two more fighters in the earlier months have succumbed from blows to the head One remembers certainly, decades ago, the long following their Knock-down. boxing fight between Espana and Lira, for the World 3 Boxing Association in a fight for the Lightweight title. fight to continue. The ring physician cleared the boxer Ernesto Espana threw an uppercut which snap his for any neurological damage. Abdusalamov was found opponent’s head upward in a gush of blood over the in a coma after the fight at a Hospital and never re- right eye, stopping Johnny Lira in nine rounds. Lira gained the ability to speak or to walk. In 2017, the suffered a broken jaw. Howard Cosell did not State of New York agreed to pay the boxer 22 million. understand that he was witnessing a fight who took the A writer wrote a plea to ban boxing. “life” of Johnny Lira. The ring doctor stopped the fight and Espana won by a technical knock-out. In a basement in Chicago, a gym’s owner, Glenn Leonard, 6 foot-tall, gave up his boxing carrier to work Cosell is now dead and Johnny Lira suffered from as a trainer and rarely gets into the ring to spar and paranoia, forgetting things and drinking profusely. His when asked why he quitted fighting, he responded that speech become slurred and he used sign-languages he he suffered from headaches. Other boxers may present picked up while training young deaf boxers. The with a history of paranoia or with violent behavior and boxing community in Chicago rallies around and held mood swings. Some have terrorized members of their fundraisers to pay for his medical bills. He died families with violence to a point that they used the penniless like many others. extreme act of suicide to put an end to their life. In 1982, Barry Mc Guigan fought Young Ali and Ali We have demonstrated in a previous AMHE went to a coma to never recovered. In the late 2015, Newsletter (#254) what science believes happen in the Hamzah Aljahmi died in Ohio following his early stages of CTE where people with a history of professional debut. In 2016, Mike Towell a Scottish concussion and repeated blows to the head like in NFL boxer died after a match in Glascow. Nick Blackwell players present with memory loss, slowness of an English boxer was forced to retire after a head movement because the brain is affected. You would injury sustained during a fight. The boxers who haven’t expect many boxers to come forward with symptoms. died in the ring, have healed their bloodied noses or Unfortunately, they appear to be in denial and refused their split lips. The old “Punch Drunk” is now better to talk about the blows to the head responsible for called Chronic Traumatic Encephalopathy (CTE). some of their symptoms. Most boxers in such condition are amateurs and they have little support. In April 2013, a Zambian-born boxer, Michael (Hitman) Norgrove felt dizzy during his sixth A movie in 2015 in which Will Smith played the professional fight which was stopped by the referee. significant role of a professional Football player with He died in the hospital following the fight. A Mexican Chronic Traumatic Brain Injury, has bought to light the boxer, Frankie, “the little soldier “was knocked out and consequences of repeated blows to the head. After carried out on a stretcher in March 2012, but returned viewing it, people had the tendency in believing that to fight in October 2013. He was again knocked down this condition was strictly seen in professional Football to the canvas in Cabo San Lucas. He died days after. players, victims of the disease. In fact, the first known description of an athlete with Chronic Traumatic Brain An Australian fighter Davey Browne Jr fought Carlo Injury was reported in boxers by a New-Jersey Magali from Philippines in a 12 rounds super- physician, Harrison Martland MD, in an article called featherweight fight in Sydney, but unfortunately took a “Punch drunk” in 1928. A second physician JA crashing blow to the head which knocked him down. Millspaugh MD, named the condition “dementia He was transported to the hospital and died four days pugilistica” but now the term Chronic Traumatic later from a brain injury. Scott Westgarth in February Encephalopathy is coined (CTE).

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