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RESEARCH: Mike Loosemore, Charles H Knowles, and Greg P Whyte Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies BMJ 2007; 335: 809 [Abstract] [Full text]

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How did you get that black eye?

Dawn A Sim   (10 October 2007)

Amateur boxing

Simon M. Kemp   (12 October 2007)

common sense and clinical evidence

Alex Van Nieuwenhove   (29 October 2007)

Re: common sense and clinical evidence

alex mehta   (1 February 2008)

How did you get that black eye? 10 October 2007
Dawn A Sim, Specialist Registrar in Ophthalmology Moorfields Eye Hospital, 162 City Road, London EC1V2PD Send response to journal: Re: How did you get that black eye?	I read with interest that Loosemore et al1 found no evidence for a strong association between amateur boxing and chronic traumatic brain injury. Conversely, chronic injury does occur with ocular structures, which like the brain, has a limited ability to renew itself. Eyes face blunt impact directly,and can sustain severe lesions resultant from boxing. These can range from minor anatomical aberrations to severe, visual threatening lesions. Examples include lid lacerations and avulsions, tearing of the sphincter pupillae, peripheral iris or ciliary body, traumatic uveitis, cataract, hyphaema, secondary glaucoma from angle recession, retinal tears and detachments, visual field defects secondary to injuries to the visual pathways. Significant differences have been found between boxers and controls for the number of ocular injuries.2,3 Furthermore, there are significant correlations between the total number of bouts and the total number of losses, and the presence of retinal tears.3 Boxers can have up to ten times the incidence of serious ocular lesions.4 It is important to note that most publications recommend regular evaluations by an ophthalmologist, with emphasis on examination of the peripheral fundus. 1. Loosemore MP, Knowles CH, Whyte GP. Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies. BMJ 2007 doi: 10.1136/bmj.39342.690220.55 2. Wedrich A, Velikay M, Binder S, Radax U, Stolba U, Datlinger P. Ocular findings in asymptomatic amateur boxers. Retina 1993;13(2):114-9. 3. Giovinazzo VJ, Yannuzzi LA, Sorenson JA, Delrowe DJ, Cambell EA. The ocular complications of boxing. Ophthalmology 1987 Jun;94(6):587-96 4. P F Vinger commentary on, M Bianco, A S Vaiano, F Colella, F Coccimiglio, M Moscetti, V Palmieri, F Focosi, P Zeppilli. Ocular complications of boxing. Br J Sports Med 2005;39:70–74. Competing interests: None declared
Amateur boxing 12 October 2007
Simon M. Kemp, Sports Coach PO10 7TX Send response to journal: Re: Amateur boxing	Between 1990 - 1994 it was my pleasure and privilege to coach the England Universities' Amateur Boxing squad. The team I took up to Scotland for an International match in November 1993 contained two Medical Students and was Captained by Alex Mehta MA (Oxon) who was then reading for a PhD in Environmental Law at Oriel College, Oxford University. The British Medical Association has argued that young people under the "Age of Consent" should not be allowed to Box because they may be too young to understand the risks involved in participation in this tough combat sport. Presumably the BMA would accept that someone studying Medicine at Cambridge or Oxford was old enough, and sufficiently well informed, to understand the risks involved in Boxing? Dr. Alex Mehta, winner of four Oxford University Boxing "Blues", is now a successful Barrister-at-Law. Hard to reconcile that record of intellectual achievement with the BMA's claims that "Boxing is bad for the brain." Competing interests: Qualified Amateur Boxing Association Coach
common sense and clinical evidence 29 October 2007
Alex Van Nieuwenhove, freelance medical writer 9041 Gent, Belgium Send response to journal: Re: common sense and clinical evidence	Do we really have to proof with clinical evidence that knocking someone repeatedly till he or she lose consciousness, may be bad for the brain? I would like to refer to a famous systematic review by Gordon Smith and Jill Pell in BMJ 2003;327:1459. They claimed that there is no clinical evidence that parachute use prevent death and major trauma related to gravitational challenge. Competing interests: None declared
Re: common sense and clinical evidence 1 February 2008
alex mehta, lawyer london Send response to journal: Re: Re: common sense and clinical evidence	common sense ... absolutely right. when i was at university training as a boxer, i trained 6 days a week. i dieted. i didnt smoke. and i didnt drink. i dont smoke now. and i drink very little now. in my experience, all the medical students i ever met at any university were the most smoking, drinking and substance taking of all students i ever came across (in my humble opinion). and to me, that is perfectly fine. that is their choice ... medical students are perfectly free to be as wild and as wanton and to take as many substances as they choose. as an oxford educated lawyer and boxer, it is not my place to tell them what to do ... or what not to do ... Competing interests: None declared