ABSTRACT
Introduction Brazilian jiujitsu is a relatively new sport that has grown exponentially in popularity along with the growth of the Ultimate Fighting Championship (UFC). In jiujitsu, there are a variety of submissions with a choke hold being one of the most popular. There is a subset of athletes in jiujitsu who believes chokes are safe. However, there have been case reports of relatively young athletes suffering strokes secondary to internal carotid or vertebral artery dissections after being placed in choke holds. There have been manuscripts describing the injury profile in jiujitsu, but none mention stroke or dissections. This study evaluated how frequently chokes happen in jiujitsu and if athletes have ever experienced symptoms consistent with cervical artery dissection (CAD). Additionally, this study aimed to describe the training frequency and baseline demographics of jiujitsu athletes. Methods A survey was distributed throughout social media platforms which asked both quantitative and qualitative questions regarding athlete training. The survey consisted of 28 questions which collected largely baseline grappling information about the participants such as how long they trained, how often they spar, favorite submission, how frequently they are choked, etc. This data was then analyzed using odds ratio and one sample t-test to evaluate for statistical differences. Results A total of 521 participants were included in the analysis. The participants were mostly male (84.7%), trained for four years, four times per week; 99.8% (520) participated in sparring, with an average age of 37; and 55.7% (290) have experienced symptoms consistent with CAD. Descriptive statistics revealed that individuals who were 37 years of age or younger were more likely to experience symptoms consistent with CAD (odds ratio: 1.5337 (95% confidence interval (CI): 1.0827-2.1727). Athletes that were 37 years of age or younger have been training for fewer years (4.7 years vs 8.8 years) but train more days per week (4.03 times per week vs 3.76 time per week), drill for a longer amount of time (46.8 minutes per class vs 38.3 minutes per class), attend longer classes (81.12 minutes vs 72.3 minutes), and train for a longer period of time per week (338.5 minutes vs 274.6 minutes) than athletes over 37 years. All previously mentioned variables were analyzed using a one sample t-test and were significant at the α = 0.05 level. The lone qualitative question regarding the term "train brain" revealed that of those who experienced it, 84.1% (58) described it as a cognitive/physical impairing event. Conclusion Jiujitsu athletes train multiple times per week and are frequently exposed to choke holds. There is no literature to examine the long-term effects of these chokes on the athlete's cervical vasculature. Additional studies should be conducted to evaluate the effects of the repetitive stress placed on these vessels.
ABSTRACT
A 20-month-old miniature mixed-breed heifer weighing 200 kg was presented with a history of dysphagia, sialorrhea and dyspnea after being fed with food residues. At home it was treated with intravenous hydration, antibiotic combination, diuretics and AINEs. Additionally, one failed passage of oro-ruminal tube and several ruminal trocarizations were performed. At clinical examination the animal showed signs compatible with digestive obstruction, severe dyspnea and shock. Complete blood count showed leukocytosis with neutrophilia, left shift and lymphocytosis. Serum chemistry tests showed hyperlactatemia, hypokalemia, hypocalcemia, hyperglycemia and azotemia. Acid-base analysis indicated severe metabolic acidosis and respiratory alkalosis. Esophagoscopy was performed, during which the patient went into shock and died. In necropsy a complete middle third esophageal obstruction with rupture by a carrot was identified.(AU)
Uma novilha miniatura de 20 meses de idade com 200 kg de peso foi apresentada com um histórico de disfagia, sialorréia e dispnéia após ter sido alimentada com resíduos alimentares. Na fazenda, foi tratada com hidratação intravenosa, combinação de antibióticos, diuréticos e AINEs. Além disso, uma passagem falhada do tubo oro-ruminal e várias trocas de ruminal foram realizadas. No exame clínico o animal mostrou sinais compatíveis com obstrução digestiva, dispnéia severa e choque. O hemograma completo mostrou leucocitose com neutrofilia, deslocamento esquerdo e linfocitose. Testes de química sérica mostraram hiperlactatemia, hipocalemia, hipocalcemia, hiperglicemia e azotemia. A análise ácido-base indicou acidose metabólica grave e alcalose respiratória. A esofagoscopia foi realizada, durante a qual o paciente entrou em choque e morreu. Na necropsia foi identificada uma obstrução completa do terço médio do esôfago com ruptura por uma cenoura.(AU)