The systolic pulmonary artery pressure and the E/e' ratio decrease after septoplasty in patients with grade 2 and 3 pure nasal septal deviation.

INTRODUCTION: Nasal septal deviation may contribute to a wide range of symptoms including nasal obstruction, headache, increased secretion, crusting, mucosal damage, and loss of taste and smell. Excessive increase in the respiratory resistance, as seen in nasal septal deviation, results in reduced lung ventilation, thereby potentially leading to hypoxia, hypercapnia, pulmonary vasoconstriction. The deformities in the nasal cavity can be associated with major respiratory and circulatory system diseases. OBJECTIVE: To investigate cardiovascular effects of septoplasty by comparing pre- and postoperative transthoracic echocardiography findings in nasal septal deviation patients undergoing septoplasty. METHODS: The prospective study included 35 patients with moderate and severe nasal septal deviation (mean age, 23.91±7.01) who underwent septoplasty. The Turkish version of the nasal obstruction symptom evaluation, NOSE questionnaire, was administered to each participant both pre- and postoperatively in order to assess their views on the severity of nasal septal deviation, the effect of nasal obstruction, and the effectiveness of surgical outcomes. A comprehensive transthoracic echocardiography examination was performed both preoperatively and at three months postoperatively for each patient and the findings were compared among patients. RESULTS: Mean preoperative NOSE score was 17.34±1.62 and the mean postoperative score was 2.62±1.68 (p=0.00). Mean preoperative systolic pulmonary artery pressure value was 22.34±4.31mmHg and postoperative value was 18.90±3.77mmHg (p=0.00). Mean E/e' ratio was 5.33±1.00 preoperatively and was 5.01±0.90 postoperatively (p=0.01). The NOSE scores, systolic pulmonary artery pressure values, and the E/e' ratios decreased significantly after septoplasty (p<0.05 for all), whereas no significant difference was found in other transthoracic echocardiography parameters (p>0.05). CONCLUSION: The decrease in NOSE scores following septoplasty indicated that the satisfaction levels of the patients were increased. Upper airway obstruction secondary to nasal septal deviation may be a cardiovascular risk factor and may affect transthoracic echocardiography measurements. Moreover, the significant decrease in the systolic pulmonary artery pressure value and E/e's ratio following septoplasty indicated that negative echocardiographic findings may be prevented by this surgery.

Fútbol en la altura en Bolivia / football at altitude in Bolivia

El presente trabajo se realizó en razón del tercer veto emitido por la FIFA, de jugar partidos eliminatorios para Copas Mundiales de Fútbol en alturas por encima de los 2500 m. Los objetivos del estudio se basaron en las preocupaciones de la FIFA por la preservación de la salud de los jugadores de fútbol y por la garantía de oportunidades iguales respecto al rendimiento físico cuando se juega a gran altura. En consecuencia se hizo un estudio comparativo entre un equipo de fútbol aclimatado a la altura de la Paz (3600 m) (equipo HAT; 10 jugadores) y otro equipo que vivía y entrenaba en una altura cercana a nivel del mar (60 m) (equipo LAT; 10 jugadores). Ambos equipos fueron estudiados en los laboratorios del Instituto Boliviano de Biología de Altura (IBBA) y en altura cercana al nivel del mar (Hotel América; Santa Cruz, 420m). La salud fue evaluada aplicando el cuestionario de Lake Louise para establecer la presencia de Enfermedad Aguda de Altura (EAA), así como mediante pruebas funcionales respiratorias y estimación de la presión arterial pulmonar sistólica(PAPs) mediante Eco Doppler. El rendimiento físico fue evaluado mediante prueba de esfuerzo máximo en rampa conmedición del consumo máximo de oxígeno (VO2max) y parámetros relacionados. Los resultados mostraron valores delVO2max algo mayores en la altura en HAT que en LAT. PAPs fue significativamente mayor a gran altura en ambos equipos. Proponemos un tiempo de aclimatación de 72 horas previa a los partidos de fútbol en La Paz en base a las estadísticas elaboradas que toman en cuenta el resultado de los partidos en relación con el tiempo de estadía en La Paz.

The present study was conducted as response to the third veto by FIFA against playing eliminatory football games forFIFA World Cups at altitudes above 2500 m. The aim of the study took into account FIFA ́s preoccupations with regard tothe health of the football players and concerning igual opportunities for physical performance when playing at high altitude. Consequently, a comparative study was conducted of two football teams, one acclimatized to the altitude of La Paz (3600m) (HAT, 10 players), and the second one living and training at an altitude close to sealevel (60 m) (LAT, 10 players). Bothteams were examined in the laboratories of he Instituto Boliviano de Biología de Altura (IBBA) and at an altitude close tosealevel (Hotel América, Santa Cruz, 420 m). Health was assessed applying the Lake Louise scoring system for AcuteAltitude Sickness as well as by measuring pulmonary function and by assessing systolic pulmonary artery pressure (PAPs)using theEcho Doppler technique. The physical capacity was measured by a progressive maximal exercise test on atreadmillwith determination of the maximal oxygen uptake (VO2max) andrelated parmeters. The results I howed a VO2max somwht higher at high altitude in HAT than in LAT. PAPs was significantly higher at high than at low altitude in bothteams. Wepropose an acclimatization time of 72 hours previous to football games in La Paz based on statistics that tookinto account the results of the games in relation to the time of the stay in La Paz.