Validity of a novel device for indoor analysis of cyclists' drag area.

PURPOSE: Cyclists need to measure aerodynamic resistance accurately and reliably, as well as economically. Devices such as Notio Aerostick, an equipment device that includes one pitot tube, have appeared for this purpose. The aim of this study is, therefore, to test the reliability and degree of agreement in the evaluation of the CdA (coefficient of aerodynamic drag), assessed by means of the Notio Aerostick compared to the Virtual Elevation (VE) and Martin mathematical models. METHOD: Seventeen professional cyclists rode in a 250-metre-long velodrome covered with a concrete surface with their own time trial bikes. Each cyclist completed three rides of 15 laps at constant speed for the evaluation of the CdA, each of them in a different position [Baseline (B), Change 1 (C1) and Change 2 (C2)]. RESULTS: The differences in CdA between methods were found for Martin in comparison with VE in all positions (p <.001) and with Notio Aerostick in B and C2 (p> .05). About differences of CdA for each method, considering between position changes, the results were the same for VE and Martin, but different for Notio Aerostick. CONCLUSIONS: Findings suggest that, notwithstanding Notio Aerostick is valid if we compare CdA values with respect to VE, since the direction of their between-positions CdA changes differs, the results of their aerodynamic evaluation could lead us to recommend different final setups. We need studies that evaluate different units of the Notio Aerostick device as well as the reliability and precision of each sensor that includes Notio Aerostick.HighlightsThe CdA calculated by the Notio Aerostick and VE, a mathematical model previously validated, can be interchangeable, however the final position recommended by each method may be different, since the changes in the following position are given by the changes of the CdA in the previous position.None of the three methods allowed elite cyclists to measure statistically significant differences between the proposed setups.Although the CdA differences between positions were not significant, they can be decisive in the final result of a time trial competition.

Anthropometric characteristics according to the role performed by World Tour road cyclists for their team.

Certain anthropometric characteristics are required for athletes to successfully perform in elite endurance sports. The present study aims to analyse the anthropometric characteristics of professional cyclists according to their specialty. Anthropometric measurements were conducted of the body composition of 76 male professional road cyclists in line with International Society for Advancement of Kinanthropometry protocol. Fat mass did not differ (p > 0.05) between climbers, all-rounders and flat specialists, although the following anthropometric variables did differ according to the role played within the team (p < 0.05): Body mass (climbers: 63.8 ± 3.6, all-rounders: 68.8 ± 5.3, flat specialists: 74.5 ± 5.6 kg) skeletal body mass (climbers: 29.7 ± 1.6, all-rounders: 31.4 ± 1.9, flat specialists: 33.5 ± 2.4 kg); body surface area (climbers: 1.78 ± 0.07, all-rounders: 1.89 ± 0.10, flat specialists: 1.96 ± 0.1 m2); frontal area (climbers: 0.33 ± 0.01, all-rounders: 0.35 ± 0.02, flat specialists: 0.36 ± 0.02 m2). Anthropometric characteristics differ between world-class cyclists depending on their specialty. These differences could influence performance in relation to different types of road cycling competitions. The present study identified characteristics that could be used by coaches to evaluate their athletes in the context of elite or professional road cycling.HighlightsNormative reference values of a large sample of professional cyclists of the highest category are presented.Anthropometric characteristics differ between world-class cyclists depending on their specialty.Body mass, BMI, height and skeletal muscle mass are determining factors to determine the role of the cyclist.

Validity and reliability of different smartphones applications to measure HRV during short and ultra-short measurements in elite athletes.

BACKGROUND AND OBJECTIVE: Heart rate variability (HRV) has been proposed as a useful marker that can show the performance adaptation and optimize the training process in elite athletes. The development of wearable technology permits the measurement of this marker through smartphone applications. The purpose of this study is to assess the validity and reliability of short and ultra-short HRV measurements in elite cyclists using different smartphone applications. METHOD: Twenty-six professional cyclists were measured at rest in supine and in seated positions through the simultaneous use of an electrocardiogram and two different smartphone applications that implement different technologies to measure HRV: Elite HRV (with a chest strap) and Welltory (photoplethysmography). Level of significance was set at p < 0.05. RESULTS: Compared to an electrocardiogram, Elite HRV and Welltory showed no differences neither in supine nor in seated positions (p > 0.05) and they showed very strong to almost perfect correlation levels (r = 0.77 to 0.94). Furthermore, no differences were found between short (5 min) and ultra-short (1 min) length measurements. Intraclass correlation coefficient showed good to excellent reliability and the standard error of measurement remained lower than 6%. CONCLUSION: Both smartphone applications can be implemented to monitor HRV using short- and ultra-short length measurements in elite endurance athletes.

Heart rate dynamics and lactate following high-intensity race-pace continuous vs interval workouts in highly trained athletes.

PURPOSE: The present study aimed to compare the physiological responses of high-intensity race-pace continuous vs. interval workouts commonly used in middle-distance athletics, by means of analyzing post-exercise cardiac autonomic regulation and lactate. METHODS: Nineteen highly-trained 800-m male runners were asked to run a 600-m race-pace continuous workout and a 2 × 4 × 200-m interval training, counterbalanced and randomized within one week of difference. Blood lactate jointly with linear and nonlinear heart rate dynamics were assessed during the immediate 15-min recovery. Age-category (Under23-Senior vs. Juvenile-Junior) was considered as an inter-subject factor. RESULTS: Peak lactate was higher following the interval training (15.51 ± 0.99 vs 13.83 ± 1.77 mmol L-1; P < 0.05) whereas lactate removal was almost nonexistent 15 min after both workouts (between 0 and 16%). Vagal modulation (ln RMSSD and lnRMSSD to RR ratio) remained significantly depressed at the end of recovery following both workouts, although the alteration was larger following the interval training. Detrended Fluctuation Analysis evidenced a more random HR behavior (DFA1 closer to 0.5) during the first 9 min of recovery after the interval training, whereas no significant change was observed in heart rate complexity (SampEn). Neither were differences found in post-exercise lactate and HR dynamics as a function of age-category. CONCLUSIONS: High-intensity workouts commonly used in middle-distance athletics, both race-pace continuous and intervallic approaches, induce a large depression of vagal modulation in highly trained runners, although interval trainings appear to induce even a greater alteration of both linear and nonlinear HR dynamics and a higher post-exercise peak lactate.

Nonergodic subdiffusion from transient interactions with heterogeneous partners.

Spatiotemporal disorder has been recently associated to the occurrence of anomalous nonergodic diffusion of molecular components in biological systems, but the underlying microscopic mechanism is still unclear. We introduce a model in which a particle performs continuous Brownian motion with changes of diffusion coefficients induced by transient molecular interactions with diffusive binding partners. In spite of the exponential distribution of waiting times, the model shows subdiffusion and nonergodicity similar to the heavy-tailed continuous time random walk. The dependence of these properties on the density of binding partners is analyzed and discussed. Our work provides an experimentally testable microscopic model to investigate the nature of nonergodicity in disordered media.

Transient subdiffusion from an Ising environment.

We introduce a model in which a particle performs a continuous-time random walk (CTRW) coupled to an environment with Ising dynamics. The particle shows locally varying diffusivity determined by the geometrical properties of the underlying Ising environment, that is, the diffusivity depends on the size of the connected area of spins pointing in the same direction. The model shows anomalous diffusion when the Ising environment is at critical temperature. We show that any finite scale introduced by a temperature different from the critical one, or a finite size of the environment, cause subdiffusion only during a transient time. The characteristic time, at which the system returns to normal diffusion after the subdiffusive plateau depends on the limiting scale and on how close the temperature is to criticality. The system also displays apparent ergodicity breaking at intermediate time, while ergodicity breaking at longer time occurs only under the idealized infinite environment at the critical temperature.

Acute effect of Snus on physical performance and perceived cognitive load on amateur footballers.

Smokeless tobacco (Snus) is a substance that contains nicotine, which has been placed on World Anti-Doping Agency's 2014 Monitoring Program. A proliferation of nicotine use in sport has been observed in recent years, but little is known regarding its effects, especially on football players' performance. Therefore, the aim of this study was to assess the effect of Snus on physical performance, heart rate variability, subjective activation, mental fatigue, and perceived readiness before a physical test in non-smoker, non-Snus user, amateur football players. Participants were administered either Snus or placebo 40 min prior to a fitness test battery (handgrip test, countermovement jump, agility test, and Yo-Yo intermittent recovery test). Results showed that Snus intake (compared with placebo) increased perceived mental fatigue level and mental load, and reduced perceived readiness level and heart rate variability. No significant differences between the two experimental conditions were found in either performance in the physical tests or perceived physical fatigue levels. In light of these results, Snus could not be considered an ergogenic substance. On the contrary, based on the extant evidence linking mental load and fatigue with physical performance, we argue that the observed negative effects on mental fatigue, perceived readiness, and heart rate variability should be considered.

Current trends in British dairy management regimens.

This paper presents a summary of results from a 2012 survey that investigated feeding and housing management regimens currently adopted by dairy farmers in Britain. Responses from 863 farms provide a snapshot of dairy industry structure and a description of the range of management systems currently in operation. Outcomes highlight a diversity of management practices, showing that 31% of farms maintained a traditional grazing system with no forage feeding indoors during the summer, whereas 38% of farmers indicated that all their milking cows received some feeding indoors during the summer. A system of housing dairy cows for 24 h/d while they are lactating was implemented by 8% of farms, whereas 1% of farms did not house their cows at any time of the year. Statistical analyses were carried out on 3 distinct groups identified from survey responses: (1) farmers who did not undertake any indoor feeding during the summer; (2) farmers who fed all their milking cows indoors during the summer; and (3) farmers who continuously housed their cows for 24h/d while lactating. Results showed a significant relationship between management type and herd size, and between management type and breed type; on average, herd sizes were larger within systems that feed indoors. No significant relationship was found between management type and farm location when classified by estimated grassland productivity. The results indicate that traditional all-summer grazing is no longer the predominant system adopted by dairy farmers and that other systems such as all-year-round indoor feeding and continuous housing are becoming more prevalent in Britain.

Environmental efficiency of alternative dairy systems: a productive efficiency approach.

Agriculture across the globe needs to produce "more with less." Productivity should be increased in a sustainable manner so that the environment is not further degraded, management practices are both socially acceptable and economically favorable, and future generations are not disadvantaged. The objective of this paper was to compare the environmental efficiency of 2 divergent strains of Holstein-Friesian cows across 2 contrasting dairy management systems (grazing and nongrazing) over multiple years and so expose any genetic × environment (G × E) interaction. The models were an extension of the traditional efficiency analysis to account for undesirable outputs (pollutants), and estimate efficiency measures that allow for the asymmetric treatment of desirable outputs (i.e., milk production) and undesirable outputs. Two types of models were estimated, one considering production inputs (land, nitrogen fertilizers, feed, and cows) and the other not, thus allowing the assessment of the effect of inputs by comparing efficiency values and rankings between models. Each model type had 2 versions, one including 2 types of pollutants (greenhouse gas emissions, nitrogen surplus) and the other 3 (greenhouse gas emissions, nitrogen surplus, and phosphorus surplus). Significant differences were found between efficiency scores among the systems. Results indicated no G × E interaction; however, even though the select genetic merit herd consuming a diet with a higher proportion of concentrated feeds was most efficient in the majority of models, cows of the same genetic merit on higher forage diets could be just as efficient. Efficiency scores for the low forage groups were less variable from year to year, which reflected the uniformity of purchased concentrate feeds. The results also indicate that inputs play an important role in the measurement of environmental efficiency of dairy systems and that animal health variables (incidence of udder health disorders and body condition score) have a significant effect on the environmental efficiency of each dairy system. We conclude that traditional narrow measures of performance may not always distinguish dairy farming systems best fitted to future requirements.

The effects of umbilical cord milking in extremely preterm infants: a randomized controlled trial.

OBJECTIVE: Delayed cord clamping has been shown to decrease the need for transfusion in preterm neonates, but may delay resuscitation. The aim of this study was to determine whether umbilical cord milking compared with immediate cord clamping in extremely preterm deliveries reduces the need for neonatal red blood cell transfusion. STUDY DESIGN: Women admitted to a tertiary care center and expected to deliver between 24 to 28 completed weeks of gestation were randomized to cord milking before clamping or immediate cord clamping. The primary outcome was the risk of neonatal transfusion, reported as risk ratio (RR) and 95% confidence interval (CI). RESULT: Of 113 women who were enrolled and randomized, 56 were assigned to cord milking with 36 remaining eligible and completing the study and 57 were assigned to the control group with 39 remaining eligible and completing the study. Albeit not statistically significant, neonates in the cord milking group were less likely to require transfusion compared with those in the control group (RR: 0.86; 95% CI: 0.73 to 1.0). Neonates whose cords were milked had higher hematocrits at birth (P=0.004) and were less likely to develop an intraventricular hemorrhage (P=0.0195). CONCLUSION: Milking the umbilical cord of a preterm neonate is an easy intervention with the potential to improve perinatal outcomes. Our results suggest that milking of the cord increases the neonate's initial hematocrit and may lessen the need for transfusion in the neonatal period. The observed reduction in the incidence of intraventricular hemorrhage may have important long-term implications that warrant further study.

Specific infiltration pattern of FOXP3+ regulatory T cells in chronic histiocytic intervillositis of unknown etiology.

INTRODUCTION: Chronic histiocytic intervillositis of unknown etiology (CIUE) is a rare placental lesion characterized by an intervillous mononuclear inflammatory infiltrate of maternal origin. Although the mechanism and origin of these lesions are currently not understood, they appear to be related to an immune conflict between mother and fetus cells. AIM: To clarify the inflammatory cell profile and evaluate the T regulatory lymphocyte (Treg) status in CIUE. MATERIALS AND METHODS: All cases of CIUE that occurred over an 8-year period were analyzed using immunohistochemistry. RESULTS: The inflammatory profile of CIUE was characterized by a clearly predominant component of histiocytic cells (80% ± 6.9) associated with some T cells (24% ± 5.7). The ratio of CD4+ versus CD8+ T cells was close to 1. This profile differs from infectious disease and chronic histiocytic villitis, the main differential diagnoses of CIUE. As for normal pregnancies most regulatory T cells were localized in the decidua basalis. Nevertheless, their appearance was also noted in the intervillous space. In both the intervillous space and the deciduas the number of Tregs gradually increased from grade 1 to 3. CONCLUSION: We found that CIUE is associated with an increase in Treg lymphocytes in the decidua basalis and the intervillous space. Contrary to previously published data on human miscarriage, this result appears to be specific to CIUE and would support the hypothesis of an immunopathological disorder for CIUE.

Physical profile of elite young motorcyclists.

The aim of the study was to describe anthropometric and physical characteristics of elite young road-race motorcyclists (MC). 27 riders (15.6±1.1 years, 54.6±6.9 kg, 166.9±6.7 cm) competing at international elite level participated in this study. Anthropometric variables, hand grip and lumbar isometric strength, and lower-body muscular strength were measured. Comparisons of the MC and a reference group of Spanish physically active adolescents (16.0±0.6 years) showed that the riders were significantly lighter (-12.5 kg), and smaller (-4.7 cm). Riders also had significantly lower values for almost all skinfolds, and for all the measured girths (except forearm) than the reference group. Motorcyclists showed significantly less percent body fat (%BF) and higher muscle mass, and differences were observed for somatotype components compared to the reference group, except for the ectomorphy. Somatotype could be defined as mesomorphic-ectomorph (2.5-4.4-3.7). Mean (±SD) values of all riders were 34.8±5.0 cm for vertical jump height, 402.1±74.5 N for the right hand and 370.7±77.5 N for the left hand strengths, and 120.6±19.3 kg for lumbar isometric strength, respectively. Results demonstrate that MC are small and light, with lower body mass index, skinfolds, girth and breadth dimensions, and %BF than a reference group and other athletes, with high values of hand grip and lumbar isometric strength.

Chronic migraine: current concepts and ongoing treatments.

Migraine is an episodic painful disorder occasionally developing into a chronic form. Such disorder represents one of the most common neurological diseases in clinical practice. Chronicization is often accompanied by the appearance of acute drugs overuse. Chronic migraine (CM) constitutes migraine's natural evolution in its chronic form and involves headache frequency of 15 days/month, with features similar to those of migraine attacks. Medication Overuse Headache (MOH) has been defined as a headache present on > or = 15 days/month, with regular overuse for > 3 months of one or more drugs used for acute and/or symptomatic headache management. Subtypes of MOH attributed to different medications were delineated. Misuse of ergots, triptans, opioids or combination analgesics on > or = 10 days/month was required to make the diagnosis of MOH, while > or = 15 days/month were needed for simple analgesic-overuse headache. CM's low prevalence produces an extremely high disability grade. Therefore, special attention should be paid to both control and reduction of risk factors which might favour the migraine chronicization process and/or the outbreak of MOH. In MOH sufferers, the only treatment of choice is represented by drug withdrawal. Successful detoxification is necessary to ensure improvement in the headache status when treating patients who overuse acute medications. Different procedures have been suggested for withdrawal namely at home, at the hospital, with or without the use of steroids, with re-prophylaxis performed immediately or at the end of the washout period. At the moment we have not a total agreement whether prophylactic treatment should be started before, during, or after discontinuation of the overuse drug. Both drugs have been approved for CM treatment in view of their well-defined resistance to previous prophylaxis drugs. Recently, the PREEMPT clinical program has confirmed onabotulinumtoxinA as an effective, safe, and well-tolerated prophylactic treatment for adults with CM.

Radiographic findings among children hospitalized with severe community-acquired pneumonia.

BACKGROUND: Community-acquired pneumonia (CAP) is a leading cause of childhood death. There are few published reports of radiographic findings among children with severe CAP. OBJECTIVE: To describe chest X-ray (CXR) findings and assess association between these radiographic findings and pneumococcal isolation in children with severe CAP. METHODS: A prospective, multicenter, observational study was conducted in 12 centers in Argentina, Brazil, and the Dominican Republic. Children aged 3-59 months, hospitalized with severe pneumonia, were included. On admission, blood and pleural effusion cultures were performed. Streptococcus pneumoniae was identified according to standard procedures in the respective national reference laboratory. Chest X-rays were taken on admission and read before the culture results were reported. RESULTS: Out of 2,536 enrolled patients, 283 (11.2%) had S. pneumoniae isolated, in 181 cases (7.1%) from blood. The follow radiographic patterns were observed: alveolar infiltrate (75.2%), pleural effusion (15.6%), and interstitial infiltrate (9.2%). Overall, pleural effusion was associated with pneumococcal isolation and pneumococcal bacteremia (P < 0.001). Infiltrates were unilateral (78.7%) or bilateral (21.3%), right-sided (76%) or left-sided (24%), in the lower lobe (53.6%) or the upper lobe (46.4%). Multivariate analysis including patients with affection of only one lobe showed that upper lobe affection and pleural effusion were associated with pneumococcal isolation (OR 1.8, 95% CI, 1.3-2.7; OR 11.0, 95% CI, 4.6-26.8, respectively) and with pneumococcal bacteremia (OR 1.7, 95% CI, 1.2-2.6; OR 3.1, 95% CI, 1.2-8.0, respectively). CONCLUSIONS: Three-quarters of the patients studied had alveolar infiltrates. Upper lobe compromising and pleural effusion were associated with pneumococcal invasive disease.

Pulmonary tuberculosis in adolescents: radiographic features.

We studied radiographic features of pulmonary tuberculosis (PTB) described in the report forms for 907 adolescents from two Brazilian cities. A descriptive analysis showed that the most common radiographic lesions were post-primary tuberculosis (53.3%), tuberculous expansile pneumonia (27%) and primary complex with adenomegaly (1.8%). Cavitary lesions occurred in 67/243 (27.6%) patients aged 0-15 years and in 116/321 (36.1%) adolescents aged 16-19 years (P = 0.031). Most of the PTB cases had forms similar to those in adults.

Clinical scoring system for paediatric tuberculosis in HIV-infected and non-infected children in Rio de Janeiro.

The scoring system for diagnosing tuberculosis (TB) used in Brazil has already been validated in human immunodeficiency virus (HIV) negative tuberculous children. Here we studied HIV-positive children. The individuals were divided into four groups: 1) tuberculous infection; 2) other pulmonary diseases; 3a) pulmonary TB and 3b)pulmonary TB and HIV. Group 3a had a significantly higher score than Groups 1 and 2, and Group 1 had a higher score than Group 2. Scores for Group 3b were lower than for Group 3a, although they were still >30 points, which is enough to establish a TB diagnosis (P = 0.0005). The system was useful for the diagnosis of pulmonary TB in HIV-negative and -positive children.

Male osteoporosis.

Osteoporosis is a worldwide major public health problem, defined as "a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fractures". Osteoporosis is diagnosed by bone mineral density measurement (T-score of -2.5 or below) also in men. However, most of the studies carried out in the last decade focused on pathogenesis, diagnosis and treatment of osteoporosis in women. In spite of this, recent epidemiological and observational studies have shown that osteoporosis in men is an increasingly important clinical issue. In part because the world population is aging, it is likely that the total number of hip fractures in men in 2025 will be similar to current estimates in women. Furthermore 25-33% of men in some populations will sustain osteoporotic fractures in their lifetime. Nevertheless, male osteoporosis is still underdiagnosed and further studies are required to clarify the pathogenesis and find out the right therapy. Prevention and early diagnosis are, nowadays, the best ways of treatment.

Brazilian paediatricians' awareness of national guidelines for community-acquired pneumonia.

BACKGROUND: The Integrated Management of Childhood Illness (IMCI) strategy uses simple clinical signs for the diagnosis and severity evaluation of community-acquired pneumonia (CAP). OBJECTIVE: To describe paediatrician awareness of the IMCI strategy for CAP. DESIGN: A cross-sectional study analysing a descriptive case of severe CAP, presented as part of the Brazilian Board of Paediatrician Evaluation (BBPE) tests. RESULTS: Eighty-six (774/898) per cent of paediatricians followed the IMCI protocol to treat CAP. Although hospitalisation was considered in 90% of the answers, only 35% based this decision on lower chest indrawing. CONCLUSION: The BBPE showed that most physicians are aware of the IMCI recommendations.

Valoración desde la dispensación activa de la efectividad y seguridad del uso de medicamentos antihipertensivos / Assessment from the perspective of the community pharmacy of the effectiveness and safety of the use of antihypertensive drugs

Introducción y objetivos: Este estudio pone de manifiesto la situación actual del uso de medicamentos antihipertensivos en pacientes ambulatorios, y valora la efectividad y seguridad de éstos desde la oficina de farmacia. El tema tiene un gran alcance debido a la elevada prevalencia de la hipertensión arterial (HTA) en nuestra sociedad. El objetivo del estudio fue determinar el grado de cumplimiento que tienen los pacientes en el uso de los medicamentos antihipertensivos para así poder valorar la efectividad y seguridad de estos tratamientos. Método: Estudio cualitativo, descriptivo, transversal, multicéntrico y prospectivo, realizado a 335 pacientes ambulatorios atendidos en 12 oficinas de farmacia del Baix Llobregat (Barcelona). Resultados: En el estudio se pudo detectar y prevenir un gran número de problemas relacionados con los medicamentos (PRM) (un total de 131). El grado de control de la HTA en el grupo de pacientes estudiados fue moderado (62% de los casos) y el grado de cumplimiento de la población estudiada según el test de Morisky-Green fue del 72 ± 4,8%. Conclusiones: Se observó la relación existente entre el cumplimiento terapéutico según el test de Morisky-Green y los valores de presión arterial medidos. Las intervenciones farmacéuticas mejoraron la implicación del paciente en el tratamiento en relación con la adherencia e incidieron en la modificación de sus hábitos. El estudio concluye que los datos y los resultados recogidos permiten afirmar que los tratamientos estudiados para la HTA son moderadamente efectivos y mayoritariamente seguros (AU)

Background: This study illustrates the current situation in terms of the use of antihypertensive drugs by ambulatory patients and assesses the effectiveness and safety of these medications from the perspective of the community pharmacy. The problem is of utmost importance owing to the high prevalence of hypertension in our society. The objective of this study was to determine the degree of patient compliance in terms of the use of antihypertensive drugs for the purpose of assessing the effectiveness and safety of these treatments. Methods: A prospective, qualitative, descriptive, cross-sectional, multicenter study involving 335 patients was carried out in 12 community pharmacies in Baix Llobregat, Barcelona, Spain. Results: This study has enabled the detection of a large number of drug-related problems (n= 131). The degree of hypertension control in the group of patients studied was moderate (62% of the cases) and the degree of compliance among the study population, according to the Morisky-Green test, was 72% ± 4.8%. Conclusions: From the perspective of the community pharmacy, there is a direct relationship between treatment compliance, according to Morisky-Green’s test, and the arterial blood pressure values. Pharmaceutical interventions improve the involvement of the patients in their treatment in relation to adherence to the treatment, and influence the modification of their habits. The study concludes that the data and the results gathered demonstrate that the treatments for hypertension studied are reasonably effective and, for the most part, safe (AU)