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4 results on '"G, Brunström"'

1. Bedtime dosing of antihypertensive medications: systematic review and consensus statement: International Society of Hypertension position paper endorsed by World Hypertension League and European Society of Hypertension

Author

Stergiou, G. Brunström, M. MacDonald, T. Kyriakoulis, K.G. Bursztyn, M. Khan, N. Bakris, G. Kollias, A. Menti, A. Muntner, P. Orias, M. Poulter, N. Shimbo, D. Williams, B. Adeoye, A.M. Damasceno, A. Korostovtseva, L. Li, Y. Muxfeldt, E. Zhang, Y. Mancia, G. Kreutz, R. Tomaszewski, M. and Stergiou, G. Brunström, M. MacDonald, T. Kyriakoulis, K.G. Bursztyn, M. Khan, N. Bakris, G. Kollias, A. Menti, A. Muntner, P. Orias, M. Poulter, N. Shimbo, D. Williams, B. Adeoye, A.M. Damasceno, A. Korostovtseva, L. Li, Y. Muxfeldt, E. Zhang, Y. Mancia, G. Kreutz, R. Tomaszewski, M.

Abstract

Antihypertensive drug therapy is one of the most efficient medical interventions for preventing disability and death globally. Most of the evidence supporting its benefits has been derived from outcome trials with morning dosing of medications. Accumulating evidence suggests an adverse prognosis associated with night-time hypertension, nondipping blood pressure (BP) profile and morning BP surge, with increased incidence of cardiovascular events during the first few morning hours. These observations provide justification for complete 24-h BP control as being the primary goal of antihypertensive treatment. Bedtime administration of antihypertensive drugs has also been proposed as a potentially more effective treatment strategy than morning administration. This Position Paper by the International Society of Hypertension reviewed the published evidence on the clinical relevance of the diurnal variation in BP and the timing of antihypertensive drug treatment, aiming to provide consensus recommendations for clinical practice. Eight published outcome hypertension studies involved bedtime dosing of antihypertensive drugs, and all had major methodological and/or other flaws and a high risk of bias in testing the impact of bedtime compared to morning treatment. Three ongoing, well designed, prospective, randomized controlled outcome trials are expected to provide high-quality data on the efficacy and safety of evening or bedtime versus morning drug dosing. Until that information is available, preferred use of bedtime drug dosing of antihypertensive drugs should not be routinely recommended in clinical practice. Complete 24-h control of BP should be targeted using readily available, long-acting antihypertensive medications as monotherapy or combinations administered in a single morning dose. © 2022 Lippincott Williams and Wilkins. All rights reserved.

Published
2022

2. Surveillance for stage I testicular germ cell tumours

Author

L. Holden, Edward S. Newlands, Michael J. Seckl, Gordon J. S. Rustin, Mark Bower, RJ Francis, and G Brunström

Subjects
Oncology, Cancer Research, medicine.medical_specialty, endocrine system diseases, Germinoma, business.industry, Mortality rate, Seminoma, Disease, urologic and male genital diseases, medicine.disease, Testicular germ cell, Surgery, Sepsis, Germ cell cancer, Internal medicine, medicine, Orchiectomy, business
Abstract

Between 1979 and 1996 303 men with stage I testicular germ cell tumours (120 seminoma and 183 non-seminomatous germ cell tumours (NSGCT)) were enrolled onto a programme of surveillance. In our institutions the frequency of computed tomography (CT) scans is reduced compared with other centres. For all 303 men, the median follow-up is 5.1 years (range: 0.1-21.7 years) and there have only been 3 deaths (1 from disease, 1 from neutropenic sepsis and 1 from secondary leukaemia). 52/183 (28%) patients with NSGCT and 18/120 (15%) patients with seminoma have relapsed. The relapse-free survival at 5 years is 82% for seminoma and 69% for NSGCT (Logrank P=0.004). All men who relapsed, except 1 man with NSGCT, were in the International Germ Cell Cancer Collaborative Group good or intermediate prognosis group at relapse. Half of the seminoma relapses presented with symptoms and 31% of the NSGCT relapses. The remaining relapses were detected serologically or radiologically by the surveillance programme. 5 men (2%) on surveillance, 3 with initial diagnosis of seminoma and 2 with NSGCT, have developed second contralateral testis tumours (all stage I seminomas). In a well motivated centre a policy of surveillance for stage I testicular germ cell tumours (both NSGCT and seminoma) is associated with a low mortality rate (3/303, 1%) and may have the advantage of sparing overtreatment with potentially toxic therapies in this group of young men.

Published
2000
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3. Surveillance for stage I testicular germ cell tumours: results and cost benefit analysis of management options

Author

R, Francis, M, Bower, G, Brunström, L, Holden, E S, Newlands, G J, Rustin, and M J, Seckl

Subjects
Adult, Male, Adolescent, Cost-Benefit Analysis, Infant, Neoplasms, Second Primary, Disease-Free Survival, Seminoma, Testicular Neoplasms, Child, Preschool, Antineoplastic Combined Chemotherapy Protocols, Humans, Germinoma, Neoplasm Recurrence, Local, Child, Orchiectomy, Follow-Up Studies, Program Evaluation
Abstract

Between 1979 and 1996 303 men with stage I testicular germ cell tumours (120 seminoma and 183 non-seminomatous germ cell tumours (NSGCT)) were enrolled onto a programme of surveillance. In our institutions the frequency of computed tomography (CT) scans is reduced compared with other centres. For all 303 men, the median follow-up is 5.1 years (range: 0.1-21.7 years) and there have only been 3 deaths (1 from disease, 1 from neutropenic sepsis and 1 from secondary leukaemia). 52/183 (28%) patients with NSGCT and 18/120 (15%) patients with seminoma have relapsed. The relapse-free survival at 5 years is 82% for seminoma and 69% for NSGCT (Logrank P=0.004). All men who relapsed, except 1 man with NSGCT, were in the International Germ Cell Cancer Collaborative Group good or intermediate prognosis group at relapse. Half of the seminoma relapses presented with symptoms and 31% of the NSGCT relapses. The remaining relapses were detected serologically or radiologically by the surveillance programme. 5 men (2%) on surveillance, 3 with initial diagnosis of seminoma and 2 with NSGCT, have developed second contralateral testis tumours (all stage I seminomas). In a well motivated centre a policy of surveillance for stage I testicular germ cell tumours (both NSGCT and seminoma) is associated with a low mortality rate (3/303, 1%) and may have the advantage of sparing overtreatment with potentially toxic therapies in this group of young men.

Published
2000

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