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Biomedical subjects

M Dunn

Publications and source records attributed to M Dunn.

At least 109 records · Page 6Linked to original sources
PubMed1987

Mortality among Australian conscripts of the Vietnam conflict era. I. Death from all causes.

A retrospective cohort study of mortality was conducted to assess whether Army service of young Australian men in the Vietnam conflict influenced the subsequent risk of premature death. Analysis related to all National Servicemen (generally conscripts in the Australian Army) who enlisted during the conflict and served in the Army for at least 12 months. Of these veterans, 19,205 served in Vietnam, while 25,677 served only in Australia. All men were traced from the end of their national service engagement (between 1966 and 1976) until January, 1, 1982. For both groups, death rates were statistically significantly lower than expected for Australian males of the same age. Overall mortality of Vietnam veterans was 1.3 times that of non-Vietnam veterans (95% confidence interval (Cl) = 1.1-1.5). After adjustment for the confounding effects of Army corps grouping, Vietnam veteran mortality was 1.2 times that of non-Vietnam veterans (95% Cl = 1.0-1.4). No other variable examined was confounding. The excess of deaths among Vietnam veterans relative to the veterans not serving in Vietnam was largely confined to The Royal Australian Engineers. Among members of this corps, the relative mortality rate was 2.5 (95% Cl = 1.4-4).

Adult↗
PubMed1987

Indoramin--an effective new drug in the management of bladder outflow obstruction.

There is a need for symptomatic relief in some patients with bladder outflow obstruction. The alpha blocker indoramin was tested in a prospective, double-blind, placebo-controlled trial. Thirty men were given indoramin or placebo. Flow rates and cystometrograms were performed before inclusion and at the end of 8 weeks' treatment. Indoramin gave significant relief of symptoms and dramatically improved peak flow rates. There were three withdrawals because of adverse effects and two withdrawals in the placebo group because of retention. Other side effects were either minor or transient.

Aged↗
PubMed1987

The role of arachidonic acid metabolites in renal homeostasis. Non-steroidal anti-inflammatory drugs renal function and biochemical, histological and clinical effects and drug interactions.

Prostaglandins (PG) E2 and I2 have a number of effects on renal function, such as causing vasodilatation, increasing the glomerular filtration rate, sodium chloride excretion, water excretion, and stimulating renin secretion. Studies in dogs have shown that reductions in renal blood flow associated with angiotensin II administration are accompanied by increased synthesis of vasodilatory PGE2 followed by a compensatory increase in blood flow. Moreover, in rats and dogs, non-steroidal anti-inflammatory drugs (NSAIDs) markedly augment the reductions in renal blood flow associated with angiotensin II administration. Clinical use of NSAIDs can induce 1 of 2 types of renal syndromes in patients with certain predisposing conditions. These syndromes are ischaemic acute renal failure and papillary necrosis or, rarely, an idiosyncratic reaction. It is believed that the effects of cyclo-oxygenase inhibitors on renal function are most important in patients with these predisposing conditions because in many of these conditions there is increased synthesis of renal PGE2 and PGI2 to compensate for abnormally high plasma concentrations of vasoconstrictor hormones. Angiotensin II produces a concentration-dependent contraction of isolated rat glomeruli or mesangial cells which is potentiated by pretreatment with indomethacin or meclofenamate. Pretreatment with arachidonic acid, or addition of exogenous PGE2, inhibits the angiotensin-mediated glomerular contraction. Stable endoperoxide analogues, which mimic the effects of thromboxane A2, induce a similar glomerular contraction to angiotensin. Similar findings were recorded using isolated rat mesangial cells. Mesangial cell contraction is believed to reduce the filtration surface area of the glomerulus and, therefore, the glomerular filtration rate. In these cells angiotensin II not only induces contraction but also increases the rate of synthesis of PGE2. Associated with the acute reduction in renal function after induction of an immune glomerular nephritis in rats, there is a marked increase in glomerular thromboxane synthesis. The thromboxane synthetase inhibitor dazoxiben inhibits this increase and prevents the acute renal changes which occur in untreated animals during the first 3 hours after antibody injection. However, thromboxane synthetase inhibitors have no influence on renal function when nephrotoxic serum nephritis has been established for 14 days. In conclusion, maintenance of adequate renal function would seem to be dependent on a balance of substances causing mesangial relaxation (PGE2 and PGI2) and contraction (thromboxanes, endoperoxides and leukotrienes).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1986

Amiodarone: an effective alternative for recalcitrant supraventricular and ventricular tachycardias.

Amiodarone was used in the treatment of 21 patients with supraventricular or ventricular arrhythmias which were refractory to conventional antiarrhythmic drugs, individually or in combination. Six of seven patients with supraventricular arrhythmias and 12 of 14 with ventricular tachycardia were controlled with amiodarone. Although side effects were common, only one patient was removed from treatment due to pulmonary fibrosis. We conclude that amiodarone is an effective antiarrhythmic drug for refractory ventricular and supraventricular arrhythmias.

Amiodarone↗
PubMed1986

Starr-Edwards aortic prosthesis: a 20-year retrospective study.

Over the years the Starr Edwards prosthesis has demonstrated a high durability and improved survival in patients with severe aortic stenosis or insufficiency. While the ideal valve prosthesis is not yet available, the Starr-Edwards valve in most instances demonstrates an adequate hemodynamic performance, does not degenerate throughout the human life span, is biocompatible, and is inserted reliably without requiring unique technical dexterity. Despite occasional valve-related complications with early models, beneficial effects of valve replacement are clearly seen in patients with a reversible myocardial dysfunction, a lower level New York Heart Association functional class (II to III), and who survive the early postoperative period and the first year. Long-term complications seen with the Starr-Edwards valve are primarily thromboembolism, endocarditis, hemolysis, and anticoagulation related complications. Despite good operative results, the major cause of deaths in these patients remains cardiac.

Adult↗