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B Castleton

Publications and source records attributed to B Castleton.

3 recordsLinked to original sources
PubMed2006

A multicentre longitudinal observational study of changes in self reported health status in people with Parkinson's disease left untreated at diagnosis.

BACKGROUND: The issue of when to start treatment in Parkinson's disease (PD) remains controversial. Some favour treatment at diagnosis while others opt for a "wait and watch" policy. The effect of the latter policy on the self reported health status of people with PD is unknown. AIMS: To record self reported health status through longitudinal use of a validated PD specific questionnaire (PDQ-39) in untreated PD patients in multiple centres in the UK. To compare patients who were left untreated with those who were offered treatment during follow-up. METHODS: A multicentre, prospective, "real life" observational audit based study addressing patient reported outcomes in relation to self reported health status and other sociodemographic details. RESULTS: 198 untreated PD were assessed over a mean period of 18 months. During two follow-up assessments, the self reported health status scores in all eight domains of the PDQ-39 and the overall PDQ-39 summary index worsened significantly (p<0.01) in patients left untreated. In a comparative group in whom treatment was initiated at or soon after diagnosis, there was a trend towards improvement in self reported health status scores after treatment was started. CONCLUSIONS: This study addresses for the first time self reported health status, an indicator of health related quality of life, in untreated PD. The findings may strengthen the call for re-evaluation of the policy to delay treatment in newly diagnosed patients with PD.

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PubMed1976

Cephazolin treatment of pneumonia in the elderly.

Cephazolin, a semi-synthetic cephalosporin for parenteral use, was evaluated in 39 elderly hospital patients. Thirty-three of these patients were seriously ill at the start of treatment, suffering from pulmonary infections. In the other six patients, the drug was used post-operatively as a prophylactic, and it was effective in all cases in preventing any subsequent infection. Cephazolin was very effective in the treatment of 27 of the severely ill patients; the primary pathogen was eradicated and there was good clinical improvement. In two patients the primary pathogens were resistant to cephazolin, and the antibiotic therapy was changed after sensitivities were known. Of four patients with Haemophilus influenzae infection, clinical cure was obtained in two. Cephazolin therapy was discontinued in one woman because she developed a rash. However, there were no major toxic effects of therapy in terms of hepatic, renal or haematological function. No patient complained of pain when the intramuscular therapy was given. A dose of 1 g IM twice daily was shown to produce consistently high serum concentrations. Thus, in the elderly, the advantages of cephazolin are its lack of nephrotoxicity even when diuretic therapy is being administered concurrently, its lack of pain on intramuscular injection, and its sustained concentrations in the blood and urine so that it only requires to be given twice daily. In vitro studies showed that cephazolin is more active than cephaloridine against hospital pathogens.

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