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Biomedical subjects

M C Moffitt

Publications and source records attributed to M C Moffitt.

5 recordsLinked to original sources
PubMed1993

TnphoA-mediated disruption of K54 capsular polysaccharide genes in Escherichia coli confers serum sensitivity.

To assess whether non-K1, group 2 capsular serotypes are important in conferring serum resistance to extraintestinal isolates of Escherichia coli, a K54 blood isolate (CP9) was evaluated as a model pathogen. Transposon mutagenesis (TnphoA) was used to generate isogenic capsule-negative mutants. CP9 was resistant to the bactericidal effects of serum, growing in 80% serum. In contrast, all of the capsule-negative mutants had an increased sensitivity to 80% normal human serum, undergoing a 2- to 3-log kill over 3 h when starting inocula of 10(4) to 10(7) CFU/ml were used. The killing of the capsule-negative strains was mediated through the alternative complement pathway and not by lysozyme or beta-lysins. The protective effect of the K54 capsule against the bactericidal activity of serum was not through inhibition of the complement cascade, nor did it appear to be through a difference in the binding of C3.

Antimicrobial Cationic Peptides↗
PubMed1993

Missed psychiatric appointments: who returns and who stays away.

OBJECTIVE: This study investigated reasons for missed psychiatric appointments, rescheduling of appointments, adverse outcomes, and the association of specific diagnoses and treatments with missed appointments. METHOD: A prospective survey covering all individual outpatient visits to seven mental health clinic psychiatrists was conducted during a 3-month period in 1991. Of the 1,620 scheduled visits, 142 (8.8%) were missed, representing 130 separate patients. For each missed appointment, the psychiatrist involved completed a questionnaire on the type of visit, the patient's DSM-III-R diagnosis, the reason for missing the appointment, the date of patient recontact, and adverse outcome, if any. RESULTS: Of the 142 missed appointments, 71.1% were rescheduled spontaneously by the patients; of these, most (73.3%) were rescheduled within 2 weeks. The remaining missed appointments represented various outcomes, including dropping out of treatment. The most common stated reason for missing an appointment was patient error, such as forgetting, oversleeping, or getting the date wrong. Patients with PTSD and/or substance abuse were significantly more likely than others to miss appointments, and those with major depression were somewhat less likely to do so. CONCLUSIONS: Most patients quickly reschedule missed appointments, and those in more intensive treatments miss fewer appointments. Missed appointments for initial evaluation are not rescheduled most often. Patients in ongoing treatment who do not return may have histories of noncompliance with treatment. The high rate of rescheduling suggests that follow-up of patients who miss appointments should be a clinical decision rather than a routine policy.

Ambulatory Care↗