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Biomedical subjects

R J Becker

Publications and source records attributed to R J Becker.

At least 19 recordsLinked to original sources

A chromogenic plating medium for the isolation and identification of Enterobacter sakazakii from foods, food ingredients, and environmental sources.

A chromogenic agar, R&F Enterobacter sakazakii chromogenic plating medium (ESPM), was developed for isolating presumptive colonies of E. sakazakii from foods and environmental sources. ESPM contains two chromogenic substrates (5-bromo-4-chloro-3-indoxyl-alpha-D-glucopyranoside and 5-bromo-4-chloro-3-indoxyl-beta-D-cellobioside), three sugars (sorbitol, D-arabitol, and adonitol), a pH indicator, and inhibitors (bile salts, vancomycin, and cefsulodin), which all contribute to its selectivity and differential properties. On ESPM, 79 pure culture strains of E. sakazakii (10 clinical isolates and others from food and environmental sources) yielded blue-black (three strains were blue-gray) raised colonies, 1 to 2 mm in diameter with and without halos after 24 h at 35 degrees C. Other enteric organisms plus Pseudomonas aeruginosa yielded white, yellow, green, or clear colonies with and without clear halos. Of these genera, only Shigella sonnei and one Pantoea strain produced blue-black to blue-gray colonies. ESPM was used to isolate E. sakazakii from a variety of foods: corn, wheat, and rice flours; powdered infant formula; dairy products (dried milk, whey, and caseinates); cereals; and environmental sources. Most false-positive results on ESPM were eliminated by observing acid production on either sucrose or melibiose after 6 h at 35 degrees C on a R&F E. sakazakii screening medium (ESSM) biplate. In an analysis of 240 samples, the number of samples positive for E. sakazakii by the ESPM-ESSM method and the U.S. Food and Drug Administration protocols (violet red bile glucose agar and tryptic soy agar) were 27 and 16, respectively, with sensitivity and specificity values of 100.0 and 96.9% versus 59.3 and 43.7%, respectively. These data support the fact that E. sakazakii confirmation should be based on more than one confirmation system. Both the API 20E and Biolog Microlog3 4.20 systems should be used for confirmation of E. sakazakii isolates.

Colony Count, Microbial↗

Evidence for association of bacteriocinogenic activity with membrane vesicles of Thermus rubens.

Thermus rubens has previously been reported to exhibit bacteriocin-like antagonism against other members of the genus Thermus when assayed via the deferred antagonism technique. Bacteriocin activity was not detectable in various age batch culture supernatants assayed by simple spotting procedures. Successful cell-free isolation was accomplished by way of a procedure employing French press disruption of T. rubens cells. Ultrafiltration and molecular exclusion chromatographic studies ascribed a high molecular weight to the agent which was found to be completely precipitable by ammonium sulphate. Activity was totally sedimentable upon ultracentrifugation. Transmission electron microscopic examination of column fractions containing high specific activity revealed numerous circular, apparently trilaminar, structures indicative of membrane vesicles.

Bacteriocins↗

Managed care is utilization review.

The role of utilization review (UR) as a form of managed care is described. As technology has advanced, the use of diagnostic and therapeutic services has increased and care delivery has shifted to outpatient settings, but the increase in healthcare costs has not slowed. The shift to delivery of medical care outside the hospital setting has increased the need for effective UR in both inpatient and outpatient settings. UR is performed not only by private UR organizations and through external review programs of insurance carriers but also through care-providers' internal programs. UR has been driven by increased medical costs and by redesign of insurance benefit plans to include financial incentives and penalties and copayments. UR has attempted to control the use of hospital services through preadmission certification and concurrent review, requirements for second surgical opinions, and medical case management, which is the identification before or during hospitalization of patients who could safely receive treatment outside the hospital. In-patient mental health and substance-abuse programs have been the subject of intensive review because of high expenditures for such services. Practice indicators are being developed that will be used for prospective determination of treatment plans. As UR techniques improve, management of care in all organized health-care settings will intensify.

Drug Utilization↗

Physician-to-physician accountability aids UR. Interview by Mary T. Koska.

Robert J. Becker, M.D., risked his house, his pension, and all the assets from his 26-year medical career to start Health Care Compare, Inc., a Downers Grove, IL, utilization review (UR) company. Since then, Becker has seen that risk pay off. His method of employing physicians as part of the UR team is an attempt to alleviate some of the anxiety physicians have about the UR process.

Contract Services↗

Bacteriocinlike Activity within the Genus Thermus.

Members of the genus Thermus were examined for the presence of bacteriocinlike inhibitory activity. Testing was done by the deferred antagonism technique. Antagonistic activity, as evidenced by zones of inhibition, was expressed by Thermus rubens against all other Thermus strains tested. T. rubens itself was immune to this activity. Plasmid analysis of T. rubens revealed the presence of one plasmid of approximately 64 megadaltons.

Journal Article↗

Whither allergy or wither allergy.

The specialty of allergy appears to be at a scientific and economic crossroad. With a significant number of scientific papers questioning the value of immunotherapy, the movement of the country towards prepaid care and the necessity for demonstrating cost/benefit ratio for all therapeutic procedures, the specialty of allergy can present an enigma.

Delivery of Health Care↗