Los nudos del sistema

Pieza central del antiguo régimen; pacto, acuerdo o trato con algunos actores decisivos del sistema político susceptible de ser revisado; forma cultural de relaciones de poder o de intercambio; pirámide de organizaciones o estructura sectorial: ¿qué tan invisible sigue siendo, qué tan montada sigue estando la pirámide del corporativismo mexicano antes y después del 2 de julio de 2000? Este fenómeno constituye el eje central de las reflexiones del presente ensayo. En torno al mismo, se presenta información para reconstruir o conocer con más detalle los contenidos, alcances y perfiles de aquel proceso de ruptura del pacto corporativo forjado entre el PRI y los sectores que lo conformaban históricamente, como datos que podrían explicar la pérdida de la base electoral tradicionalmente leal a este partido; identificar el papel que han venido desempeñando en dicho proceso los actores políticos más diversos —PAN, PRD, organizaciones laborales independientes—, para identificar las formas que podría adoptar un “contrato corporativo” en un orden político democrático y un nuevo sistema de partidos, y formular algunas hipótesis sobre el curso que podría tomar la inevitable reforma del PRI, considerando los elementos anteriores y algunos puntos de comparación tomados de la transición española. Para ello se toman exclusivamente los ejemplos de mayor peso histórico y social, considerados como los más nítidos y representativos del corporativismo mexicano: el del sector obrero y el de las organizaciones campesinas

Nosocomial infective endocarditis: should the definition be extended to 6 months after discharge

ABSTRACTBecause the microbiology and patient population of infective endocarditis (IE) have evolved, the traditional definition of nosocomial IE may require revision. The question of whether this definition should be extended to 6 months after discharge was explored, and a high rate of episodes with nosocomial pathogens (coagulase-negative staphylococci) and a low rate of episodes with community pathogens (streptococci) in the extended nosocomial group were found. Therefore, modification of the traditional definition is proposed, distinguishing between early (as traditionally described) and late nosocomial IE (IE in association with a significant invasive procedure performed during a hospitalization between 8 weeks and 6 months before the onset of symptoms)

Recommendations for the use of the 23-valent polysaccharide pneumococcal vaccine in adults: : a Belgian consensus report

329-337A multidisciplinary expert panel, appointed by the High Council for Public Health, evaluated the scientific evidence on which the recommendations for the appropriate use of the pneumococcal vaccine was based and reviewed the studies that became available since previous reports. The conclusions of the working group, presented in this manuscript, resulted in an update of the Belgian recommendations for pneumococcal vaccination

Polyclonal Staphylococcus epidermidis intravascular catheter-related infections

During a 4-month period we prospectively investigated the frequency of polyclonal catheter infections with Staphylococcus epidermidis. Of each catheter with pure growth of S. epidermidis, six colonies were genotypically analyzed with pulsed-field gel electrophoresis. Two out of 12 patients with catheter infection had a polyclonal infection. Both clones of each catheter had a clearly different antibiotic susceptibility. This study shows that polyclonal catheter infections are not exceptional. Further studies are needed to define the clinical consequences of polyclonal catheter infection

Divergent intentions to use antibiotic guidelines: A theory of planned behavior survey

Background. To improve physicians' antimicrobial practice, it is important to identify barriers to and facilitators of guideline adherence and assess their relative importance. The theory of planned behavior permits such assessment and has been previously used for evaluating antibiotic use. According to this theory, guideline use is fueled by 3 factors: attitude, subjective norm (perceived social pressure regarding guidelines), and perceived behavioral control (PBC; perceived ability to follow the guideline). The authors aim to explore factors affecting guideline use in their hospital. Methods. Starting from their earlier observations, the authors constructed a questionnaire based on the theory of planned behavior, with an additional measure of habit strength. After pilot testing, the survey was distributed among physicians in a major teaching hospital. Results. Of 393 contacted physicians, 195 completed questionnaires were received (50.5% corrected response rate). Using multivariate analysis, the overall intention toward using antibiotic guidelines was not very predictable (model R-2 = .134). Habit strength (relative weight = .391) and PBC (relative weight = .354) were the principal significant predictors. A moderator effect of respondents' position (staff member v. resident) was found, with staff members' intention being significantly influenced only by habit strength and residents' intention by PBC. Regarding previously identified barriers, education on antibiotics and guidelines was rated unsatisfactory. Conclusions. These divergent origins of influence on guideline adherence point to different approaches for improvement. As habits strongly influence staff members, methods that focus on changing habits (e.g., automated decision support systems) are possible interventions. As residents' intention seems to be guided mainly by external influences and experienced control, this may make feedback, convenient guideline formats, and guideline familiarization more suitable

Toll-like receptor 2 and Toll-like receptor 4 polymorphisms in invasive pneumococcal disease.

BACKGROUND: Toll-like receptors (TLRs) recognize distinct pathogen-associated molecular patterns and trigger anti-microbial host defense responses. Several in vitro and in vivo studies in mice indicate that TLR2 and TLR4 are involved in the defense against Streptococcus pneumoniae. Studies have revealed associations between polymorphisms in TLRs and human diseases. The effect of polymorphisms in TLR2 and TLR4 in the human defense to S. pneumoniae has not been studied. METHODS: We genotyped 99 Caucasian patients with invasive pneumococcal disease and 178 Caucasian controls for the known R579H, P631H and R753Q polymorphisms in TLR2 and the D299G polymorphism in TLR4 with PCR-RFLP methods. RESULTS: The distribution of the TLR2 R579H, P631H and R753Q and TLR4 D299G variants was not significantly different between the patients and the controls. After stratification of the patient population by age, sex, diagnosis, and mortality no significant differences for the TLR2 R753Q genotype and TLR4 D299G genotype were found between various patient subgroups and between patient subgroups and the control population. It should be mentioned that for the TLR2 polymorphisms neither the control group nor the patient group contains homozygous mutant individuals. CONCLUSION: We found no association between TLR2 and TLR4 polymorphisms and invasive pneumococcal infection

Implementation of antibiotic management teams in Belgian hospitals

SCOPUS: re.jinfo:eu-repo/semantics/publishe