RESUMEN
We present two cases of peritonitis shortly after endoscopic examination of the large bowel with polypectomy in patients on continuous ambulant peritoneal dialysis (CAPD) despite the standard preventive measure to drain the dialysate from the abdomen prior to the procedure. We have reviewed the current literature on this topic. These cases demonstrate that the administration of prophylactic broad-spectrum antibiotics next to the drainage of the abdomen prior to colonoscopy in CAPD patients should be considered as recommended in the International Society for Peritoneal Dialysis (IS PD) guidelines 2005.
Asunto(s)
Profilaxis Antibiótica , Colonoscopía/efectos adversos , Diálisis Peritoneal Ambulatoria Continua , Peritonitis/etiología , Guías de Práctica Clínica como Asunto , Anciano , Antibacterianos/uso terapéutico , Ceftazidima/uso terapéutico , Femenino , Gentamicinas/uso terapéutico , Humanos , Enfermedad Iatrogénica , Masculino , Diálisis Peritoneal Ambulatoria Continua/efectos adversos , Peritonitis/tratamiento farmacológico , Vancomicina/uso terapéuticoRESUMEN
BACKGROUND: Self-regulation theory explains how patients' illness perceptions influence self-management behaviour (e.g. via adherence to treatment). Following these assumptions, we explored whether illness perceptions of ESRD-patients are related to mortality rates. METHODS: Illness perceptions of 182 patients participating in the NECOSAD-2 study in the period between December 2004 and June 2005 were assessed. Cox proportional hazard models were used to estimate whether subsequent all-cause mortality could be attributed to illness perception dimensions. RESULTS: One-third of the participants had died at the end of the follow-up. Mortality rates were higher among patients who believed that their treatment was less effective in controlling their disease (perceived treatment control; RR = 0.71, P = 0.028). This effect remained stable after adjusting for sociodemographic and clinical variables (RR = 0.65, P = 0.015). CONCLUSIONS: If we consider risk factors for mortality, we tend to rely on clinical parameters rather than on patients' representations of their illness. Nevertheless, results from the current exploration may suggest that addressing patients' personal beliefs regarding the effectiveness of treatment can provide a powerful tool for predicting and perhaps even enhancing survival.
