Clinical profile and outcomes of adult Filipino patients with septic arthritis: A descriptive study

Introduction@#Septic arthritis is an infection of the joint. Considered a medical emergency, it requires prompt diagnosis and treatment. Local data on the clinical profile of septic arthritis patients in the Philippines are still limited. Therefore, this study aims to determine the clinical characteristics and outcomes of patients with septic arthritis in the local setting.@*Objective@#To determine the clinical profile and outcome of adult Filipino patients with septic arthritis admitted at a tertiary hospital. @*Methodology@#This is a retrospective descriptive study of the medical records of patients with septic arthritis admitted at Chong Hua Hospital, Cebu City, from January 2012 to December 2019.@*Results@#Fifty- seven patients were included in this study. Sixty-four percent were males. Forty-three percent were between the ages of 45 to 64 years old. Diabetes mellitus (49.12%) was identified as the most common comorbidity. 94% of patients presented with monoarthritis, with the knee being the most commonly involved joint (73%). 85% of patients presented with joint pain and swelling. Gram-negative bacilli were the most common pathogen isolated at 31.5%. In addition, 87% of patients had synovial fluid white blood cell counts of more than 50,000/uL. Ceftriaxone was the most commonly used empiric antibiotic (31.5%). Based on sensitivity results, empiric antibiotic treatment was adequate in 66.67% of the cases. 64% of patients underwent surgical intervention in addition to antibiotic therapy.@*Conclusion@#This study highlights the unique characteristics of septic arthritis in this population, such as its prevalence in middle-aged patients and the isolation of gram-negative bacilli as the most common isolate. This study showed that the majority of patients were male, with monoarthritis as the most common presentation. Half of the studied population had diabetes mellitus. High clinical suspicion and awareness of risk factors should be emphasized so that timely and adequate treatment may be provided.

Cardiovascular risk factors in Filipinos with Rheumatoid Arthritis included in the Rheumatoid Arthritis Database and Registry (RADAR)

Introduction@#Rheumatoid arthritis (RA) is the most common autoimmune inflammatory arthritis of unknown etiology. Cardiovascular disease (CVD) remains a major problem for these patients. This paper aims to describe the presence of cardiovascular risk factors among filipino patients with rheumatoid arthritis seen in the Philippine General Hospital Rheumatology outpatient department. This will also serve as a baseline database for patients with cardiovascular risk factors for future studies on the impact of rheumatoid arthritis on cardiovascular morbidity and mortality. Objective: to describe the presence of cardiovascular risk factors among filipino patients with rheumatoid arthritis seen in the Philippine General Hospital Rheumatology outpatient department included in the Rheumatoid Arthritis Database and Registry (RADAR)@*Methods@#Cases entered in the study were taken from the RADAR. Included patients were those worked up for traditional and non-traditional cardiovascular risk factors. Demographic data, traditional and nontraditional cardiovascular risk factors and management for RA and CVD were extracted. Descriptive statistics were applied. This study is approved by the Institutional Review Board.@*Results@#Ninety eight patients were included in this study. Ninety four percent were female with mean age at diagnosis of 49.95±10.17 (SD) years and mean disease duration of 63.01 months. For traditional cardiovascular risk factors: 18% were smokers; 34% (24/71) were obese; mean BMI was 23.85±4.60 (SD) kg/m2; 39% (38/98) had hypertension of which 87% were on antihypertensive medication; 19% has impaired fasting glucose (IFG) or diabetes and 55% had dyslipidemia but only 53% and 33% were on oral hypoglycemic agents and statins, respectively. For non-traditional CV or diseaserelated risk factors, 20% still had high disease activity and 65% had elevated sedimentation rate (mean 45.58±18.36 (SD) mm/hr) on latest consult. Eighty seven percent were taking methotrexate but only three percent were on biologic agents.@*Conclusion@#This study shows the presence of important traditional risk factors such as hypertension, diabetes, dyslipidemia, and obesity in this population. Significantly, more than half the cases have dyslipidemia. In addition, RA disease activity was high to moderate. The combination of traditional and disease related risk factors for cardiovascular disease is ominous and warrants aggressive treatment. In addition, patient education and weight control should be emphasized. It is recommended that this cohort be followed up prospectively.