RESUMO
BACKGROUND: Group B Streptococcus (GBS) emerged as the frequent pathogen for septic arthritis. There was no study comparing risks, clinical presentations and outcomes between GBS septic arthritis and other bacterial septic arthritis.The aim of this study is to evaluate the differences in risks, clinical presentations, and outcomes of GBS septic arthritis and other bacterial septic arthritis, and identify independent risks and clinical presentations suggesting GBS septic arthritis. METHOD: Medical records of patients diagnosed with non-gonococcal bacterial arthritis admitted in Phramongkutklao Hospital during 2006-2018 were reviewed. Associated risks, clinical presentations and outcomes were compared between GBS septic arthritis (GBS group) and other bacterial septic arthritis (other bacterial group). RESULT: Two hundred and thirty one cases of non-gonococcal bacterial arthritis confirmed by positive joint fluid cultures and/or hemocultures were included. The three most common pathogens were GBS (37.7%), Staphylococcus aureus (23.4%) and Streptococcus viridans (7.4%). GBS group was more commonly found in rainy season than other bacterial group. Patients in GBS group were less likely to have underlying diseases and had more number of involved joints than those in other bacterial group. The clinical presentations more commonly found in GBS group than other bacterial group were oligo-polyarthritis, upper extremities joint involvement, axial joint involvement, tenosynovitis and central nervous system involvement.Multivariate analysis found the independent associated factors of GBS arthritis are tenosynovitis, oligo-polyarthritis and rainy season. CONCLUSIONS: GBS is now the most common pathogen for bacterial septic arthritis. The independent associated factors of GBS arthritis were oligo-polyarthritis, tenosynovitis and rainy season.
RESUMO
Background: The study of metabolic syndrome after delivery and its relationship to gestational diabetes (GDM) in Thai is lacking. Objective: To compare the prevalence and risk factors of metabolic syndrome after delivery in GDM and normal pregnant Thai women. Material and Method: A case-control study was performed at Thammasat University Hospital. Women with previous history of GDM (n = 56) and normal pregnant women (n = 51) delivered during 2007-2013 were enrolled. All of them underwent metabolic profile evaluation and 75 gm oral glucose tolerance test in 2013-2014. Risk factors of metabolic syndrome were assessed by logistic regression model. Results: Women were recruited a mean of 2.97±)1.15 years after delivery. Compared to the control group, the mean current age, median body mass index (BMI) before pregnant, current BMI, waist/height ratio and systolic blood pressure were significantly higher in GDM group. Metabolic syndrome was more in the GDM group (26.8% (15/56) vs. 7.8% (4/51), OR 4.3, 95% CI: 1.32-13.99). Only a BMI ≥25 kg/m2 before index pregnancy was a significant independent factor for this condition (OR 7.18, 95% CI 1.79-28.80; p = 0.005). After delivery, GDM group had more insulin resistance, assessed by HOMA-IR, less insulin sensitivity assessed by Masuda index and QUICKI score and less insulin secretion assessed by HOMA-B, comparing to control group without metabolic syndrome. Conclusion: Previously diagnosed GDM women have higher prevalence of metabolic syndrome after delivery. Obesity before pregnant is a strong independent risk factor for this condition.
