Examinando por Autor "Giglio, Andres"

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    Prognostic Value of International Normalized Ratio and Thrombocytopenia in Early Risk Stratification of Septic Patients
    (MDPI, 2026-04-07) Tejada, Sofia; Giglio, Andres; Aranda, Maria; Socias, Antonia; del Castillo, Alberto; Mena, Joana; Franco, Sara; Ortega, Maria; Nieto, Yasmina; Borges-Sa, Marcio
    Background/Objective: Coagulopathy is a hallmark of sepsis, associated with poor outcomes. Although platelet count has commonly been used for risk stratification, its prognostic value has remained limited. This study compared the ability of the International Normalized Ratio (INR) and platelet count to predict in-hospital mortality in septic patients. Methods: A retrospective study was conducted including adult patients diagnosed with sepsis and admitted to Hospital Universitario Son Llàtzer (Spain) between 2006 and 2022. The INR and platelet count at diagnosis were categorized using clinical thresholds. The primary outcome was in-hospital mortality. Results: Among 6433 patients (60.6% females), mortality was 8.8%. Mortality increased from 6.3% (INR ≤ 1.2) to 20.2% (INR 2.0–3.0), slightly decreasing at INR > 3.0 (10.8%). The platelet count showed a weaker association, with the highest mortality observed at <50 × 109/L (24.6%). The combined markers identified a high-risk subgroup with 50% mortality (INR > 3.0 and platelet count < 50 × 109/L). In the full cohort, multivariable analysis confirmed the INR as an independent predictor of mortality (OR 2.183, p = 0.0002), whereas the platelet count was not significant. The model including the INR achieved an AUC 0.746, while adding the platelet count did not improve performance. Conclusions: the INR at diagnosis was a strong and independent predictor of in-hospital mortality, outperforming the platelet count. These findings could support the consideration of the INR in early risk stratification frameworks and highlight the need for prospective validation before integration into sepsis guidelines.
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    Weight management interventions before IVF in overweight and obese women: a scoping review
    (Springer Nature, 2026-05-11) Arancibia, Constanza; Giglio, Andres; Camus, Adela; Mondion, Mauricio; Jesam, Cristian
    Background: Overweight and obesity are associated with reduced fertility outcomes in assisted reproduction. This scoping review maps available evidence on pre-IVF weight management interventions. Methods: We searched PubMed/MEDLINE (2008–2025) for studies evaluating weight management interventions (dietary, exercise, pharmacological, surgical) before or during IVF in women with BMI ≥ 25 kg/m². We included randomized controlled trials, quasi-xperimental studies, and cohorts with interventions. Two reviewers independently screened records and extracted data on interventions and outcomes. Supplementary searches included reference screening and citation tracking. Results: From 230 records, 19 studies met inclusion criteria: 17 evaluating IVF-specific outcomes — lifestyle or dietary interventions (n = 10), pharmacological therapies (n = 3), and bariatric surgery (n = 4) — and 2 examining preconception interventions before other ART modalities included exclusively to inform implementation challenges. Weight loss was achieved across intervention categories, though the magnitude varied substantially. Improvements in reproductive outcomes were inconsistent. Some studies reported improved pregnancy rates following lifestyle interventions, while well-designed trials showed no significant differences despite weight reduction. Orlistat showed no reproductive benefit; GLP-1 agonist combination therapy showed preliminary promise in PCOS. Bariatric surgery produced substantial weight loss but inconsistent live birth outcomes. High attrition rates (> 20%), treatment delays, and variable adherence were common challenges. Conclusions: Pre-IVF weight management interventions demonstrate substantial outcome heterogeneity. While weight loss is achievable, reproductive benefits are inconsistent. Evidence does not support rigid BMI cutoffs. Clinical decisions should be individualized. Future research should identify predictive factors and optimize intervention protocols.