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Abstract Objective To assess a screening program for sexually transmitted infections (STIs) in under‐30‐year‐old pregnant women, focusing on Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium infections, which though often asymptomatic, may significantly affect women's health and can be vertically transmitted. Design Prospective, descriptive, observational study. Setting Gipuzkoa (Basque Country, Spain). Population Under‐30‐year‐old pregnant women. Methods Between 2016 and 2020, cervical samples were taken at first prenatal appointments from 3051 women. STIs were detected by multiplex nucleic acid amplification. Main Outcome Measures Prevalence of infections by age and geographical origin groups, and screening coverage. Results The coverage rate was 86% between 2017 and 2020. At least one STI was detected in 5.2% of the under‐30‐year‐olds screened (95% confidence interval [CI]: 4.5%, 6.1%): C. trachomatis in 4%, M. genitalium in 1.3% and N. gonorrhoeae in 0.1%. C. trachomatis and M. genitalium prevalence rates were higher among younger women (7.2% and 2.8%, respectively in under‐25‐year‐olds), while C. trachomatis prevalence in 25‐ to 30‐year‐olds was 2.5%. C. trachomatis was more common among Latin American women (9.7% [95% CI: 7.4%, 12.3%] vs. 2.5% [95% CI: 2.0%, 3.2%] in other women). Additionally, analysing samples from 708 pregnant over‐30‐year‐old women with STI risk factors, 1.6% had at least one of the STIs studied. Notably, 20% of all cases had STI‐related symptoms or complications during pregnancy. Conclusions The high coverage achieved, and prevalence, clinical and epidemiological results support the view that the implementation of a screening program across Spain for C. trachomatis in under‐30‐year‐old pregnant women would be both feasible and appropriate. Tweetable abstract High Chlamydia trachomatis infection prevalence (4%) and coverage (>80%) in local program support pregnancy screening across Spain.

BACKGROUND: Although the sentinel lymph node technique in endometrial cancer is currently replacing pelvic and aortic lymphadenectomy for the evaluation of lymph node status in endometrial cancer, its performance is not yet standardized. OBJECTIVE: This study aimed to describe the detection rates and locations of aortic sentinel lymph node detection after dual cervical and fundal indocyanine green injection in patients with endometrial cancer, using the transperitoneal and extraperitoneal approaches. STUDY DESIGN: Between June 26, 2014 and December 31, 2019, 278 patients underwent laparoscopic surgery for endometrial cancer at our institution. In all cases, we performed sentinel lymph node biopsy with dual cervical and fundal indocyanine green injection, and back-up lymphadenectomy in high-risk cases. A post hoc analysis was performed to evaluate differences between the transperitoneal and extraperitoneal approach to aortic sentinel lymph nodes. RESULTS: The detection rates were as follows: overall detection rate: 93.2% (259/278); pelvic detection rate: 90.3% (251/278); bilateral pelvic detection rate: 68.0% (189/278); aortic detection rate: 66.9% (186/278); and isolated aortic detection rate: 2.88% (8/278). Transperitoneal and extraperitoneal aortic detection rates were similar (65.0% and 69.6%, respectively), with no significant differences (P=.441). Isolated aortic metastases were similar in both groups (2% vs 4.7%, respectively; P=.185). The laterality of aortic sentinel lymph node detection was influenced by the surgical approach (P=.002), but not its location above or below the inferior mesenteric artery (P=.166 and P=.556, respectively). CONCLUSION: The detection rates at the aortic level were similar between the transperitoneal and extraperitoneal approaches, with no impact on subsequent pelvic detection. The transperitoneal approach detected more laterocaval, precaval, and interaortocaval nodes, whereas the extraperitoneal approach detected more preaortic and left lateroaortic nodes.

Objetivo: Evaluar el impacto de una intervención multifactorial para promover la desprescripción de tratamientos con bisfosfonatos de duración superior a 5 años (BF5a) en la Comarca Gipuzkoa y compararlo con la intervención estándar en el resto de las organizaciones de servicios (OS) de Osakidetza. Métodos: Estudio de evaluación del impacto de dos intervenciones con medida de resultados antes y después, con un seguimiento de 8 meses. Se incluyeron todos los pacientes de Osakidetza que en julio de 2013 tenían un tratamiento activo con BF5a (prescripción electrónica). La intervención estándar (9 OS) consistió en el envío de un documento de consenso sobre desprescripción de BF5a y en facilitar los identificadores de pacientes con BF5a para su revisión por el médico de atención primaria. La intervención multifactorial (Comarca Gipuzkoa) incluyó, además, un consenso local con los especialistas de referencia y sesiones de formación en los centros de salud. Resultados: Se incluyeron 18.725 pacientes, el 94,7% mujeres. Con la intervención estándar, los porcentajes de desprescripción oscilaron entre el 26,4% (C. Bilbao) y el 49,4% (C. Araba), siendo del 37,2% en su conjunto. Con la intervención multifactorial la desprescripción fue del 44,6%, un 7,4% superior a la estándar (p