Accuracy of the combination of commercially available biomarkers and cervical length measurement to predict preterm birth in symptomatic women: A systematic review.

An accurate prognostic method for preterm birth (PTB) could avoid unnecessary treatment(s) with potentially negative effects. The objective was to explore the prognostic accuracy of commercially available bedside cervicovaginal biomarker tests in combination with cervical length (CL) compared to CL measurement alone and/or a biomarker test alone, for PTB within 7 days after testing symptomatic women at 22-34 weeks. The MEDLINE, Cochrane, Embase and Web of Science databases were searched from inception to August 28th, 2019. Seven hundred and eight articles were identified and screened using Rayyan. Studies reporting on the predictive accuracy of combined tests compared to CL or biomarker alone for the prediction of PTB within 7 days of testing in symptomatic women with intact membranes were included. A piloted data extraction form was used. Direct comparisons of the prognostic accuracy of the combination test with CL measurement or a biomarker alone were done, as well as comparisons of prognostic accuracy of the included combination tests (indirect comparisons). Twelve articles were included (seven on fetal fibronectin, four on phosphorylated insulin-like growth factor binding protein-1, one comparing both). A variety of CL cut-offs was reported. The results could not demonstrate superiority of a combination method compared to single methods. Due to data scarcity and quality, the superiority of either predictive test for PTB, either combination or single, cannot be demonstrated with this systematic review. We recommend further research to compare available biomarkers.

European Network of Trainees in Obstetrics and Gynaecology-ENTOG Exchange 2017: an experience report from Slovenia outlining the different trainee situations around Europe.

PURPOSE: The European Network of Trainees in Obstetrics and Gynaecology (ENTOG) is a non-profit, independent organisation that represents young trainees in obstetrics and gynaecology around Europe. At present, ENTOG has 32 member countries. The organisation was founded in 1997 and shall assure the exchange of experiences between young physicians all over Europe. The aim is to improve the quality of traineeship in all participating countries and consequently enhance the standards for women's healthcare. METHODS: This article reports about the experiences of trainees during the ENTOG Exchange 2017 in Slovenia and gives an overview of the trainee situations in different ENTOG member countries. RESULTS: The ENTOG exchange in Slovenia was a unique opportunity to get insights to the Slovenian medical system. Reflecting about their training situations, the participants found considerable differences in the training of young gynaecologists throughout Europe. CONCLUSIONS: Working on the ENTOG goal of raising the quality of training is still highly relevant. The ENTOG exchange is an excellent way to build a network among trainees and stimulate their commitment to improve women's healthcare in their home countries and beyond.

Willingness to take travel-related health risks--a study among Finnish tourists in Asia during the avian influenza outbreak.

BACKGROUND: Health risk perception and behavior of tourists during epidemics is a challenge for behavioral medicine. PURPOSE: The purpose was to analyze associations of psychosocial factors and willingness to take health risks on holiday and business trips. METHOD: Subjects (survey n = 338) were Finnish tourists visiting South-East Asia during the avian influenza epidemic of 2004. On holidays, 13.8%, and on business trips, 6.3% would take (rather) high risks, 14.1% reported having tendency to take health risks. Willingness to take health risks on both kinds of trips was lower among those +40 years old than those <40. Comparatively high risk-taking tendency and high perceived HIV risk were related to the increased willingness to take health risks on both kinds of trips. RESULTS: On holidays, willingness to take health risks was related to trust in fate, and on business trips, this was also related to trust in God and less precautionary behavior of avoiding hand shaking, but also to higher estimation of other risks in life. CONCLUSION: Younger travelers and those on holidays are willing to take more health risks than those who are older or on business trips. Travel advice during epidemics could be differentially targeted to different age groups and to holiday and business travelers.