Linear endo-ultrasonographic signs of muscularis propria invasion in early rectal cancer.

Background And Study Aim: Local resection of early rectal cancer is being increasingly used. With invasion of the muscularis propria layer of the rectal wall, the risk of lymph node metastasis becomes too high to consider this the optimal oncological treatment. Therefore, a diagnosis of muscular invasion is important before attempting local resection; however, endoscopic and magnetic resonance imaging (MRI) images have limitations, such as overstaging (26-31%).

Exposure to Thioguanine During 117 Pregnancies in Women With Inflammatory Bowel Disease.

Background: Safety of thioguanine in pregnant patients with inflammatory bowel disease [IBD] is sparsely recorded. This study was aimed to document the safety of thioguanine during pregnancy and birth.

Methods: In this multicentre case series, IBD patients treated with thioguanine during pregnancy were included.

Assessing the efficacy and safety of mycophenolate mofetil versus azathioprine in patients with autoimmune hepatitis (CAMARO trial): study protocol for a randomised controlled trial.

Background: Currently, the standard therapy for autoimmune hepatitis (AIH) consists of a combination of prednisolone and azathioprine. However, 15% of patients are intolerant to azathioprine which necessitates cessation of azathioprine or changes in therapy. In addition, not all patients achieve complete biochemical response (CR).

[Meaningful interventions for peripheral arterial disease: Stopping primary referral to the vascular surgeon and angioplasty].

Supervised exercise therapy with lifestyle counseling by a specialized physical therapist has replaced endovascular or open revascularization as primary treatment for intermittent claudication for most patients in the Netherlands. Succesful implementation of this guideline-recommended treatment strategy was achieved by warranting availability and quality of care by organizing care around a national network. Further reductions in unnecessary interventions in this population may be achieved when general practitioners and medical specialists collaborate, for instance by making in-hospital vascular diagnostic laboratories accessible for primary care.

Bidirectional learning opportunities: How GP-supervisors and trainees exchange knowledge.

Introduction: Workplace-based learning conversations can be a good opportunity for supervisors and trainees to learn from each other. When both professionals discuss their specific knowledge openly with each other, learning conversations may be a useful educational tool, for instance for learning how to apply evidence-based medicine (EBM) in the workplace. We do, however, need a better understanding of how the exchange of knowledge provides opportunities for such bidirectional learning.