PubMed Health⌕ Search

Biomedical subjects

Torben Palshof

Publications and source records attributed to Torben Palshof.

5 recordsLinked to original sources
PubMed2006

[General practitioners' attitudes towards the diagnosis of lung cancer and the diagnostic organisation].

INTRODUCTION: The aim of this study was to determine whether there is a nihilistic attitude towards diagnosing lung cancer among Danish general practitioners (GPs) and to obtain the GPs' evaluation of the present approach to lung cancer diagnosis. MATERIALS AND METHODS: A questionnaire was sent to 1,186 randomly selected GPs. Most of the questions addressed the possibilities of improving primary prevention, GPs' attitudes towards diagnosing lung cancer, their opinions about waiting times and their clinical practice. RESULTS: A total of 848 (71%) completed the questionnaire. Only 12% agreed with the statement that the prognosis for lung cancer is so unfavourable that there is no hurry to diagnose the disease, while 22% agreed to the statement that diagnostic delay rarely means anything for the prognosis. About half of the GPs found the diagnostic period too long. There were, however, wide variations among the different counties in Denmark. The majority of GPs followed the recommendations of the Danish Lung Cancer Group for diagnosing lung cancer, especially the elderly GPs, who were also more inclined to make follow-up appointments after lung infections. More than one in every four practitioners was reluctant to use the word "cancer" in referrals to hospitals or for investigation. CONCLUSION: The study showed that Danish GPs do not have a nihilistic attitude towards diagnosing lung cancer and that elderly practitioners are more careful about diagnosing lung cancer. GPs' satisfaction with waiting times varies widely among the different counties in Denmark. Many practitioners were reluctant to use the word "cancer" in referrals.

Adult↗
PubMed2006

Delay in diagnosis of lung cancer in general practice.

BACKGROUND: Lung cancer is a common cancer disease; nevertheless, in Denmark a GP only sees one new case of lung cancer per year. The core symptoms of lung cancer, cough and dyspnoea, are on the other hand very common in general practice. This represents a challenge to the diagnostic process and increases the risk of diagnostic delay. AIM: To explore diagnostic delay in primary health care among patients with lung cancer. DESIGN OF STUDY: A population based observational case series of 84 lung cancer patients' delay. SETTING: The County of Aarhus, Denmark. METHOD: From county-based registers of all histological and cytological tests we identified all patients in the County of Aarhus with lung cancer diagnosed during a 6 month period in 2003. Inclusion was verified by contacting the departments involved in the treatment of lung cancer. Data were based on telephone interviews with patients' GPs. A review of delay was made starting with the first symptom until referral to secondary care. RESULTS: The overall median delay in primary health care was 32.5 days (interquartile interval (IQI) = 12-68 days). One-third of the patients were referred to the diagnostic investigation after their first consultation. Important reasons for delay in primary care were: symptoms not related to the lungs, chest X-ray without suspicion of cancer, comorbidity, waiting times for investigations and lack of explicit follow-up appointment. Prolonged delay was often due to a combination of these factors. CONCLUSION: When diagnosing lung cancer, it is important that GPs are aware of the low sensitivity of chest X-ray. Shorter waiting times for investigations could reduce delay considerably.

Adult↗
PubMed2002

Peripheral blood accessory cells modulate committed colony-forming units but not 5-week cobblestone-area-forming cell outgrowth from CD34+ cells.

While cellular modulation in vitro of committed hematopoietic stem cell (HSC) growth has been known for some time, less is known about the effect of accessory cells (AC) on the growth of more immature HSC. We have examined the effect of peripheral blood (PB) AC on hematopoiesis by coculturing enriched PB CD34+ cells (>96% pure) with different quantities of CD34 cells (<1% contamination) harvested from 10 breast cancer patients. As expected colony growth was predominantly present in the CD34+ fractions, in which colony forming units granulocyte-macrophage (CFU-GM) varied between 89-3289/10(5) (median 1422/10(5) seeded cells) and week 5 cobblestone area forming cells (CAFC) between 64-1330/10(5) (median 427/10(5) seeded cells). Few CFU-GM (0-27/10(5) seeded cells) and no week 5 CAFC (0-1/10(5) seeded cells) were present in the CD34 fractions. The addition of PB CD34 cells to cultures of CD34+ cells resulted in a considerable variation in the cloning efficiency at the CFU-GM level, and the extent of modulation within the single patient was inconsistent between the different CD34+/CD34 cell mixtures. Overall the stimulatory effect was more pronounced than inhibition and on average the CFU-GM formation per CD34+ cell seeded increased 3 fold (stimulatory effect ranged between 3-17 fold and decreases between 2-10 fold). In contrast, the cloning efficiency at the week 5 CAFC level of differentiation remained unaffected by the addition of different amounts of CD34 cells (the stimulatory effect was maximally 3-fold and inhibition 3-fold). We conclude that while the CFU assay is modulated by the presence of AC, the CAFC assay is more robust and can be employed as a reliable and reproducible tool for HSC measurement.

Adult↗