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When the number of eosinophil granulocytes in blood increases, the cause is not always easy to disentangle. This review highlights the symptoms of rare clonal and common reactive diagnoses, how to approach the patient clinically, and how to implement the armamentarium of available tests in order to identify the correct diagnosis and offer the proper treatment. Two referral centres for eosinophilia have been established in Denmark to support this activity by a collaboration between all departments of haematology and the relevant specialities, meeting the manifestations of eosinophilia.

Cancer is dependent on so-called cancer stem cells that initiate and maintain the cancer cell population. Stem cells are described in normal tissue as low-frequent, self-renewing cells with a multi- or pluripotent differentiation potential. The true characteristics of the cancer-initiating cells are still not entirely known, but it is obvious that identifying these cells will enable us to better understand the biology of cancer. In this article, we focus on normal haematopoietic stem cells and cancer stem cells in leukaemia and multiple myeloma.

Psychosis in childhood and adolescence is rare. Psychotic manifestations in childhood are associated with diagnostic diversities. The diagnostic group pervasive developmental disorder, not otherwise specified (PDD-NOS) are often used in childhood and may be a precursor of schizophrenia or affective psychosis. In this short review, expressions of psychosis in childhood and adolescence are listed and discussed. The authors speak in favour of a closer collaboration between child- and adolescent psychiatry and adult psychiatry clinically as well as in research contexts to expand the knowledge about the genesis and aetiology of psychoses.

In a prospective randomized trial the frequency of infectious complications and natural killer cell function were investigated in 197 patients undergoing elective colorectal surgery and having either no blood transfusion (n = 93), transfusion with whole blood (n = 56), or filtered blood free from leucocytes (n = 48). Postoperative infections developed in 13 patients transfused with whole blood (23%), in one patient transfused with blood free from leucocytes (2%) and in two non-transfused patients (2%) (p < 0.01). Natural killer cell function was significantly (p < 0.001) impaired up to 30 days after surgery in patients transfused with whole blood. These data provide a strong case against the use of whole blood transfusion in patients undergoing elective colorectal surgery.

A 73 year old woman presenting with an acute abdomen was diagnosed as having phlegmonous enteritis after microscopic examination revealed the characteristic finding of a diffuse suppurative inflammation limited to the submucosa in the resected ileal segment. Culture of Klebsiella pneumoniae, and the microscopic demonstration of gram positive cocci and gram negative rods confirmed the bacterial etiology of this disease. There was no evidence of mucosal injury in this patient, but the possible role of ischemia secondary to atherosclerotic vascular disease cannot be assessed. Because of the associated high morbidity and mortality, phlegmonous enteritis should be considered in the differential diagnosis of acute abdomen.

Achalasia is a motor disease of the oesophagus which can be treated surgically (myotomy), medically or by dilatation. After myotomy satisfactory results are obtained in 84%-95% of the patients. Unacceptable results are due primarily to gastro-oesophageal reflux, inadequate or healed myotomy. Dilatation provide good results in about 70% but generally repeated dilatation is required. The remaining 30% can usually be treated surgically. Dilatation is complicated by perforation in about 3% of the patients, but reflux is not as frequent as after myotomy. At present medical treatment is only indicated temporarily prior to dilatation or surgery. Surgical treatment is recommended for patients with contemporary delayed gastric emptying, hiatal hernia, vigorous achalasia, epiphrenic diverticula and for children with achalasia. For the remaining patients both methods can be used but after 2-3 dilatations myotomy is recommended.