Artikel
Abstracts fra Bibliotek for Læger 4/2008
14. sep. 2018
6 min.
Forord
Søren Rittig & Kirsten Boisen
Originalartikel: Syge børn og børnelæger gennem 100 år
Karsten Kaas Ibsen
Sick children and pediatricians in 100 years
Bibl Læger 2008;200:387–426.
The article sums up the development of Danish pediactrics from the late 19th century until recent days. Examples of treatments, institutions, and trendsetting pediatricians are put forward, and Danish Pediatric Society (founded in 1908) receives special attention.
Interview: Børnelæger i to generationer
Marianne Hoffmann & Else Andersen
Originalartikel: »I en sal på hospitalet«. Børnesanatoriet i Vordingborg 1935–1965
Ning de Coninck-Smith
In a bed in the hospital. The children’s sanatorium at Vordingborg 1935–1965
Bibl Læger 2008;200:436–65.
In 1938, a new Danish sanatorium for children suffering from lung tuberculosis was inaugurated. It had room for 100 patients. Money was raised through a national campaign, and the donators came from all walks of life. After World War II the number of children with tuberculosis declined. The paediatric section of the hospital closed in 1965. The article looks into the visions, arguments, and actors behind the campaign. It asks the question, to which degree it made a difference that the modern sanatorium was built with children in mind. Did it have its own scale, related to a specific view of children and their health? The article discusses this question from the perspective of the history of children’s medicine and architectural history. The conclusion is that it did matter. Children should remain in bed and the form of the building, its design and interior supported this purpose. The innate messages of hygiene, discipline and order was downscaled to the size of children. The article draws on a variety of sources from architectural drawings, correspondence, newspaper reports, and articles to memoirs and a big collection of photos belonging to the Danish National Society Against Tuberculosis, which was the owner of and initiator of the project.
Originalartikel: Welanderhjemmet på Bispebjerg Bakke
Ole Sylvester Jørgensen
The »Welander Home« on Bispebjerg Bakke
Bibl Læger 2008;200:467–72.
The article provides a brief insight into the construction of the so-called “Welanderhjem” (Welander Home) for syphilitic children on Bispebjerg Bakke in Copenhagen, launched with inspiration from Sweden in 1916. A number of Welander Homes were constructed in urban and rural Denmark, and they functioned until the early 1950’s, when syphilis seized to be a dominant medical problem. Almost 1000 children were treated in the Welander Home on Bispebjerg Bakke, and initially the mortality was almost 30%.
Originalartikel: Ro, renlighed og regelmæssighed. Sundhedsoplysning og amning ved Københavns børneplejestationer 1908–1930
Anne Løkke
Tranquility, cleanliness, and regularity. Health education, breastfeeding, and infant welfare clinics in Copenhagen 1908–1930
Bibl Læger 2008;200:474–89.
Infant welfare clinics were organised in Copenhagen in 1908. The paediatrician Svenn Monrad (1867–1945), who developed the medical design of the clinics, decided that they should not be French inspired “gouttes the lait” with free sterilized milk for poor babies, but rather breastfeeding propaganda centres. Only breast feeding mothers were received, and they got milk for themselves, clothes for their babies, and received counselling in infant care. The results were very good. The infant mortality rate for these very poor infants declined from around 15% to a level around 4%, the same as well situated infants in Copenhagen. The counselling did, however, include an understanding of the right conducting of breast feeding that produced a lack of milk for many mothers when the infants were 3 or 4 months of age. A problem escalating in the 1950’ies and 1960’ies when the official required intervals between feedings became longer. Many mothers experienced a “failure” as mothers and women because of the faulty health guidance. To be a good mother you had to breast feed six months, but if you followed the regularity scheme, there was a very high risk of not producing enough milk to do so.
Originalartikel: Børn under Åndssvageforsorgen
Birgit Kirkebæk
Children in institutions for mentally deficient
Bibl Læger 2008;200: 491–507.
The history about children in institutions for mentally deficient is a history about care, insight, paternalism and societal desertion. Not least is it a history about how a medical specialty developed and how it was practised at different times throughout history. It is a story about how the incipient medical interest for a group that had previously been neglected, gradually led to the construction of big institutions with doctors in charge. The article describes how the institutions were constructed, what kind of everyday-life the mentally deficient lived, and how doctors communicated their work to colleagues, politicians, and the public. The mentally deficient and their doctors were two sides of the same coin: no institutions for mentally deficient without medical diagnosis and classification, and no medical specialty without institutions for mentally deficient.
Interview: Glem ikke forebyggelsen!
– En samtale med fhv. amtslæge, dr.med. Vagn Christensen
Christian Graugaard
Originalartikel: De mindste børn i pædiatrien
– Etiske overvejelser om livsbevarende behandling
Gorm Greisen
The smallest children in paediatrics
Bibl Læger 2008;200:516–26.
Increasing numbers of extremely preterm infants have been live-born during the last years in Denmark, particularly at 22 to 24 weeks of gestation. This is a likely result of the change of law in 2004, now defining stillbirth from 22 weeks, and of a recommendation from the National Board of Health in 2005 to classify infants as liveborn in the presence of any sign of life. Extremely preterm infants contribute by one third to the prenatal mortality and by 15% to all-child-mortality in Denmark. Fifteen years ago the lay panel of a National Consensus Conference recommended that infants of less than 26 weeks of gestation should not be offered life support. Although this recommendation did not result in action of the National Board of Health it may have resulted in consolidation of a conservative, minimally invasive treatment strategy. The improved health statistics now demonstrates that the mortality of these infants is higher in Denmark than in the other Nordic countries. The neurodevelopmental outcome of the survivors is relatively favorable: 75% may live a normal life in young adulthood. Furthermore, Danish parents in general request a treatment that gives the best chances of survival.
Originalartikel: Behandling af tidligt fødte børn på Rigshospitalet i perioden 1955–2007
René Mathiasen, Bo Mølholm Hansen, Anne Løkke & Gorm Greisen
Handling of preterm children at Rigshospitalet Copenhagen University Hospital 1955–2007
Bibl Læger 2008;200:528–46.
During the last 100 years, the percentage of child death in the neonatal period due to preterm birth has increased. In Denmark neonatology was firmly established as late as 1965 by the foundation of the neonatal department at Copenhagen University Hospital (Rigshospitalet). Since then, there has been a marked increase in the survival of prematurely born individuals. The treatment and care of premature children has evolved dramatically; ethics and treatment of respiratory failure has been among the main issues. The introduction of nasal-CPAP in the early 1970’s, the consolidation of this treatment in the 1980’s, and the combination with surfactant treatment in the 1990’s has limited the use of mechanical ventilation when compared to other countries. During recent years, the treatment of prematurely born children below 26 weeks of gestation has been more active and thus approaches what is done in other countries where modern neonatology is widely implemented.
Forside: Operationsstuen på Fuglebakkens Børnehospital anno 1940 (Medicinsk Museion).