Kan lægeløftet gradbøjes? Dødsfald blandt og lægehjælp til de tyske flygtninge i Danmark 1945

Is There any Limit to the Hippocratic Oath? Deathrates and Medical Care of the German Refugees in Denmark 1945In the last chaotic months of World War II, 200.000 German refugees, including 70.000 children under the age of 15, were sent to occupied Denmark from the eastern provinces of Germany. The Danish officials refused to take care of the refugees. They handed them over to the German Wehrmacht and forced the German officials to confiscate buildings and foods for the refugees. The Germans tried to persuade the Danes to offer medical treatment to the miserable refugees and the negotiations between the Danish doctors and the Danish officials and between the Danes and the Germans are revealed in this paper. The head of the unofficial Danish 'government' by the permanent under-secretaries, Nils Svenningsen, and the chairman of the Danish medical association, Mogens Fenger, advocated for a bargain with the Germans. In return for medical attendance to the refugees, the Danish gendarmes and policemen, who were deported to German concentration camps, should be sent back to Denmark. But strong fractions of the medical association, The National Board of Health and the Danish Liberation Council were opposed to any negotiations with the Germans. The conclusion was, that only refugees who suffered from the diseases, typhoid and paratyphoid fever, dysentery and spotted fever, which could threaten the Danish population, were treated by Danish doctors and in Danish hospitals. All other German patients were left in their lodgings or were sent to the German Wehrmachtlazaretten, which were quite unable to manage the great number of patients. The life-threatening diseases which many of the small children were suffering from (such as measles, gastroenteritis and malnutrition), were not included in those diseases, which the Danish doctors had agreed on treating. That turned out to be fatal for thousands of children. After the German capitulation Denmark kept the German Wehrmacht-doctors in internment in Denmark against international conventions, in order to treat the German refugees. The statistics of mortality and morbidity for the refugees 1945 are very incomplete, because the health authorities at that time decided not to collect data. In this paper, therefore, I have from very different sources tried to collect available data. More than 13.000 refugees died in 1945 in Denmark and almost 7.000 children under the age of 5 died. When a census of the refugees was done in August 1946, probably most of the children under the age of 2 had died. It is of course not possible to tell exactly how many children under the age of 5 would have died, if the Danish doctors had intervened and offered them proper medical treatment, but it is my opinion, that most of them would have survived. In 1945 public opinion was against any help to the Germans, even to the small children, and the Danish medical profession was with a few exceptions of the same opinion

Arma Caritas. Røde Kors og forvaltningen af de tyske flygtninge i Danmark 1945-1949

The Red Cross and the Administration of the German Refugees in Denmark 1945-1949The Red Cross has, for over a hundred years, been synonymous with providing help to the victims of armed conflicts. In the last months of World War II, 250.000 civilian refugees from the eastern provinces of Germany ended up in Denmark. Three different organizations under the Red Cross, namely the International Committee of the Red Cross, the German Red Cross and the Danish Red Cross were involved in assisting the refugees in Denmark. The Geneva Conventions are the international legislation which obliged the states to follow specific rules for the treatment of the victims of war. In 1945 the Geneva Conventions did not include civilians, but, since the first Geneva Conventions from 1864, medical personnel of the armies have been included and specific rules for their treatment described.The German Red Cross was ordered by the Danish authorities and the British Military Mission in Denmark to continue its supervision of the German refugee camps after the surrender of Germany. But in the summer of 1945 the German Red Cross had considerable problems with both the resistance movement and the German emigrants who had arrived in Denmark in the 1930s. The leaders of the German Red Cross were repeatedly arrested by the resistance movement and the British Military Mission, and finally in October 1945 the leader of the Danish Refugee Administration, Johannes Kjærbøl, decided to close down the German Red Cross, realizing that it was not possible for a German organization to function in Denmark at that time. But the sanitary personnel from the German Red Cross whom the Germans had ordered to go to Denmark in March-April 1945, after the Danish health system had refused to treat the German refugees, were retained in Denmark against their will by the Danish authorities until the last refugees left Denmark in 1949. German military doctors and other army sanitary personnel were also forced to stay in Denmark, in clear contradiction of their rights according to the Geneva Conventions.Before the German surrender the Danish Red Cross refused to assist the refugees. Their excuse was, that they thought it impossible to persuade Danish volunteers to help Germans. After the capitulation the Danish Red Cross was prepared to care for the refugees, but the Danish authorities handed the job over to another organization. The Danish Red Cross did not show much interest in the treatment of the German refugees and believed without any objections everything the Danish authorities told them about the conditions in the refugee camps. It supported the Danish authorities in their attempt to exclude the International Committee of the Red Cross from supervising the refugee camps. On the other hand the Danish Red Cross was without prejudice delivering food aid to the Germans in Germany, and defending and upholding this program, despite the fact that public opinion in Denmark opposed it, contributed to the dismissal of the president of the Danish Red Cross in 1950.The International Committee of the Red Cross was, at first, not aware of any problems in caring for the German refugees in Denmark. However from October 1945 to the summer of 1947 there was a permanent delegate attached to Denmark, committed to supervising the German refugee camps. The International Committee of the Red Cross acknowledged the burden put upon Denmark in providing for such a large population of German refugees, but it also pointed out to the Danish authorities the intolerable conditions in some of the camps, and it forced the Danish Government to acknowledge that the German military sanitary personnel were protected by the Geneva Conventions. The delegate was not welcome in Denmark, but the International Committee could not be turned down and it managed to improve the conditions for the sanitary personnel.The role of the Red Cross in the administration of the German refugees in Denmark is a good example of the conditions faced by a foreign Red Cross society in a hostile country and the naivety of a national Red Cross society in believing blindly what the national authorities tell it. However it also shows the strength of the International Committee of the Red Cross, which had no power to force the Government to follow humanitarian principles and the Geneva Conventions but nevertheless had so much moral authority, that it was able to put pressure on the Government to improve the conditions for the refugees

S100A8/A9 (Calprotectin), Interleukin-6, and C-Reactive Protein in Obesity and Diabetes before and after Roux-en-Y Gastric Bypass Surgery

Background: In obesity, which is a major contributor to insulin resistance and diabetes, the circulating level of S100A8/A9 (calprotectin) is elevated and declines after Roux-en-Y gastric bypass surgery (RYGB). However, studies on S100A8/A9 and the pathophysiological mechanisms in insulin resistance and diabetes are few and contradictory. Methods: We studied 48 subjects who underwent RYGB, comprising a non-diabetic control group and two diabetic groups in whom diabetes either regressed or persisted, 6-12 months post-surgically. S100A8/A9, interleukin 6 (IL-6) as well as other inflammatory and diabetes-related markers were measured pre- and post-surgically. Results: Significant and similar decreases of BMI were found in all groups. S100A8/A9 and IL-6 decreased significantly in the group with diabetes remission and in the control group, but not in the group with persistent diabetes. The relative changes in S100A8/A9 and IL-6 correlated significantly (r = 0.905, p = 0.005) only in the group with persistent diabetes. In contrast, leukocyte count and C-reactive protein correlated significantly to S100A8/A9 only in the control group. Conclusion: Our study is suggestive of S100A8/A9 and IL-6 being related to a persistent diabetes status post-surgically and of different pathophysiological mechanisms being involved in the post-surgical changes in the three groups, despite similar decreases in BMI

Genomic and exoproteomic analyses of cold- and alkaline-adapted bacteria reveal an abundance of secreted subtilisin-like proteases

Proteases active at low temperature or high pH are used in many commercial applications, including the detergent, food and feed industries, and bacteria specifically adapted to these conditions are a potential source of novel proteases. Environments combining these two extremes are very rare, but offer the promise of proteases ideally suited to work at both high pH and low temperature. In this report, bacteria from two cold and alkaline environments, the ikaite columns in Greenland and alkaline ponds in the McMurdo Dry Valley region, Antarctica, were screened for extracellular protease activity. Two isolates, Arsukibacterium ikkense from Greenland and a related strain, Arsukibacterium sp. MJ3, from Antarctica, were further characterized with respect to protease production. Genome sequencing identified a range of potential extracellular proteases including a number of putative secreted subtilisins. An extensive liquid chromatography–tandem mass spectrometry analysis of proteins secreted by A. ikkense identified six subtilisin‐like proteases as abundant components of the exoproteome in addition to other peptidases potentially involved in complete degradation of extracellular protein. Screening of Arsukibacterium genome libraries in Escherichia coli identified two orthologous secreted subtilisins active at pH 10 and 20°C, which were also present in the A. ikkense exoproteome. Recombinant production of both proteases confirmed the observed activity