The first healed injury in a hyolith operculum.

The Palaeozoic sediments of the Barrandian area are globally well-known as a classic example of rocks characterised by an abundant skeletal marine fauna, including well-preserved remains of hyoliths. Several tens specimens of malformed invertebrates such as trilobites, cephalopods and gastropods have been collected and documented from Cambrian to Devonian clastic sediments and carbonates in this area. However, no malformed hyolith specimen has yet been recorded. Hyoliths are Palaeozoic animals with small calcium carbonate shells composed of the conch (= oblong, conical and bilaterally symmetrical shell of diverse cross section and aperture at its wide end) and the operculum (= cap closing the conch aperture). Here we describe an operculum showing regeneration after non-lethal predatory attack in the Ordovician hyolith Elegantilites custos. This is the first record of regeneration in a hyolith operculum that has been repaired after a failed durophagous attack. Epibenthic/infaunal predatory echinoderms, such as ophiuroids, are considered as potential culprits.

Experience with viral hepatitis C treatment among people who inject drugs and participate in a methadone substitution treatment program.

OBJECTIVES: Long-term monitoring of the mutual effects of chronic viral hepatitis C (VHC) treatment and tailored addiction treatment. In 2016, the World Health Organization (WHO) published an action plan to eliminate viral hepatitis C globally by 2030. People who inject drugs (PWID) are a key population that needs increased attention and care. Two decades before the announcement of the WHO plan for the global elimination of HCV (hepatitis C virus), the Remedis Medical Facility, where the study was conducted, established a “Comprehensive Care Program for patients with substance use disorders and addictive behaviour”. METHODS: We evaluated all patients who were in the methadone program as of 1 March 2020, regardless of OST duration, OST dosage, age or gender. Their epidemiological and demographic data obtained during a structured clinical interview and laboratory test results were analysed. RESULTS: Of 24 patients on methadone substitution therapy, 12 (50%) were anti-HCV negative before starting OST. None of them became newly infected with hepatitis C virus (HCV) during OST. The remaining 12 of the study patients were anti-HCV positive. Ten of them have already undergone successful treatment for viral hepatitis. Two patients were re-infected with HCV. CONCLUSION: The presented work confirms the high efficacy of chronic VHC treatment among PWID in inducing suitable conditions. We consider combination of HCV infection treatment and targeted tailored addiction treatment as a starting point for achieving control over the HCV epidemic in the Czech Republic, with a possible positive impact on other blood-borne infections related to risky behaviour.

Ten years of laparoscopic sleeve gastrectomy at the Military University Hospital in Prague.

INTRODUCTION: The aim of this study was to evaluate a group of bariatric patients operated at the Military University Hospital in Prague during the last 10 years (20112020), in whom laparoscopic sleeve gastrectomy was performed. METHODS: Retrospective survey of the internal operation database. The search used the following combination of keywords: “sleeve“, “LSG“ and the diagnosis “E6*“. A total of 279 operated patients were enrolled. We evaluated the sex, age at the time of surgery, complications, need for drainage, weight, BMI, presence of type two diabetes mellitus and any effect of the surgery on its improvement, length of hospital stay, follow-up duration and % excess weight loss. RESULTS: A total of 279 patients, including 195 women and 84 men, underwent laparoscopic sleeve gastrectomy in the period of 10 years. The mean age was 44.46 years. The average operating time was 111 minutes. The mean BMI of the patients before surgery was 42.24 and the weight was 123.4 kg. The mean BMI one year after the surgery corresponded to a decrease of approximately 10 and the mean weight of 93.8 kg. Rather severe acute postoperative complications occurred in 2.87% patients. An improvement or complete cure of type two diabetes mellitus was observed in 57.8% patients. CONCLUSION: Currently, laparoscopic sleeve gastrectomy is the most common bariatric operation at the Military University Hospital in Prague. This study demonstrates a satisfactory effect of bariatric surgery in terms of long-term significant weight loss and an improvement or even cure of associated diseases such as type two diabetes mellitus, arterial hypertension and others.

Health care at the St. George Monastery at the Prague Castle in the 17th and 18th century.

The article expresses main phenomena of the health care at the oldest Czech monastery - St. George Monastery at the Prague Castle - in the early modern period. The care is studied based on the period regulations, archive information about resident and local (para)medics, facilities, control or diseases. The medical problems had to be in the spotlight of the monastery inhabitants since every disease meant the paralysing of the nun community. In this respect, the monastery was not independent of its environs. The St. George nuns was often brought face to face with male (para)medics. Direction of the men within the monastery belonged to the main problems of the health care in the early modern female communities.

Evaluation and reporting of biopsies from the columnar-lined esophagus and gastro-esophageal junction (GEJ).

This review is part of a collaboration between the American Registry of Pathology (the publisher of the Armed Forces Institute of Pathology Fascicles) and Annals of Diagnostic Pathology. It is in a series of expert recommendations on topics encountered in daily practice. The authors, two pathologists and a gastroenterologist, met on 19 January 2019 tasked with developing expert recommendations on reporting biopsies from the columnar lined esophagus and gastroesophageal junction. Our opinions for reporting revolve around noting the presence and absence of goblet cells and clues for confirming whether a sample is from the tubular esophagus. We also illustrate congeners of goblet cell. We present the information in the form of questions and answers.

Otto Kahler and his family: II. Ripening years in Prague.

Otto Kahler (1849-1893), a son of a wound physician at the Provincial Prison, spent his childhood and youth in his native Prague. After graduated from Charles-Ferdinand University (1871, 1872) he became a second-generation physician in an old German-Czech peasant family. He thereafter worked as an intern (from 1873) and assistant (from 1875) with Prof. Joseph Halla at the IInd Medical Clinic of the General Hospital. Shortly before habilitation (1878), in collaboration with Arnold Pick from the Insane Asylum, he began an intense research on pathology and pathological anatomy of the central nervous system (1878-1880) which resulted in discovery of the rule for arrangement of fibres in the posterior funiculi of the spinal cord - the Kahler-Pick law (1880). Then he coedited the weekly Prager medicinische Wochenschrift (1880-1889). After the division of the University according to teaching language the recently appointed extraordinary professor (1882) as well as the whole IInd Medical Clinic belonged to the German Charles-Ferdinand University. His encounter of a case of multiple myeloma in the Prague Merchants´ Hospital in December 1885 attracted his attention to symptomatology of this disease.

Quality of endoscopic surveillance of Barrett's esophagus.

OBJECTIVES: The aim of this study was to evaluate adherence to Barrett's esophagus (BE) surveillance guidelines in Denmark. METHODS: The Danish Pathology Registry was used to identify 3692 patients. A total of 300 patients were included by drawing a simple random sample. Description of the BE segment, biopsy protocol, communication with the pathologist and planned follow-up endoscopy, was evaluated. RESULTS: Thirty-one patients were excluded due to missing reports and 83 patients (28%) due to no endoscopic evidence of BE. Endoscopists suspected BE in 186 patients (62%) and these patients were included. Prague C&M classification was used in 34% of the endoscopy reports. The median number of biopsies was 4 (interquartile range (IQR), 3-6). The BE segment was stratified by lengths of 1-5, 6-10 and 11-15 cm and endoscopists obtained a sufficient number of biopsies in 12, 8 and 0% of cases, respectively. 28% of endoscopists described the exact location of the biopsy site in the pathology requisition. Patients with nondysplastic BE had endoscopic surveillance performed after a median of 24 months (IQR, 6-24). CONCLUSIONS: Adherence to the Danish guidelines was poor. This may be associated with insufficient quality of BE surveillance. Lack of endoscopic evidence of BE in the Danish Pathology Registry may have underestimated the incidence of adenocarcinoma in BE patients in previous studies.

How Should We Report Endoscopic Results in Patient's with Barrett's Esophagus?

Barrett's esophagus is the only known pre-cancerous lesion for esophageal adenocarcinoma and is diagnosed by high-definition white light endoscopy demonstrating a columnar-lined esophagus along with biopsy evidence of intestinal metaplasia. With accurate performance and reporting of the endoscopic procedure, an evidence-based management strategy can be developed for treatment of Barrett's dysplasia. However, cross-sectional data demonstrate that there is still inconsistency among gastroenterologists in performance and reporting of endoscopic findings in patients with Barrett's esophagus. Here, we present an evidence-based review of how to report endoscopic findings in Barrett's esophagus.

Quality indicators for the management of Barrett's esophagus, dysplasia, and esophageal adenocarcinoma: international consensus recommendations from the American Gastroenterological Association Symposium.

The development of and adherence to quality indicators in gastroenterology, as in all of medicine, is increasing in importance to ensure that patients receive consistent high-quality care. In addition, government-based and private insurers will be expecting documentation of the parameters by which we measure quality, which will likely affect reimbursements. Barrett's esophagus remains a particularly important disease entity for which we should maintain up-to-date guidelines, given its commonality, potentially lethal outcomes, and controversies regarding screening and surveillance. To achieve this goal, a relatively large group of international experts was assembled and, using the modified Delphi method, evaluated the validity of multiple candidate quality indicators for the diagnosis and management of Barrett's esophagus. Several candidate quality indicators achieved >80% agreement. These statements are intended to serve as a consensus on candidate quality indicators for those who treat patients with Barrett's esophagus.

Prague 1337, the first successful caesarean section in which both mother and child survived may have occurred in the court of John of Luxembourg, King of Bohemia.

OBJECTIVE: An interdisciplinary historical-medical study, analysis of historical sources, and critical interpretation of the indirect evidence surrounding the childbirth of Beatrice of Bourbon, the second wife of the Bohemian King John of Luxembourg. STUDY TYPE: A material-based study founded on a comparative analysis of available private and public sources, particularly surviving letters, and narrative sources. The conclusions are reached based on a textual interpretation according to historical methods. SETTINGS: Department of Obstetrics and Gynecology of the First Faculty of Medicine of Charles University and General University Hospital in Prague. METHODS AND RESULTS: Until the second half of the 19th century, medical knowledge of antiseptics and anesthesia was lacking, and techniques for cleaning wounds and staunching bleeding were primitive.Because no effective anesthetics were known before that time, people did not know how to perform painless abdominal surgery. There are a very few credible reports of caesarean sections performed on living women as early as the 17th century. However, before the 19th century, a caesarean section meant almost certain death for the mother, with related mortality as high as 90%. If the woman did not die of stress from the pain of the abdominal surgery, then she usually died of either bleeding or later of sepsis. However, there is some indirect evidence that the first caesarean section that was survived by both the mother and child was performed in Prague in 1337. The mother was Beatrice of Bourbon (1318-1383), the second wife of the King of Bohemia John of Luxembourg (1296-1346). Beatrice gave birth to the kings son Wenceslaus I (1337-1383), later the duke of Luxembourg, Brabant, and Limburg, and who became the half brother of the later King of Bohemia and Holy Roman Emperor, Charles IV (1316-1378). CONCLUSIONS: From a historical analysis based on the indirect evidence, it is not possible to unequivocally determine whether a caesarean section that was survived by both the mother and child was actually performed in the 14th century. From a medical standpoint in the context of all the known surrounding circumstances, however, this rare event could indeed have taken place.

[History of the 4th Department of Internal Medicine of the First Faculty of Medicine at Charles University and the General University Hospital in Prague]. / Historie IV. interní kliniky 1. LF UK a VFN.

In 2015, the doctors and nurses of the 4th Department of Internal Medicine of the First Faculty of Medicine, Charles University and the General University Hospital in Prague celebrated the 70th anniversary of its founding. The article summarizes the clinics contribution to the field of internal medicine, and particularly to angiology, hepatogastroenterology and lipidology. It comments the clinics current activities and the possibilities of its further development. Attention is also paid to the tradition of high ethical and professional standards of medical care in accordance with the norms established by the clinic's founder, prof. MUDr. Bohumil Prusík.

[Double jubilee of undervalued professor J. D. John]. / Dvojnásobné jubileum nedoceneného profesora J. D. Johna (1764-1814).

Paper draws attention to an interesting personality of a professor of medical police and forensic medicine, overlooked by historians. This year 250 years has passed since his birth and 200 years since his death. Professor Johns biography is given and his work appraised.

Prevalence of SARS-CoV-2 variants in Prague wastewater determined by nanopore-based sequencing.

The early detection of upcoming disease outbreaks is essential to avoid both health and economic damage. The last four years of COVID-19 pandemic have proven wastewater-based epidemiology is a reliable system for monitoring the spread of SARS-CoV-2, a causative agent of COVID-19, in an urban population. As this monitoring enables the identification of the prevalence of spreading variants of SARS-CoV-2, it could provide a critical tool in the fight against this viral disease. In this study, we evaluated the presence of variants and subvariants of SARS-CoV-2 in Prague wastewater using nanopore-based sequencing. During August 2021, the data clearly showed that the number of identified SARS-CoV-2 RNA copies increased in the wastewater earlier than in clinical samples indicating the upcoming wave of the Delta variant. New SARS-CoV-2 variants consistently prevailed in wastewater samples around a month after they already prevailed in clinical samples. We also analyzed wastewater samples from smaller sub-sewersheds of Prague and detected significant differences in SARS-CoV-2 lineage progression dynamics among individual localities studied, e.g., suggesting faster prevalence of new variants among the sites with highest population density and mobility.

Small effects of olfactory identification and discrimination on global cognitive and executive performance over 1 year in aging people without a history of age-related cognitive impairment.

Olfactory and cognitive performance share neural correlates profoundly affected by physiological aging. However, whether odor identification and discrimination scores predict global cognitive status and executive function in healthy older people with intact cognition is unclear. Therefore, in the present study, we set out to elucidate these links in a convenience sample of 204 independently living, cognitively intact healthy Czech adults aged 77.4 ± 8.7 (61-97 years) over two waves of data collection (one-year interval). We used the Czech versions of the Montreal Cognitive Assessment (MoCA) to evaluate global cognition, and the Prague Stroop Test (PST), Trail Making Test (TMT), and several verbal fluency (VF) tests to assess executive function. As a subsidiary aim, we aimed to examine the contribution of olfactory performance towards achieving a MoCA score above vs. below the published cut-off value. We found that the MoCA scores exhibited moderate associations with both odor identification and discrimination. Furthermore, odor identification significantly predicted PST C and C/D scores. Odor discrimination significantly predicted PST C/D, TMT B/A, and standardized composite VF scores. Our findings demonstrate that olfaction, on the one hand, and global cognition and executive function, on the other, are related even in healthy older people.

Practice patterns among U.S. gastroenterologists regarding endoscopic management of Barrett's esophagus.

BACKGROUND: Endoscopic management of Barrett's esophagus (BE) has evolved over the past decade; however, the practice patterns for managing BE among gastroenterologists remain unclear. OBJECTIVE: To assess practice patterns for management of BE among gastroenterologists working in various practice settings. DESIGN: A random questionnaire-based survey of practicing gastroenterologists in the United States. The questionnaire contained a total of 10 questions pertaining to practice setting, physician demographics, and strategies used for managing BE. SETTING: Survey of gastroenterologists working in various practice settings. INTERVENTION: Questionnaire. MAIN OUTCOME MEASUREMENTS: Practice patterns for endoscopic imaging and management of BE. RESULTS: The response rate was 45% (236/530). The majority (85%) were gastroenterologists in community practice, 72% were aged 41 to 60 years, 80% had >10 years of experience, and 81% had attended postgraduate courses and/or seminars on BE management. A total of 78% did not use the Prague C & M classification, and about a third used advanced endoscopic imaging routinely (37%) or in selected cases (31%). For nondysplastic BE, 86% practiced surveillance, 12% performed ablation, and 3% did no intervention. For BE with low-grade dysplasia, 56% practiced surveillance, 26% performed endoscopic ablation in all low-grade dysplasia cases, and 18% performed endoscopic ablation in only selected patients with low-grade dysplasia. The majority of respondents (58%) referred their patients with high-grade dysplasia to centers with BE expertise, 13% performed endoscopic ablation in all patients with high-grade dysplasia, 25% performed endoscopic ablation in selected cases only, and 3% referred these patients for surgery. The most frequently used endoscopic eradication therapy was radiofrequency ablation (39%) followed by EMR (17%). LIMITATIONS: The sample may be unrepresentative, participation in the study was voluntary, and responses may be skewed toward following the guidelines. CONCLUSION: Results from this survey show that the majority of practicing gastroenterologists in the United States practice surveillance endoscopy in patients with nondysplastic BE and provide endoscopic therapy for those with high-grade dysplasia. The Prague C & M classification and advanced imaging techniques are used by less than a third of gastroenterologists. Practice patterns did not appear to be affected by respondent age or duration of clinical practice.

[Teaching at the Czech Faculty of Medicine has started 130 years ago]. / Pred 130 lety byla zahájena výukana ceské lékarské fakulte

Act on the division of Charles-Ferdinand University in Prague into the Czech and German universities was signed by the emperor on 28 February 1882. Czech Faculty of Medicine was able to start education only in the school year 1882/83, one year after the Faculty of Law and Faculty of Arts. It was necessary to establish all institutes of theoretical medicine and some clinical departments, because German professors transferred their clinics to the German University, which the Act allowed. Celebration of the beginning of the teaching at the Czech Faculty of Medicine was imposing and it was described in the Journal of Czech Physicians and in the daily papers.

Monitoring COVID-19 spread in selected Prague's schools based on the presence of SARS-CoV-2 RNA in wastewater.

The COVID-19 pandemic has demanded a broad range of techniques to better monitor its extent. Owing to its consistency, non-invasiveness, and cost effectiveness, wastewater-based epidemiology has emerged as a relevant approach to monitor the pandemic's course. In this work, we analyzed the extent of the COVID-19 pandemic in five primary schools in Prague, the Czech Republic, and how different preventive measures impact the presence of SARS-CoV-2 RNA copy numbers in wastewaters. Copy numbers were measured by reverse transcription-multiplex quantitative real-time PCR. These copy numbers were compared to the number of infected individuals in each school identified through regular clinical tests. Each school had a different monitoring regime and subsequent application of preventive measures to thwart the spread of COVID-19. The schools that constantly identified and swiftly quarantined infected individuals exhibited persistently low amounts of SARS-CoV-2 RNA copies in their wastewaters. In one school, a consistent monitoring of infected individuals, coupled with a delayed action to quarantine, allowed for the estimation of a linear model to predict the number of infected individuals based on the presence of SARS-CoV-2 RNA in the wastewater. The results show the importance of case detection and quarantining to stop the spread of the pandemic and its impact on the presence of SARS-CoV-2 RNA in wastewaters. This work also shows that wastewater-based epidemiological models can be reliably used even in small water catchments, but difficulties arise to fit models due to the nonconstant input of viral particles into the wastewater systems.

Negligible risk of surface transmission of SARS-CoV-2 in public transportation.

BACKGROUND: Exposure to pathogens in public transport systems is a common means of spreading infection, mainly by inhaling aerosol or droplets from infected individuals. Such particles also contaminate surfaces, creating a potential surface-transmission pathway. METHODS: A fast acoustic biosensor with an antifouling nano-coating was introduced to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on exposed surfaces in the Prague Public Transport System. Samples were measured directly without pre-treatment. Results with the sensor gave excellent agreement with parallel quantitative reverse-transcription polymerase chain reaction (qRT-PCR) measurements on 482 surface samples taken from actively used trams, buses, metro trains and platforms between 7 and 9 April 2021, in the middle of the lineage Alpha SARS-CoV-2 epidemic wave when 1 in 240 people were COVID-19 positive in Prague. RESULTS: Only ten of the 482 surface swabs produced positive results and none of them contained virus particles capable of replication, indicating that positive samples contained inactive virus particles and/or fragments. Measurements of the rate of decay of SARS-CoV-2 on frequently touched surface materials showed that the virus did not remain viable longer than 1-4 h. The rate of inactivation was the fastest on rubber handrails in metro escalators and the slowest on hard-plastic seats, window glasses and stainless-steel grab rails. As a result of this study, Prague Public Transport Systems revised their cleaning protocols and the lengths of parking times during the pandemic. CONCLUSIONS: Our findings suggest that surface transmission played no or negligible role in spreading SARS-CoV-2 in Prague. The results also demonstrate the potential of the new biosensor to serve as a complementary screening tool in epidemic monitoring and prognosis.

PROF. DR CARL FERDINAND RITTER VON ARLT (1812-1887): HIS LIFE AND WORK DURING HIS OPHTHALMOLOGICAL CAREER IN PRAGUE.

The aim of this paper is to provide an overview of the life and work in Prague of the famous ophthalmologist Carl Ferdinand Ritter von Arlt (1812‒1887). The paper presents data on his stay in Prague while studying Medicine and working as a private physician and ophthalmologist. Professor von Arlt was Head of the Chair of Ophthalmology at Charles University. He was Director of the Eye Clinic at Prague General Hospital from 1849 to 1856. A detailed description is given of his residences and their appearance today. Very little has been written about this aspect, so the paper will be a supplement to his impressive biography. A brief, chronological, systematic and concise biography is also provided, including details of his family and his contributions to Ophthalmology. During his 25-year stay in Prague (1831-1856), he commuted between the city centre and the General Hospital where he worked. He changed the location of his residence five times. It is important to note and not to forget where one of the greatest ophthalmologists of the 19th century worked and resided in Prague.