Biomedical subjects
Publications and source records attributed to Miroslav Novotný.
Benign paroxysmal positional vertigo has been considered a separate nosological entity. This status is explained by the theories of cupulolithiasis and canalolithiasis. The disorder is treated with training; success was achieved in 88% of our cases, which correlates with the literary data. Trauma and inflammation in the head and neck region may be regarded as possible etiological factors.
Vertigo in children is less frequent than in adults, and examiners of patients showing these symptoms must rely on parents' or relatives' observations and details. Besides the equilibrium disorders caused by hereditary malabsorption syndromes or lesions in the peripheral and central vestibular structures, we know of typical diseases that are associated with vertigo and hearing problems and develop during childhood. One of them is Ménière's disease. Careful examinations are necessary to differentiate these illnesses from other vestibular disturbances accompanied by vertigo. Neurootological examinations in children, especially in small children, are more difficult than in adults. The reasons are the time-consuming examination necessary in the case of children and the problems connected with a plethora of troublesome individual tests. Our study gives an overview of Ménière's disease and related vestibular disturbances occurring during childhood.
This work deals with analysis of technical and legal aspects of qualified electronic signature implementation in the area of electronic medical information systems with respect to real usability of such a signature as an equivalent to a manual signature on paper medical documents.
In a randomized, double-blind clinical study, we evaluated the efficacy and tolerability of the fixed combination of cinnarizine, 20 mg, and dimenhydrinate, 40 mg (Arlevert [ARL]) in comparison to betahistine dimesylate (12 mg) in 82 patients suffering from Ménière's disease for at least 3 months and showing the characteristic triad of symptoms (paroxysmal vertigo attacks, cochlear hearing loss, and tinnitus). The treatment (one tablet three times daily) extended to 12 weeks, with control visits at 1, 3, 6, and 12 weeks after drug intake. The study demonstrated for both the fixed-combination ARL and for betahistine a highly efficient reduction of vertigo symptoms in the course of the 12 weeks of treatment; however, no statistically significant difference between the two treatment groups could be established. Similar results were found for tinnitus (approximately 60% reduction) and for the associated vegetative symptoms (almost complete disappearance). Vestibulospinal reactions, recorded by means of craniocorpography, also improved distinctly, with a statistically significant superiority of ARL versus betahistine (p < .042) for the parameter of lateral sway (Unterberger's test). The caloric tests (electronystagmography) showed only minor changes for both treatment groups in the course of the study. A statistically significant improvement of hearing function of the affected ear (p = .042) was found for the combination preparation after 12 weeks of treatment. The tolerability was judged by the vast majority of patients (97.5%) in both groups to be very good. Only one patient (betahistine group) reported a nonserious adverse event, and two betahistine patients did not complete the study. In conclusion, the combination preparation proved to be a highly efficient and safe treatment option for Ménière's disease and may be used both in the management of acute episodes and in long-term treatment. Efficacy and safety were found to be similar to the widely used standard therapy with betahistine.