FrancophonIA/ELRC3.0 huggingface dataset:
English: The degree of hyperglycaemia appeared to be higher in patients with pre-diabetic conditions or established diabetes mellitus.
Croatian: Čini se da je stupanj hiperglikemije bio viši u bolesnika s pred-dijabetičkim stanjima ili ustanovljenom šećernom bolešću.
English: Ampoules of Signifor of different strengths (0.3 mg, 0.6 mg and 0.9 mg) are available to match the specific dose prescribed by your doctor.
Croatian: Dostupne su ampule Signifora različitih jačina (0,3 mg, 0,6 mg i 0,9 mg) kako bi odgovarale specifičnoj dozi koju Vam je propisao liječnik.
English: The apparent clearance (CL/F) of pasireotide intramuscular use in healthy volunteers is on average 4.5-8.5 litres/h.
Croatian: Prividni klirens (CL/F) pasireotida primijenjenog intramuskularno u zdravih dobrovoljaca u prosjeku je 4,5-8,5 litara/h.
English: In healthy volunteers, pasireotide is widely distributed with large apparent volume of distribution (Vz/F >100 litres).
Croatian: U zdravih dobrovoljaca pasireotid ima opsežnu distribuciju uz veliki volumen distribucije (Vz/F >100 litara).
English: It is not known whether Signifor passes into breast milk.
Croatian: Nije poznato prelazi li Signifor u majčino mlijeko.
English: How long to use Signifor
Croatian: Koliki dugo primjenjivati Signifor
English: If hyperglycaemia develops in a patient being treated with Signifor, the initiation or adjustment of antidiabetic treatment is recommended, following the established treatment guidelines for the management of hyperglycaemia.
Croatian: Ako se razvije hiperglikemija kod bolesnika koji se liječi Signiforom, preporučuje se započeti ili prilagoditi antidijabetičko liječenje, slijedeći utvrđene terapijske smjernice za zbrinjavanje hiperglikemije.
English: Patients who did not meet these criteria were unblinded and the dose was increased by 0.3 mg twice daily.
Croatian: Za bolesnike koji nisu ispunili te kriterije liječenje je bilo razotkriveno, a doza je povećana za 0,3 mg dvaput na dan.
English: This means that it is injected through a needle into the muscles of your buttocks.
Croatian: To znači da se ubrizgava kroz iglu u mišić na Vašoj stražnjici.
English: Put the cover back on the needle.
Croatian: Vratite poklopac na iglu.
English: Injection site reactions were reported in 13.6% of patients enrolled in the phase III study in Cushing's disease.
Croatian: Reakcije na mjestu primjene injekcije bile su prijavljene u 13,6% bolesnika uključenih u ispitivanje faze III kod Cushingove bolesti.
English: Dose adjustment of medicinal products such as beta blockers, calcium channel blockers, or medicinal products to control electrolyte balance, may be necessary (see also section 4.5).
Croatian: U tim slučajevima može biti potrebno prilagođavanje doze lijekova kao što su beta blokatori, blokatori kalcijevih kanala ili drugi lijekovi za kontroliranje ravnoteže elektrolita (vidjeti također dio 4.5).
English: Decreases in sitting systolic and diastolic blood pressure, body mass index (BMI) and total cholesterol were observed in both dose groups at month 6.
Croatian: Smanjenja u sistoličkom i dijastoličkom krvnom tlaku u sjedećem položaju, indeksu tjelesne težine (BMI) i ukupnom kolesterolu bila su uočena u obje dozne skupine u 6. mjesecu.
English: Dose adjustments (decrease or increase) of insulin and antidiabetic medicinal products (e.g. metformin, liraglutide, vildagliptin, nateglinide) may be required when administered concomitantly with pasireotide (see also section 4.4).
Croatian: Prilagođavanja doze (smanjenje ili povećanje) inzulina i antidijabetika (npr. metformina, liraglutida, vildagliptina, nateglinida) može biti potrebno kada se ti lijekovi primjenjuju istodobno s pasireotidom (vidjeti također dio 4.4).
English: Table 4 Key results at month 12 - phase III study in acromegaly patients
Croatian: Tablica 4 Ključni rezultati u 12. mjesecu - ispitivanje faze III u bolesnika s akromegalijom
English: In both studies, mean FPG and HbA1c levels peaked within the first three months of treatment with pasireotide intramuscular use.
Croatian: U oba ispitivanja, srednje razine FPG-a i HbA1c dosegle su vršne vrijednosti unutar prva tri mjeseca liječenja pasireotidom primijenjenim intramuskularno.
English: The elevations were mostly low grade and reversible while continuing treatment.
Croatian: Povišenja su bila uglavnom niskog stupnja i reverzibilna uz nastavak liječenja.
English: Remove the lid film of the vial adapter packaging, but do NOT remove the vial adapter from its packaging.
Croatian: Uklonite film kojim je pokriveno pakiranje nastavka za bočicu, ali NEMOJTE vaditi nastavak za bočicu iz njegovog pakiranja.
English: The safety profile of pasireotide intramuscular use was largely similar between the acromegaly and Cushing's disease indications.
Croatian: Sigurnosni profil pasireotida koji se primjenjuje intramuskularno uvelike je bio sličan između indikacija akromegalije i Cushingove bolesti.
English: After four months of treatment, patients with mUFC ≤1.5xULN continued on the blinded dose to which they were randomised, and patients with mUFC >1.5xULN had their doses increased in a blinded manner from 10 mg to 30 mg, or from 30 mg to 40 mg, provided there were no tolerability concerns.
Croatian: Nakon četiri mjeseca liječenja, bolesnici koji su imali mUFC ≤1,5xGGN nastavili su primati slijepu dozu na koju su bili randomizirani, a bolesnicima koji su imali mUFC >1,5xGGN doze su povećane na zaslijepljeni način s 10 mg na 30 mg, ili s 30 mg na 40 mg, pod uvjetom da nije bilo problema s podnošljivošću.
English: Your doctor may want to monitor your blood sugar and start treatment with or adjust your antidiabetic medicine.
Croatian: Liječnik će možda htjeti pratiti razinu šećera u Vašoj krvi te započeti liječenje antidijabetikom ili prilagoditi antidijabetik koji uzimate.
English: Anticipated pharmacokinetic interactions resulting in effects on other medicinal products
Croatian: Očekivane farmakokinetičke interakcije koje utječu na druge lijekove
English: The study met the primary efficacy objective for both dose groups (lower bound of the 95% CI for the response rate of each treatment arm >15%).
Croatian: Ispitivanje je ispunilo svoj primarni cilj djelotvornosti za obje dozne skupine (donja granica 95%-tnog CI za stopu odgovora svake terapijske skupine >15%).
English: Not all pack sizes or strengths may be marketed.
Croatian: Na tržištu se ne moraju nalaziti sve jačine ili veličine pakiranja.
English: 81 patients were crossed over from octreotide intramuscular use to pasireotide intramuscular use, and 38 patients were crossed over from pasireotide intramuscular use to octreotide intramuscular use.
Croatian: 81 bolesnik je prešao s oktreotida primijenjenog intramuskularno na pasireotid primijenjen intramuskularno, a 38 bolesnika je prešlo s pasireotida primijenjenog intramuskularno na oktreotid primijenjen intramuskularno.
English: Management of suspected adverse reactions at any time during the treatment may require temporary dose reduction of Signifor.
Croatian: Zbrinjavanje u slučaju sumnje na nuspojave u bilo kojem trenutku tijekom liječenja moglo bi zahtijevati privremeno smanjenje doze Signifora.
English: Inadequately controlled patients in study C2402 are defined as patients with a mean GH concentration of a 5-point profile over a 2-hour period >2.5 μg/l and sex- and age-adjusted IGF-1 >1.3 × ULN.
Croatian: Neodgovarajuće kontrolirani bolesnici u ispitivanju C2402 definirani su kao bolesnici sa srednjom koncentracijom GH-a na profilu od 5 točaka tijekom razdoblja od 2 sata >2,5 μg/l i IGF-1 prilagođenim za spol i dob od >1,3 x GGN.
English: Based on in vitro data pasireotide appears to be a substrate of efflux transporter P-gp (P-glycoprotein).
Croatian: Na temelju in vitro podataka, čini se da je pasireotid supstrat P-gp (P-glikoprotein) transportera za izbacivanje.
English: After three months of treatment, patients with a mean 24-hour UFC ≤2 x ULN and below or equal to their baseline value continued blinded treatment at the randomised dose until month 6.
Croatian: Nakon tri mjeseca liječenja, bolesnici sa srednjim 24-satnim UFC-om ≤2 x GGN i niže ili jednako početnoj vrijednosti nastavili su sa slijepim liječenjem uz randomiziranu dozu do 6. mjeseca.
English: Dose increase for efficacy was allowed at the discretion of the investigators after three and six months of treatment if biochemical parameters showed a mean GH ≥2.5 µg/l and/or IGF-1 >ULN (age and sex related).
Croatian: Povećanje doze za djelotvornost bilo je dopušteno prema odluci ispitivača nakon tri i šest mjeseci liječenja ako su biokemijski parametri pokazali srednji GH ≥2,5 µg/l i/ili IGF-1 >GGN (povezano s dobi i spolom).
English: Activate the safety guard over the needle, in one of the two methods shown: - either press the hinged section of the safety guard down onto a hard surface - or push the hinge forward with your finger An audible “click” confirms proper activation.
Croatian: Aktivirajte štitnik preko igle, na jedan od dva prikazana načina: - ili pritisnite pregibni dio štitnika o tvrdu površinu - ili prstom gurnite pregibni dio prema naprijed Čut ćete “klik” kao potvrdu pravilne aktivacije.
English: Alterations in blood glucose levels have been frequently reported in healthy volunteers and patients treated with pasireotide.
Croatian: Bilo je učestalih izvješća o promjenama u razinama glukoze u krvi kod zdravih dobrovoljaca i bolesnika liječenih pasireotidom.
English: FOR DEEP INTRAMUSCULAR INJECTION ONLY.
Croatian: SAMO ZA DUBOKU INTRAMUSKULARNU INJEKCIJU.
English: Glycaemic status (fasting plasma glucose/haemoglobin A1c [FPG/HbA1c]) should be assessed prior to starting treatment with pasireotide.
Croatian: Glikemijski status (omjer glukoze u plazmi natašte i hemoglobina A1c [FPG; engl. fasting plasma glucose/HbA1c]) treba procijeniti prije početka liječenja pasireotidom.
English: Activate the safety guard over the needle, in one of the two methods shown: - either press the hinged section of the safety guard down onto a hard surface (figure A), - or push the hinge forward with your finger
Croatian: Aktivirajte štitnik preko igle, na jedan od dva prikazana načina: - ili pritisnite pregibni dio štitnika o tvrdu površinu (slika A), - ili prstom gurnite pregibni dio prema naprijed (slika B).
English: 51.6% p=0.536 * Primary endpoint (patients with IGF-1 <lower limit of normal (LLN) were not considered “responders”).
Croatian: 51,6% p=0,536 * Mjera primarnog ishoda (bolesnici s IGF-1 ispod donje granice normale (DGN) nisu se smatrali bolesnicima s odgovorom).
English: Pasireotide works in a very similar way to somatostatin.
Croatian: Pasireotid funkcionira vrlo slično somatostatinu.
English: - Signifor controls over-production of cortisol.
Croatian: - Signifor kontrolira prekomjerno stvaranje kortizola.
English: Mean improvements from baseline were greater for pasireotide intramuscular use than for octreotide intramuscular use with no statistical significance.
Croatian: Srednja poboljšanja od početne vrijednosti bila su veća za pasireotid primijenjen intramuskularno nego za oktreotid primijenjen intramuskularno bez statističke značajnosti.
English: Monitoring of liver enzymes is recommended before and during treatment with Signifor (see section 4.4), as clinically appropriate.
Croatian: Preporučuje se praćenje jetrenih enzima prije i tijekom liječenja Signiforom (vidjeti dio 4.4), u skladu s kliničkim potrebama.
English: Hypokalaemia and/or hypomagnesaemia must be corrected prior to administration of Signifor and should be monitored periodically during therapy.
Croatian: Hipokalijemiju i/ili hipomagnezemiju treba korigirati prije primjene Signifora te periodički pratiti tijekom terapije.
English: Due to the increase in unbound drug exposure, Signifor should be used with caution in patients with severe renal impairment or end stage renal disease (see section 5.2).
Croatian: Zbog povećane izloženosti nevezanom lijeku, Signifor se treba oprezno primjenjivati u bolesnika s teškim oštećenjem bubrega ili završnim stadijem bolesti bubrega (vidjeti dio 5.2).
English: All observed cases of concurrent elevations were identified within ten days of initiation of treatment.
Croatian: Svi uočeni slučajevi istodobnih povišenja bili su utvrđeni u roku od deset dana od početka liječenja.
English: Pasireotide is not recommended for use during pregnancy and in women of childbearing potential who are not using contraception (see section 4.4).
Croatian: Ne preporučuje se koristiti pasireotid tijekom trudnoće niti u žena reproduktivne dobi koje ne koriste kontracepciju (vidjeti dio 4.4).
English: In a pooled analysis of the two pivotal studies, the overall incidence of hyperglycaemia-related adverse reactions was 58.6% (all grades) and 9.9% (CTC Grade 3 and 4) for Signifor intramuscular use versus 18.0% (all grades) and 1.1% (CTC Grade 3 and 4) for the active control.
Croatian: U objedinjenoj analizi tih dvaju ključnih ispitivanja, ukupna incidencija nuspojava povezanih s hiperglikemijom bila je 58,6% (svi stupnjevi) i 9,9% (stupanj 3 i 4 prema Zajedničkim kriterijima toksičnosti (CTC)) za Signifor primijenjen intramuskularno u odnosu na 18,0% (svi stupnjevi) i 1,1% (CTC stupanj 3 i 4) za aktivnu kontrolu.
English: Monitoring of liver function is recommended prior to treatment with pasireotide intramuscular use and after the first two to three weeks, then monthly for three months on treatment.
Croatian: Praćenje jetrene funkcije preporučuje se prije liječenja pasireotidom primijenjenim intramuskularno te nakon prva dva do tri tjedna liječenja, a zatim svaki mjesec tijekom tri mjeseca za vrijeme liječenja.
English: More cases of discontinuation and a higher reporting rate of severe adverse events due to hyperglycaemia were reported in patients treated with the dose of 0.9 mg twice daily.
Croatian: Prijavljeno je više slučajeva prekida primjene i više izvješća o teškim štetnim događajima uzrokovanim hiperglikemijom u bolesnika liječenih dozom od 0,9 mg dvaput na dan.
English: Ultrasonic examination of the gallbladder before and at 6 to 12 month intervals during Signifor therapy is therefore recommended.
Croatian: Stoga se preporučuje pregled žučnog mjehura ultrazvukom prije te u intervalima od 6 do 12 mjeseci tijekom terapije Signiforom.
English: The study met the primary efficacy objective for the 0.9 mg twice-daily group as the lower limit of the 95% CI is greater than the pre-specified 15% boundary.
Croatian: Ispitivanje je ispunilo primarni cilj djelotvornosti za skupinu koja je primala 0,9 mg dvaput na dan budući da je donja granica 95%-tnog CI veća od unaprijed određene granice od 15%.
English: Two cases of hyperglycaemia-related emergencies (diabetic ketoacidosis and diabetic hyperglycaemic coma) were reported following a dose increase of pasireotide to 60 mg in medical treatment naïve patients; one in a patient with untreated hyperglycaemia and HbA1c >8% prior to initiation of pasireotide and the other in a patient with untreated hyperglycaemia and a fasting plasma glucose of 359 mg/dl, respectively.
Croatian: Dva slučaja hitnih stanja povezanih s hiperglikemijom (dijabetička ketoacidoza i dijabetička hiperglikemijska koma) prijavljena su nakon povećanja doze pasireotida na 60 mg u bolesnika bez prethodne terapije lijekovima; jedan u bolesnika s neliječenom hiperglikemijom i HbA1c >8% prije uvođenja pasireotida, a drugi u bolesnika s neliječenom hiperglikemijom i glukozom u plazmi natašte od 359 mg/dl.
English: Health-related quality of life measured by AcroQol indicated statistically significant improvements in the Physical, Psychological-Appearance and Global scores in both treatment groups at month 12.
Croatian: Kvaliteta života povezana sa zdravljem mjerena upitnikom AcroQol ukazala je na statistički značajna poboljšanja u rezultatima za fizičku komponentu, psihološku komponentu-izgled te u globalnom rezultatu u obje terapijske skupine u 12. mjesecu.
English: A baseline ECG is recommended prior to initiating therapy with Signifor.
Croatian: Preporučuje se napraviti početni EKG prije početka terapije Signiforom.
English: Grade 3 and 4 adverse reactions were mostly related to hyperglycaemia.
Croatian: Nuspojave 3. i 4. stupnja uglavnom su bile povezane s hiperglikemijom.
English: Health-related quality of life was assessed by a disease-specific patient-reported outcome measure (CushingQoL) and a generic quality of life measure (SF-12v2 General Health Survey).
Croatian: Kvaliteta života povezana sa zdravljem bila je procijenjena pomoću upitnika za bolesnike za procjenu kvalitete života specifičnog za bolest (Cushing QoL) te općeg upitnika za procjenu kvalitete života (SF-12v2 General Health Survey).
English: Furthermore, a higher proportion of patients on pasireotide intramuscular use (18.5% and 10.8% for 40 mg and 60 mg, respectively) than active comparator (1.5%) achieved a reduction in tumour volume of at least 25%.
Croatian: Nadalje, veći udio bolesnika na pasireotidu primijenjenom intramuskularno (18,5% za 40 mg i 10,8% za 60 mg) nego na aktivnom komparatoru (1,5%) postigao je smanjenje volumena tumora od najmanje 25%.
English: Non-clinical safety data from studies performed with pasireotide administered via the subcutaneous route reveal no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity and carcinogenic potential.
Croatian: Neklinički podaci o sigurnosti primjene iz ispitivanja provedenih s pasireotidom primijenjenim supkutano ne ukazuju na poseban rizik za ljude na temelju konvencionalnih ispitivanja sigurnosne farmakologije, toksičnosti ponovljenih doza, genotoksičnosti i kancerogenog potencijala.
English: If concomitant use of coumarin-derivative or heparin-derivative anticoagulants with Signifor intramuscular use cannot be avoided, patients should be monitored regularly for alterations in their coagulation parameters (PT and PTT) and the anticoagulant dose adjusted accordingly.
Croatian: Ako se ne može izbjeći istodobna primjena antikoagulansa koji su derivati kumarina ili heparina sa Signiforom koji se primjenjuje intramuskularno, bolesnike treba redovito pratiti da bi se uočile eventualne promjene u parametrima koagulacije (PT i PTT) te sukladno tome prilagoditi dozu antikoagulansa.
English: Decreased appetite, type 2 diabetes mellitus, glucose tolerance impaired
Croatian: Smanjeni apetit, šećerna bolest tipa 2, poremećena tolerancija glukoze
English: The suppression of ACTH (adrenocorticotropic hormone) secretion can result in hypocortisolism in patients treated with Signifor.
Croatian: Supresija izlučivanja ACTH-a (adrenokortikotropnog hormona) može za posljedicu imati hipokortizolizam u bolesnika liječenih Signiforom.
English: One case of ketosis and one case of ketoacidosis have been reported during compassionate use of Signifor.
Croatian: Tijekom milosrdne uporabe Signifora bio je prijavljen jedan slučaj ketoze i jedan slučaj ketoacidoze.
English: Dispose of the used syringe and needle immediately in a sharps container or other rigid closed disposal container.
Croatian: Odmah odložite upotrijebljenu štrcaljku i iglu u spremnik za oštre predmete ili neki drugi čvrsti, zatvoreni spremnik za otpad.
English: If the finding is confirmed, the patient should be followed with frequent liver function monitoring until values return to pre-treatment levels.
Croatian: Ako se nalaz potvrdi, kod bolesnika treba učestalo pratiti funkciju jetre dok se vrijednosti ne vrate na razine od prije liječenja.
English: After you have started treatment, your doctor may also decide to increase your dose to one ampoule of Signifor 0.9 mg twice a day.
Croatian: Nakon što ste započeli liječenje, liječnik bi mogao odlučiti da Vam poveća dozu na jednu ampulu Signifora od 0,9 mg dvaput na dan.
English: • After adding the solvent, shake the vial moderately for a minimum of 30 seconds until a uniform suspension is formed.
Croatian: • Nakon što dodate otapalo, umjereno tresite bočicu najmanje 30 sekundi dok ne dobijete jednoličnu suspenziju.
English: You may experience extreme weakness, tiredness, weight loss, nausea,
Croatian: Možete osjetiti izraženu slabost, umor, gubitak težine, mučninu,
English: In a clinical study with single subcutaneous dose administration of 900 µg pasireotide in subjects with impaired renal function, renal impairment of mild, moderate or severe degree, or end stage renal disease (ESRD) did not have a significant impact on total pasireotide plasma exposure.
Croatian: U kliničkom ispitivanju s jednokratnom primjenom supkutane doze 900 µg pasireotida u ispitanika s oštećenom bubrežnom funkcijom, blago, umjereno ili teško oštećenje bubrega ili završni stadij bolesti bubrega (ESRD, engl. end stage renal disease) nisu imali značajan utjecaj na ukupnu izloženost pasireotidu u plazmi.
English: The study met its primary efficacy endpoint for both pasireotide intramuscular use doses.
Croatian: Ispitivanje je ispunilo svoju mjeru primarnog ishoda djelotvornosti za obje doze pasireotida primijenjenog intramuskularno.
English: Let the kit stand at room temperature for a minimum of 30 minutes before reconstitution, but do not exceed 24 hours.
Croatian: Ostavite set na sobnoj temperaturi najmanje 30 minuta prije rekonstitucije, ali ne duže od 24 sata.
English: Pasireotide is metabolically highly stable and in vitro data show that pasireotide is not a substrate, inhibitor or inducer of any major enzymes of CYP450.
Croatian: Pasireotid je metabolički visoko stabilan, a in vitro podaci pokazuju da pasireotid nije supstrat, inhibitor ili induktor bilo kojeg od glavnih enzima CYP450.
English: In Cushing's disease patients, pasireotide demonstrates linear and time-independent pharmacokinetics in the dose range of 0.3 mg to 1.2 mg twice a day.
Croatian: U bolesnika s Cushingovom bolešću, pasireotid pokazuje linearnu farmakokinetiku ovisnu o vremenu u rasponu doza od 0,3 mg do 1,2 mg dvaput na dan.
English: Biochemical control was achieved early in the study (i.e. month 3) by a higher proportion of patients in the pasireotide intramuscular use arm than in the octreotide intramuscular use arm (30.1% and 21.4%) and was maintained in all subsequent evaluations during the core phase.
Croatian: Biokemijsku kontrolu postigao je rano u ispitivanju (tj. 3. mjesec) veći udio bolesnika u skupini s pasireotidom primijenjenim intramuskularno nego u skupini s oktreotidom primijenjenim intramuskularno (30,1% i 21,4%), a održala se u svim naknadnim ocjenjivanjima tijekom osnovne faze.
English: During your treatment with Signifor - Signifor controls over-production of cortisol.
Croatian: Tijekom liječenja Signiforom - Signifor kontrolira prekomjerno stvaranje kortizola.
English: Avoid soreness and skin irritation by choosing a different site from the previous one for each injection.
Croatian: Bol i nadražaj kože možete izbjeći tako što ćete za svaku injekciju odabrati drugo mjesto.
English: Most patients (82.0%) had undergone prior pituitary surgery, and the mean baseline mUFC was 470 nmol/24h (ULN: 166.5 nmol/24h).
Croatian: Većina bolesnika (82,0%) prethodno je imala operaciju hipofize, a srednja početna vrijednost mUFC-a bila je 470 nmol/24h (GGN: 166,5 nmol/24h).
English: No studies have been conducted to evaluate the absolute bioavailability of pasireotide in humans.
Croatian: Nisu provedena ispitivanja za procjenu apsolutne bioraspoloživosti pasireotida kod ljudi.
English: Amylase increased, prothrombin time prolonged
Croatian: Povišenje amilaze, produljeno protrombinsko vrijeme
English: Especially, tell your doctor if you are using: - medicines to treat irregular heartbeat, such as medicines containing disopyramide,
Croatian: Svakako recite liječniku ako uzimate: - lijekove koji liječe nepravilne otkucaje srca, kao što su lijekovi koji sadrže dizopiramid,
English: Pasireotide binds and activates four of the five hssts, especially hsst5, in corticotrophs of ACTH producing adenomas, resulting in inhibition of ACTH secretion.
Croatian: Pasireotid veže i aktivira četiri od pet hsst-a, osobito hsst5, u kortikotropnim adenomima koji luče ACTH, što rezultira inhibicijom izlučivanja ACTH.