FrancophonIA/ELRC3.0 huggingface dataset:
English: Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Ibrance have been included in the summary of product characteristics and the package leaflet.
Slovenian: Priporočila in varnostni ukrepi, ki jih morajo za varno in učinkovito uporabo zdravila Ibrance upoštevati zdravstveni delavci in bolniki, so vključeni v povzetek glavnih značilnosti zdravila in navodilo za njegovo uporabo.
English: Ibrance can only be obtained with a prescription and treatment should be started and supervised by a doctor experienced in the use of cancer medicines.
Slovenian: Predpisovanje in izdaja zdravila Ibrance je le na recept, zdravljenje pa mora začeti in nadzorovati zdravnik, ki ima izkušnje z uporabo zdravil za zdravljenje raka.
English: What is Ibrance and what is it used for?
Slovenian: Kaj je zdravilo Ibrance in za kaj se uporablja?
English: What benefits of Ibrance have been shown in studies?
Slovenian: Kakšne koristi je zdravilo Ibrance izkazalo v študijah?
English: • together with fulvestrant (another hormonal medicine for cancer) in patients who have previously been treated with a hormonal medicine.
Slovenian: • skupaj s fulvestrantom (drugim hormonskim zdravilom za zdravljenje raka) pri bolnikih, ki so se predhodno zdravili s hormonskim zdravilom.
English: • together with an aromatase inhibitor (a hormonal medicine for cancer);
Slovenian: • skupaj z zaviralcem aromataze (hormonskim zdravilom proti raku);
English: Why is Ibrance approved?
Slovenian: Zakaj je bilo zdravilo Ibrance odobreno?
English: It is not intended to provide practical advice on how to use Ibrance.
Slovenian: Povzetek ni namenjen zagotavljanju praktičnih nasvetov o njegovi uporabi.
English: What are the risks associated with Ibrance?
Slovenian: Kakšna tveganja so povezana z zdravilom Ibrance?
English: They received either Ibrance and letrozole (an aromatase inhibitor) or placebo and letrozole.
Slovenian: Prejemale so zdravilo Ibrance in letrozol (zaviralec aromataze) ali placebo in letrozol.
English: For more information about treatment with Ibrance, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.
Slovenian: Za več informacij o zdravljenju z zdravilom Ibrance preberite navodilo za uporabo (ki je prav tako del EPAR) ali se posvetujte z zdravnikom ali farmacevtom.
English: The most common side effects with Ibrance (which may affect more than 1 in 5 people) are neutropenia (low blood levels of neutrophils, a type of white blood cell that fights infection), infections, leucopenia (low white blood cell counts), tiredness, nausea (feeling sick), stomatitis (inflammation of the lining of the mouth), anaemia (low red blood cell counts), alopecia (hair loss) and diarrhoea.
Slovenian: Najpogostejši neželeni učinki zdravila Ibrance (ki se lahko pojavijo pri več kot 1 bolniku od 5) so nevtropenija (nizke vrednosti nevtrofilcev v krvi, vrste belih krvnih celic, ki se borijo proti okužbam), okužbe, levkopenija (nizke vrednosti belih krvnih celic), utrujenost, navzeja (slabost), stomatitis (vnetje ustne sluznice), anemija (nizke vrednosti rdečih krvnih celic), alopecija (izguba dlak) in driska.
English: In women who have not yet reached menopause, a medicine called a luteinising hormone-releasing hormone agonist should also be given.
Slovenian: Pri ženskah, ki še niso prišle v menopavzo, je treba dajati tudi zdravilo, imenovano agonist gonadoliberina.
English: The most common severe side effects with Ibrance (which may affect up to 1 in 50 people) are neutropenia, leucopenia, anaemia, tiredness and infections.
Slovenian: Najpogostejši resni neželeni učinki zdravila Ibrance (ki se lahko pojavijo pri največ 1 bolniku od 50) so nevtropenija, levkopenija, anemija, utrujenost in okužbe.
English: Ibrance has been shown to prolong the time patients live without their disease getting worse by an average of 6 to 10 months, which is considered of clear clinical value.
Slovenian: Zdravilo Ibrance dokazano podaljšuje čas brez poslabšanja bolezni na povprečno 6 do 10 mesecev, kar ima jasno klinično vrednost.
English: Ibrance must not be used by patients who are taking St John's wort (a herbal preparation used to treat depression).
Slovenian: Zdravila Ibrance ne smejo uporabljati bolniki, ki jemljejo šentjanževko (zeliščni pripravek, namenjen za zdravljenje depresije).
English: For practical information about using Ibrance, patients should read the package leaflet or contact their doctor or pharmacist.
Slovenian: Za praktične informacije o uporabi zdravila Ibrance naj bolniki preberejo navodilo za uporabo ali se posvetujejo z zdravnikom ali farmacevtom.
English: Women taking Ibrance and fulvestrant lived on average 11.2 months without their disease getting worse compared with 4.6 months for women taking placebo and fulvestrant.
Slovenian: Ženske, ki so jemale zdravilo Ibrance in fulvestrant, so živele povprečno 11,2 meseca dlje, ne da bi se jim bolezen poslabšala, v primerjavi s 4,6 meseca pri ženskah, ki so jemale placebo in fulvestrant.
English: By blocking CDK4 and CDK6, Ibrance slows the growth of HRpositive breast cancer cells.
Slovenian: Z zaviranjem encimov CDK4 in CDK6 zdravilo Ibrance upočasni rast HR-pozitivnih celic raka dojk.
English: Women taking Ibrance and letrozole lived on average 24.8 months without their disease getting worse compared with 14.5 months for women taking placebo and letrozole.
Slovenian: Ženske, ki so jemale zdravilo Ibrance in letrozol, so živele povprečno 24,8 meseca dlje, ne da bi se jim bolezen poslabšala, v primerjavi s 14,5 meseca pri ženskah, ki so jemale placebo in letrozol.
English: The active substance in Ibrance, palbociclib, blocks the activity of enzymes known as cyclin-dependent kinases (CDK) 4 and 6, which play a key role in regulating the way cells grow and divide.
Slovenian: Zdravilna učinkovina v zdravilu Ibrance, palbociklib, zavira dejavnost encimov, imenovanih od ciklina odvisne kinaze (CDK) 4 in 6, ki imata ključno vlogo pri uravnavanju rasti in delitve celic.
English: In some cancers, including HR-positive breast cancer, the activity of CDK 4 and 6 is increased, which helps the cancer cells to multiply uncontrollably.
Slovenian: Pri nekaterih vrstah raka, vključno s HR-pozitivnim rakom dojk, se dejavnost encimov CDK 4 in 6 poveča, zato se rakave celice lažje nenadzorovano razmnožujejo.
English: For the full list of all side effects reported with Ibrance, see the package leaflet.
Slovenian: Za celoten seznam neželenih učinkov, o katerih so poročali pri uporabi zdravila Ibrance, glejte navodilo za uporabo.
English: How does Ibrance work?
Slovenian: Kako zdravilo Ibrance deluje?
English: How is Ibrance used?
Slovenian: Kako se zdravilo Ibrance uporablja?
English: Ibrance contains the active substance palbociclib.
Slovenian: Zdravilo Ibrance vsebuje zdravilno učinkovino palbociklib.
English: This means that it affects the activity of the immune system (the body's natural defences).
Slovenian: To pomeni, da učinkuje na aktivnost imunskega sistema (naravne obrambe telesa).
English: The company withdrew its application before the European Commission had adopted a formal decision.
Slovenian: Družba je umaknila svojo vlogo, še preden je Evropska komisija sprejela formalno odločitev.
English: Its effectiveness was studied in one main study, carried out in a number of hospitals and clinics (‘sites') in the United States of America and Germany.
Slovenian: Njegovo učinkovitost so preučevali v eni glavni študiji, izvedeni v številnih bolnišnicah in klinikah („lokacijah“) v Združenih državah Amerike in Nemčiji.
English: International non-proprietary name (INN): lenalidomide
Slovenian: Mednarodno nelastniško ime (INN): lenalidomid
English: The balance of benefits and risks for Revlimid remains unchanged.
Slovenian: Razmerje med koristmi in tveganji zdravila Revlimid ostaja nespremenjeno.
English: Ref. EMEA/294089/2008
Slovenian: EMEA/391210/2008 Error!
English: In addition, an inspection of one of the sites where the main study was carried out raised some concerns over the way the results were recorded, which could have further affected the reliability of the main study.
Slovenian: Poleg tega je inšpekcijski pregled ene izmed lokacij, kjer je bila izvedena glavna študija, vzbudil nekaj dvomov glede beleženja rezultatov, kar lahko še nadalje okrni zanesljivost glavne študije.
English: The evaluation had finished and the CHMP had given a negative opinion, which had been confirmed following a re-examination procedure.
Slovenian: Postopek ocenjevanja je bil zaključen in CHMP je izrazil negativno mnenje, ki ga je potrdil tudi postopek ponovne presoje.
English: Lenalidomide has been authorised in the European Union since June 2007 under the name Revlimid, for the treatment of multiple myeloma.
Slovenian: Lenalidomid je v Evropski uniji odobren od junija 2007 pod imenom Revlimid za zdravljenje multiplega mieloma.
English: The main measure of effectiveness was the proportion of patients who became ‘transfusion independent', meaning that their anaemia was controlled without the need for a blood transfusion over an eight-week period.
Slovenian: Glavno merilo učinkovitosti je bil delež bolnikov, ki so postali „neodvisni od transfuzije“, kar pomeni, da je bila njihova anemija v obdobju osmih tednov uravnana brez transfuzije krvi.
English: The effects of Lenalidomide Celgene Europe were first tested in experimental models before being studied in humans.
Slovenian: Učinki zdravila Lenalidomide Celgene Europe so bili najprej preizkušeni na poskusnih modelih, nato pa so jih raziskali pri ljudeh.
English: The study looked at the effects of treatment with a daily dose of 10 mg Lenalidomide Celgene Europe either given continuously or as a repeated cycle of three weeks on treatment followed by one week off.
Slovenian: Študija je preučevala učinke zdravljenja z dnevnim odmerkom 10 mg zdravila Lenalidomide Celgene Europe, ki so ga dajali bodisi neprekinjeno ali pa v ponavljajočem se ciklusu, ki je obsegal tri tedne prejemanja zdravila, ki jim je sledil en teden brez zdravila.
English: There are no consequences of this withdrawal on the use of Revlimid, which also contains lenalidomide, in its authorised indication.
Slovenian: Umik nima nobenih posledic za uporabo zdravila Revlimid, ki prav tako vsebuje lenalidomid, za odobreno indikacijo.
English: The CHMP had concerns over the way the main study was carried out, which meant that the safety of Lenalidomide Celgene Europe was difficult to assess.
Slovenian: CHMP je imel zadržke glede načina izvedbe glavne študije, zaradi česar je bilo težko oceniti varnost zdravila Lenalidomide Celgene Europe.
English: The exact way that lenalidomide works in myelodysplastic syndromes is not known, but it is thought that it blocks the growth of tumour cells in the bone marrow, while allowing the growth of normal bone marrow cells, including the cells that produce red blood cells.
Slovenian: Natančen način delovanja lenalidomida pri mielodisplastičnih sindromih ni znan, vendar se domneva, da blokira rast tumorskih celic v kostnem mozgu, medtem ko dopušča rast normalnih celic kostnega mozga, vključno s celicami, ki tvorijo rdeče krvne celice.
English: QUESTIONS AND ANSWERS ON THE WITHDRAWAL OF THE MARKETING APPLICATION for LENALIDOMIDE CELGENE EUROPE
Slovenian: VPRAŠANJA IN ODGOVORI V ZVEZI Z UMIKOM VLOGE ZA DOVOLJENJE ZA PROMET z zdravilom LENALIDOMIDE CELGENE EUROPE
English: What are the consequences of the withdrawal for patients undergoing clinical trials or compassionate use programmes with Lenalidomide Celgene Europe?
Slovenian: Kakšne so posledice umika za bolnike, ki sodelujejo v kliničnih preskušanjih ali programih sočutne uporabe zdravila Lenalidomide Celgene Europe?
English: Lenalidomide Celgene Europe was designated as an orphan medicinal product on 8 March 2004.
Slovenian: Zdravilo Lenalidomide Celgene Europe je bilo dne 8. marca 2004 določeno kot zdravilo sirota.
English: In some cases, myelodysplastic syndromes can lead to the development of acute myeloid leukaemia (a type of cancer affecting the white blood cells).
Slovenian: V nekaterih primerih lahko mielodisplastični sindromi privedejo do razvoja akutne mieloidne levkemije (vrste raka, ki prizadene bele krvne celice).
English: What is happening with Revlimid used for the treatment of multiple myeloma?
Slovenian: Kaj to pomeni za nadaljnjo uporabo zdravila Revlimid, ki se uporablja za zdravljenje multiplega mieloma?
English: On 30 May 2008, Celgene Europe Limited officially notified the Committee for Medicinal Products for Human Use (CHMP) that it wishes to withdraw its application for a marketing authorisation for Lenalidomide Celgene Europe, for the treatment of anaemia due to myelodysplastic syndromes.
Slovenian: Družba Celgene Europe Limited je dne 30. maja 2008 uradno obvestila Odbor za zdravila za uporabo v humani medicini (CHMP), da želi umakniti vlogo za dovoljenje za promet z zdravilom Lenalidomide Celgene Europe, namenjenim zdravljenju anemije, ki je posledica mielodisplastičnih sindromov.
English: The study involved 148 patients with transfusion-dependent anaemia, low or intermediate (level 1) risk myelodysplastic syndromes and a deletion of part of chromosome 5 (‘5q deletion').
Slovenian: Študija je vključevala 148 bolnikov z anemijo, ki zahteva transfuzije krvi, majhnim ali srednjim tveganjem (stopnja 1) za prisotnost mielodisplastičnih sindromov in izgubo dela kromosoma št. 5 („delecija 5q“).
English: Based on the review of the data and the company's response to the CHMP list of questions, at the time of the withdrawal, the CHMP had given a negative opinion and did not recommend a marketing authorisation for Lenalidomide Celgene Europe for the for the treatment of anaemia due to myelodysplastic syndromes.
Slovenian: Na podlagi pregleda podatkov in odgovorov družbe na seznam vprašanj, ki jih je do umika vloge zastavil CHMP, je Odbor izrazil negativno mnenje in ni priporočil odobritve dovoljenja za promet z zdravilom Lenalidomide Celgene Europe, namenjenim zdravljenju anemije, ki je posledica mielodisplastičnih sindromov.
English: Therefore, at the time of the withdrawal, the CHMP's view was that a benefit of Lenalidomide Celgene Europe had not been sufficiently demonstrated and any benefits did not outweigh the identified risks.
Slovenian: Zato je CHMP v času umika menil, da koristi zdravila Lenalidomide Celgene Europe niso bile zadostno dokazane in da ne odtehtajo znanih tveganj.
English: Multiple myeloma is a cancer of the plasma cells in the bone marrow.
Slovenian: Multipli mielom je rak plazemskih celic v kostnem mozgu.
English: The company informed the CHMP that it will continue to make lenalidomide available for patients included in clinical trials or compassionate use programmes.
Slovenian: Družba je obvestila CHMP, da bo bolnikom, vključenim v klinična preskušanja ali programe sočutne uporabe, še dalje omogočala dostop do lenalidomida.
English: Lenalidomide Celgene Europe was expected to be used to treat anaemia (low red blood cell counts) caused by myelodysplastic syndromes, a group of conditions where too few blood cells are produced by the bone marrow.
Slovenian: Zdravilo Lenalidomide Celgene Europe naj bi se uporabljalo za zdravljenje anemije (nizkega števila rdečih krvnih celic), ki jo povzročajo mielodisplastični sindromi, skupina bolezni, pri katerih kostni mozeg tvori premalo krvnih celic.
English: Lenalidomide Celgene Europe is a medicine containing the active substance lenalidomide.
Slovenian: Lenalidomide Celgene Europe je zdravilo, ki vsebuje zdravilno učinkovino lenalidomid.
English: Lenalidomide Celgene Europe was to be used in patients who were dependent on receiving blood transfusions to treat their anaemia and whose myelodysplastic syndromes were associated with a specific genetic mutation (deletion of part of chromosome number 5), and with a low to intermediate risk of progressing to leukaemia or death.
Slovenian: Zdravilo Lenalidomide Celgene Europe naj bi se uporabljalo pri bolnikih, ki morajo za zdravljenje anemije prejemati transfuzije krvi in pri katerih so mielodisplastični sindromi povezani s specifično gensko mutacijo (izgubo dela kromosoma št. 5) in ki so izpostavljeni majhnemu ali srednjemu tveganju za napredovanje bolezni v levkemijo ali za nastop smrti.
English: The active substance in Lenalidomide Celgene Europe, lenalidomide, is an immunomodulating agent.
Slovenian: Zdravilna učinkovina zdravila Lenalidomide Celgene Europe je lenalidomid, ki je imunomodulator.
English: What is Lenalidomide Celgene Europe?
Slovenian: Kaj je zdravilo Lenalidomide Celgene Europe?
English: How is Lenalidomide Celgene Europe expected to work?
Slovenian: Kako naj bi zdravilo Lenalidomide Celgene Europe delovalo?
English: What was Lenalidomide Celgene Europe expected to be used for?
Slovenian: Za kaj naj bi se zdravilo Lenalidomide Celgene Europe uporabljalo?
English: In particular, because the study did not compare the medicine to any other treatment, it was difficult to determine if treatment with Lenalidomide Celgene Europe increased the risk of progression to acute myeloid leukaemia.
Slovenian: Presoja, ali zdravljenje z zdravilom Lenalidomide Celgene Europe poveča tveganje za napredovanje bolezni v akutno mieloidno levkemijo, je bila otežena zlasti zato, ker študija ni primerjala zdravila z nobenim drugim zdravljenjem.
English: --1 Live attenuated Muscovy duck parvovirus ≥ 2.6 log10 CCID50 * * Cell culture infectious dose 50%
Slovenian: --1 Atenuiran parvovirus rac moškatnih bleščavk, sev GM 199 ≥2,6 log10 CCID50* (*) 50% infektivni odmerek za celično kulturo
English: EU (MA) Number
Slovenian: EU številka
English: Suspension and diluent for suspension for injection
Slovenian: Suspenzija in vehikel za
English: 10 vials Not applicable
Slovenian: 1 viala Ni smiselno
English: Not applicable
Slovenian: Ni smiselno
English: Muscovy ducks
Slovenian: Race moškatne
English: This summary was last updated in 12-2016.
Slovenian: Povzetek je bil nazadnje posodobljen 12-2016.
English: The percentages of successful injections for the two groups were around 30% and 9%, respectively.
Slovenian: Odstotek uspešnih injiciranj v obeh skupinah je bil okoli 30 % oziroma 9 %.
English: The European Commission granted a marketing authorisation valid throughout the European Union for Relistor on 2 July 2008.
Slovenian: Evropska komisija je dovoljenje za promet z zdravilom Relistor, veljavno po vsej Evropski uniji, izdala 2. julija 2008.
English: The full EPAR for Relistor can be found on the Agency's website: ema.europa.eu/Find medicine/Human medicines/European Public Assessment Reports.
Slovenian: Celotno evropsko javno poročilo o oceni zdravila (EPAR) za zdravilo Relistor je na voljo na spletni strani agencije: ema.europa.eu/Find medicine/Human medicines/European Public Assessment Reports.
English: These side effects are generally mild or moderate.
Slovenian: Ti neželeni učinki so bili običajno blagi ali zmerni.
English: This is a summary of the European public assessment report (EPAR) for Relistor.
Slovenian: To je povzetek evropskega javnega poročila o oceni zdravila (EPAR) za zdravilo Relistor.
English: The dose depends on the patient's body weight.
Slovenian: Odmerek je odvisen od bolnikove telesne mase.
English: These receptors are also found in the gut.
Slovenian: Ti receptorji so prisotni tudi v črevesju.
English: What measures are being taken to ensure the safe and effective use of Relistor?
Slovenian: Kateri ukrepi se izvajajo za zagotovitev varne in učinkovite uporabe zdravila Relistor?
English: The Agency's Committee for Medicinal Products for Human Use decided that Relistor's benefits are greater than its risks and recommended that it be given marketing authorisation.
Slovenian: Odbor za zdravila za uporabo v humani medicini (CHMP) je zaključil, da so koristi zdravila Relistor večje od z njim povezanih tveganj, in priporočil, da se zanj izda dovoljenje za promet.
English: Other information about Relistor
Slovenian: Druge informacije o zdravilu Relistor
English: This means that it blocks a specific type of opioid receptor called the ‘mu-opioid receptor'.
Slovenian: To pomeni, da zavira posebno vrsto opioidnih receptorjev, imenovanih muopioidni receptorji.
English: It is not intended to provide practical advice on how to use Relistor.
Slovenian: Povzetek ni namenjen zagotavljanju praktičnih nasvetov o njegovi uporabi.
English: In patients not on palliative care, Relistor is given as an injection under the skin at a dose of 12 mg once a day, for at least 4 days per week and up to 7 days per week as needed; treatment with usual laxatives should be stopped when starting Relistor.
Slovenian: Pri bolnikih, ki ne prejemajo paliativne oskrbe, se zdravilo Relistor daje z injiciranjem v podkožje v odmerku 12 mg enkrat na dan, vsaj štirikrat na teden in največ sedem dni na teden, če je to potrebno; zdravljenje z običajnimi odvajalnimi zdravili je treba pred začetkom jemanja zdravila Relistor prenehati.
English: Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Relistor have been included in the summary of product characteristics and the package leaflet.
Slovenian: Priporočila in varnostni ukrepi, ki jih morajo za varno in učinkovito uporabo zdravila Relistor upoštevati zdravstveni delavci in bolniki, so vključeni v povzetek glavnih značilnosti zdravila in navodilo za njegovo uporabo.
English: For more information about treatment with Relistor, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.
Slovenian: Za več informacij o zdravljenju z zdravilom Relistor preberite navodilo za uporabo (ki je prav tako del EPAR) ali se posvetujte z zdravnikom ali farmacevtom.
English: The most common side effects with Relistor (seen in more than 1 patient in 10) are abdominal pain (stomach ache), nausea (feeling sick), diarrhoea and flatulence.
Slovenian: Najpogostejši neželeni učinki zdravila Relistor (opaženi pri več kot 1 bolniku od 10) so abdominalne (trebušne) bolečine, navzeja (slabost), driska in napenjanje (vetrovi).
English: What is Relistor and what is it used for?
Slovenian: Kaj je zdravilo Relistor in za kaj se uporablja?
English: What benefits of Relistor have been shown in studies?
Slovenian: Kakšne koristi je zdravilo Relistor izkazalo v študijah?
English: Relistor methylnaltrexone bromide
Slovenian: Relistor metilnaltreksonijev bromid
English: What are the risks associated with Relistor?
Slovenian: Kakšna tveganja so povezana z zdravilom Relistor?
English: By blocking these receptors, Relistor reduces the constipation due to opioids, but does not interfere with their painkilling effects.
Slovenian: Z zaviranjem teh receptorjev zdravilo Relistor zmanjšuje zaprtje zaradi opioidov, vendar ne vpliva na njihovo protibolečinsko delovanje.
English: Methylnaltrexone bromide is less able to enter the brain than naltrexone, meaning that it blocks the mu-opioid receptors in the gut but not in the brain.
Slovenian: Metilnaltreksonijev bromid slabše prehaja v možgane kot naltrekson, kar pomeni, da zavira muopioidne receptorje v črevesju, ne pa tudi v možganih.
English: Why is Relistor approved?
Slovenian: Zakaj je bilo zdravilo Relistor odobreno?
English: For practical information about using Relistor, patients should read the package leaflet or contact their doctor or pharmacist.
Slovenian: Za praktične informacije o uporabi zdravila Relistor naj bolniki preberejo navodilo za uporabo ali se posvetujejo z zdravnikom ali farmacevtom.
English: Relistor must not be used in patients whose bowel is blocked, who are at risk of recurrent bowel blockage or who have a condition that needs immediate bowel surgery.
Slovenian: Zdravilo Relistor se ne sme uporabljati pri bolnikih, ki imajo obstrukcijo prebavil, pri katerih obstaja nevarnost za ponovitev obstrukcije prebavil, ali bolnikih z obolenjem, ki zahteva takojšnji kirurški poseg na prebavilih.
English: Relistor has also been compared with placebo in a third study involving 496 patients with constipation caused by opioids, but no advanced illness.
Slovenian: Zdravilo Relistor so s placebom primerjali tudi pri 496 bolnikih, ki so bili zaprti zaradi jemanja opioidov, a niso imeli napredovale bolezni.