natgillin/translations-raw huggingface dataset:
The product information should be updated to inform health care professionals of the potential risk of hypermagnesemia and to provide monitoring advice particularly for more vulnerable subgroups.
Informacije o zdravilu je treba posodobiti, tako da zdravstveno osebje obveščajo o morebitnem tveganju hipermagneziemije in vključujejo nasvet glede spremljanja, predvsem pri ranljivejših podskupinah.
“The MAH should liaise with the Reference Member State to agree on the appropriate procedure to be used for the fulfilment of this condition for lifting the suspension.”
„Imetnik dovoljenja za promet z zdravilom se mora v sodelovanju z referenčno državo članico dogovoriti o ustreznem postopku, ki bo uporabljen za izpolnjevanje pogojev za preklic začasnega umika.“
• In addition, the magnesium level should be monitored at baseline and at appropriate intervals thereafter, in accordance with routine clinical practice and the needs of the individual patient.
• Poleg tega je treba na izhodišču in pozneje v ustreznih presledkih spremljati ravni magnezija, skladno z rutinsko klinično prakso in potrebami posameznega bolnika.
Consequently there is a potential risk for hypermagnesemia particularly in patients with reduced renal function.
Posledično je prisotno tveganje hipermagneziemije, predvsem pri bolnikih z zmanjšanim ledvičnim delovanjem.
Pursuant to Article 6(1)(d) of Regulation (EC) No 1901/2006 as amended, the PDCO's opinion on Numeta was sought in the context of this review.
Skladno s členom 6(1)(d) Uredbe (ES) št. 1901/2006, kot je bila spremenjena, je pediatrični odbor PDCO svoje mnenje podal na podlagi tega pregleda.
For the suspension to be lifted, the National competent authorities of Member States shall verify that the following conditions are fulfilled by the MAH:
Za preklic začasnega umika morajo nacionalni pristojni organi držav članic preveriti, ali imetnik dovoljenja za promet z zdravilom izpolnjuje naslednje pogoje:
It should be noted that clinical signs may not be identifiable unless hypermagnesaemia is severe.
Treba je izpostaviti, da klinični znaki morda ne bodo opazni, dokler hipermagneziemija ne postane resna.
A DHPC was agreed, together with the timelines for distribution;
Potrjena je bila neposredna komunikacija z zdravstvenimi delavci, skupaj z urnikom distribucije;
Most patients with hypomagnesemia show no acute symptoms but it can still lead to osteoporosis and is correlated to increased inflammation and metabolic syndrome.
Večina bolnikov s hipomagneziemijo nima akutnih simptomov, vendar lahko kljub temu povzroči osteoporozo in je povezana s povečanim vnetjem ter presnovnim sindromom.
PN solutions are delivered through a peripheral or central venous catheter.
Raztopine za parenteralno prehrano se dovajajo prek perifernega ali centralnega venskega katetra.
Magnesium is an important electrolyte, particularly for a preterm infant.
Magnezij je pomemben elektrolit, predvsem pri nedonošenčkih.
The risk of hypermagnesemia and all measures considered necessary to mitigate this risk (i.e. agreed additional pharmacovigilance activities, as listed above and risk minimisation activities such as direct healthcare professional communication (DHPC), changes to the product information) should be reflected in a revised risk management plan (RMP), which should also include proposals for evaluating the effectiveness of the risk minimisation activities.
Tveganje hipermagneziemije in vse ukrepe, potrebne za zmanjševanje tega tveganja (tj. dogovorjene dodatne farmakovigilančne dejavnosti, navedene zgoraj, ter dejavnosti za zmanjševanje tveganja, kot je neposredna komunikacija z zdravstvenimi delavci, spremembe informacij o zdravilu), je treba vključiti v posodobljen načrt obvladovanja tveganja (RMP), ki naj prav tako vsebuje predloge za vrednotenje učinkovitosti dejavnosti za zmanjševanje tveganja.
In addition, recent data highlighted by the PDCO suggest paediatric reference ranges for magnesium may be higher than previously thought (Canadian Laboratory Initiative on PEdiatric Reference Intervals [CALIPER]1).
Poleg tega novi podatki, ki jih je izpostavil odbor PDCO, kažejo, da so lahko pediatrični referenčni razponi za magnezij večji, kot so menili prej (Pobuda kanadskih laboratorijev za referenčne intervale v pediatriji [CALIPER]1).
Overall Numeta was found to be acceptable to paediatric clinical staff in terms of handling, ease of use and time from prescription to infusion.
Na splošno so ugotovili, da je bilo zdravilo Numeta sprejemljivo za pediatrično klinično osebje glede ravnanja, preprostosti uporabe in časa od predpisovanja do infundiranja.
These risks are considered to be complications of PN use in general as outlined in the joint paper on paediatric PN the European society of paediatric gastroenterology, hepatology and nutrition (ESPGHAN) and the European society for clinical nutrition and metabolism (ESPEN).
Menijo, da so ta tveganja splošni zapleti parenteralne uporabe, kot je opisano v skupnem članku o pediatrični parenteralni prehrani, ki sta ga pripravila Evropsko združenje za pediatrično gastroenterologijo, hepatologijo in prehrano (European society of paediatric gastroenterology, hepatology and nutrition - ESPGHAN) ter Evropsko združenje za klinično prehrano in presnovo (European society for clinical nutrition and metabolism - ESPEN).
The primary objective of this study was to provide daily information on the performance safety of the range of Numeta products in practical therapeutic use for the 5 days of the study and during an optional treatment period in preterm newborn infants.
Primarni cilj te študije je bil pridobiti dnevne podatke o varnosti delovanja nabora zdravil Numeta pri praktični terapevtski uporabi v 5 dneh študije in med obdobjem neobveznega zdravljenja nedonošenčkov.
The levels of magnesium reported in these case reports ranged mainly from 1.025mmol/L to > 1.5mmol/L with levels greater than 1.2mmol/L reported in 9 out of 14 cases while one case was reported as > 1.5mmol/L.
Ravni magnezija v teh poročilih primerov so se gibale od 1,025 mmol/l do > 1,5 mmol/l, pri čemer so pri 9 od 14 primerov poročali o ravneh, višjih od 1,2 mmol/l, pri enem primeru pa o ravni > 1,5 mmol/l.
In order to prevent any potential harm to premature infants, the MAH decided to recall the product from the market.
Da bi preprečil kakršno koli morebitno škodo pri nedonošenčkih, se je imetnik dovoljenja za promet z zdravilom odločil, da zdravilo odpokliče s trga.
c. the marketing authorisations of Numeta G16%E should be varied (in accordance with changes to the product information as set out in Annex IV).
c. je treba dovoljenja za promet z zdravilom Numeta G16%E spremeniti (skladno s spremembami informacij o zdravilu, določenih v Prilogi IV).
The PRAC also recommended that the MAH should submit a revised RMP within 3 months after finalisation of the procedure including proposals for evaluating the effectiveness of the risk minimisation activities.
Odbor PRAC je prav tako priporočil, naj imetnik dovoljenja za promet z zdravilom predloži posodobljen načrt obvladovanja tveganja (RMP) v 3 mesecih po koncu postopka, vključno s predlogi za vrednotenje učinkovitosti dejavnosti za zmanjševanje tveganja.
Magnesium has been shown to improve neurological outcome for premature babies when given antenatally to the mother (Doyle et al, 2010) and is thought to have neuroprotective effects also in other circumstances.
Pokazali so, da magnezij izboljša nevrološki izid pri nedonošenčkih, če se daje materi pred porodom (Doyle in sod., 2010), in da ima nevroprotektivne učinke tudi v drugih okoliščinah.
Parenteral nutrition (PN) is the use of intravenous macronutrients, electrolytes, micronutrients and fluids to provide nutritional support in patients who cannot be fed by oral or enteral nutrition.
Parenteralna prehrana je uporaba intravenskih makrohranil, elektrolitov, mikrohranil in tekočin, ki omogočajo prehransko podporo pri bolnikih, ki se niso zmožni prehranjevati peroralno ali enteralno.
The PRAC considered that a DHPC was needed to communicate the outcome of the present review to relevant healthcare professionals.
Odbor PRAC je menil, da je za sporočanje izida trenutnega pregleda zadevnemu zdravstvenemu osebju potrebna neposredna komunikacija z zdravstvenimi delavci (DHPC).
Hypermagnesaemia is a serious clinical condition which can lead to generalised weakness, respiratory failure, hypotension, arrhythmias (especially if not otherwise explained by the clinical condition of the infant/child).
Hipermagneziemija je resno klinično stanje, ki lahko povzroči generalizirano šibkost, dihalno odpoved, hipotenzijo, aritmije (predvsem, če tega ni mogoče drugače razložiti na podlagi kliničnega stanja dojenčka/otroka).
The initial application for Numeta G13%E and Numeta G16%E was supported by a prospective, multicentre, non-comparative, open-label phase 3 study (Ped3CB/P01/06/MuB).
Prvotno vlogo za zdravili Numeta G13%E in Numeta G16%E je podprla prospektivna, multicentrična, neprimerjalna, odprta študija 3. faze (Ped3CB/P01/06/MuB).
The magnesium content of Numeta G13%E is 0.43mmol/100mL.
Vsebnost magnezija v zdravilu Numeta G13%E je 0,43 mmol/100 ml.
The safety concerns of Numeta products outlined in the initial application and risk management plan include drug administration errors, use of Numeta in patients with hypersensitivity to one of the components, use of Numeta in patients with severe metabolic disease, catheter-related infection and sepsis, re-feeding syndrome, use of Numeta in patients with certain organ impairment and extravasation and thrombophlebitis when peripherally administered.
Varnostne težave pri zdravilih Numeta, navedene v prvotni vlogi in načrtu obvladovanja tveganja, vključujejo napake pri dajanju zdravila, uporabo zdravila Numeta pri bolnikih s preobčutljivostjo na eno od sestavin, uporabo zdravila Numeta pri bolnikih s hudo presnovno boleznijo, s katetrom povezano okužbo ter sepso, sindrom ponovnega hranjenja, uporabo zdravila Numeta pri bolnikih z določeno organsko okvaro in ekstravazacijo ter tromboflebitisom, kadar se daje periferno.
Therefore, in summary, there is no unconfounded report of hypermagnesemia with Numeta G16%E, no evidence of harm and there are uncertainties in relation to paediatric reference ranges for magnesium which may be higher than previously thought.
Če povzamemo, ni nobenega zanesljivega poročila o hipermagneziemiji pri zdravilu Numeta G16%E, nobenih dokazov o škodi, obstajajo pa negotovosti, povezane s pediatričnimi referenčnimi razponi za magnezij, ki so lahko večji, kot so menili prej.
Numeta G13%E and Numeta G16%E are industrially manufactured, heat sterilised parenteral nutrition solutions (glucose, lipids, amino acids and electrolytes).
Zdravili Numeta G13%E in Numeta G16%E sta industrijsko izdelani, toplotno sterilizirani raztopini za parenteralno prehrano (glukoza, lipidi, aminokisline in elektroliti).
Early recognition and treatment of hypermagnesemia may prevent or minimise life-threatening events, however the vast majority of mild hypermagnesaemia patients may be missed as measurement of magnesium levels is not routine in clinical practice.
Zgodnje odkrivanje in zdravljenje hipermagneziemije lahko preprečita ali zmanjšata smrtno nevarne dogodke, vendar se to lahko spregleda pri večini bolnikov z blago hipermagneziemijo, saj meritve ravni magnezija v klinični praksi niso rutinske.
The ESPEN/ESPGHAN guideline recommends a lower magnesium intake of 0.2mmol/kg/d for infants of 0-12 months of age and 0.1mmol/kg/d for children between 1 to 13 years of age.
Smernica ESPEN/ESPGHAN priporoča manjši vnos magnezija, ki je 0,2 mmol/kg/dan za dojenčke, stare 0-12 mesecev, in 0,1 mmol/kg/dan za otroke, stare od 1 do 13 let.
If serum magnesium levels are elevated the infusion of Numeta G16%E should be stopped or infusion rate reduced as deemed clinically appropriate and safe.
Če so ravni magnezija v serumu povišane, je treba infundiranje zdravila Numeta G16%E prekiniti ali zmanjšati hitrost infundiranja, kot je klinično primerno in varno;
Numeta G16%E Having considered the overall submitted data provided by the MAH in writing, the stakeholder's submission and the PDCO advice, the PRAC concluded that: a. the marketing authorisation holders should sponsor a post-authorisation safety study together with the follow up evaluation of the results of that study; b. the marketing authorisation holders should implement risk minimisation measures; c. the marketing authorisations should be varied.
Numeta G16%E Po preučitvi vseh podatkov, ki jih je v pisni obliki predložil imetnik dovoljenja za promet z zdravilom, prošnje zainteresirane strani in nasveta odbora PDCO je odbor PRAC zaključil, da: a. morajo imetniki dovoljenj za promet z zdravili sponzorirati študijo o varnosti zdravila v obdobju trženja in nadaljnje vrednotenje rezultatov študije; b. naj imetniki dovoljenj za promet z zdravili izvajajo ukrepe za zmanjšanje tveganja; c. so potrebne spremembe dovoljenj za promet z zdravili.
This is especially important in those patients at increased risk of developing hypermagnesaemia including patients with impaired renal function, patients receiving other medicinal products which place them at risk of developing hypermagnesaemia or patients receiving magnesium from other sources, including neonates whose mother's recently received magnesium in the antepartum period.
To je še posebej pomembno pri bolnikih s povečanim tveganjem za razvoj hipermagneziemije, vključno z bolniki s poslabšanim ledvičnim delovanjem, bolniki, ki prejemajo druga zdravila, ki jih izpostavijo tveganju za razvoj hipermagneziemije, ali bolniki, ki prejemajo magnezij iz drugih virov, kot so novorojenčki, katerih matere so pred porodom prejemale magnezij.
Magnesium serves several important functions in the human body; it is a co-factor for DNA and protein synthesis, oxidative phosphorylation, enzyme activity and regulation of parathyroid hormone secretion (Volpe, 2013; Ayuk & Gittoes, 2011; Shils et al, 1999).
Ima več pomembnih funkcij v telesu: je kofaktor (sodelujoči dejavnik) pri sintezi DNK ter beljakovin, oksidativni fosforilaciji, dejavnosti encimov in uravnavanju izločanja paratiroidnih hormonov (Volpe, 2013; Ayuk & Gittoes, 2011; Shils in sod., 1999).
This magnesium intake with Numeta G13%E appears higher than the recommendation of the American Society of Parenteral and Enteral Nutrition (ASPEN) and ESPGHAN/ESPEN guidelines for preterm neonates (0.15 to 0.25mmol/kg/d and 0.13-0.25mmol/kg/d respectively).
Ta vnos magnezija z zdravilom Numeta G13%E je videti večji od priporočil Ameriškega združenja za parenteralno in enteralno prehrano (American Society of Parenteral and Enteral Nutrition - ASPEN) in smernic ESPGHAN/ESPEN za nedonošenčke (od 0,15 do 0,25 mmol/kg/dan oziroma od 0,13 do 0,25 mmol/kg/dan).
Magnesium also plays a critical role in maintaining normal nerve and muscle function, cardiac excitability, neuromuscular conduction, muscular contraction, vasomotor tone and for a balanced immune response (Brandao et al, 2013).
Magnezij ima prav tako ključno vlogo pri vzdrževanju normalnega delovanja živcev in mišic, srčni vzdržljivosti, živčno-mišični prevodnosti, krčenju mišic, vazomotoričnem tonusu ter uravnovešenem imunskem odzivu (Brandao in sod., 2013).
The CMDh also reached an agreement on the variation to the terms of the Marketing Authorisations for Numeta G16%E for which the relevant sections of Summary of Product Characteristics and package leaflet are set out in Annex IV, subject to the conditions set out in Annex V.
Skupina CMDh se je prav tako dogovorila glede spremembe pogojev dovoljenj za promet z zdravilom Numeta G16%E, ki so za zadevne dele povzetka glavnih značilnosti zdravila ter navodilo za uporabo navedeni v Prilogi IV in so predmet pogojev, določenih v Prilogi V.
The MAH should reformulate the product, to include a level of magnesium which is justified based on the most recent knowledge in the area (see Annex III - Conditions for lifting the suspension of the marketing authorisations).
Imetnik dovoljenja za promet z zdravilom mora reformulirati zdravilo tako, da bo vsebovalo raven magnezija, ki je upravičena na podlagi najsodobnejšega znanja na strokovnem področju (glejte Prilogo III - Pogoji za preklic začasnega umika dovoljenj za promet z zdravilom).
• The PRAC reviewed all available data on the risk of hypermagnesemia in term newborn infants and children up to two years;
• odbor PRAC je pregledal vse razpoložljive podatke o tveganju hipermagneziemije pri novorojenčkih in otrocih, starih do dveh let;
Considering uncertainties regarding the appropriateness of the levels of magnesium in Numeta G13%E and the clinical consequences of this along with uncertainties regarding the availability of adequate alternatives across the EU member states, the Swedish competent authority notified the EMA, in accordance with Article 107i of Directive 2001/83/EC, of the urgency to undertake a review and requesting the PRAC to give a recommendation on the benefit-risk balance of Numeta G13%.
Glede na negotovosti v zvezi z ustreznostjo ravni magnezija v zdravilu Numeta G13%E in njene klinične posledice, vključno z negotovostjo glede razpoložljivosti ustreznih alternativ v državah članicah EU, je švedski pristojni organ v skladu s členom 107i Direktive 2001/83/ES Evropsko agencijo za zdravila obvestil o nujnosti ponovnega pregleda in zaprosil odbor PRAC, da poda priporočila glede razmerja med tveganji in koristmi zdravila Numeta G13%E.
Studies investigating levels of magnesium in preterm infants have reported higher levels of magnesium as compared to more mature newborn infants indicating that plasma magnesium may be inversely related to somatic maturity (Ariceta et al, 1995; Tsang et al, 1970).
V študijah, v katerih so preučevali ravni magnezija pri nedonošenčkih, so poročali o višjih ravneh magnezija kot pri zrelejših novorojenčkih, kar kaže, da je lahko raven magnezija v plazmi obratno sorazmerna s somatsko zrelostjo (Ariceta in sod., 1995; Tsang in sod., 1970).
The CMDh, having considered the PRAC recommendation dated 5 September 2013 with regards to Numeta G13%E and Numeta G16%E agrees with the overall PRAC scientific conclusions and grounds for the conclusions therein as stated below:
Skupina CMDh je preučila priporočilo odbora PRAC z dne 5. septembra 2013 glede zdravil Numeta G13%E in Numeta G16%E ter se strinjala s splošnimi znanstvenimi zaključki odbora PRAC ter podlago zanje, kot je navedeno spodaj:
Hypermagnesaemia may also cause non-specific symptoms such as nausea, vomiting and flushing.
Hipermagneziemija lahko povzroči tudi nespecifične simptome, kot so slabost, bruhanje in zardevanje.
The PRAC, considering all evidence available, including the PDCO advice, concluded that the risk of hypermagnesaemia is enhanced by both the clinical complexity of identifying the symptoms in this patient population and the fact that renal clearance of magnesium is decreased in neonates leading to the potential for persistence of increased magnesium levels (Mittendorf et al, 2001).
Odbor PRAC je na podlagi vseh razpoložljivih dokazov, vključno z nasvetom pediatričnega odbora PDCO, sklenil, da je tveganje hipermagneziemije povečano zaradi klinične kompleksnosti odkrivanja simptomov pri tej populaciji bolnikov in zmanjšanega ledvičnega očistka magnezija pri novorojenčkih, ki lahko povzroči morebitno vztrajno povišane ravni magnezija (Mittendorf in sod.,
Considering the number of cases of hypermagnesemia reported with Numeta G13%, the vulnerability of the patient population, difficulties in recognising clinical symptoms of hypermagnesaemia in this patient population and the content of Magnesium in Numeta G13%E in the context of relevant recommendations for magnesium intake in guidelines and literature, the MAH identified the need for reformulation the product.
Glede na število primerov hipermagneziemije, o katerih so poročali pri zdravilu Numeta G13%E, ranljivost populacije bolnikov, težave pri prepoznavanju kliničnih simptomov hipermagneziemije pri tej populaciji bolnikov in vsebnost magnezija v zdravilu Numeta G13%E v primerjavi z zadevnimi priporočili za vnos magnezija v smernicah ter literaturi je imetnik dovoljenja za promet z zdravilom izpostavil potrebo po reformulaciji zdravila.
At a maximal dose of 96.2 ml/kg/d Numeta G16%E delivers 0.3 mmol/kg/d of magnesium which is above the recommended levels.
Pri največjem odmerku 96,2 ml/kg/dan se z zdravilom Numeta G16%E vnese 0,3 mmol/kg/dan magnezija, kar je nad priporočenimi ravnmi.
The kidney is the main regulatory organ of magnesium homeostasis and impaired renal function is the most common cause of hypermagnesemia in children (Ali et al, 2003).
Ledvice so glavni organ, ki uravnava homeostazo magnezija, zato je poslabšano ledvično delovanje najpogostejši vzrok hipermagneziemije pri otrocih (Ali in sod., 2003).
The PRAC therefore recommended the suspension of the marketing authorisation for Numeta G13%E.
Odbor PRAC je zato priporočil začasen umik dovoljenja za promet z zdravilom Numeta G13%E.
To date there has been only one report of hypermagnesaemia received for Numeta G16%E (magnesium level 1.14 mmol/L) but this report was confounded because Numeta G16% E was supplemented with additional magnesium administration and no associated adverse events were reported.
Do danes so prejeli samo eno poročilo o hipermagneziemiji pri zdravilu Numeta G16%E (raven magnezija 1,14 mmol/l), vendar je bilo to poročilo nezanesljivo, saj se je zdravilu Numeta G16%E dodajal magnezij, poročali pa niso o nobenih povezanih neželenih dogodkih.
In order to receive on the third day 4g amino acids/kg/d, the preterm infant would receive 127.7 ml/kg/d or 0.55 mmol/kg/d of magnesium.
Če nedonošenček tretji dan prejme 4 g aminokislin/kg/dan, to pomeni 127,7 ml/kg/dan ali 0,55 mmol/kg/dan magnezija.
The CMDh, having considered the PRAC recommendation dated 5 September 2013 pursuant to Article 107k(1) and (2) of Directive 2001/83/EC, reached an agreement on the suspension of the marketing authorisations for Numeta G13%E.
Skupina CMDh je po obravnavi priporočila odbora PRAC z dne 5. septembra 2013 v skladu s členom 107k(1) in (2) Direktive 2001/83/ES sprejela dogovor glede začasnega umika dovoljenj za promet z zdravilom Numeta G13%E.
In view of the safety concerns in relation to hypermagnesemia in the vulnerable indicated patient population (preterm neonates) arising from the magnesium content in the current formulation of Numeta G13%E and taking account of the reported cases and the available evidence from literature and guidelines, the PRAC concluded that pursuant to Article 116 of Directive 2001/83/EC the benefitrisk balance of Numeta G13%E as parenteral nutrition for preterm newborn infants for whom oral or enteral nutrition is not possible, insufficient or contraindicated is no longer favourable.
Na podlagi varnostnih težav, povezanih s hipermagneziemijo pri ranljivi populaciji bolnikov, za katero je zdravilo indicirano (nedonošenčki), ki jih povzroča vsebnost magnezija v trenutni formulaciji zdravila Numeta G13%E, in upoštevajoč poročane primere ter razpoložljive dokaze iz literature in smernic, je odbor PRAC sklenil, da skladno s členom 116 Direktive 2001/83/ES razmerje med tveganji in koristmi zdravila Numeta G13%E za parenteralno prehrano nedonošenčkov, pri katerih je peroralna ali enteralna prehrana nemogoča, nezadostna ali kontraindicirana, ni več ugodno.
Additionally, the PRAC took account of differences in the indicated population for Numeta G16%E versus Numeta G13%E and that full term neonates and children up to two years have further progressed in terms of nephrogenic development.
Poleg tega je odbor PRAC upošteval razlike pri populaciji z indikacijo za zdravilo Numeta G16%E v primerjavi z zdravilom Numeta G13%E in da je nefrogeni razvoj pri donošenčkih ter otrocih, starih do dveh let, naprednejši.
Overall, the majority of studies which have reported measured levels of serum magnesium in preterm neonates, full term neonates and children have reported levels below 1 mmol/L.
Na splošno so v večini študij pri nedonošenčkih, donošenčkih in otrocih poročali o izmerjenih ravneh magnezija v serumu pod 1 mmol/l.