natgillin/translations-raw huggingface dataset:
It is not intended to provide practical advice on how to use Lartruvo.
Povzetek ni namenjen zagotavljanju praktičnih nasvetov o njegovi uporabi.
However, because of the small number of patients included in the main study, further data will be needed from the company that markets the medicine.
Zaradi majhnega števila bolnikov, vključenih v glavno študijo, bo morala družba, ki trži zdravilo, predložiti nadaljnje podatke.
Doxorubicin is given on day 1 of each cycle, after the Lartruvo infusion.
Doksorubicin se daje 1. dan vsakega cikla po infuziji zdravila Lartruvo.
Because the number of patients with soft tissue sarcoma is low, the disease is considered ‘rare', and Lartruvo was designated an ‘orphan medicine' (a medicine used in rare diseases) on 12 February 2015.
Ker je bolnikov s sarkomom mehkih tkiv malo, velja ta bolezen za redko, zato je bilo zdravilo Lartruvo 12. februarja 2015 določeno kot „zdravilo sirota“ (zdravilo za zdravljenje redkih bolezni).
Lartruvo has been given ‘conditional approval'.
Zdravilo Lartruvo je pridobilo „pogojno dovoljenje za promet“.
What benefits of Lartruvo have been shown in studies?
Kakšne koristi je zdravilo Lartruvo izkazalo v študijah?
By attaching to PDGFRα on sarcoma cells, Lartruvo is expected to block its activity, thereby slowing down the growth of the cancer.
Z vezavo na PDGFRα na celicah sarkoma naj bi zdravilo Lartruvo zavrlo njegovo aktivnost in tako upočasnilo rast raka.
What are the risks associated with Lartruvo?
Kakšna tveganja so povezana z zdravilom Lartruvo?
Since Lartruvo has been granted a conditional approval, the company that markets Lartruvo will provide additional data from an ongoing study in order to further confirm the efficacy and safety of the medicine.
Ker je zdravilo Lartruvo pridobilo pogojno dovoljenje za promet, bo družba, ki ga trži, zagotovila dodatne podatke iz potekajoče študije in tako dodatno potrdila učinkovitost in varnost zdravila.
What is Lartruvo and what is it used for?
Kaj je zdravilo Lartruvo in za kaj se uporablja?
Lartruvo can only be obtained with a prescription and treatment must be started and monitored by a doctor experienced in the treatment of cancer.
Predpisovanje in izdaja zdravila Lartruvo je le na recept, zdravljenje pa mora začeti in nadzorovati zdravnik, ki ima izkušnje z zdravljenjem raka.
For more information about treatment with Lartruvo, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.
Za več informacij o zdravljenju z zdravilom Lartruvo preberite navodilo za uporabo (ki je prav tako del EPAR) ali se posvetujte z zdravnikom ali farmacevtom.
In cancers such as soft tissue sarcoma, this protein is present in high levels or is overactive, causing cells to become cancerous.
Pri vrstah raka, kakršen je sarkom mehkih tkiv, je ta beljakovina prisotna v prevelikih količinah ali je čezmerno aktivna, zato celice postanejo rakave.
The full EPAR for Lartruvo can be found on the Agency's website: ema.europa.eu/Find medicine/Human medicines/European public assessment reports.
Celotno evropsko javno poročilo o oceni zdravila (EPAR) za zdravilo Lartruvo je na voljo na spletni strani agencije: ema.europa.eu/Find medicine/Human medicines/European public assessment reports.
In addition, patients treated with the combination Lartruvo plus doxorubicin lived overall almost twice as long as patients treated with doxorubicin (26.5 versus 14.7 months, respectively).
Poleg tega so bolniki, zdravljeni s kombinacijo zdravila Lartruvo in doksorubicina, celokupno živeli skoraj dvakrat dlje kot bolniki, zdravljeni z doksorubicinom (26,5 v primerjavi s 14,7 meseca).
The most frequent side effects which lead to treatment termination were infusion-related reactions (allergic reactions which can be serious, with symptoms such as chills, fever and difficulty breathing) and mucositis.
Najpogostejši neželeni učinki, ki privedejo do prenehanja zdravljenja, so bile reakcije, povezane z infuzijo (alergijske reakcije, ki so lahko resne, s simptomi, kot so mrzlica, povišana telesna temperatura in težave z dihanjem), in mukozitis.
Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Lartruvo have been included in the summary of product characteristics and the package leaflet.
Priporočila in varnostni ukrepi, ki jih morajo za varno in učinkovito uporabo tega zdravila upoštevati zdravstveni delavci in bolniki, so vključeni v povzetek glavnih značilnosti zdravila in navodilo za njegovo uporabo.
The active substance in Lartruvo, olaratumab, is a monoclonal antibody (a type of protein) that has been designed to recognise and attach to a protein called ‘platelet-derived growth factor receptor alpha' (PDGFRα).
Zdravilna učinkovina v zdravilu Lartruvo, olaratumab, je monoklonsko protitelo (vrsta beljakovine), zasnovano za prepoznavo in vezavo na beljakovino, imenovano receptor alfa za trombocitni rastni dejavnik (PDGFRα).
For practical information about using Lartruvo, patients should read the package leaflet or contact their doctor or pharmacist.
Za praktične informacije o uporabi zdravila Lartruvo naj bolniki preberejo navodilo za uporabo ali se posvetujejo z zdravnikom ali farmacevtom.
Why is Lartruvo approved?
Zakaj je bilo zdravilo Lartruvo odobreno?
Lartruvo is available as a solution for infusion (drip) into a vein.
Zdravilo Lartruvo je na voljo kot raztopina za infundiranje (kapalno infuzijo) v veno.
Lartruvo is a cancer medicine used to treat adults with advanced soft tissue sarcoma, a type of cancer that affects the soft, supportive tissues of the body such as muscles, blood vessels and fat tissue.
Lartruvo je zdravilo proti raku, ki se uporablja za zdravljenje odraslih z napredovalim sarkomom mehkih tkiv, tj. vrste raka, ki prizadene mehka podporna tkiva v telesu, kot so mišice, krvne žile in maščobno tkivo.
For the full list of all side effects and restrictions with Lartruvo, see the package leaflet.
Za celoten seznam neželenih učinkov in omejitev pri uporabi zdravila Lartruvo glejte navodilo za uporabo.
What information is still awaited for Lartruvo?
Katere informacije o zdravilu Lartruvo še pričakujemo?
Patients treated with Lartruvo plus doxorubicin lived for an average of 6.6 months without their disease getting worse, compared with 4.1 months for patients treated with doxorubicin alone.
Bolniki, zdravljeni z zdravilom Lartruvo v kombinaciji z doksorubicinom, so brez poslabšanja bolezni živeli povprečno 6,6 meseca, v primerjavi s 4,1 meseca pri bolnikih, ki so se zdravili samo z doksorubicinom.
The most common side effects with Lartruvo (which may affect more than 1 in 10 people) include nausea (feeling sick), musculoskeletal pain (bone and muscle pain), neutropenia (low levels of neutrophils, a type of white blood cells that fights infection) and mucositis (inflammation of the body's moist surfaces, most commonly affecting the mouth and throat).
Najpogostejši neželeni učinki zdravila Lartruvo (ki se lahko pojavijo pri več kot 1 bolniku od 10) vključujejo navzejo (slabost), mišično-skeletno bolečino (bolečino v kosteh in mišicah), nevtropenijo (nizke vrednosti nevtrofilcev, vrste belih krvnih celic, ki se borijo proti okužbam) in mukozitis (vnetje telesnih sluznic, najpogosteje ust in žrela).
With regards to the safety profile of the medicine, it was observed that patients treated with Lartruvo plus doxorubicin experienced an increase in the frequency of side effects; however, in view of the benefits of treatment, side effects were considered tolerable and manageable.
Kar zadeva varnostni profil zdravila, so opazili, da so bili neželeni učinki pri bolnikih, zdravljenih z zdravilom Lartruvo in doksorubicinom, pogostejši, vendar pa so bili neželeni učinki z vidika koristi zdravljenja ocenjeni kot znosni in obvladljivi.
Lartruvo has been investigated in one main study involving 133 adults with advanced soft tissue sarcoma who couldn't undergo surgery or radiotherapy and who had not been previously treated with anthracyclines (a group of cancer medicines that includes doxorubicin).
Zdravilo Lartruvo so proučevali v eni glavni študiji, ki je vključevala 133 odraslih z napredovalim sarkomom mehkih tkiv, ki jih ni bilo mogoče zdraviti z operacijo ali radioterapijo in ki se predhodno še niso zdravili z antraciklini (skupino zdravil proti raku, ki vključuje doksorubicin).
Lartruvo is used together with doxorubicin (another cancer medicine) in patients who cannot undergo surgery or radiotherapy (treatment with radiation) and who have not been previously treated with doxorubicin.
Zdravilo Lartruvo se uporablja skupaj z doksorubicinom (drugim zdravilom proti raku) pri bolnikih, ki jih ni mogoče zdraviti z operacijo ali radioterapijo (zdravljenjem z obsevanjem) in ki se predhodno še niso zdravili z doksorubicinom.
The study showed that Lartruvo plus doxorubicin was more effective than doxorubicin alone at prolonging the time patients live without their disease getting worse (progression-free survival).
Študija je pokazala, da je zdravilo Lartruvo v kombinaciji z doksorubicinom učinkovitejše od doksorubicina kot samostojnega zdravljenja pri podaljševanju časa do poslabšanja bolezni (preživetja brez napredovanja).
Data from the main study show that Lartruvo in combination with doxorubicin improves progressionfree and overall survival of patients with advanced soft tissue sarcoma.
Podatki iz glavne študije kažejo, da zdravilo Lartruvo v kombinaciji z doksorubicinom pri bolnikih z napredovalim sarkomom mehkih tkiv izboljša preživetje brez napredovanja in celokupno preživetje.
How does Lartruvo work?
Kako zdravilo Lartruvo deluje?
Lartruvo is given in combination with doxorubicin for up to 8 cycles of treatment, followed by Lartruvo alone in patients whose disease has not got worse.
Zdravilo Lartruvo se največ 8 ciklov zdravljenja daje v kombinaciji z doksorubicinom, čemur pri bolnikih, ki se jim bolezen ni poslabšala, sledi samostojno zdravljenje z zdravilom Lartruvo.
How is Lartruvo used?
Kako se zdravilo Lartruvo uporablja?
The recommended dose of Lartruvo is 15 mg per kilogram body weight, given twice over a period of three weeks, on days 1 and 8.
Priporočeni odmerek zdravila Lartruvo je 15 mg na kilogram telesne mase in se daje dvakrat v treh tednih, in sicer 1. in 8. dan. Ti tritedenski cikli se ponavljajo, dokler se bolezen ne poslabša ali neželeni učinki ne postanejo nesprejemljivi.
What measures are being taken to ensure the safe and effective use of Herzuma?
Kateri ukrepi se izvajajo za zagotovitev varne in učinkovite uporabe zdravila Herzuma?
This means that Herzuma is similar to another biological medicine (the ‘reference medicine') that is already authorised in the European Union (EU).
To pomeni, da je podobno biološkemu zdravilu (t. i. „referenčnemu zdravilu“), ki je že odobreno v Evropski uniji (EU).
Herzuma can cause cardiotoxicity (harm to the heart), including heart failure (when the heart does not work as well as it should).
Zdravilo Herzuma lahko povzroča kardiotoksičnost (škoduje srcu), vključno s srčnim popuščanjem (srce ne deluje tako dobro, kot bi moralo).
Patients who tolerate the first 90-minute infusion can receive subsequent infusions over 30 minutes.
Pri bolnikih, ki dobro prenesejo prvo 90-minutno infundiranje, lahko naslednje infuzije trajajo 30 minut.
The infusion may be associated with allergic reactions, so the patient should be monitored during and after the infusion.
Infuzija je lahko povezana z alergijskimi reakcijami, zato je treba bolnika med infundiranjem in po njem opazovati.
This is a summary of the European public assessment report (EPAR) for Herzuma.
To je povzetek evropskega javnega poročila o oceni zdravila (EPAR) za zdravilo Herzuma.
The full EPAR for Herzuma can be found on the Agency's website: ema.europa.eu/Find medicine/Human medicines/European public assessment reports.
Celotno evropsko javno poročilo o oceni zdravila (EPAR) za zdravilo Herzuma je na voljo na spletni strani agencije: ema.europa.eu/Find medicine/Human medicines/European public assessment reports.
There were no relevant differences in the main measure of effectiveness (absence of invasive cancer cells in the breast or in linked tissues called lymph nodes) between the two products: this was seen in nearly 44% of those given Herzuma (118 of 271) and 47% of those given Herceptin (131 of 278).
Med zdraviloma ni bilo pomembnih razlik glede glavnega merila učinkovitosti (odsotnost invazivnih rakavih celic v dojki ali z njo povezanih tkivih, imenovanih bezgavke): to je bilo opaženo pri skoraj 44 % bolnic, ki so prejemale zdravilo Herzuma (118 od 271), in pri 47 % bolnic, ki so prejemale zdravilo Herceptin (131 od 278).
The most common or serious side effects with Herzuma are heart problems, reactions related to the Herzuma infusion, reduced levels of blood cells (especially white blood cells), infections and lung problems.
Najpogostejši ali resni neželeni učinki zdravila Herzuma so težave s srcem, reakcije, povezane z infuzijo zdravila Herzuma, zmanjšana količina krvnih celic (zlasti belih krvnih celic), okužbe in težave s pljuči.
Herzuma is a cancer medicine used to treat the following conditions:
Herzuma je zdravilo za zdravljenje raka, ki se uporablja za zdravljenje naslednjih bolezni:
For the full list of all side effects and restrictions with trastuzumab, see the package leaflet.
Za celoten seznam neželenih učinkov in omejitev pri uporabi trastuzumaba glejte navodilo za uporabo.
The infusion is given over 90 minutes every week or every three weeks for breast cancer, and every three weeks for gastric cancer.
Infuzija se daje 90 minut vsak teden ali vsake tri tedne pri raku dojke in vsake tri tedne pri raku želodca.
In addition, one main study involving 549 patients with early breast cancer that overexpressed HER2 showed that Herzuma was as effective as Herceptin.
Poleg tega je ena glavna študija, v katero je bilo vključenih 549 bolnic z zgodnjim rakom dojke, ki je čezmerno izražal beljakovino HER2, pokazala, da je zdravilo Herzuma enako učinkovito kot zdravilo Herceptin.
HER2 is overexpressed in about a quarter of breast cancers and a fifth of gastric cancers.
HER2 se čezmerno izraža pri približno četrtini rakov dojke in petini rakov želodca.
Other information about Herzuma
Druge informacije o zdravilu Herzuma
It must not be used in patients who have serious breathing problems because of advanced cancer, even when resting, or who need oxygen therapy.
Ne sme se uporabljati pri bolnikih, ki imajo zaradi napredovalega raka resne težave z dihanjem tudi med počitkom, in bolnikih, ki potrebujejo zdravljenje s kisikom.
It is also used in combination with other cancer medicines: with paclitaxel or docetaxel, or with another class of medicines called aromatase inhibitors;
Uporablja se tudi v kombinaciji z drugimi zdravili proti raku: s paklitakselom ali docetakselom ali drugim razredom zdravil, imenovanim zaviralci aromataze;
What are the risks associated with Herzuma?
Kakšna tveganja so povezana z zdravilom Herzuma?
Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Herzuma have been included in the summary of product characteristics and the package leaflet.
Priporočila in varnostni ukrepi, ki jih morajo za varno in učinkovito uporabo zdravila Herzuma upoštevati zdravstveni delavci in bolniki, so vključeni v povzetek glavnih značilnosti zdravila in navodilo za njegovo uporabo.
It is available as a powder used to make up a solution for adding to an infusion (drip) into a vein.
Na voljo je v obliki praška za pripravo raztopine, ki se doda (kapalni) infuziji v veno.
Herzuma must not be used in people who are hypersensitive (allergic) to trastuzumab, mouse proteins or to any of the other ingredients.
Zdravila Herzuma ne smejo uporabljati osebe, ki so preobčutljive za (alergične na) trastuzumab, mišje beljakovine ali na katero koli drugo sestavino zdravila.
What is Herzuma and what is it used for?
Kaj je zdravilo Herzuma in za kaj se uporablja?
For more information about treatment with Herzuma, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.
Za več informacij o zdravljenju z zdravilom Herzuma preberite navodilo za uporabo (ki je prav tako del EPAR) ali se posvetujte z zdravnikom ali farmacevtom.
The recommended dose depends on the patient's body weight, on the condition being treated and on whether Herzuma is given weekly or three-weekly.
Priporočeni odmerek je odvisen od telesne mase bolnika, od zdravljene bolezni in od tega, ali se zdravilo Herzuma daje vsak teden ali vsake tri tedne.
• early breast cancer (when the cancer has spread within the breast or to the glands under the arm but not to other parts of the body) after surgery, chemotherapy (medicines to treat cancer), and radiotherapy (treatment with radiation) if applicable.
• zgodnjega raka dojke (kadar se je rak razširil znotraj dojke ali v podpazdušne žleze, ne pa na druge dele telesa) po kirurškem posegu, kemoterapiji (zdravljenju z zdravili proti raku) in radioterapiji (zdravljenju z obsevanjem), če je to smiselno.
The European Medicines Agency decided that, in accordance with EU requirements for biosimilar medicines, Herzuma has been shown to have a comparable quality, safety and effectiveness to Herceptin.
Evropska agencija za zdravila je zaključila, da je bilo v skladu z zahtevami EU glede podobnih bioloških zdravil dokazano, da je zdravilo Herzuma po kakovosti, varnosti in učinkovitosti primerljivo zdravilu Herceptin.
What benefits of Herzuma have been shown in studies?
Kakšne koristi je zdravilo Herzuma izkazalo v študijah?
Patients were given either Herzuma or Herceptin with other cancer medicines before surgery to remove the cancer, and then the same medicine on its own every three weeks for 1 year.
Bolnice so zdravilo Herzuma ali zdravilo Herceptin skupaj z drugimi zdravili proti raku prejele pred operacijo za odstranitev raka, nato pa so isto zdravilo samostojno prejemale še eno leto vsake tri tedne.
For tumours that are locally advanced (including those that are inflammatory) or more than 2 cm wide, Herzuma is used before surgery in combination with chemotherapy and then again after surgery on its own;
Pri lokalno napredovalih tumorjih (vključno z vnetnimi tumorji) ali tumorjih, širših od 2 cm, se zdravilo Herzuma pred kirurškim posegom uporablja v kombinaciji s kemoterapijo, po kirurškem posegu pa kot samostojno zdravilo;
For early breast cancer, treatment is given for a year or until the disease comes back, and for metastatic breast or gastric cancer, treatment is continued for as long as it remains effective.
Pri zgodnjem raku dojke zdravljenje poteka eno leto ali dokler se bolezen ne ponovi, pri metastatskem raku dojke in raku želodca pa traja, dokler je še učinkovito.
The active substance in Herzuma, trastuzumab, is a monoclonal antibody (a type of protein) that has been designed to recognise and attach to the HER2 protein.
Zdravilna učinkovina v zdravilu Herzuma, trastuzumab, je monoklonsko protitelo (vrsta beljakovine), ki je bilo zasnovano tako, da prepozna beljakovino HER2 in se veže nanjo.
Herzuma can only be obtained with a prescription and treatment should be started by a doctor who has experience in the use of cancer medicines.
Predpisovanje in izdaja zdravila Herzuma je le na recept, zdravljenje z njim pa mora uvesti zdravnik, ki ima izkušnje z zdravili proti raku.
Why is Herzuma approved?
Zakaj je bilo zdravilo Herzuma odobreno?
For practical information about using Herzuma, patients should read the package leaflet or contact their doctor or pharmacist.
Za praktične informacije o uporabi zdravila Herzuma naj bolniki preberejo navodilo za uporabo ali se posvetujejo z zdravnikom ali farmacevtom.
It is used on its own in patients in whom previous treatments have failed.
Pri bolnikih, pri katerih je bilo predhodno zdravljenje neuspešno, se uporablja kot samostojno zdravilo.
Because Herzuma is a biosimilar medicine, the studies on effectiveness and safety of trastuzumab carried out with Herceptin do not all need to be repeated for Herzuma.
Zdravilo Herzuma je „podobno biološko zdravilo“, zato študij o učinkovitosti in varnosti trastuzumaba, izvedenih z zdravilom Herceptin, z zdravilom Herzuma ni treba ponavljati.
• metastatic gastric (stomach) cancer, in combination with cisplatin and either capecitabine or fluorouracil (other cancer medicines).
• metastatskega raka želodca, in sicer v kombinaciji s cisplatinom in bodisi kapecitabinom bodisi fluorouracilom (drugima zdraviloma proti raku).
It is not intended to provide practical advice on how to use Herzuma.
Povzetek ni namenjen zagotavljanju praktičnih nasvetov o njegovi uporabi.
The reference medicine for Herzuma is Herceptin.
Referenčno zdravilo za zdravilo Herzuma je zdravilo Herceptin.
Studies have also shown that giving Herzuma produces similar levels of the active substance in the body to giving Herceptin.
Študije so pokazale tudi, da zdravilo Herzuma ustvari podobne ravni zdravilne učinkovine v telesu kot zdravilo Herceptin.
Herzuma is a ‘biosimilar medicine'.
Zdravilo Herzuma je „podobno biološko zdravilo“.
Laboratory studies comparing Herzuma with Herceptin have shown that the active substance in Herzuma is highly similar to that in Herceptin in terms of structure, purity and biological activity.
Laboratorijske študije, v katerih so zdravilo Herzuma primerjali z zdravilom Herceptin, so pokazale, da je zdravilna učinkovina v zdravilu Herzuma po zgradbi, čistosti in biološkem delovanju zelo podobna zdravilni učinkovini v zdravilu Herceptin.
How is Herzuma used?
Kako se zdravilo Herzuma uporablja?
How does Herzuma work?
Kako zdravilo Herzuma deluje?
Therefore, the Agency's view was that, as for Herceptin, the benefit outweighs the identified risk and Herzuma should be given marketing authorisation.
Zato je menila, da njegove koristi enako kot pri zdravilu Herceptin odtehtajo znana tveganja.
Herzuma can only be used when the cancer has been shown to ‘overexpress HER2': this means that the cancer produces a protein called HER2 in large quantities on the surface of the tumour cells.
To pomeni, da na površini tumorskih celic v velikih količinah nastaja beljakovina, imenovana HER2.
56 ampoules x 1 administration device
56 ampul x 1 pripomoček za aplikacijo
170 mg Nebuliser solution Inhalation use ampoule (PE)
za inhaliranje ampula (PE)
Further information about the EU-wide safety review:
Dodatne informacije o analizi varnosti, opravljeni v EU:
• Parents who have any questions or concerns should speak to the treating doctor or other healthcare professional.
• Starši, ki imajo kakršna koli vprašanja ali skrbi, naj se posvetujejo z lečečim zdravnikom ali drugim zdravstvenim delavcem.
Information to parents and carers
Informacije za starše in negovalce
The CMDh is a medicines regulatory body representing the EU Member States.
Skupina CMDh je regulativni organ za zdravila, ki zastopa države članice EU.
The review was conducted by the Pharmacovigilance Risk Assessment Committee (PRAC).
Pregled je izvedel Odbor za oceno tveganja na področju farmakovigilance (PRAC).
This should be done in accordance with routine clinical practice and the clinical needs of the individual patient.
Pri tem morajo upoštevati vsakdanjo klinično prakso in klinične potrebe posameznega bolnika.
References:
Referenčna literatura:
This report was confounded by the fact that additional magnesium may have been given.
Vendar pa je to poročilo nezanesljivo zaradi dejstva, da je bil morda uporabljen dodaten magnezij.
However, healthcare professionals should be aware of the potential risk for hypermagnesaemia.
Vendar pa se morajo zdravstveni delavci zavedati možnega tveganja za hipermagneziemijo.
Numeta G13%E and Numeta G16%E have been authorised since 2011 via national procedures in the following Member States: Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Spain, Sweden, United Kingdom.
Zdravili Numeta G13%E in Numeta G16%E sta po nacionalnih postopkih odobreni od leta 2011 v naslednjih državah članicah: v Avstriji, Belgiji, Češki republiki, na Danskem, Finskem, v Franciji, Nemčiji, Grčiji, na Irskem, v Italiji, Luksemburgu, na Malti, Nizozemskem, Norveškem, Poljskem, Portugalskem, v Španiji, na Švedskem in v Združenem kraljestvu.