natgillin/translations-raw huggingface dataset:
The expert unanimously agreed that the risk of air embolism is not related to the medicinal product itself but to the device design and its misuse in practice.
Strokovnjaki so se soglasno strinjali, da tveganje za zračno embolijo ni povezano s samim zdravilom, pač pa z zasnovo pripomočka in njegovo napačno uporabo v praksi.
• The Committee reviewed all the data provided by the MAH in writing and in the oral explanation and the outcome of the ad-hoc expert advisory group meeting;
• Odbor je pregledal vse podatke, ki jih je predložil imetnik dovoljenja za promet v pisni obliki in v obliki ustnega pojasnila, ter zaključke sestanka začasne strokovne svetovalne skupine.
Spraying Quixil in endoscopic procedures should therefore be contra-indicated.
Pršenje zdravila Quixil v endoskopskih postopkih mora biti zato kontraindicirano.
The fibrinogen component of Quixil also contains tranexamic acid.
Fibrinogenska sestavina zdravila Quixil vsebuje tudi traneksamično kislino.
In the same period, 4 cases (of which two had a fatal outcome) were reported following spray application of Evicel, a second generation fibrin sealant, approved via the centralised procedure in 2008.
V enakem obdobju so poročali o štirih primerih (od katerih sta dva imela smrtni izid) ob napršitvi zdravila Evicel, fibrinskega tesnilnega sredstva druge generacije, ki je bilo odobreno po centraliziranem postopku leta 2008.
Quixil is a first generation fibrin sealant containing two components, human clottable protein and human thrombin and was approved via the mutual recognition procedure with the UK as reference member state.
Zdravilo Quixil je fibrinsko tesnilno sredstvo prve generacije, ki vsebuje dve sestavini, humani protein, ki koagulira, in humani trombin, ter je bilo odobreno v postopku z medsebojnim priznavanjem, v katerem je bila referenčna država članica Združeno kraljestvo.
Finally, the CHMP agreed on a Direct Healthcare Professional Communication (DHPC), to communicate the outcome of the present review.
Odbor CHMP se je dogovoril tudi o neposrednm obvestilu za zdravstvene delavce (DHPC - Direct Healthcare Professional Communication), da bi jim sporočil izid tega pregleda.
Evicel was sprayed antero-laterally via pressure regulator with N2 (nitrogen) for a single two-second burst at approximately 2½ to 3 centimetres with reduced pressure of 8 (eight) PSI.
Zdravilo Evicel se je napršilo anterolateralno z regulatorjem tlaka z N2 (dušik) v enkratnem dvosekundnem odmerku na površino, ki je obsegala približno 2½ do 3 centimetre, z znižanim tlakom 8 (osem) PSI.
The CHMP agreed that the DHPC should be circulated to all Quixil users in France and Italy, no later than 30 November 2012.
Odbor CHMP se je strinjal, da morajo neposredno obvestilo za zdravstvene delavce prejeti vsi uporabniki zdravila Quixil v Franciji in v Italiji najkasneje do 30. novembra 2012.
They also recommended that appropriate educational materials and training for healthcare professionals to administer the product correctly (at the recommended distance and pressure for spray application) is required.
Priporočili so tudi primerno gradivo za izobraževanje in usposabljanje zdravstvenih delavcev za pravilno uporabo zdravila (ob priporočeni razdalji in tlaku za napršitev).
It can be either dripped onto the tissue or sprayed onto the tissue in short bursts.
Zdravilo se bodisi nakapa ali naprši na tkivo v majhnih odmerkih.
Based on the above, the European Commission initiated a procedure under Article 20 of Regulation (EC) No 726/2004 on 21 May 2012, requesting the CHMP to assess the above concerns and their impact on the benefit-risk for Evicel, to give its opinion on measures necessary to ensure the safe and effective use of Evicel and on whether the marketing authorisation for this product should be maintained, varied, suspended or withdrawn.
Glede na navedeno je Evropska komisija 21. maja 2012 začela postopek v skladu s členom 20 Uredbe (ES) št. 726/2004, v katerem je Odbor za zdravila za uporabo v humani medicini (CHMP) pozvala, naj prouči zgornje pomisleke in njihov vpliv na razmerje med koristmi in tveganji za zdravilo Evicel ter predloži svoje mnenje o ukrepih, potrebnih za zagotavljanje varne in učinkovite uporabe zdravila Evicel in o tem, ali se lahko dovoljenje za promet za to zdravilo ohrani ali pa ga je treba spremeniti, začasno umakniti oziroma preklicati.
The pressure range for Quixil is therefore higher (2.0-2.5 bar) compared with that of Evicel (1.0-1.7 bar).
Območje tlaka je tako pri zdravilu Quixil višje (2,0−2,5 bara) kot območje tlaka pri zdravilu Evicel (1,0−1,7 bara).
The MAH confirmed that the shipment of Quixil in Europe had ceased in May 2012 and that only very few units of Quixil were available in France and Italy.
Imetnik dovoljenja za promet z zdravilom je potrdil, da je maja 2012 v Evropi prenehal dobavljati zdravilo Quixil in da je majhno število enot zdravila Quixil na voljo še v Franciji in Italiji.
They were of the opinion that CO2 should be used instead of air as a safety precaution because of the markedly lower risk of gas embolism due to the high solubility of CO2 in the blood.
Menili so, da je treba kot varnostni ukrep za bistveno nižje tveganje plinske embolije namesto zraka uporabiti CO2, saj ima CO2 večjo topnost v krvi.
Despite risk mitigation activities put in place between August 2010 and early 2011 for Quixil and Evicel, including: 1) a direct healthcare professional communication regarding a change in product labelling, 2) field safety notification for the pressure regulator including change in the instructions for use, and 3) updated customer training programs, two new cases of air embolism (and a third one during the referral procedure) have been reported following use of the spray application of Evicel (one non-fatal case in August 2011 and a fatal case in January 2012).
Kljub ukrepom za zmanjšanje tveganja, ki so bili sprejeti med avgustom 2010 in začetkom leta 2011 za zdravili Quixil in Evicel, vključno z: 1) neposrednim obvestilom zdravstvenim delavcem glede sprememb v označevanju zdravila, 2) obvestilom o varnosti v praksi za regulator tlaka, vključno z navodili za uporabo in 3) posodobljenimi programi usposabljanja strank, so po napršitvi zdravila Evicel poročali o dveh novih primerih zračne embolije (en primer z nesmrtnim izidom avgusta 2011 in primer s smrtnim izidom januarja 2012) (med postopkom napotitve pa so poročali še o tretjem primeru).
Following this, the UK's Medicines and Healthcare products Regulatory Agency triggered a procedure under Article 31 on 24 May 2012, requesting the CHMP to carry out the same assessment for the other fibrin sealants available in the EU, including Quixil.
Potem je regulativna agencija Združenega kraljestva za zdravila 24. maja 2012 sprožila postopek v skladu s členom 31, s katerim je odbor CHMP zaprosila, naj opravi enako presojo za druga fibrinska tesnilna sredstva, ki so na voljo v EU, vključno z zdravilom Quixil.
The CHMP therefore considered that correct administration of sprayable fibrin sealants is essential to reduce this risk and focused its assessment on the identification of measures that would be necessary and adequate to minimise this risk.
Zato je menil, da je pravilna uporaba fibrinskih tesnilnih sredstev nujna za zmanjšanje tega tveganja in svojo presojo usmerila na določanje ukrepov, potrebnih in zadostnih za zmanjšanje tega tveganja na najnižjo raven.
• The Committee considered the procedure under Article 31 of Directive 2001/83/EC fibrinogencontaining solutions for sealant authorised for administration by spray application, including Quixil;
• Odbor je upošteval postopek v skladu s členom 31 Direktive 2001/83/ES o tesnilnih raztopinah, ki vsebujejo fibrinogen, odobrenih za uporabo s pršenjem, vključno z zdravilom Quixil.
Finally, the product should only be sprayed using pressurised carbon dioxide gas and with a pressure regulator that caps the maximum pressure at 2.5 bars.
Ne nazadnje se lahko zdravilo naprši le z ogljikovim dioksidom pod tlakom in z regulatorjem tlaka, ki omeji najvišji tlak na 2,5 bara.
Clear instructions to surgeons with regard to the distances and pressures recommended and the pressurised gas to be used should be provided and the use should be restricted to experienced surgeons who have been trained in the use of Quixil.
Kirurgom je treba dati jasna navodila glede priporočenih razdalj in tlakov ter plina pod tlakom, ki naj ga uporabljajo, uporaba zdravila pa mora biti omejena na izkušene kirurge, ki so bili usposobljeni za uporabo zdravila Quixil.
During the Article 31 procedure, the CHMP also noted a new case of gas embolism reported with the use of Evicel during laser prostatectomy.
Med postopkom v skladu s členom 31 je Odbor opozoril tudi na nov primer plinske embolije, o katerem so poročali pri zdravilu Evicel med lasersko prostatektomijo.
Furthermore, the device design should have a specific gas pressure governor to be used with the spray applicator and with a limit not above the maximal optimal pressure recommended.
Poleg tega je treba pripomoček zasnovati s posebnim krmilnikom plinskega tlaka, ki bi se uporabljal s pršilnikom in z omejitvijo, ki ne bi presegla najvišjega priporočenega optimalnega tlaka.
The CHMP revised the Quixil PI accordingly, to ensure the safe and effective use of Quixil (see Annex III).
Odbor CHMP je v skladu s tem pregledal informacije o zdravilu Quixil, da bi zagotovil varno in učinkovito uporabo zdravila Quixil (glejte Prilogo III).
• The CHMP agreed on a number of additional risk minimisation measures, including changes to the product information regarding the use of the product as well as educational materials and training to be provided to users of the product, which adequately addressed the identified risk of air embolism;
• CHMP je soglašal s številnimi dodatnimi ukrepi za zmanjšanje tveganja, vključno s spremembami informacij o zdravilu glede uporabe zdravila ter tudi z izobraževalnim gradivom in usposabljanjem, ki se morajo zagotoviti za uporabnike zdravila, v katerih bo ustrezno obravnavano ugotovljeno tveganje za zračno embolijo.
This case occurred during a clinical trial and highlights the problems with the application of sprayable fibrin sealants during endoscopic procedures, where it is not always feasible to judge distances (such as 4cm) accurately when spraying.
Do tega primera je prišlo med kliničnim preskušanjem in izpostavlja težave ob uporabi fibrinskih tesnilnih sredstev v pršilu med endoskopskimi postopki, kadar ni vedno mogoče natančno oceniti razdalj (kot npr. 4 cm) med pršenjem.
With regard to safety, the CHMP noted that the main risk with sprayable fibrin sealants is the risk of air/gas embolism, due to air/gas entering the vasculature.
Glede varnosti je poudaril, da je glavno tveganje pri fibrinskih tesnilnih sredstvih v pršilu tveganje za zračno/plinsko embolijo zaradi zraka/plina, ki vstopi v ožilje.
An ad-hoc expert advisory group meeting was convened in October 2012 at the request of the CHMP, during which the experts discussed the benefits of sprayable fibrin sealants as well as potential risk minimisation measures, in particular with regard to the risk of air embolism.
Na zahtevo odbora CHMP je bil v oktobru 2012 sklican sestanek začasne strokovne svetovalne skupine, na katerem so strokovnjaki razpravljali o koristih fibrinskih tesnilnih sredstev v pršilu ter o ukrepih za zmanjšanje možnih tveganj, še zlasti tveganja za zračno embolijo.
The CHMP therefore concluded that the available evidence supports the efficacy and use of Quixil in the approved indications.
Zato je sklenil, da razpoložljivi dokazi podpirajo učinkovitost in uporabo zdravila Quixil za odobrene indikacije.
The CHMP pointed out that surgeons and surgical staff should be advised on the appropriate means of achieving a tissue surface that is as dry as possible (e.g. intermittent application of compresses, swabs, use of suction devices).
Odbor CHMP je izpostavil, da je treba kirurge in kirurško osebje seznaniti z ustreznimi načini doseganja čim bolj suhe površine tkiva (npr. z uporabo kompres, tamponov ali uporabo sesalnih naprav med postopkom).
Appropriate means of achieving a tissue surface that is as dry as possible should be used and changes in blood pressure, pulse, oxygen saturation and end tidal CO2 should be monitored during application of Quixil by spray because of the possibility of occurrence of air or gas embolism.
Uporabiti je treba ustrezne načine za doseganje čim bolj suhe površine tkiva, med pršenjem zdravila Quixil pa je treba spremljati spremembe v krvnem tlaku, srčnem utripu, nasičenosti s kisikom ter CO2 v izdihanem zraku ob koncu izdiha zaradi možnega pojava zračne ali plinske embolije.
The thrombin component of Evicel is identical to the thrombin component of Quixil but the fibrinogen component of Evicel differs mainly from that of Quixil in the fact that it does not contain tranexamic acid.
Trombinska sestavina zdravila Evicel je identična trombinski sestavini zdravila Quixil, vendar se fibrinogenska sestavina zdravila Evicel od fibrinogenske v zdravilu Quixil razlikuje predvsem v tem, da ne vsebuje traneksamične kisline.
The experts agreed that sprayable fibrin sealants are recommended when there is a large surface area of surgical bleeding, generally oozing, and that not using sprayable fibrin sealants in these cases would lead to an increased use of other blood products, which would lead to a higher risk of complications.
Strokovnjaki so se strinjali, da je uporaba fibrinskih tesnilnih sredstev v pršilu priporočljiva pri kirurških krvavitvah velike površine z mezenjem krvi, kadar bi neuporaba fibrinskih tesnilnih sredstev v pršilu povzročila povečano uporabo drugih krvnih produktov, kar bi povečalo tveganje za zaplete.
In particular, the MAH was requested to submit an EU risk management plan to the national competent authorities which includes the safety concern of gas embolism and to ensure that all users of the spray application are provided with adequate educational material on the correct use of the product and are offered an educational program which teaches the content of the mentioned educational material.
Imetnik dovoljenja za promet z zdravilom je bil zlasti naprošen, naj pristojnim nacionalnim organom predloži strategijo obvladovanja tveganja na ravni EU, kar vključuje varnostni zadržek glede plinske embolije in zagotovi, da bodo vsi uporabniki zdravila v pršilu prejeli ustrezno izobraževalno gradivo o pravilni uporabi zdravila ter jim bo bo omogočen dostop do programa usposabljanja, v okviru katerega bodo poučeni o vsebini navedenega izobraževalnega gradiva.
In addition, the MAH should ensure that all users of the spray application of this product are provided with labels for the pressure regulator that inform about the correct pressure and distance in open surgery, a warning card that informs about the correct pressure and distance for the spray application for open surgery and a yellow tag, to be placed on the device air hose, which provides instructions for use.
Zagotoviti mora tudi, da bodo vsi uporabniki tega zdravila v pršilu prejeli oznake za regulator tlaka, ki opozarjajo na pravilen tlak in razdaljo pri odprti kirurški tehniki, opozorilno kartico, ki opozarja na pravilen tlak in razdaljo pršenja pri odprti kirurški tehniki, in rumen kartonček za namestitev na zračno cev pripomočka, ki bo vseboval navodilo za uporabo.
• The Committee considered all the cases of air embolism associated with the use of Quixil by spray application that have been reported and concluded that the risk minimisation measures previously implemented were insufficient to mitigate the identified risk of air embolism associated with the use of the Quixil spray application;
• Odbor je proučil vse primere zračne embolije, povezane z napršitvijo zdravila Quixil, o katerih so poročali, in sklenil, da predhodno sprejeti ukrepi za zmanjšanje tveganja ne zadoščajo za odpravo ugotovljenega tveganja za zračno embolijo, povezano z napršitvijo zdravila Quixil.
Regarding the clinical use of the product, the CHMP was of the opinion, based on the last case of air embolism that was reported during an endoscopy procedure, where the surgeon has limited visibility of the tissue surface that the use of Quixil by spray application should only be considered if it is possible to accurately judge the spraying distance.
Glede klinične uporabe zdravila je bil odbor CHMP na podlagi zadnjega primera zračne embolije, o katerem so poročali med postopkom endoskopije, pri katerem je bila kirurgova vidljivost površine tkiva omejena, mnenja, da je pršenje zdravila Quixil primerno le v okoliščinah, kadar je mogoče razdaljo pršenja natančno oceniti.
Quixil is indicated as supportive treatment in surgery where standard surgical techniques are insufficient, for improvement of haemostasis.
Zdravilo Quixil je indicirano kot podporno zdravljenje v kirurgiji za izboljšanje hemostaze, kadar standardne kirurške tehnike ne zadoščajo.
The CHMP reviewed all cases of gas embolism reported with the use of sprayable fibrin sealants.
Odbor je pregledal vse primere plinske embolije, o katerih so poročali ob uporabi fibrinskih tesnilnih sredstev v pršilu.
With regard to the efficacy of sprayable fibrin sealants, the CHMP assessed the available information, including data submitted by the MAH.
Odbor CHMP je glede učinkovitosti fibrinskih tesnilnih sredstev v pršilu ocenil razpoložljive informacije, vključno s podatki, ki jih je predložil imetnik dovoljenja za promet z zdravilom.
Having considered all the available data, including the MAH responses provided in writing and during oral explanations and the conclusions of the Ad-hoc Expert meeting, the CHMP agreed that the benefitrisk balance of Quixil as supportive treatment in surgery where standard surgical techniques are insufficient, for improvement of haemostasis, remains positive under normal conditions of use, subject to the changes to the product information, (see Annex III), together with the agreed risk minimisation measures (see Annex IV) and the agreed Direct Healthcare Professionals Communication.
Po preučitvi vseh razpoložljivih podatkov, vključno z odgovori imetnika dovoljenja za promet z zdravilom v pisni obliki in v obliki ustnega pojasnila ter zaključki srečanja začasne strokovne skupine je CHMP sklenil, da ostaja razmerje med koristmi in tveganji zdravila Quixil kot podpornega zdravljenja v kirurgiji za izboljšanje hemostaze, kadar standardne kirurške tehnike niso zadostne, ostaja pozitivno v normalnih pogojih uporabe, v skladu s spremembami informacij o zdravilu (glejte Prilogo III), skupaj z odobrenimi ukrepi za zmanjšanje tveganja (glejte Prilogo IV) in z dogovorjenim neposrednim obvestilom za zdravstvene delavce.
Moreover, the CHMP concluded that there was insufficient evidence to substantiate a higher risk of air embolus for Quixil (relative to Evicel) because of the different pressure range required for Quixil.
Sklenil je tudi, da dokazi ne zadoščajo za utemeljitev višjega tveganja za zračno embolijo z zdravilom Quixil (v primerjavi z zdravilom Evicel) zaradi drugačnega območja tlaka, ki je potreben za uporabo zdravila Quixil.
In conclusion, having considered the available data, the MAH's responses and taking into account the ad-hoc advisory group recommendations, the CHMP identified and agreed upon a number of risk minimisation measures to be implemented by the MAH to reduce the risk of air/gas embolism associated with sprayable fibrin sealants.
V zaključku je odbor CHMP po preučitvi vseh razpoložljivih podatkov, odgovorov imetnika dovoljenja za promet z zdravilom in ob upoštevanju priporočil začasne svetovalne skupine ugotovil ter odobril številne ukrepe za zmanjšanje tveganja, ki jih bo uvedel imetnik dovoljenja za promet z zdravilom za zmanjšanje tveganja za zračno/plinsko embolijo, povezano s fibrinskimi tesnilnimi sredstvi v pršilu.
In one of the Quixil cases, the air embolism was caused by using pressurised air to dry the wound area, with a fatal outcome, although no product was administered.
V enem od primerov z zdravilom Quixil je prišlo do zračne embolije s smrtnim izidom zaradi uporabe zraka pod tlakom, ki so ga uporabili za sušenje območja z rano, zdravila pa sploh niso uporabili.
The MAH also provided responses to a request from the CHMP to discuss the merits and feasibility of any risk minimisation measures which could be introduced in order to improve the benefit/risk of the Quixil spray application.
Imetnik dovoljenja za promet z zdravilom je na zahtevo odbora CHMP predložil tudi odgovore za razpravo o utemeljenosti in izvedljivosti ukrepov za zmanjšanje tveganja, ki bi jih lahko uvedli za izboljšanje razmerja med koristmi in tveganji napršitve zdravila Quixil.
The analysis of the case reports showed that symptomatic air/gas embolism had occurred only when the instructions for use were not followed; in each of the other cases there was a failure to follow at least one of the current guidelines on administration of spray application of Quixil using pressurised gas: 1.
Analiza poročil o primerih je pokazala, da je do simptomatske zračne/plinske embolije prišlo samo, kadar se niso upoštevala navodila za uporabo; v vseh drugih primerih je šlo za neupoštevanje vsaj ene od veljavnih smernic o nanosu pršila zdravila Quixil z uporabo plina pod tlakom: 1. neustrezna razdalja od površine tkiva, 2. previsok tlak, 3. uporaba na odprtih žilah ali v zelo ožiljenih telesnih votlinah, kot je npr. kostni mozeg.
The CHMP noted that the difference in composition between Quixil and Evicel results in a higher viscosity for Quixil, which in turn has the consequence that more force is required to deliver spray application of Quixil.
Odbor CHMP je opozoril, da je zaradi razlike v sestavi med zdraviloma Quixil in Evicel zdravilo Quixil bolj viskozno, zaradi česar je za njegovo napršitev potrebna večja sila.
The CHMP noted that despite the different recommended pressure regulator settings fibrin sealant spray systems may have similar gas velocity.
Opozoril je tudi, da je lahko hitrost plina v sistemih fibrinskih tesnilnih sredstev v pršilu kljub priporočenim različnim nastavitvam regulatorja tlaka podobno.
If spraying is required, a pressure regulator has to be used with pressurized CO2 or compressed air. From 2008 until May 2012, four cases of life-threatening air embolism were reported for the spray application of Quixil (of which one had a fatal outcome but without any product being administered).
Od leta 2008 do maja 2012 so poročali o štirih primerih življenjsko nevarne zračne embolije ob napršitvi zdravila Quixil (od katerih je ena imela smrtni izid, pri čemer zdravilo sploh ni bilo uporabljeno).
• The Committee, as a consequence, concluded that the benefit-risk balance of Quixil as supportive treatment in surgery where standard surgical techniques are insufficient, for improvement of haemostasis, is positive under normal conditions of use, subject to the agreed risk minimisation measures, including changes to the product information.
• Odbor je posledično sklenil, da je razmerje med koristmi in tveganji zdravila Quixil kot podpornega zdravljenja v kirurgiji za izboljšanje hemostaze, kadar standardne kirurške tehnike niso zadostne, pozitivno v normalnih pogojih uporabe, v skladu z odobrenimi ukrepi za zmanjšanje tveganja, vključno s spremembami informacij o zdravilu, je odbor CHMP priporočil spremembo pogojev dovoljenj za promet z zdravilom, navedenimi v Prilogi I, v skladu s spremembami povzetka glavnih značilnosti zdravila in navodila za uporabo, določenih v Prilogi III, in pod pogoji, določenimi v Prilogi IV.
• It is important to follow the advice given in section 3 How to take Tredaptive.
• Pomembno je, da upoštevate navodila v poglavju 3 Kako jemati zdravilo Tredaptive.
Tredaptive with food, drink and alcohol
Zdravilo Tredaptive skupaj s hrano, pijačo in alkoholom
Your doctor will decide if Tredaptive is right for you.
Zdravnik bo odločil, ali je zdravilo Tredaptive primerno za vas.
Daily doses greater than 2000 mg/40 mg have not been studied and therefore are not recommended.
Dnevni odmerki, večji od 2.000 mg/40 mg, niso raziskani in zato niso priporočljivi.
Efficacy and safety of Tredaptive in combination with simvastatin > 40 mg were not included in this study.
Učinkovitosti in varnosti zdravila Tredaptive v kombinaciji s simvastatinom > 40 mg v tej študiji niso preučevali.