natgillin/translations-raw huggingface dataset:
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.
It is therefore recommended that the marketing authorisation is suspended, and the product reformulated with a level of magnesium which is justified based on the most recent knowledge in the area. 
Priporočil je, da se dovoljenje za promet z zdravilom začasno umakne, zdravilo pa reformulira z ravnijo magnezija, ki je upravičena na podlagi najsodobnejšega znanja na strokovnem področju.
Overall summary of the scientific evaluation of Numeta G13%E and Numeta G16%E by PRAC 
Splošni povzetek znanstvenega vrednotenja zdravil Numeta G13%E in Numeta G16%E, ki ga je opravil odbor PRAC
Neonatal hypermagnesemia can also be caused by increased magnesium load such as with maternal magnesium sulphate administration for preeclampsia, newborn magnesium therapy, or decreased renal magnesium excretion due to prematurity and asphyxia (Hyun et al, 2011). 
Hipermagneziemijo pri novorojenčkih lahko povzroči tudi povečano breme magnezija, kot je uporaba magnezijevega sulfata pri materi za zdravljenje preeklampsije, zdravljenje novorojenčka z magnezijem ali zmanjšano izločanje magnezija iz ledvic zaradi nedonošenosti ter asfiksije (Hyun in sod., 2011).
• The PRAC is of the opinion that there is a potential risk for hypermagnesaemia when Numeta G16%E is administered to term newborn infants and children up to two years, particularly in patients with reduced renal function, and newborn infants of mothers who were receiving supplemental magnesium prior to delivery; 
• odbor PRAC je menil, da obstaja morebitno tveganje hipermagneziemije, kadar se zdravilo Numeta G16%E uporablja pri donošenčkih in otrocih, starih do dveh let, predvsem pri bolnikih s poslabšanim ledvičnim delovanjem, ter pri novorojenčkih mater, ki so pred porodom prejemale nadomestke magnezija;
Parenteral nutrition is essential in certain situations, and there are various methods available for preparation and delivery. 
Na voljo so različne metode priprave ter dovajanja.
Based on the currently available information, the benefit-risk balance of Numeta G16%E is considered to remain favourable subject to the warnings, additional pharmacovigilance activities and additional risk minimisation measures agreed. 
Na podlagi trenutno razpoložljivih podatkov menijo, da je razmerje med tveganji in koristmi zdravila Numeta G16%E še vedno ugodno, če se upoštevajo opozorila in uvedejo dogovorjene dodatne farmakovigilančne dejavnosti ter ukrepi za zmanjševanje tveganja.
Therefore, following the provisions under Article 107j(3) of Directive 2001/83/EC, the PRAC recommends the suspension of the marketing authorisations for Numeta G13%E. 
Zato je v skladu z določbami člena 107j(3) Direktive 2001/83/ES priporočil začasen umik dovoljenj za promet z zdravilom Numeta G13%E.
• The PRAC considered the role of magnesium in the development of pre-term newborn infants and reviewed all available data on the risk of hypermagnesemia in this population, the available clinical guidelines on parenteral magnesium intake in preterm newborn infants and the content of magnesium in the current formulation of Numeta G13%E; 
• odbor PRAC je upošteval vlogo magnezija pri razvoju nedonošenčkov in pregledal vse razpoložljive podatke o tveganju hipermagneziemije pri tej populaciji, razpoložljive klinične smernice o parenteralnem vnosu magnezija pri nedonošenčkih ter vsebnost magnezija v trenutni formulaciji zdravila Numeta G13%E;
• The PRAC considered the role of magnesium in the development of term newborn infants and children up to two years, all available guidance providing recommendation for parenteral magnesium intake in newborn infants and in children up to two years, and the content of magnesium in the current formulation of Numeta G16%E; 
• odbor PRAC je upošteval vlogo magnezija pri razvoju donošenčkov in otrok, starih do dveh let, vse razpoložljive smernice o parenteralnem vnosu magnezija pri novorojenčkih ter otrocih, starih do dveh let, in vsebnost magnezija v trenutni formulaciji zdravila Numeta G16%E;
Therefore, the benefit-risk balance for Numeta G13%E as currently formulated is considered as not favourable. 
Zato je ocenil, da razmerje med tveganji in koristmi zdravila Numeta G13%E v trenutni formulaciji ni ugodno.
The MAH should submit the protocol for the above mentioned study within the revised RMP submission. 
Imetnik dovoljenja za promet z zdravilom mora protokol za zgoraj navedeno študijo predložiti skupaj s posodobljenim načrtom obvladovanja tveganja.
• The PRAC reviewed all available data from clinical studies, published literature, post-marketing experience on the safety and efficacy of Numeta G16%E in particular with regards to the risk of hypermagnesemia, as well as the stakeholder's submission and the PDCO advice; 
• odbor PRAC je pregledal vse razpoložljive podatke iz kliničnih študij, objavljene literature, izkušenj iz obdobja trženja glede varnosti in učinkovitosti zdravila Numeta G16%E, predvsem v povezavi s tveganjem hipermagneziemije, ter prošnjo zainteresirane strani in nasvet odbora PDCO;
• The PRAC considered the procedure under Article 107i of Directive 2001/83/EC for Numeta G16%E; 
• odbor PRAC je obravnaval postopek v skladu s členom 107i Direktive 2001/83/ES za zdravilo 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 the benefit-risk balance of Numeta G13%E for parenteral nutrition in preterm newborn infants when oral or enteral nutrition is not possible, insufficient or contraindicated is no longer favourable. 
Na podlagi 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 sklenil, da razmerje med tveganji in koristmi zdravila Numeta G13%E za parenteralno prehranjevanje nedonošenčkov, kadar je peroralna ali enteralna prehrana nemogoča, nezadostna ali kontraindicirana, ni več ugodno.
For the suspension of the marketing authorisation to be lifted, the MAH should reformulate the product, to include a level of magnesium which is justified based on the most recent knowledge in the area. 
Za preklic začasnega umika dovoljenja za promet z zdravilom mora imetnik dovoljenja za promet z zdravilom reformulirati zdravilo tako, da bo vsebovalo raven magnezija, ki temelji na najnovejšem znanju na strokovnem področju.
• The PRAC reviewed all available data from clinical studies, published literature, post-marketing experience on the safety and efficacy of Numeta G13%E in particular with regards to the risk of hypermagnesemia, as well as the stakeholder's submission and the PDCO advice; 
• odbor PRAC je pregledal vse razpoložljive podatke iz kliničnih študij, objavljene literature, izkušenj iz obdobja trženja glede varnosti in učinkovitosti zdravila Numeta G13%E, predvsem v povezavi s tveganjem hipermagneziemije, ter prošnjo zainteresirane strani in nasvet odbora PDCO;
• The PRAC concluded that there is a risk for hypermagnesaemia when Numeta G13%E is administered to preterm newborn infants. 
• odbor PRAC je zaključil, da je tveganje hipermagneziemije prisotno, kadar se zdravilo Numeta G13%E uporablja pri nedonošenčkih.
• The PRAC concluded that in view of the currently available safety data in order to maintain a favourable benefit-risk as parenteral nutrition in term newborn infants and children up to 2 years when oral or enteral nutrition is not possible, insufficient or contraindicated, additional warnings on the risk of hypermagnesemia should be introduced in the Product Information; 
• odbor PRAC je na podlagi trenutno razpoložljivih varnostnih podatkov sklenil, da je treba za vzdrževanje ugodnega razmerja med tveganji in koristmi zdravila za parenteralno prehrano pri donošenčkih in otrocih, starih do dveh let, kadar je peroralna ali enteralna prehrana nemogoča, nezadostna ali kontraindicirana, v informacije o zdravilu vključiti dodatna opozorila o tveganju hipermagneziemije.
• The PRAC considered the procedure under Article 107i of Directive 2001/83/EC for Numeta G13%E; 
• odbor PRAC je obravnaval postopek v skladu s členom 107i Direktive 2001/83/ES za zdravilo Numeta G13%E;
In order to facilitate its implementation at national level, the CMDh considered that clarification on the supervision of the appropriate procedure for the fulfilment of the condition to lift the suspension of Numeta G13%E should be provided and therefore the following was added to Annex III: 
Pogoji za preklic začasnega umika dovoljenj za promet z zdravilom Numeta G13%E so določeni v Prilogi III. Za uvedbo začasnega umika na nacionalni ravni je skupina CMDh menila, da je treba pripraviti pojasnitev za nadzorovanje ustreznega postopka za izpolnjevanje pogojev za preklic začasnega umika dovoljenj za promet z zdravilom Numeta G13%E, zato so Prilogi III dodali naslednje:
the first few months after birth and the immature kidney has limited adaptability in case of excess administrations of electrolytes, monitoring of serum magnesium levels should mitigate the potential risk, with initial monitoring at baseline and frequency of follow-up monitoring determined by the clinical circumstances and routine clinical practice. 
Čeprav je glomerularna nezrelost v prvih nekaj mesecih po rojstvu še vedno prisotna in je prilagodljivost nezrelih ledvic ob čezmernem vnosu elektrolitov omejena, bo spremljanje ravni magnezija v serumu zmanjšalo morebitno tveganje - prvo spremljanje ob
A new safety concern with Numeta G13%E was identified based on a signal raised by the marketing authorisation holder (MAH) following receipt of case reports of hypermagnesaemia in preterm neonates. 
Pri zdravilu Numeta G13%E so odkrili novo varnostno težavo, ki jo je po prejemu poročil o primerih hipermagneziemije pri nedonošenčkih izpostavil imetnik dovoljenja za promet z zdravilom.
• The PRAC also concluded that a prospective non-interventional post-authorisation safety study should be conducted to further evaluate magnesium levels observed in term newborn infants and children up to two years of age treated with Numeta G16%E in routine clinical practice. 
• odbor PRAC je prav tako sklenil, da je treba opraviti prospektivno, neintervencijsko študijo varnosti po pridobitvi dovoljenja za promet z zdravilom, s katero bo nadalje ocenil ravni magnezija, opažene pri donošenčkih in otrocih, starih do dveh let, ki se zdravijo z zdravilom Numeta G16%E v rutinski klinični praksi.
In addition to these measures, it is also considered that the MAH should conduct a prospective noninterventional post-authorisation safety study to further evaluate magnesium levels observed in term newborn infants and children up to two years of age treated with Numeta G16%E in routine clinical practice. 
Poleg teh ukrepov mora imetnik dovoljenja za promet z zdravilom po odobritvi dovoljenja za promet opraviti tudi prospektivno neintervencijsko študijo varnosti, s katero bo nadalje ocenil ravni magnezija, opažene pri donošenčkih in otrocih, starih do dveh let, ki se zdravijo z zdravilom Numeta G16%E v rutinski klinični praksi.
The PRAC, as a consequence, concluded that the benefit-risk balance for Numeta G16%E as parenteral nutrition in term newborn infants and children up to two years when oral or enteral nutrition is not possible, insufficient or contraindicated remains favourable subject to the warnings, additional pharmacovigilance activities and additional risk minimisation measures agreed. 
Odbor PRAC je posledično zaključil, da razmerje med tveganji in koristmi zdravila Numeta G16%E za parenteralno prehrano pri donošenčkih in otrocih, starih do dveh let, kadar je peroralna ali enteralna prehrana nemogoča, nezadostna ali kontraindicirana, ostaja ugodno, če se upoštevajo opozorila in uvedejo dogovorjene dodatne farmakovigilančne dejavnosti ter ukrepi za zmanjševanje tveganja.
Numeta G16% Whereas, 
Numeta G16% Ob upoštevanju naslednjega:
The PRAC concluded that the benefit-risk balance of Numeta G16%E for parenteral nutrition in term newborn infants and children up to two years when oral or enteral nutrition is not possible, insufficient or contraindicated remains favourable subject to the warnings, additional pharmacovigilance activities and additional risk minimisation measures agreed. 
Odbor PRAC je sklenil, da razmerje med tveganji in koristmi zdravila Numeta G16%E za parenteralno prehrano pri donošenčkih in otrocih, starih do dveh let, kadar je peroralna ali enteralna prehrana nemogoča, nezadostna ali kontraindicirana, ostaja ugodno, če se upoštevajo opozorila in uvedejo dogovorjene dodatne farmakovigilančne dejavnosti ter ukrepi za zmanjševanje tveganja.
The MAH identified 14 case reports of hypermagnesaemia or increased magnesium associated with Numeta G13%E in their global safety database and 1 case associated with Numeta G16%. 
Imetnik dovoljenja za promet z zdravilom je v svoji globalni varnostni podatkovni zbirki pri zdravilu Numeta G13%E odkril 14 poročil primerov hipermagneziemije ali povišane ravni magnezija, pri zdravilu Numeta G16%E pa en primer.
A prospective non-interventional post-authorisation safety study to further evaluate magnesium levels observed in term newborn infants and children up to two years of age treated with Numeta G16%E in routine clinical practice should be conducted. 
Opraviti je treba prospektivno, neintervencijsko študijo varnosti po pridobitvi dovoljenja za promet z zdravilom, s katero se bodo nadalje ocenile ravni magnezija, opažene pri donošenčkih in otrocih, starih do dveh let, ki se zdravijo z zdravilom Numeta G16%E v rutinski klinični praksi.
The PRAC in accordance with Article 107j(3) of Directive 2001/83/EC, recommends by consensus 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 (see Annex V - Conditions of marketing Authorisations); 
a. imetniki dovoljenj za promet z zdravili sponzorirajo študijo varnosti zdravila v obdobju trženja in nadaljnje vrednotenje rezultatov študije (glejte Prilogo V - Pogoji dovoljenj za promet z zdravilom);
Numeta G16%E is indicated for parenteral nutrition in term newborn infants and children up to two years when oral or enteral nutrition is not possible, insufficient or contraindicated. 
Zdravilo Numeta G16%E je indicirano za parenteralno prehrano pri donošenčkih in otrocih, starih do dveh let, kadar je peroralna ali enteralna prehrana nemogoča, nezadostna ali kontraindicirana.
Severe hypomagnesemia is uncommon but can cause seizures, drowsiness, cardiac ventricular defibrillation, hypokalemia and hypocalcemia (Whang et al, 1994). 
Huda hipomagneziemija je redka, vendar lahko povzroči epileptične napade, zaspanost, srčno ventrikularno defibrilacijo, hipokaliemijo in hipokalciemijo (Whang in sod., 1994), zato je primerno, da raztopina za prehrano nedonošenčkov vsebuje magnezij kot en elektrolit, čeprav je treba količino uravnovesiti, da omogoči ustrezne ravni.
Numeta G13%E is specifically designed for preterm newborn infants for whom oral or enteral nutrition is not possible, insufficient or contraindicated. 
Zdravilo Numeta G13%E je posebej zasnovano za nedonošenčke, pri katerih je peroralna ali enteralna prehrana nemogoča, nezadostna ali kontraindicirana.