natgillin/translations-raw huggingface dataset:
In doubtful cases, patients should be referred to a neurologist for appropriate investigations. 
V primeru dvoma je treba bolnike napotiti k nevrologu na ustrezne preiskave.
Ophthalmology 
Oftalmologija
It should be noted that the study was conducted using the Bruce protocol that it is known to underestimate the treatment effect of drugs compared to the modified Bruce protocol. 
Opozoriti je treba, da je bila študija opravljena z Bruceovim protokolom, za katerega je znano, da podcenjuje učinke zdravljenja z zdravili v primerjavi s prilagojenim Bruceovim protokolom.
Of the ten studies submitted, nine do not apply the relevant methodological principles currently required to demonstrate efficacy. 
Od desetih predloženih študij jih devet ne uporablja ustreznih metodoloških načel, ki so potrebna za dokazovanje učinkovitosti.
Among these studies, five studies were conducted against placebo including the additional study published in 1990 by Coyas. 
Med temi študijami je bilo pet študij izvedenih s placebom, vključno z dodatno študijo, ki jo je leta 1990 objavil Coyas.
Therefore, the results which were presented as supporting a similar efficacy than trimetazidine are not reliable. 
Zato rezultati, predstavljeni v podporo podobni učinkovitosti, kot jo ima trimetazidin, niso zanesljivi.
In addition, Vitte study (2002) had the same methodological weaknesses as the Wayoff and Morgon studies. 
Tudi študija Vitte (2002) je vsebovala enake metodološke šibkosti kot študiji Wayoff in Morgon.
These changes are considered adequate to manage the risk of pakinsonian symptoms and tremors. 
Te spremembe se smatrajo za zadostne za upravljanje s tveganjem simptomov pakinsonove bolezni in tremorjev.
The study results may thus be considered conservative in terms of magnitude of the effect of trimetazidine. 
Rezultati študije se lahko zato obravnavajo kot konservativni v smislu obsega učinka trimetazidina.
The clinical experience with trimetazidine dates back to the early 70s. 
Klinične izkušnje s trimetazidinom segajo v zgodnja sedemdeseta leta.
Trimetazidine has no hemodynamic effect on blood pressure or heart rate. 
Trimetazidin nima hemodinamskega učinka na krvni tlak ali srčni utrip.
The new proposed wording in the angina pectoris indication is in accordance with the available efficacy and safety data assessed. 
Novo predlagano besedilo za indikacijo angine pektoris je v skladu z ocenjenimi razpoložljivimi podatki o učinkovitosti in varnosti.
France on 22 April 2011 requested the CHMP to give its opinion under Article 31 of Directive 2001/83/EC on whether the marketing authorisation for trimetazidine-containing medicinal products should be maintained, varied, suspended or withdrawn on the basis of the increased Parkinson's reports. 
Dne 22. aprila 2011 je Francija CHMP zaprosila za mnenje v skladu s členom 31 Direktive 2001/83/ES o tem, ali naj se dovoljenje za promet z zdravili, ki vsebujejo trimetazidin, ohrani, spremeni, začasno odvzame ali umakne zaradi vse več poročil o parkinsonovi bolezni.
The CHMP considered all the studies submitted for this indication. 
CHMP je za to indikacijo upošteval vse predložene študije.
The efficacy of trimetazidine was also summarised in a recent network meta-analysis including 358 clinical trials and 27058 patients. 
Učinkovitost trimetazidina je povzeta tudi v nedavni omrežni metaanalizi, v katero je bilo vključenih 358 kliničnih preskušanj in 27 058 bolnikov.
A significant difference was also evidenced for the time to onset of angina pectoris (p=0.049). 
Pomembna razlika se je pokazala tudi v času do pojava angine pektoris (p = 0,049).
The majority of the patients who recovered, had their symptoms disappeared within four months after trimetazidine withdrawal. 
Pri večini bolnikov, ki so okrevali, so simptomi izginili v roku štirih mesecev po prenehanju uporabe trimetazidina.
Less than 50% of patients included in the VASCO study had chronic stable angina despite probable coronary artery disease. 
Manj kot 50 % bolnikov, vključenih v študijo VASCO, je imelo kronično stabilno angino pektoris, kljub verjetni koronarni arterijski bolezni.
None of these three studies was predefined as non-inferiority study. 
Nobena od teh treh študij ni bila vnaprej označena kot študija enakovrednosti.
Of note, all the data submitted and assessed for this referral are newly available data since the first authorisation of trimetazidine. 
Opozoriti je treba, da so vsi podatki, predloženi in ocenjeni v tej napotitvi, na novo razpoložljivi podatki od prve odobritve trimetazidina.
They were first authorised in France in 1978 and are available in three different pharmaceutical forms in the EU: 20 mg tablet, 20 mg/ml oral solution and 35 mg modified release (MR) tablet. 
Najprej so bila odobrena v Franciji leta 1978 in so v EU na voljo v treh različnih farmacevtskih oblikah: 20 mg tablete, 20 mg/ml peroralna raztopina in 35 mg tablete s prirejenim sproščanjem.
These cases have a low prevalence and are usually reversible after treatment discontinuation. 
Ti pojavi so redki in običajno reverzibilni po prekinitvi zdravljenja.
The CHMP concluded that following the assessment of all these studies the efficacy of trimetazidine is not proven on the ophthalmological indication. 
CHMP je zaključil, da po oceni vseh teh študij učinkovitost trimetazidina za oftalmološko indikacijo ni dokazana.
Furthermore, these studies present other specific weaknesses: the Cordella study (versus cinnarizine) did not include inter-group comparison. 
V teh študijah so bile tudi druge specifične pomanjkljivosti: študija Cordella (v primerjavi s cinarizinom) ni vključevala primerjave med skupinami.
Based on the data submitted for the ophthalmologic indications, the CHMP considered that the evidence does not fulfill the requirements and criteria for the evaluation of efficacy currently requested in these pathologies. 
Na podlagi podatkov, predloženih za oftalmološke indikacije, je CHMP menil, da dokazi ne izpolnjujejo zahtev in kriterijev za ocenitev učinkovitosti, ki se trenutno zahtevajo za te patologije.
Its mechanism of action results partly of its effect on cellular metabolism. 
Mehanizem delovanja je delno posledica učinka na celično presnovo.
The non-comparative nature of three studies conducted in patients with heterogeneous ocular disorders, did not allow concluding to the existence of a clinical benefit. 
Neprimerjalna narava treh študij, opravljenih pri bolnikih s heterogenimi boleznimi oči, ni omogočala sklepanja na obstoj kliničnih koristi.
A prescription study in France showed that trimetazidine was prescribed in patients in cardiovascular indications in 45.3% of cases, in ENT indications in 30% of cases and in ophthalmological indications in 0.4% of cases. 
Študija predpisovanja v Franciji je pokazala, da so trimetazidin predpisovali bolnikom za kardiovaskularne indikacije v 45,3 % primerov, za ORL indikacije v 30 % primerov in za oftalmološke indikacije v 0,4 % primerov.
The VASCO study was conducted in symptomatic and asymptomatic patients with chronic ischemic heart disease. 
Študijo VASCO so izvedli pri simptomatskih in asimptomatskih bolnikih s kronično ishemično boleznijo srca.
The most recent study conducted with trimetazidine 35 mg from 1999 (France, ARMD 2) related to a higher number of patients monitored for 3 to 5 years. 
Najnovejša študija, izvedena s trimetazidinom 35 mg iz leta 1999 (Francija, ARMD 2), zajema večje število bolnikov, ki so jih spremljali 3 do 5 let.
The CHMP endorsed a communication, Direct Healthcare Professional Communication (DHPC), to communicate the outcome of the present review. 
CHMP je odobril neposredno obvestilo zdravstvenim delavcem (Dear Healthcare Professional Communication, DHPC), da se jim sporoči izid tega pregleda.
The reporting rate of Parkinson's syndrome plausibly related to trimetazidine is stable over time since the last 8 years, despite the increase, since 2007, in the number of spontaneous reports of Parkinson's syndrome and related symptoms. 
Stopnja poročanja parkinsonovega sindroma, ki je najverjetneje povezana s trimetazidinom, je v zadnjih 8 letih stabilna,kljub povečanju števila spontanih poročil parkinsonovega sindroma in povezanih simptomov od leta 2007.
The presence of stable angina pectoris is a pivotal inclusion criterion as it identifies the target population for the use of anti-anginal drugs. 
Prisotnost stabilne angine pektoris je osrednji vključitveni kriterij, saj opredeljuje ciljno populacijo za uporabo zdravil proti angini pektoris.
If parkinsonian symptoms persist more than four months after drug discontinuation, a neurologist opinion should be sought. 
Če simptomi parkinsonove bolezni več kot štiri mesece po prekinitvi uporabe zdravila ne izginejo, se je treba posvetovati z nevrologom.
Two additional and more recent studies were focused on dizziness but the exploratory nature of the Sterkers study (2001) and the extremely small populations included (28 patients) do not make it possible to give any demonstrative weight to the results reported. 
Dve dodatni, pred kratkim opravljeni študiji, sta se osredotočili na vrtoglavico, vendar raziskovalna narava študije Sterkers (2001) in izjemno majhna vključena populacija (28 bolnikov) poročanim rezultatom ne dajeta nobene dokazne teže.
The studies suggested limited methodology in the ENT field and do not confirm the current methodology of investigation by applying the basic statistical principles of clinical trials methodology. 
Študije kažejo na omejeno metodologijo na področju ORL in ne potrjujejo trenutne raziskovalne metodologije, ki uporablja osnovna statistična načela za metodologijo v kliničnih preskušanjih.
However, the TRIMPOL-II study (2001), the study by Sellier (2003) and the revised data from the VASCO study (2011) were the studies providing evidence generated in support of the add-on indication of trimetazidine in symptomatic patients with angina pectoris. 
Vendar pa so študija TRIMPOL-II (2001), študija, ki jo je opravil Sellier (2003), in revidirani podatki študije VASCO (2011) tiste študije, iz katerih so razvidni dokazi v podporo dodatni indikaciji trimetazidina pri simptomatskih bolnikih z angino pektoris.
The most exposed population based on sales data, is patients aged more than 75 years old, and they received the treatment for very long periods mainly in cardiology indications. 
Na podlagi podatkov o prodaji je najbolj izpostavljena populacija bolnikov, starih več kot 75 let, ki so se zelo dolgo zdravili, pretežno za kardiološke indikacije.
They also mixed ENT pathologies and symptomatologies from different etiologies such as tinnitus, different kinds of vertigo or deafness. 
Mešali so tudi patologije ORL in simptomatiko različnih etiologij, kot so tinitus, različne vrste vrtoglavice ali gluhota.
The main studies conducted versus placebo were Wayoff study (tinnitus, dizziness, hearing loss) and Morgon study (tinnitus). 
Glavne študije, opravljene s placebom, so bile študija Wayoff (tinitus, vrtoglavica, izguba sluha) in študija Morgon (tinitus).
However, some patients had symptoms only partially reversible after TMZ withdrawal, and the connection to TMZ in some cases of non-reversible symptoms cannot be ruled out. 
Vendar pa so imeli nekateri bolniki simptome, ki so bili po umiku trimetazidina le delno reverzibilni, povezave s trimetazidinom pa v nekaterih primerih nereverzibilnih sindromov ni mogoče izključiti.
The VASCO study showed a significant difference in the effect on ergometric parameters between trimetazidine at the highest dosage (140 mg) and placebo in the group of symptomatic patients. 
Študija VASCO je pokazala pomembno razliko v učinkih na ergometrične parametre med najvišjimi odmerki trimetazidina (140 mg) in placebom v skupini simptomatskih bolnikov.
• The Committee reviewed all available submitted data from clinical studies, published literature and post-marketing experience on the safety of trimetazidine containing medicinal products, in particular with regards to the Parkinson syndrome and related events. 
• Odbor je pregledal vse razpoložljive predložene podatke iz kliničnih študij, objavljene literature in izkušenj iz obdobja trženja zdravila o varnosti zdravil, ki vsebujejo trimetazidin, zlasti v zvezi s sindromom parkinsonove bolezni in povezanimi dogodki.
The clinical studies supporting ophthalmic field suffer from major methodological flaws. 
Klinične študije, ki podpirajo področje oftalmologije, vsebujejo velike metodološke napake.
By decreasing fatty acid oxidation at the level of 3-ketoacyl coenzyme A thiolase, it favours glucose oxidation, which improves the use of the cells' energy reserves in the event of ischaemia. 
Z znižanjem oksidacije maščobnih kislin na ravni 3-ketoacil koencim A tiolaze pospeši oksidacijo glukoze, kar izboljša uporabo energetskih rezerv celice v primeru ishemije.
Furthermore, the multiplicity of comparisons was not taken into account in the statistical analyses and the criteria were not presented hierarchically, so this comparison cannot have any demonstrative value; and lastly, the Perdriel single dose electroretinographic study (versus pyridoxilate) used an injectable intravenous form of trimetazidine 20 mg that has not been authorised. 
Nadalje pri statističnih analizah številne primerjave niso bile upoštevane, kriteriji pa niso bili predstavljeni hierarhično, zato taka primerjava nima nobene prikazne vrednosti; in nazadnje, v elektroretinografski študiji avtorja Perdriel z enim odmerkom (v primerjavi s piridoksilatom) je bila uporabljena intravenska oblika trimetazidina 20 mg za injiciranje, ki ni odobrena.
Most ophthalmologic trimetazidine clinical trials have been conducted with the 20 mg strength but in some studies the daily doses used (20mg and 40 mg/day) were lower than those recommended in the current marketing authorisation (60 mg or 70 mg), which is also a limit of these studies, particularly in documenting the safety at the registered dosage. 
Večina oftalmoloških kliničnih preskušanj s trimetazidinom je bilo izvedenih z jakostjo 20 mg, vendar so bili v nekaterih študijah uporabljeni manjši dnevni odmerki (20 mg in 40 mg/dan) od priporočenih v trenutno odobrenem dovoljenju za promet z zdravilom (60 mg ali 70 mg), kar je tudi meja za te študije, zlasti pri dokumentiranju varnosti pri registriranem odmerku.
The Sellier study was an exercise study not primarily designed to assess clinical parameters. 
Študija avtorja Sellier je bila študija vadbe, ki v primarni zasnovi ni vsebovala ocene kliničnih parametrov.
• The Committee also recommended that trimetazidine can cause or worsen parkinsonian symptoms (tremor, akinesia, hypertonia). 
• Odbor je opozoril tudi, da lahko trimetazidin povzroči ali poslabša simptome parkinsonove bolezni (tremor, akinezija, hipertonija).
Of importance the efficacy was confirmed in patients at maximal dose of metoprolol as well as in patients with recurrent angina. 
Pomembno je, da je bila učinkovitost potrjena tako pri bolnikih z največjim odmerkom metoprolola kot pri bolnikih s ponavljajočo se angino pektoris.
In response to the CHMP's request regarding the re-evaluation of the risk/benefit ratio of trimetazidine (all forms and dosages) in its ophthalmologic indications, the clinical package submitted comprises of nine studies. 
V odziv na zahtevek CHMP za ponovno ocenitev razmerja med tveganji in koristmi trimetazidina (vse oblike in odmerki) za oftalmološke indikacije je bil predložen paket devetih študij.
The improvement in the primary end point with trimetazidine was observed in the pooled analysis of patients receiving 35 and 70 mg twice daily and in the analysis of patients receiving either 35 mg twice daily or 70 mg twice daily. 
Izboljšanje primarnega opazovanega dogodka s trimetazidinom so opazili v združeni analizi bolnikov, ki so prejemali 35 in 70 mg dvakrat na dan in v analizi bolnikov, ki so prejemali 35 mg dvakrat na dan ali 70 mg dvakrat na dan.
These data support the efficacy of trimetazidine in add-on to beta-blockers. 
Ti podatki podpirajo učinkovitost trimetazidina kot dodatnega zdravila k zaviralcem receptorjev beta.
Patients with a cardiovascular profile were significantly older (mean age: 74.8 years) than those with an ophthalmological and ENT profile (70.3 years and 63.5 years, respectively). 
Bolniki s kardiovaskularnim profilom so bili precej starejši (povprečna starost: 74,8 let) kot bolniki z oftalmološkim (70,3 leta) in ORL profilom (63,5 let).
Population pharmacokinetics data indicate that serious adverse events were more frequent in treated elderly patients with high trimetazidine plasma concentrations. 
Populacijski farmakokinetični podatki kažejo, da so resni neželeni učinki bolj pogosti pri starejših zdravljenih bolnikih z visokimi koncentracijami trimetazidina v plazmi.
Three studies were conducted against betahistine (Haguenauer, 1980; Kluyskens, 1990; Martini, 1990) to demonstrate a clinical benefit of trimetazidine in the treatment of dizziness. 
V treh študijah so zdravilo primerjali z betahistinom (Haguenauer, 1980; Kluyskens, 1990; Martini, 1990), da bi dokazali klinične koristi trimetazidina pri zdravljenju vrtoglavice.
The Committee concluded that trimetazidine is associated with the occurrence of Parkinson syndrome and related symptoms. 
Odbor je zaključil, da je trimetazidin povezan s pojavom sindroma parkinsonove bolezni in povezanih simptomov.
Eight of them show inclusions of patients presenting very heterogeneous pathologies of various severities with absence of prior stratification on these pathologies, and short durations of treatment (between 2 and 6 months) while these pathologies are known to progress slowly and to require extended treatments. 
Osem izmed njih vključuje bolnike z zelo heterogenimi patologijami različnih stopenj resnosti z odsotnostjo predhodne stratifikacije teh patologij in kratkim časom zdravljenja (med 2 in 6 meseci), vendar pa je znano, da te patologije napredujejo počasi in da jih je treba dolgo zdraviti.
The posthoc analysis of the study in 298 patients receiving trimetazidine in combination mainly with metoprolol is in line and it is considered useful to better assess the effect of trimetazidine in a population of patients that are often difficult to be treated with haemodynamic agents. 
Post hoc analiza študije z 298 bolniki, ki so prejemali trimetazidin, v glavnem v kombinaciji z metoprololom, je skladna in koristna za boljšo oceno učinka trimetazidina pri populaciji bolnikov, ki jih je pogosto težko zdraviti s hemodinamskimi zdravili.
Dose titration in elderly patients should be exercised with caution. 
Pri starejših bolnikih je treba odmerek titrirati previdno.
The aim of the Sellier study (2003) was to assess the efficacy of the combination of trimetazidine MR 70 mg/day in patients suffering from angina pectoris who were insufficiently controlled on 50 mg/day of atenolol after two months of treatment. 
Cilj študije avtorja Sellier (2003) je bil oceniti učinkovitost kombinacije trimetazidina MR 70 mg/dan pri bolnikih z angino pektoris, pri katerih ni bil dosežen ustrezen nadzor z atenololom 50 mg/dan po dveh mesecih zdravljenja.
They are studies whereby the results, often presented as statistically in favour of trimetazidine, are disputable mainly for methodological reasons. 
V tej študijah so rezultati pogosto predstavljeni tako, da so statistično v korist trimetazidina, vendar so sporni zaradi uporabljene metodologije.
In addition the two studies by Manchanda (1997 and 2003) and four other minor studies are considered supportive of the efficacy of trimetazidine in add-on to calcium channel blockers (CCBs). 
Prav tako študiji avtorja Manchanda (1997 in 2003) in štiri druge manjše študije podpirajo učinkovitost trimetazidina kot dodatnega zdravila k zaviralcem kalcijevih kanalčkov.
Most of these studies included patients presenting very heterogeneous pathologies of various severities with absence of prior stratification on these pathologies, and of very limited duration of treatment (between 2 and 3 months) not in line with what is required by these pathologies that necessitate long term treatments. 
Večina študij je vključevala bolnike, ki so imeli zelo raznolike patologije različnih stopenj resnosti z odsotnostjo predhodne stratifikacije teh patologij in z zelo omejenim trajanjem zdravljenja (med 2 in 3 meseci), kar ni bilo v skladu s tem, kar seza te patologije zahteva, saj je potrebno dolgotrajno zdravljenje.
In patients with moderate renal impairment (creatinine clearance [30-60] ml/min) the recommended dose has been added in the SmPC. 
Pri bolnikih z zmerno okvaro ledvic (očistek kreatinina [30-60] ml/min) je bil v povzetek glavnih značilnosti zdravila dodan priporočeni odmerek.
The proposed multicentre, randomised, double-blind, placebo controlled long-term study in postpercutaneous coronary intervention (PCI) patients and the prospective and comparative cohort study to assess the prevalence of EPS in patients receiving trimetazidine may be adequate to solve the concerns on long-term efficacy and safety of trimetazidine. 
Predlagana multicentrična, randomizirana, dvojno slepa, s placebom kontrolirana dolgoročna študija bolnikov po perkutani koronarni intervenciji ter prospektivna in primerjalna kohortna študija za ocenitev obolevnosti za ekstrapiramidalnim sindromom pri bolnikih, ki prejemajo trimetazidin, sta morda ustrezni za razrešitev pomislekov o dolgoročni učinkovitosti in varnosti trimetazidina.
In order to show a benefit on daily episodes of angina it is important to adequately assess the baseline occurrence of angina and sublingual nitrate use and to calculate the sample size on the basis of the expected treatment effect. 
Za prikaz koristi pri dnevnih epizodah angine pektoris je pomembno ustrezno oceniti izhodiščni pojav angine pektoris in uporabo podjezičnega nitrata terizračunati velikost vzorca na podlagi pričakovanega učinka zdravljenja.
The CHMP agreed that trimetazidine can cause or worsen parkinsonian symptoms (tremor, akinesia, hypertonia), which should be regularly investigated, especially in elderly patients. 
CHMP se je strinjal, da lahko trimetazidin povzroči ali poslabša simptome parkinsonove bolezni (tremor, akinezija, hipertonija), zato so zlasti pri starejših bolnikih potrebne redne preiskave.
Results from this study did not highlight any clinical benefit of trimetazidine in comparison to the placebo to prevent the bilateralisation of choroidal neovascularisation in patients suffering from age-related macular degeneration, principal criterion of evaluation chosen to demonstrate the clinical benefit of trimetazidine 35 mg to slow the progression of age-related macular degeneration (ARMD). 
Rezultati te študije niso izpostavili nobenih kliničnih koristi trimetazidina v primerjavi s placebom pri preprečevanju bilateralizacije horoidne neovaskularizacije pri bolnikih s starostno makularno degeneracijo, kar je bil načelni kriterij ovrednotenja, izbran za dokazovanje kliničnih koristi trimetazidina 35 mg pri upočasnitvi napredovanja starostne makularne degeneracije.
In response to the CHMP request regarding the re-evaluation of the risk/benefit ratio of trimetazidine (all forms and dosages) in the ENT indications, 9 clinical studies (Wayoff, 1984; Sterkers, 2001; Vitte, 2002; Haguenauer, 1980; Kluyskens, 1990; Martini, 1990; Morgon 1990; Coyas 1990 and France cochlea study, 2009 presented as support of safety since the efficacy objective was not reached) were submitted or presented as literature references. 
V odgovor na zahtevek CHMP v zvezi s ponovno ocenitvijo razmerja med tveganji in koristmi za trimetazidin (vse oblike in odmerki) za indikacije ORL je bilo predloženih ali predstavljenih kot reference v literaturi 9 kliničnih študij (Wayoff, 1984; Sterkers, 2001; Vitte, 2002; Haguenauer, 1980; Kluyskens, 1990; Martini, 1990; Morgon 1990; Coyas 1990 in študija kohlee v Franciji, 2009 v podporo varnosti, saj cilj učinkovitosti ni bil dosežen).
The occurrence of movement disorders such as parkinsonian symptoms, restless leg syndrome, tremors, gait instability should lead to definitive withdrawal of trimetazidine. 
Pri pojavu motenj gibanja, kot so simptomi parkinsonove bolezni, sindrom nemirnih nog, tremorji in nestabilna hoja, je treba dokončno ukiniti uporabo trimetazidina.