natgillin/translations-raw huggingface dataset:
The European Medicines Agency has concluded its review of the cancer medicine Xofigo (radium-223 dichloride), and has recommended restricting its use to patients who have had two previous treatments for metastatic prostate cancer (prostate cancer that has spread to the bone) or who cannot receive other treatments. 
Evropska agencija za zdravila je 26. julija 2018 zaključila pregled zdravila za zdravljenje raka Xofigo ([223Ra]radijev klorid) ter priporočila omejitev njegove uporabe na tiste bolnike, ki so se predhodno zdravili z dvema zdraviloma proti metastatskemu raku prostate (raku prostate, ki se je razširil na kosti) ali ki ne morejo prejemati drugih zdravil.
The CHMP opinion will now be forwarded to the European Commission, which will issue a final legally binding decision applicable in all EU Member States in due course. 
Mnenje odbora CHMP je bilo predloženo Evropski komisiji, ki je 28. septembra 2018 izdala končni pravno zavezujoči sklep, ki velja za vse države članice EU.
• If you experience any new or unusual bone pain or swelling before, during or after your treatment with Xofigo, you should consult your doctor. 
• Če pred ali med zdravljenjem z zdravilom Xofigo ali po njem občutite nove ali nenavadne bolečine v kosteh ali se pri vas pojavi otekanje, se posvetujte z zdravnikom.
• The prostate cancer medicine Xofigo can increase the risk of having fractures. 
• Zdravilo za zdravljenje raka prostate Xofigo lahko poveča tveganje za pojav zlomov.
• Concurrent use of bisphosphonates or denosumab has been found to reduce the incidence of fractures in patients treated with Xofigo. 
• Ugotovili so, da sočasna uporaba difosfonatov ali denozumaba zmanjšuje pojavnost zlomov pri bolnikih, ki se zdravijo z zdravilom Xofigo.
The Agency's recommendations are based on the assessment of data from a randomised, double blind, placebo controlled phase III trial (ERA-223), which showed that there was an increased incidence of fractures (28.6% vs 11.4%), a possible reduction in median overall survival (30.7 months vs 33.3 months, HR 1.195, 95% confidence interval (CI) 0.950 - 1.505, p=0.13) and an increased risk of radiological non-bone progression (HR 1.376 [95% CIs 0.972, 1.948], p=0.07) among patients receiving Xofigo in combination with abiraterone acetate plus prednisone/prednisolone (n=401) compared to patients receiving placebo in combination with abiraterone acetate plus prednisone/prednisolone (n=405). 
Zgornja priporočila temeljijo na oceni podatkov iz randomiziranega, dvojno slepega, s placebom nadzorovanega preskušanja III. faze (ERA-223), ki je pri bolnikih, ki so prejemali zdravilo Xofigo v kombinaciji z abirateron acetatom in prednizonom/prednizolonom (n =401), v primerjavi z bolniki, ki so prejemali placebo v kombinaciji z abirateron acetatom in prednizonom/prednizolonom (n = 405), pokazalo povečano pojavnost zlomov (28,6 v primerjavi z 11,4 %), možno zmanjšanje medianega celokupnega preživetja (30,7 meseca v primerjavi s 33,3 meseca, HR 1,195, 95-odstotni interval zaupanja (IZ) 0,950-1,505, p = 0,13) in povečano tveganje za radiološko napredovanje zunaj kosti (HR 1,376 [95-odstotni interval zaupanja 0,972, 1,948], p = 0,07).
• Xofigo should only be used as monotherapy or in combination with an LHRH analogue for the treatment of adult patients with metastatic castration-resistant prostate cancer (mCRPC), symptomatic bone metastases and no known visceral metastases, who are in progression after at least two prior lines of systemic therapy for mCRPC (other than LHRH analogues), or ineligible for any available systemic mCRPC treatment. 
• Zdravilo Xofigo se sme uporabljati samo kot monoterapija ali v kombinaciji z analogom LHRH za zdravljenje odraslih bolnikov z metastatskim, proti kastraciji odpornim rakom prostate (mCRPC), simptomatskimi kostnimi metastazami in brez znanih visceralnih metastaz, v napredovanju po vsaj dveh predhodnih vrstah sistemskega zdravljenja mCRPC (poleg analogov LHRH), ali bolnikov, za katere nobeno razpoložljivo sistemsko zdravljenje mCRPC ni primerno.
The review of Xofigo was carried out by EMA's Pharmacovigilance Risk Assessment Committee (PRAC) after data from a clinical study suggested that patients given Xofigo in combination with Zytiga and prednisone/prednisolone could be at risk of dying earlier and had more fractures than patients given placebo (a dummy treatment) with Zytiga and prednisone/prednisolone. 
Pregled zdravila Xofigo je opravil Odbor za ocenjevanje tveganja na področju farmakovigilance (PRAC) pri agenciji EMA, potem ko so podatki iz klinične študije pokazali, da pri bolnikih, ki prejemajo zdravilo Xofigo v kombinaciji z zdravilom Zytiga in prednizonom/prednizolonom, lahko obstaja tveganje za prezgodnjo smrt, poleg tega pa se je pri teh bolnikih pojavilo več zlomov kot pri bolnikih, ki so skupaj z zdravilom Zytiga in prednizonom/prednizolonom prejemali placebo (zdravilo brez učinkovine).
In addition, Xofigo should not be started in the first 5 days following the last dose of abiraterone and prednisone/prednisolone. 
Poleg tega se zdravljenje z zdravilom Xofigo ne sme začeti prej kot pet dni po zadnjem odmerku abiraterona in prednizona/prednizolona.
In addition Xofigo, used on its own or with medicines called ‘luteinising hormone releasing hormone (LHRH) analogues', will be reserved for patients who have had at least two previous treatments for prostate cancer that has spread to the bone, or who cannot receive other treatments. 
Poleg tega bo zdravilo Xofigo, uporabljeno samostojno ali skupaj z zdravili, imenovanimi analogi gonadoliberina (LHRH), prihranjeno za bolnike, ki so se zdravili že z vsaj dvema zdraviloma za zdravljenje raka prostate, ki se je razširil na kosti, ali ki ne morejo prejemati drugih zdravil.
• Xofigo is contraindicated in combination with abiraterone acetate and prednisone/prednisolone. 
• Zdravilo Xofigo je kontraindicirano v kombinaciji z abirateron acetatom in prednizonom/prednizolonom.
The PRAC's recommendations have now been endorsed by EMA's Committee for Medicinal Products for Human Use (CHMP) and will be sent to the European Commission for a final legal decision. 
Odbor za zdravila za uporabo v humani medicini (CHMP) pri agenciji EMA je podprl priporočila odbora PRAC.
A possible increased risk of death was also observed in a clinical trial investigating Xofigo in combination with abiraterone acetate and prednisone/prednisolone in patients with asymptomatic or mildly symptomatic castration-resistant prostate cancer. 
V kliničnem preskušanju zdravila Xofigo v kombinaciji z abirateron acetatom in prednizonom/prednizolonom pri bolnikih z asimptomatskim ali blago simptomatskim, proti kastraciji odpornim rakom prostate so opazili tudi možno povečano tveganje za smrt.
• Xofigo is authorised for use only when the spreading cancer is causing symptoms; depending on how the cancer has spread to the bone, your doctor will decide whether Xofigo is the right treatment for you. 
Odvisno od tega, kako se je rak razširil na kosti, se bo zdravnik odločil, ali je zdravilo Xofigo za vas primerno.
The medicine should also not be used in patients who have no symptoms, in line with the current indication; in addition, the use of Xofigo is not recommended in patients with a low number of bone metastases called osteoblastic bone metastases. 
Prav tako njegova uporaba ni priporočljiva pri bolnikih z majhnim številom kostnih metastaz, imenovanih osteoblastne kostne metastaze.
The final stage of the review procedure is the adoption by the European Commission of a legally binding decision applicable in all EU Member States. 
Evropska komisija je 28. septembra 2018 izdala končni pravno zavezujoči sklep, ki velja v vsej EU.
PRAC recommended contraindicating the use of Xofigo with Zytiga and prednisone/prednisolone, as an interim measure, while the review was ongoing. 
Marca 2018 je odbor PRAC kot začasni ukrep med potekom pregleda priporočil kontraindikacijo uporabe zdravila Xofigo skupaj z zdravilom Zytiga in prednizonom/prednizolonom.
Children Procoralan is not intended for use in children and adolescents younger than 18 years. 
Procoralan ni namenjen za uporabo pri otrocih in mladostnikih, mlajših od 18 let.
Date of latest renewal: 31/08/2010 
Datum zadnjega podaljšanja: 31.08.2010
In this way Procoralan helps to control and reduce the number of angina attacks. 
Procoralan pripomore k nadzoru in zmanjševanju anginoznih napadov.
Concomitant use with precaution 
Sočasno jemanje ob previdnostnih ukrepih
Procoralan 5 mg film-coated tablets EU/1/05/316/001-007 
Procoralan 5 mg filmsko obložene tablete EU/1/05/316/001-007
What Procoralan contains - The active substance is ivabradine (as hydrochloride). 
Kaj vsebuje zdravilo Procoralan - Učinkovina je ivabradin (v obliki klorida).
Under physiological conditions, ivabradine is rapidly released from tablets and is highly water-soluble (>10 mg/ml). 
5.2 Farmakokinetične lastnosti V fizioloških pogojih se ivabradin hitro sprošča iz tablet in je zelo topen v vodi (> 10 mg/ml).
Do not take Procoralan - if you are allergic to ivabradine or any of the other ingredients of this medicine (listed in section 
Kaj morate vedeti, preden boste vzeli zdravilo Procoralan Ne jemljite zdravila Procoralan - če ste alergični na ivabradin ali katero koli sestavino tega zdravila (navedeno v poglavju 6);
The antianginal and anti-ischaemic efficacy of ivabradine was studied in five double-blind randomised trials (three versus placebo, and one each versus atenolol and amlodipine). 
Klinična učinkovitost in varnost Antianginozno in antiishemično učinkovitost ivabradina so proučevali v petih dvojno slepih randomiziranih študijah (treh v primerjavi s placebom ter po eni z atenololom in amlodipinom).
Procoralan 7.5 mg film-coated tablets EU/1/05/316/008-014 
Procoralan 7,5 mg filmsko obložene tablete EU/1/05/316/008-014
The study demonstrated a clinically and statistically significant relative risk reduction of 18% in the rate of the primary composite endpoint of cardiovascular mortality and hospitalisation for worsening heart failure (hazard ratio: 0.82, 95%CI [0.75;0.90] - p<0.0001) apparent within 3 months of initiation of treatment. 
Študija je dokazala klinično in statistično značilno relativno zmanjšanje tveganja za 18 % za primarni končni izid, sestavljen iz srčno-žilne umrljivosti in hospitalizacije zaradi poslabšanja srčnega popuščanja (razmerje tveganja: 0,82, 95 % interval zaupanja [0,75;0,90] - p<0,0001), vidnega po 3 mesecih po začetku zdravljenja.
There was a significant improvement in NYHA class at last recorded value, 887 (28%) of patients on ivabradine improved versus 776 (24%) of patients on placebo (p=0.001). 
Pri razredu NYHA v zadnji zabeleženi vrednosti je bilo značilno izboljšanje, 887 (28 %) bolnikom, zdravljenih z ivabradinom, se je stanje izboljšalo v primerjavi z izboljšanjem pri 776 (24 %) bolnikih, ki so prejemali placebo (p=0,001).
Ivabradine is rapidly and almost completely absorbed after oral administration with a peak plasma level reached in about 1 hour under fasting condition. 
Absorpcija in biološka uporabnost Ivabradin se po peroralnem jemanju hitro in skoraj v celoti absorbira ter doseže največjo koncentracijo v plazmi po približno 1 uri v pogojih na tešče.
The European Medicines Agency has waived the obligation to submit the results of studies with Procoralan in all subsets of the paediatric population for the treatment of angina pectoris. 
Procoralan za vse podskupine pediatrične populacije za zdravljenje angine pektoris.
The frequency of possible side effects listed below is defined using the following convention: very common: may affect more than 1 in 10 people common: may affect up to 1 in 10 people uncommon: may affect up to 1 in 100 people rare: may affect up to 1 in 1,000 people very rare: may affect up to 1 in 10,000 people not known: frequency cannot be estimated from the available data 
zelo pogosti: pojavijo se lahko pri več kot 1 od 10 bolnikov pogosti: pojavijo se lahko pri največ 1 od 10 bolnikov občasni: pojavijo se lahko pri največ 1 od 100 bolnikov redki: pojavijo se lahko pri največ 1 od 1.000 bolnikov zelo redki: pojavijo se lahko pri največ 1 od 10.000 bolnikov neznana pogostnost: pogostnosti iz razpoložljivih podatkov ni mogoče oceniti Najpogostejši neželeni učinki tega zdravila so odvisni od odmerka ter so povezani z njegovim mehanizmom delovanja: Zelo pogosti:
ECG prolonged QT interval * Frequency calculated from clinical trials for adverse events detected from spontaneous report 
Preiskave občasni povečanje kreatinina v krvi podaljšanje intervala QT na EKG *Pogostnost neželenih učinkov iz spontanega poročanja je izračunana na podlagi podatkov iz kliničnih študij Opis izbranih neželenih učinkov
If any of the above applies to you, talk straight away to your doctor before or while taking Procoralan. 
Če karkoli od naštetega velja za vas, se takoj pogovorite z zdravnikom pred jemanjem zdravila
Procoralan (ivabradine) is a heart medicine used to treat: - Symptomatic stable angina pectoris (which causes chest pain) in adult patients whose heart rate is over or equal to 70 beats per minute. 
Kaj je zdravilo Procoralan in za kaj ga uporabljamo Procoralan (ivabradin) je zdravilo za srce, namenjeno za zdravljenje: - simptomatske stabilne angine pektoris (bolezen, ki povzroča bolečine v prsih) pri odraslih bolnikih, ki imajo srčno frekvenco višjo ali enako 70 utripom na minuto.
- if your resting heart rate before treatment is too slow (below 70 beats per minute); - if you are suffering from cardiogenic shock (a heart condition treated in hospital); - if you suffer from a heart rhythm disorder; - if you are having a heart attack; - if you suffer from very low blood pressure; - if you suffer from unstable angina (a severe form in which chest pain occurs very frequently and with or without exertion); - if you have heart failure which has recently become worse; - if your heartbeat is exclusively imposed by your pacemaker; - if you suffer from severe liver problems; - if you are already taking medicines for the treatment of fungal infections (such as ketoconazole, 
- če imate kardiogeni šok (bolezen srca, ki zahteva zdravljenje v bolnišnici); - če imate motnje srčnega ritma; - če imate miokardni infarkt; - če imate zelo nizek krvni tlak; - če imate nestabilno angino pektoris (hudo obliko, pri kateri se bolečine v prsih pojavljajo zelo pogosto, med naporom ali brez njega); - če imate srčno popuščanje, ki se je pred kratkim poslabšalo;
Concomitant use with precautions - Moderate CYP3A4 inhibitors: the concomitant use of ivabradine with other moderate CYP3A4 inhibitors (e.g. fluconazole) may be considered at the starting dose of 2.5 mg twice daily and if resting heart rate is above 70 bpm, with monitoring of heart rate. 
- Zmerni zaviralci citokroma P450 3A4: o sočasnem jemanju ivabradina z drugimi zmernimi zaviralci citokroma P450 3A4 (na primer flukonazolom) se lahko odločate ob začetnem odmerku 2,5 mg dvakrat na dan in če je srčna frekvenca med mirovanjem nad 70 utripov na minuto, ob spremljanju srčne frekvence.
What Procoralan looks like and contents of the pack Procoralan 5 mg tablets are salmon-coloured, oblong film-coated tablets scored on both sides, engraved with “5” on one face and on the other. 
Izgled zdravila Procoralan in vsebina pakiranja Tablete zdravila Procoralan 5 mg so lososove barve, podolgovate in filmsko obložene, z zarezo na obeh straneh in vrezano oznako “5” na eni ter na drugi strani.
The European Medicines Agency has waived the obligation to submit the results of studies with Procoralan in children aged 0 to less than 6 months for the treatment of chronic heart failure. 
Procoralan za otroke od 0 do manj kot 6 mesecev starosti za zdravljenje kroničnega srčnega popuščanja.
In a 1277-patients randomised placebo-controlled study, ivabradine demonstrated a statistically significant additional efficacy on response to treatment (defined as a decrease of at least 3 angina attacks per week and/or an increase in the time to 1 mm ST segment depression of at least 60 s during a treadmill ETT) on top of amlodipine 5 mg o.d. or nifedipine GITS 30 mg o.d. at the trough of drug activity (12 hours after oral ivabradine intake) over a 6-week treatment period (OR = 1.3, 95% CI [1.0-1.7]; p=0.012). 
V randomizirani, s placebom nadzorovani študiji pri 1.277 bolnikih je ivabradin kot dodatek amlodipinu 5 mg enkrat na dan ali nifedipinu GITS (gastrointestinalni terapevtski sistem) 30 mg enkrat na dan v času najmanjšega učinka (12 ur po peroralnem jemanju) med 6-tedenskim zdravljenjem (razmerje obetov = 1,3; 95% interval zaupanja [1,0-1,7]; p = 0,012) dokazal statistično značilno dodatno učinkovitost pri odzivu na zdravljenje (definiranem kot zmanjšanje za najmanj 3 napade angine pektoris na teden in/ali podaljšanje časa do 1-mm depresije segmenta ST za najmanj 60 s med obremenitvenim testiranjem (ETT) hoje po tekočem traku).
Ivabradine has low affinity for CYP3A4, shows no clinically relevant CYP3A4 induction or inhibition and is therefore unlikely to modify CYP3A4 substrate metabolism or plasma concentrations. 
Ivabradin ima majhno afiniteto za citokrom P450 3A4, ki ga ne spodbuja ali zavira klinično pomembno, zato ni verjetno, da bi vplival na presnovo substratov citokroma P450 3A4
Talk to your doctor if you are breast-feeding or intending to breast-feed as breast-feeding should be discontinued if you take Procoralan. 
Če dojite ali nameravate dojiti se posvetujte z zdravnikom, ker morate z dojenjem prekiniti, če jemljete zdravilo Procoralan.
The usual recommended starting dose is one tablet of Procoralan 5 mg twice daily increasing if necessary to one tablet of Procoralan 7.5 mg twice daily. 
Če se zdravite zaradi kroničnega srčnega popuščanja Običajen priporočljiv začetni odmerek je ena tableta zdravila Procoralan 5 mg dvakrat na dan, kar lahko povečate na eno tableto zdravila Procoralan 7,5 mg dvakrat na dan, če je potrebno.
Procoralan 7.5 mg film-coated tablets 
Procoralan 7,5 mg filmsko obložene tablete
Talk to your doctor or pharmacist before taking Procoralan - if you suffer from heart rhythm disorders (such as irregular heartbeat, palpitation, increase in chest pain) or sustained atrial fibrillation (a type of irregular heartbeat), or an abnormality of electrocardiogram (ECG) called ‘long QT syndrome', - if you have symptoms such as tiredness, dizziness or shortness of breath (this could mean that your heart is slowing down too much), - if you suffer from symptoms of atrial fibrillation (pulse rate at rest unusually high (over 110 beats per minute) or irregular, without any apparent reason, making it difficult to measure), - if you have had a recent stroke (cerebral attack), - if you suffer from mild to moderate low blood pressure, - if you suffer from uncontrolled blood pressure, especially after a change in your antihypertensive treatment, - if you suffer from severe heart failure or heart failure with abnormality of ECG called ‘bundle branch block', - if you suffer from chronic eye retinal disease, - if you suffer from moderate liver problems, - if you suffer from severe renal problems. 
Pred začetkom jemanja zdravila Procoralan se posvetujte z zdravnikom ali farmacevtom: - če imate motnje srčnega ritma (kot so nepravilen srčni utrip, palpitacije, povečana bolečina v prsih), vztrajno atrijsko fibrilacijo (vrsto nerednega srčnega utripa) ali nepravilnost v elektrokardiogramu (EKG), ki se imenuje 'podaljšan interval QT'; - če opažate simptome, kot so utrujenost, vrtoglavost ali zasoplost (to bi lahko pomenilo, da se vaše srce preveč upočasnjuje); - če imate simptome atrijske fibrilacije (nenavadno visok srčni utrip v mirovanju (nad 110
Procoralan 5 mg film-coated tablets 
Procoralan 5 mg filmsko obložene tablete
Package leaflet: information for the patient Procoralan 5 mg film-coated tablets Procoralan 7.5 mg film-coated tablets ivabradine 
Navodilo za uporabo Procoralan 5 mg filmsko obložene tablete Procoralan 7,5 mg filmsko obložene tablete ivabradin
Ivabradine is indicated : - in adults unable to tolerate or with a contraindication to the use of beta-blockers - or in combination with beta-blockers in patients inadequately controlled with an optimal beta blocker dose. 
Ivabradin je indiciran: - pri odraslih, pri katerih so antagonisti adrenergičnih receptorjev beta kontraindicirani ali jih ne prenašajo,
Chronic heart failure patients with intraventricular conduction defects (bundle branch block left, bundle branch block right) and ventricular dyssynchrony should be monitored closely. 
Bolnike s kroničnim srčnim popuščanjem z motnjami intraventrikularne prevodnosti (levokračni blok,
Specific drug-drug interaction studies have shown no clinically significant effect of the following medicinal products on pharmacokinetics and pharmacodynamics of ivabradine: proton pump inhibitors (omeprazole, lansoprazole), sildenafil, HMG CoA reductase inhibitors (simvastatin), dihydropyridine calcium channel blockers (amlodipine, lacidipine), digoxin and warfarin. 
(omeprazola, lansoprazola), sildenafila, zaviralcev hidroksimetilglutaril koencim A (HMG CoA) reduktaze (simvastatina), dihidropiridinskih kalcijevih antagonistov (amlodipina, lacidipina),
Excipient with known effect: 63.91 mg lactose monohydrate Procoralan 7.5 mg film-coated tablets 
Pomožna snov z znanim učinkom: 63,91 mg laktoze monohidrata.
NAME OF THE MEDICINAL PRODUCT Procoralan 7.5 mg film-coated tablets ivabradine 
Procoralan 7,5 mg filmsko obložene tablete ivabradin
After two weeks of treatment, the dose can be increased to 7.5 mg twice daily if resting heart rate is persistently above 60 bpm or decreased to 2.5 mg twice daily (one half 5 mg tablet twice daily) if resting heart rate is persistently below 50 bpm or in case of symptoms related to bradycardia such as dizziness, fatigue or hypotension. 
Po dveh tednih zdravljenja lahko odmerek povečate na 7,5 mg dvakrat na dan, če srčna frekvenca med mirovanjem vztraja nad 60
mefloquine, halofantrine, pentamidine, cisapride, intravenous erythromycin). 
kinidin, dizopiramid, ibutilid, sotalol, amjodaron (proti motnjam srčnega ritma) bepridil (proti angini pektoris)
In a 725-patients randomised placebo-controlled study, ivabradine did not show additional efficacy on top of amlodipine 10 mg o.d. at the trough of drug activity (12 hours after oral intake) while an additional efficacy was shown at peak (3-4 hours after oral intake). 
10 mg enkrat na dan ni pokazal dodatne učinkovitosti v času najmanjšega učinka (12 ur po peroralnem jemanju), medtem ko so v času največjega učinka (3 do 4 ure po peroralnem jemanju) dodatno učinkovitost zasledili.
Make sure to tell your doctor if you are taking any of the following medicines, as a dose adjustment of Procoralan or monitoring should be required: - fluconazole (an antifungal medicine) - rifampicin (an antibiotic) - barbiturates (for difficult sleeping or epilepsy) - phenytoin (for epilepsy) - Hypericum perforatum or St John's Wort (herbal treatment for depression) - QT prolonging medicines to treat either heart rhythm disorders or other conditions : - quinidine, disopyramide, ibutilide, sotalol, amiodarone (to treat heart rhythm disorders) - bepridil (to treat angina pectoris) - certain types of medicines to treat anxiety, schizophrenia or other psychoses (such as pimozide, ziprasidone, sertindole) - anti-malarial medicines (such as mefloquine or halofantrine) - intravenous erythromycin (an antibiotic) - pentamidine (an antiparasitic medicine) - cisapride (against the gastro-oesophageal reflux) - Some types of diuretics which may cause decrease in blood potassium level, such as furosemide, hydrochlorothiazide, indapamide (used to treat oedema, high blood pressure). 
določene vrste zdravil proti tesnobnosti, shizofreniji ali drugim psihozam (kot so pimozid, ziprazidon, sertindol) zdravila proti malariji (na primer meflokin ali halofantrin) eritromicin v žilo (antibiotik) pentamidin (zdravilo proti parazitom) cisaprid (proti gastroezofagealnemu refluksu)
The most common symptoms of heart failure are breathlessness, fatigue, tiredness and ankle swelling. 
slabotnost, utrujenost in otekanje gležnjev.