RX-TO-OTC SWITCH AND DOUBLE REGISTRATION OCCURRENCE IN POLAND--AN ILLUMINATIVE CASE STUDY.

Rx-to-OTC switch is a global occurrence, which aims to promote patients' responsible self-treatment of minor ailments. Many countries could benefit from such self-treatment and reduce their rising health care costs by allowing citizens to avoid the need for a physician's consultations. What must be noted however, is that the inappropriate use of over-the-counter medicines can have also a darker side. Potential problems arising from OTC use might include: increased costs of treating complications resulting from not proper use or abuse, or possible interactions with the other medications, that patients take for chronic diseases. To maintain the desired level of patient safety, relieving one working group (the medical profession) from an existing obligation should be associated with the need for increased involvement and/or authorizations from other working groups. Professional pharmacists are already globally recognized as being trained in the field of health condition assessment. This paper presents an objective case study of current pharmaceutical law and thus, may serve as a starting point for an responsible discussion regarding the institution of a new class of drugs understood as pharmacist-only.

Association between BDNF-196 G>A and BDNF-270 C>T polymorphisms, BDNF concentration, and rTMS-supported long-term rehabilitation outcome after ischemic stroke.

BACKGROUND: The efficacy of rehabilitation in ischemic stroke patients likely varies because of brain plasticity. One of the main neurotrophins in the central nervous system is brain-derived neurotrophic factor (BDNF). OBJECTIVES: This study aimed to determine allelic and genotypic distribution of BDNF-196 G>A and -270 C>T polymorphisms, and to assess the impact of repetitive transcranial magnetic stimulation (rTMS) on serum BDNF concentrations measured before rehabilitation, after the first 6 h of rehabilitation, and after 3 weeks of rehabilitation. METHODS: Twenty-six patients with hand paresis and 20 with aphasia were randomly assigned to treatment with rTMS or sham stimulation (placebo group). RESULTS: In men with aphasia, after the first 6 h of rTMS-supported rehabilitation, BDNF concentration was lower among rTMS-treated patients than placebo-treated patients. A similar difference was observed in women with aphasia after 3 weeks of rTMS-supported rehabilitation. No significant differences in serum BDNF concentration were observed in patients with different BDNF-196 G>A or -270 C>T genotypes. During the observation period, BDNF concentration did not differ significantly between patients who improved and those who did not. DISCUSSION: One possible explanation for the observed difference between rTMS-stimulated and sham-stimulated patients is the suppression of BDNF production by rTMS in the healthy brain hemisphere.