[Toxic hepatitis induced by Polygonum multiflorum]. / Toxicka hepatitida po Polygonum multiflorum.

Toxic liver injury is a common cause of acute hepatitis. Here we report a case of 33-year old female with toxic hepatitis caused by unusual agent- extract of chinese plant Polygonum multiflorum. The patient presented with clinical signs of nausea and icterus and laboratory signs of hepatocellular damage following 2 months of readministration of Polygonum mulltiflorum pills. All other causes of hepatocellular damage were excluded. The causality between hepatocellular damage and Polygonum multiflorum ingestion was supported by early recovery after discontinuation, by international scoring system of causality between drug and hepatotoxicity as well as by similarities with other reports from the literature. Considering the growing popularity of herbal products as nutrition supplements we appeal to caution in using these preparations.

[The influence of testosterone on cardiovascular disease in men]. / Vplyv testosterónu na kardiovaskulárne ochorenia u muzov.

The influence of testosterone on cardiovascular disease is recently discussed question. Testosterone modulates vascular reactivity by genomic and nongenomic modes of action, it has an impact on endothelial function, production of proinflamatory cytokines and lipid profiles. The possible role of sex hormone binding globulin (SHBG) in androgen action by plasmatic membrane receptors breaks "the free hormone hypothesis", especially when clinical trials reveal strong association between SHBG and risk factors of cardiovascular disease. The results of last clinical trials mention that androgen deficiency is associated with obesity, insulin resistance and dyslipidaemia. Large clinical trials demonstrated that androgen deficiency predict mortality in elderly men. Testosterone substitution restores vasoreactivity and endothelial function and could potentially reduce cardiovascular disease in men but to confirm this theory more large clinical trials are needed.

[Acute cholestasis following treatment with nimesulide and oral contraception: case report and review]. / Akútna cholestáza po uzívaní nimesulidu a kontraceptív: kazuistika a prehl'ad literatúry.

Our case report of acute cholestatic liver injury highlights the potential hepatotoxicity of nimesulide treatment in combination with oral contraception. Rarely occuring histological findings of "pure" cholestasis without any inflammatory or necrotic changes with favourable outcome following ursodeoxycholic acid administration are described. It was not possible to distinguish the separate role of any of these two drugs on hepatotoxicity according to the available information. Based on the known similarities in hepatotoxic profile of nimesulide and oral contraceptives, it can be assumed that their interaction could increase the risk of liver damage, although the precise mechanisms are not ellucidated yet. Nimesulide toxicity however is often reported in cases taking several potentially hepatotoxic drugs. It is therefore prudent to reconsider any concommitant treatment and closely monitor liver function tests in patients requiring nimesulide treatment.