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Viral B and C hepatitis are a major current health issue, both diseases having a chronic damaging effect on the liver and its functions. Chronic liver disease can lead to even more severe and life-threatening conditions, such as liver cirrhosis and hepatocellular carcinoma. Recent years have uncovered an important interplay between the liver and the gut microbiome: the gut-liver axis. Hepatitis B and C infections often cause alterations in the gut microbiota by lowering the levels of 'protective' gut microorganisms and, by doing so, hinder the microbiota ability to boost the immune response. Treatments aimed at restoring the gut microbiota balance may provide a valuable addition to current practice therapies and may help limit the chronic changes observed in the liver of hepatitis B and C patients. This review aims to summarize the current knowledge on the anato-functional axis between the gut and liver and to highlight the influence that hepatitis B and C viruses have on the microbiota balance, as well as the influence of treatments aimed at restoring the gut microbiota on infected livers and disease progression.

The paper presents an experimental study of the triboelectrostatic separation feasibility of two plastic mixtures, high-impact polystyrene (HIPS)/acrylonitrile butadiene styrene (ABS) and high-impa...

Since their first use, anaesthetic agents have seen major advancements and are now an indispensable element of surgical procedures. Two of the most used volatile anaesthetics are isoflurane and sevoflurane. These have neuroprotective effects on adult brains in different brain disorders, ranging from traumatic to hypoxic or ischemia-reperfusion injuries. In new-borns and elderly patients these effects are reversed, and volatile anaesthetics might have a neurotoxic effect, affecting the recovery and neurological capabilities of these patients. Since we are still using volatile anaesthetics, it is important to know in which conditions these substances are neurotoxic and neuroprotective, as well as to better understand the mechanisms underlying these effects. In this review we aim to summarise the current knowledge on the mechanisms involved in neuroprotection and neurotoxicity of neonatal, adult and aged brains and how these vary based on the brains age and underlying pathologies. This review should guide future experimental research towards less studied mechanisms and should help the development of neuroprotective strategies. Also, we provide a short summary of the substances used in experimental studies to prevent the neurotoxic effect of isoflurane and sevoflurane.

The aim of this work is to demonstrate the possibility of using electric field forces for the recovery of copper from a fine PVC/Cu granular mixture of low metal content (less than 15%), obtained a...

Spore-based Bacillus probiotic treatment improves intestinal health. The intestinal microbiota influences both the innate and adaptive immune responses. As such, the influence of ongoing spore-based probiotic treatment (five probiotic strains of Bacillus) on the clinical outcomes of mild COVID-19 was evaluated in this retrospective, observational study. Demographics, medical history, probiotic use, and COVID-19 symptom information were collected. The study included 120 patients with a PCR-confirmed SARS-CoV-2 infection and mild COVID-19 symptoms. The probiotic group (n = 60) comprised patients with ongoing probiotic treatment (≥1 month); the control group comprised patients not taking probiotics (n = 60). The primary outcome was time to symptom resolution; secondary outcomes included time to fever resolution and presence of digestive symptoms. The probiotic group had a significantly shorter time to symptom resolution (mean (95% confidence interval) days: control group, 8.48 (6.56, 10.05); probiotic group, 6.63 (5.56; 6.63); p = 0.003) and resolution of fever (control group, 2.67 (1.58, 3.61); probiotic group, 1.48 (1.21, 2.03); p < 0.001). More patients in the probiotic group (n = 53) than in the control group (n = 34) did not have digestive symptoms (p < 0.001). Among adults with mild COVID-19, participants receiving ongoing probiotic treatment had a shorter clinical course, and fewer had digestive symptoms compared with those not taking probiotics.

Background/aims The purpose of this prospective study was to compare patients' discomfort during water immersion (WI) colonoscopy without sedation or available on request, with that of patients during air insufflation (AI) colonoscopy with sedation, in the ambulatory setting. Material and methods A prospective observational study was conducted in 100 patients who performed a colonoscopy between August 2015 and February 2016 in an Ambulatory Gastroenterology Center in Cluj-Napoca, Romania. They were divided into two branches A and B. Patients in Group A underwent a classic colonoscopy with AI and standard sedation (2 mg of midazolam and 50 mg of tramadol), while patients in Group B underwent an unsedated or on demand sedation colonoscopy with WI technique. Results The patients in group A presented a higher discomfort (statistically significant) compared to those in group B, and had also the median total discomfort score higher than those in group B. The patients in group A had also a higher discomfort score after examination. The total time of examination was the same in the two groups, but in group B the progression to cecum time was 3 minutes lower than for those in group A. A greater discomfort of the patient was correlated with the longer time required to reach the cecum. Conclusion In conclusion, WI colonoscopy is superior to AI technique in reducing insertion pain, progression-to-cecum time, minimizing sedation requirements and also in the willingness to repeat the technique.

The ability of Berberis vulgaris bark extract (BVE) to improve the lipid profile was evaluated in an experimental model of dyslipidemia, along with its effects on liver and kidney functions. Fifty rats divided into five groups of ten animals each were fed with normal or lard-based diet and orally treated with 0.9% saline solution, atorvastatin (2.5 mg/kg per body weight) or extract of BVE (300 and 500 mg/kg/day) for eight weeks. Lipid profile, liver and renal functions were assessed in normal and diet-induced hypercholesterolemic rats. The results were compared between the groups treated with Berberis extract and the group without treatment, respectively that one treated with the standard drug (atorvastatin). Administration of BVE or atorvastatin significantly decreases the elevated serum lipid profile (p [0.05). The extract also protects against dyslipidemia-induced non-alcoholic fatty liver disease (NAFLD). The activities of the plant extract are dose dependent and it compares favorably with the standard drug atorvastatin. Variations in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and urea level measurements were neither different between the two determinations nor between groups, but creatinine values decreased in rats in the BVE or atorvastatin-treated groups. The findings of the current study have suggested that BVE intake suppresses the accumulation of hepatic lipids and lipid parameters and reduce the risk of NAFLD. So, BVE can be useful in hypercholesterolemia.

Endorectal ultrasound applications in the evaluation of rectal tumors could be a useful tool in achieving proper staging of rectal cancer. The purpose of this study was to compare the efficacy of rectal tumor staging by flexible endoscopic ultrasound (EUS) with real-time elastography (RTE) using the gold standard post-surgery histological analysis of the resected tissue as the control. The second aim of our research was to establish cutoff values for the EUS-RTE strain ratio corresponding to stages by independently comparing the stiffness values obtained with histology and EUS-RTE staging in order to minimize observation bias. We evaluated the records of 130 patients with a rectal tumor confirmed by biopsy. EUS was used in 70 patients, EUS-RTE—in the other 60. We found no statistically significant differences in staging accuracy when comparing EUS to EUS-RTE. Through a correspondence method between staging assessment and the EUS-RTE stain ratio, we identified cutoff intervals for T2, T3, and T4 staging that were nonoverlapping and proved to be statistically significant in terms of EUS-RTE values (significantly different ascending values from one interval to the other). We found that EUS-RTE offers slightly better, although not statistically significant sensitivity and specificity for T and N stage predictions compared to 2D EUS. Our results showed that EUS-RTE offers slightly higher sensitivity and specificity compared to EUS. Reliable cutoff intervals were found for strain rate elastography, previously available only for shear wave elastography (SWE) which is currently unavailable on any EUS system. Thus, these commonly available EUS-RTE systems can serve as a complementary tool in the staging of rectal tumors.

Spore-based Bacillus spp. products are considered to have a higher probiotic potential compared to products containing only lactic acid bacteria because their viability in the gastrointestinal (GI) tract is higher, even when GI environmental conditions are unfavorable. The aim of this study was to assess the effect of a Bacillus subtilis, Bacillus licheniformis and Pediococcus acidilactici spore-based potential probiotic on the natural levels of postprandial endotoxemia. A total of 11 dogs completed the study: group 1—healthy dogs: n = 5, group 2—dogs with apparent dysbiosis: n = 6. For 30 days, the dogs were fed the probiotic product, clinical examinations and blood sampling were done before and after completion of the probiotic treatment. Endotoxin levels were assessed pre-meal, 6 h and 12 h post-meal, before initiation and after completion of the treatment. The results showed a decrease in endotoxin levels after treatment, especially 12 h post-meal (group 1: 20.60%, group 2: 44.93%). This study reports new information with regard to natural endotoxemia levels in dogs and suggests that a multi-strain formula (spore-based) consisting of B. subtilis, B. licheniformis and P. acidilactici is able to diminish endotoxin values.

The aim of the paper is to show the possibility of using electrostatic technologies for the recovery of non-ferrous metals from the non-conductive fraction obtained in the recycling process of waste electrical and electronic equipment (WEEE). Prior to electrostatic separation, the material undergoes in-situ operations such as size reduction and dust and light component removal. Two granular mixtures of the same material are obtained, a coarse fraction (3.15-6) mm that contains metals, plastics and doesn’t contain any glass and a fine fraction (0-3.15) mm containing metals, plastics and a significant amount of glass. The granular mixtures are then separated using a laboratory version of a conventional roll-type corona-electrostatic separator with an extended charging zone. The virtually pure conductive fraction recovered from the mixtures makes up 4.34% of the initial material and is composed of mainly copper and brass $(\gt70$%), along with nickel, zinc, tin, and lead in lower quantities.

In inflammatory bowel disease (IBD), experimental models have proven to be important tools for evaluating potential therapeutic agents and for investigating the mechanisms of pathogenesis. Oxidative stress and the immune response have been associated with acetic acid (AA)-induced ulcerative colitis (UC). Our study aimed to evaluate, for the first time, the ability of a spore-based probiotic and an amino acid and immunoglobulin supplement in reducing tissue damage and inflammatory responses in an experimental animal model of UC. Forty-two Wistar rats were divided into six groups, receiving 1% carboxymethylcellulose, 4% AA, MegaSporeBiotic&trade, (MSB, 1 &times, 109 colony forming units/day) and MegaMucosa&trade, (MM, 70 mg/100 g/day). Pretreatment with MSB or MM alone and in combination significantly lowered inflammation and reduced damage to the colonic mucosa. Pretreatment with these agents resulted in levels of proinflammatory cytokines, vascular tight junction proteins, and measures of oxidative stress similar to those reported for methylprednisolone, one of the first-line therapies for moderate to severe activity of UC. The protection was further confirmed by histologic analysis of the colon tissue. In conclusion, pretreatment with probiotic spore-forming Bacillus strains and a supplement of amino acids in combination with immunoglobulins exhibited anti-inflammatory and antioxidant effects in an AA-induced rat model of UC.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) has been one of the most intensely studied endoscopic procedures due to its overall high complication rates when compared to other digestive endoscopy procedures. The safety and outcome of such procedures have been linked to multiple procedure- or patient-related risk factors. The aim of our study is to evaluate whether the morphology of the major duodenal papilla influences the ERCP outcomes and complication rates. Methods: A total of 322 patients with a native papilla have been included in the study over an eight month period. Morphology of the papilla has been classified into normal papilla and four anatomical variations (Type I-IV). All patients have been prospectively monitored over a 15 day period after ERCP. Procedural outcomes and complication rates have been registered. Results: Morphology of the papilla influences both overall complication rates (95%CI, p = 0.0066) and post-ERCP pancreatitis rates (95%CI, p = 0.01001) in univariate analysis. Type IV papillae have proven to be independent risk factors for post-ERCP pancreatitis in multivariate analysis (OR = 12.176, 95%CI, p = 0.005). Type I papillae have been significantly linked to difficult cannulation (AUC = 0.591, 95%CI, p = 0.008), Conclusions: In the monitored cohort morphology of the major duodenal papilla has significantly influenced both ERCP outcomes and post-procedural complication rates.

Acetaminophen (APAP) is one of the most used analgesics and antipyretic agents in the world. Intoxication with APAP is the main cause of acute liver toxicity in both the US and Europe. Spore-forming probiotic bacteria have the ability to resist harsh gastric and intestinal conditions. The aim of this study was to investigate the possible protective effect of Bacillus (B) species (sp) spores (B. licheniformis, B. indicus, B. subtilis, B. clausii, B. coagulans) against hepatotoxicity induced by APAP in rats. A total of 35 rats were randomly divided into seven groups: group I served as control, group II received silymarin, group III received MegaSporeBioticTM (MSB), group IV received APAP and served as the model of hepatotoxicity, group V received APAP and silymarin, group VI received APAP and MSB, group VII received APAP, silymarin and MSB. The livers for histopathological examination and blood samples were collected on the last day of the experiment. We determined aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total antioxidant capacity (TAC) levels and zonula occludens (ZO-1), tumor necrosis factor &alpha, (TNF-&alpha, ) and interleukin 1&beta, (IL-1&beta, ) expression. APAP overdose increased AST and ALT. It slowly decreased TAC compared to the control group, but pretreatment with silymarin and MSB increased TAC levels. Elevated plasma concentrations were identified for ZO-1 in groups treated with APAP overdose compared with those without APAP or receiving APAP in combination with silymarin, MSB or both. The changes were positively correlated with the levels of other proinflammatory cytokines (TNF-&alpha, IL-1&beta, ). In addition, histopathological hepatic injury was improved by preadministration of MSB or silymarin versus the disease model group. Bacillus sp spores had a protective effect on acute hepatic injury induced by APAP. Pretreatment with MSB resulted in a significant reduction in serum AST, ALT, TNF-&alpha, ZO-1, TAC and also hepatocyte necrosis, similar to the well-known hepatoprotective agent&mdash, silymarin.

Global electric and electronic equipment has increased greatly in recent decades, generating increasing amounts of waste. In EU alone the waste of electric and electronic equipment (WEEE) is one of the fastest growing streams of waste, with an average 3-5% yearly increase. Recycling materials from waste assures environmental protection, minimizes the waste, and provides secondary raw materials for the manufacturing industry. Electrostatic separation technologies are increasingly used to recover metals and plastics from WEEE or to separate plastic mixtures by polymer type. Triboelectrostatic separation is based on the differences in surface proprieties of granular materials that charge with opposite polarity when in contact, making it suitable for a wide range of material mixtures. The technology is clean and environmentally friendly, with no concern of further disposal and secondary pollution. It is characterized by low energy consumption, simplicity, and moderate cost maintenance. Recent results obtained at the Technical University of Cluj-Napoca and the University of Poitiers in the field of corona-electrostatic and tribo-electrostatic separation of granular materials originating from WEEE are reviewed in this paper.

Cisplatin is one of the most used drugs in the therapy of different types of cancer. However, its use is limited by nephrotoxicity. This study investigated the effects of a commercially available grape pomace extract (GE) from Vitis vinifera on cisplatin-induced kidney toxicity in rats. Sixty-four male Wistar albino rats were randomly divided into eight groups. Groups 1&ndash, 3 were controls, receiving 0.9% saline and doses 1 and 2 of GE respectively. Cisplatin was given to groups 4&ndash, 8. Two groups received pretreatment with GE, while another two groups received pre- and post-treatment with GE. Blood samples were collected and all animals sacrificed. Kidneys were harvested for histopathological analysis. GE significantly increased blood creatinine and urea levels, the severity of kidney histopathological damage, and mortality in all cisplatin groups, except for group 7 which received pre- and post-treatment with a low dose of GE. Renal toxicity was determined by mortality and severe histopathological renal lesions. Additionally, the serum total antioxidant capacity (TAC) was not significantly modified in the treated groups compared to the control. These results indicate that the GE did not have a protective effect on cisplatin-induced nephrotoxicity, on the contrary, GE accentuated the toxic effect of cisplatin.

In recent years, increased attention has been paid to the relationship between microbiota and various diseases, especially immune-mediated diseases. Because conventional therapy for many autoimmune diseases is limited both in efficacy and safety, there is an increased interest in identifying nutraceuticals, particularly probiotics, able to modulate the microbiota and ameliorate these diseases. In this review, we analyzed the research focused on the role of gut microbiota and skin in immunity, their role in immune-mediated skin diseases (IMSDs), and the beneficial effect of probiotics in patients with this pathology. We selected articles published between 2009 and 2019 in PubMed and ScienceDirect that provided information regarding microbiota, IMSDs and the role of probiotics in these diseases. We included results from different types of studies including observational and interventional clinical trials or in vivo and in vitro experimental studies. Our results showed that probiotics have a beneficial effect in changing the microbiota of patients with IMSDs; they also influence disease progression. Further studies are needed to better understand the impact of new therapies on intestinal microbiota. It is also important to determine whether the microbiota of patients with autoimmune diseases can be manipulated in order to restore homeostasis of the microbiota.

Background. Although amiodarone is a drug with many side effects, it is one of the most commonly used drugs in the treatment and prophylaxis of supraventricular and ventricular arrhythmias. Aim. The purpose of this pilot study was to evaluate plasma concentrations of amiodarone in patients with atrial fibrillation (AF) and to identify possible drug-drug interactions between amiodarone and concomitant medications. Method. A prospective observational study was conducted in 27 consecutive patients treated with amiodarone from May to July 2017 in a Clinical University Hospital. The patients included met our inclusion criteria. HPLC-UV was the device used to determine the plasma concentration of amiodarone. Results. Only 51.8% of the patients had amiodarone plasma concentration within therapeutic interval (500-2500 ng/ml). The drugs associated to amiodarone in the therapeutic plan were diuretics, beta blockers, statins, antiplatelets, fluoroquinolones, non-steroidal anti-inflammatory drugs. We observed a statistically significant difference between the plasmatic concentrations of amiodarone in patients treated with furosemide vs. patients concomitantly treated with other drugs. Interactions between other mentioned drugs and amiodarone were not registered. We can report an underuse of amiodarone for more than 50% of the patients. Also, we found a significant interaction between furosemide and amiodarone, most likely through the interaction with MDR. Conclusion. Furosemide may influence the pharmacokinetics of P-gp-interfering drugs. However, the relevance of these findings needs to be confirmed and further research is needed to characterize the interaction between amiodarone and furosemide.

Recycling of plastics from WEEE requires, first of all, separation on polymer types with various technologies being currently employed for this operation. A new solution, the single-step triboelectrostatic separation, that was developed in recent years consists in a fluidized-bed tribocharging process simultaneous with the separation process. The experimental analysis of plastic granules separation in this type of equipment shows charged granules accumulated in the zone of opposite sign electrode who do not exit the tribo-charging and separation chamber. In order to evaluate the effect of the charged granules on the field distribution two 2D geometries were modelled and the electric field was calculated. The results show that an accumulation of charged granules in the proximity of the separator electrodes leads to a decrease of the electric field intensity, which in extreme conditions can be cancelled or even reversed, with great impact on the quality and quantity of the recovered fractions. The results obtained from these simulations are particularly useful for choosing practical solutions for the construction of the separator.

Background: Physicians' adherence to guideline-recommended therapy is associated with short-term clinical outcomes in heart failure (HF) with reduced ejection fraction (HFrEF). However, its impact on longer-term outcomes is poorly documented. Here, we present results from the 18-month follow-up of the QUALIFY registry. Methods and results: Data at 18 months were available for 6118 ambulatory HFrEF patients from this international prospective observational survey. Adherence was measured as a continuous variable, ranging from 0 to 1, and was assessed for five classes of recommended HF medications and dosages. Most deaths were cardiovascular (CV) (228/394) and HF-related (191/394) and the same was true for unplanned hospitalizations (1175 CV and 861 HF-related hospitalizations, out of a total of 1541). According to univariable analysis, CV and HF deaths were significantly associated with physician adherence to guidelines. In multivariable analysis, HF death was associated with adherence level [subdistribution hazard ratio (SHR) 0.93, 95% confidence interval (CI) 0.87–0.99 per 0.1 unit adherence level increase; P = 0.034] as was composite of HF hospitalization or CV death (SHR 0.97, 95% CI 0.94–0.99 per 0.1 unit adherence level increase; P = 0.043), whereas unplanned all-cause, CV or HF hospitalizations were not (all-cause: SHR 0.99, 95% CI 0.9–1.02; CV: SHR 0.98, 95% CI 0.96–1.01; and HF: SHR 0.99, 95% CI 0.96–1.02 per 0.1 unit change in adherence score; P = 0.52, P = 0.2, and P = 0.4, respectively). Conclusion: These results suggest that physicians' adherence to guideline-recommended HF therapies is associated with improved outcomes in HFrEF. Practical strategies should be established to improve physicians' adherence to guidelines. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology

The recycling of spent alkaline and zinc-carbon batteries aims to minimize the waste, to avoid environmental pollution, and to provide valuable secondary raw materials. The paper presents the development of a new technology, based on corona-electrostatic separation, for the recovery of zinc and brass granules from the coarse fraction obtained in the recycling process of alkaline and zinc-carbon batteries. A free-fall electrostatic separator was equipped with an extended needle-type corona electrode, to strongly charge by ion bombardment all the components of the granular mixture. The difference in density between metallic granules (zinc and brass) and other non-metallic components leads to different trajectories and makes possible their collection as separated fractions. The recovery rate and purity of the metallic fraction - as high as 99% and 92% respectively, was obtained with a 52% recovery rate the non-metallic fraction. A new electrode configuration was employed to improve the granule collection efficiency, leading to a significant increase in both the recovery rate of non-metallic fraction, and the purity of the metallic fraction - 97.6% and 99.2% respectively. The experimental results show that the proposed corona-electrostatic technology allows the recovery of about 390 kg of zinc and brass with over 99% purity from 1,000 kg of granular mixture, with an energy consumption of about 48 kWh. The corona-electrostatic technology represents a competitive alternative for the recovery of zinc and brass granules from spent alkaline and zinc-carbon batteries.

Background & Aims. Triple therapy with Peg-IFNs, Ribavirin and protease inhibitors raise the treatment success for hepatitis C up to 83%, but also bring together with the significantly higher rates of sustained virologic response (SVR) more side effects, interfering with patient’s quality of life (QoL) and work productivity. We aimed to analyze the factors influencing the adherence and the QoL during triple therapy using Peg-IFNs, Ribavirin and protease inhibitors in 50 patients diagnosed with chronic hepatitis C with first line therapy failure. Multivariate Cox proportional hazards regression was used to analyze determinants of retreatment initiation and treatment compliance, according to patient features. Results: We identified as major drivers of retreatment initiation the younger age, the female gender, the urban provenience, the high income, and the psychiatric and alcohol or drugs abuse history. The adherence and the QoL during retreatment therapy were similar, despite the regimen used, and obvious lower in patients with history of previous abandon, drugs and alcohol abuse or hematologic/ psychiatric decompensation. A lower capacity to work and a temporary withdrawal from job necessary to continue the therapy were seen similar in patients taking Boceprevir/Telaprevir. Abandon of therapy without a known reason was more frequent in males, with alcohol and drugs intake history, from rural region, with low income, and with psychiatric disturbances in personal history. Conclusion. Physicians should focus to develop medical strategies or drugs to increase the adherence and to provide a better QoL for patients with chronic hepatitis C making antiviral therapy.

Background Atrial fibrillation (AF) is one of the most common sustained cardiac arrhythmia. It is associated with significant morbidity, mortality and poor quality of life. This is the reason why it is very important to closely follow its treatment. Amiodarone is one of the most frequently used antiarrhythmic drugs in patients with AF both in prophylaxis and treatment. However, the treatment with this drug results in high healthcare resource use and costs due to its poor safety profile. Purpose The objective of this study was to assess the plasmatic concentration of amiodarone in patients with AF and also to identify possible factors that could influence it. The results were correlated with used doses, with concomitantly administered drugs, renal and liver function. Material and methods A prospective observational study was conducted in 27 consecutive patients treated with amiodarone from May to July 2017 in a Clinical University Hospital. The patients included met our inclusion criteria. HPLC-MS was the device used to determine the plasma concentration of amiodarone. Results The mean age of those 27 included patients was 65/6±11 years, 44.4% females. The used doses were 200 mg or 400 mg/day. In our patients, plasmatic concentration was given in a therapeutic interval (500–2,500 ng/ml) to 51.8%. In the patients with lower plasmatic concentrations of amiodarone, the drugs associated in the therapeutic plan belonged to: diuretics (furosemide), beta-blockers, statins, antiplatelets (clopidogrel), fluoroquinolones (ciprofloxacine) and non-steroidal anti-inflammatory drugs. It was observed that there was a statistically significant difference between the plasmatic concentrations of amiodarone in patients treated with furosemide vs patients treated concomitantly with other drugs. The interactions between other mentioned drugs and amiodarone were not registered. It was observed that an increase in transaminases or creatinine is correlated with an increase in amiodarone’s plasmatic concentration. Conclusion 48.2% of the patients with AF under chronic treatment with amiodarone had the plasmatic concentration of amiodarone out of the therapeutic range. We can report an underuse of amiodarone for these patients. It was found that there was a significant interaction between furosemide and amiodarone. In order to confirm this interaction, we need to continue the research on a larger sample. References and/or Acknowledgements Thanks to all the collaborators. No conflict of interest