Direct Oral Anticoagulants for Stroke and Systemic Embolism Prevention in Patients with Left Ventricular Thrombus.

In recent years, direct oral anticoagulants (DOAC) have accumulated evidence of efficacy and safety in various clinical scenarios and are approved for a wide spectrum of indications. Still, they are currently used off-label for left ventricular thrombus owing to a paucity of evidence. For the same reason, there is a lack of guideline indication as well. Our work is based on an exhaustive analysis of the available literature and provides a structured and detailed update on the use of DOACs in patients with left ventricle thrombus. The safety and efficacy of DOACs were analyzed in particular clinical scenarios. As far as we know, this is the first paper that analyzes DOACs in this approach.

Recent Progress of Electrochemical Aptasensors toward AFB1 Detection (2018-2023).

Food contaminants represent possible threats to humans and animals as severe food safety hazards. Prolonged exposure to contaminated food often leads to chronic diseases such as cancer, kidney or liver failure, immunosuppression, or genotoxicity. Aflatoxins are naturally produced by strains of the fungi species Aspergillus, which is one of the most critical and poisonous food contaminants worldwide. Given the high percentage of contaminated food products, traditional detection methods often prove inadequate. Thus, it becomes imperative to develop fast, accurate, and easy-to-use analytical methods to enable safe food products and good practices policies. Focusing on the recent progress (2018-2023) of electrochemical aptasensors for aflatoxin B1 (AFB1) detection in food and beverage samples, without pretending to be exhaustive, we present an overview of the most important label-free and labeled sensing strategies. Simultaneous and competitive aptamer-based strategies are also discussed. The aptasensors are summarized in tabular format according to the detection mode. Sample treatments performed prior analysis are discussed. Emphasis was placed on the nanomaterials used in the aptasensors' design for aptamer-tailored immobilization and/or signal amplification. The advantages and limitations of AFB1 electrochemical aptasensors for field detection are presented.

Identification of Potential microRNA Panels for Male Non-Small Cell Lung Cancer Identification Using Microarray Datasets and Bioinformatics Methods.

Background: Non-small cell lung cancer (NSCLC) is still one of the types of cancer with the highest death rates. MicroRNAs (miRNAs) play essential roles in NSCLC development. This study evaluates miRNA expression patterns and specific mechanisms in male patients with NSCLC. Methods: We report an integrated microarray analysis of miRNAs for eight matched samples of males with NSCLC compared to the study of public datasets of males with NSCLC from TCGA, followed by qRT-PCR validation. Results: For the TCGA dataset, we identified 385 overexpressed and 75 underexpressed miRNAs. Our cohort identified 54 overexpressed and 77 underexpressed miRNAs, considering a fold-change (FC) of ±1.5 and p < 0.05 as the cutoff value. The common miRNA signature consisted of eight overexpressed and nine underexpressed miRNAs. Validation was performed using qRT-PCR on the tissue samples for miR-183-3p and miR-34c-5p and on plasma samples for miR-34c-5p. We also created mRNA-miRNA regulatory networks to identify critical molecules, revealing NSCLC signaling pathways related to underexpressed and overexpressed transcripts. The genes targeted by these transcripts were correlated with overall survival. Conclusions: miRNAs and some of their target genes could play essential roles in investigating the mechanisms involved in NSCLC evolution and provide opportunities to identify potential therapeutic targets.

Design, in vitro bioactivity and in vivo influence on oxidative stress and matrix metalloproteinases of bioglasses in experimental skin wound.

BACKGROUND: The bioactive glasses (BGs) are very attractive materials increasingly used in healing skin lesions due to their antibacterial effect and stimulation of collagen deposition and angiogenesis. In this study, three specimens of bioactive glasses (BG1, BG2 and BG3) have been synthesized and characterized. METHODS: In order to evaluate their in vitro bioactivity, the pH measurements, zeta potential and the concentration of Ca2+ and fluor ions released after immersion in phosphate buffered saline (PBS) followed by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy, inductively coupled plasma optical emission spectrometry (ICP-OES) and for BG1 and BG3, X-ray powder diffraction analysis, were performed. X-ray photoelectron spectroscopy (XPS) was also used for detection of different ions in the solid bioglasses before immersion in PBS. The impact of BG1 and BG3 on skin healing mechanisms was evaluated by oxidative stress and matrix metalloproteases (MMP)-2 and -9 and by histopathological analysis. RESULTS: The results have shown that all the BGs tested are characterized by a very high degradation rate and a very fast Ca2+, fluor and boron releases and displayed changed surface morphology at SEM, after 7 and 14 days of immersion in PBS. In addition, BG1 and BG3 reduced in vivo the lipid peroxidation, increased the nitric oxide, especially at 14 days and improved superoxide dismutase activity, mainly in BG1 treated animals. In parallel, both BG1 and BG3, diminished MMP-9 at 14 days and increased the proportion of normal collagen in the bed of the wound, particularly BG3. CONCLUSION: These results suggested that due to the antioxidant and anti-inflammatory properties of components released from BGs and regulatory properties on MMPs activities, BGs can exert beneficial effects in wound healing.

EBUS in optimizing non-small cell lung cancer diagnosis and treatment.

BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a commonly used minimally invasive method for the diagnosis and staging of lung cancer. In order to improve its diagnostic accuracy, rapid on-site cytologic evaluation (ROSE) is being utilized in some institutions. ROSE, performed by a cytopathologist in the examination room, allows the assessment of the adequacy of the collected samples, identifies malignant cells and sometimes establishes diagnosis on the spot, thus improving diagnostic sensitivity. As non-small cell lung carcinomas (NSCLC) require not only pathological subtyping, but also molecular characterization, obtaining the adequate amount of tissue is crucial. Only a limited number of studies have analyzed the suitability of EBUS-TBNA samples for assessment of epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK) and programmed death-ligand 1 (PD-L1) status. AIM: We intended to examine the diagnostic yield of ROSE in NSCLC and the results and feasibility of molecular analysis performed on EBUS-TBNA small samples. METHODS: 100 patients with lung tumors and hilar and/or mediastinal lymphadenopathy on CT or PET/CT scans were retrospectively identified over a 3-year period, from a prospectively maintained EBUS-TBNA database. All examinations were accompanied by on-site cytological exam - ROSE, histopathological exam (HPE) and, in the case of NSCLC, molecular testing. After the sampling of the lymph nodes, specimens were Diff-Quik stained and a rapid preliminary diagnosis was established. Immunohistochemistry and mutational testing were performed using cell blocks. RESULTS: Adenocarcinoma was the most frequent diagnosis in both ROSE (34%) and histopathology (53%). Overall sensitivity and positive predictive value of ROSE in NSCLC, considering HPE the gold standard, were 92.18% and 93.65%, respectively, with a specificity and negative predictive value of 75% and 70.58%, respectively. All samples that were tested for EGFR mutation and ALK rearrangement were adequate for analysis. The adequacy ratio for PD-L1 was 91.66%; 37.5% of patients showed a high PD-L1 expression level, with a tumor proportion score TPS ≥50%. CONCLUSION: EBUS-TBNA is a valuable method for lung cancer diagnosis. ROSE proved to have a moderate prediction of the final diagnosis in NSCLC. Molecular analysis of EGFR, ALK and PD-L1 can be successfully accomplished on EBUS-TBNA small tissue samples.

Cryobiopsy in Lung Cancer Diagnosis-A Literature Review.

Optimizing the diagnosis of lung cancer represents a challenge, as well as a necessity, for improving the low survival of these patients. Flexible bronchoscopy with forceps biopsy is one of the key diagnostic procedures used for lung tumors. The small sample size and crush artifacts are several factors that can often limit access to a complete diagnosis, therefore leading to the need of repeating the bronchoscopy procedure or other invasive diagnostic methods. The bronchoscopic cryobiopsy is a recent technique that proved its utility in the diagnosis of both endobronchial and peripheral lung tumors. In comparison with conventional forceps biopsy, studies report a higher diagnostic yield and a superior quality of the collected samples for both the histopathological and the molecular diagnosis of lung cancer. This method shows promising results in sampling lung tissue, alone, or in conjunction with fluoroscopy or radial endobronchial ultrasound (r-EBUS). With a good safety and cost-benefit profile, this novel method has the potential to improve the diagnosis, and therefore the management of lung cancer patients. The objective of this narrative review is to provide a comprehensive review of the recent data regarding the advantages of cryobiopsy and r-EBUS in lung cancer diagnosis.

An overview of the detection of serotonin and dopamine with graphene-based sensors.

The development of rapid and sensitive devices for the simultaneous detection of neurotransmitters has critical implications for the clinical field and for the management of several diseases. Parkinson's, Alzheimer's disease, autism, schizophrenia, depression and anxiety are major healthcare challenges for which early diagnostics and personalized therapy are of great concern. Carbon-based nanomaterials and especially graphene-based nanomaterials associated with different architectures have been extensively studied and continue to represent the first line of approach in the development of nanoplatforms for electrochemical sensors. The simultaneous detection of analytes represents a critical point that could be addressed by designing new materials with the capacity to resolve their electrochemical signals. The results can be presented as a matrix that offers a broader viewpoint toward the balance of the neurotransmitter levels that are correlated with clinical symptoms for personalized diagnosis. The goal is to describe and evaluate, in a critical manner, the elaboration of graphene-based sensors that can be included in clinical applications. A major check point discussed throughout the paper is represented by the interference between different neurotransmitters that appear due to their overlapping signals and the strategies to address them to achieve simultaneous detection of as many molecules as possible and to be similar to in vivo experiments.

Cystic malignant peritoneal mesothelioma of the abdominal wall. Case report.

We present the clinical observation of a female patient with cystic peritoneal malignant mesothelioma developed in the thickness of the abdominal wall. The diagnosis included several steps: tumor classification as mesothelioma, tumor differentiation from reactive mesothelial hyperplasia, establishment of the malignant nature and differentiation from other malignant peritoneal tumors. Relapse in about one year after surgery and about six months after the end of chemotherapy also claim malignancy of the tumor. The particular tumor location in the thickness of the abdominal muscles, seemingly without involvement of the parietal peritoneum, in a patient with a history of caesarean operation, questions its development out of ectopic tissue embedded in scar from previous surgery. KEY WORDS: Abdominal wall, Caesarian operation Cystic malignant peritoneal mesothelioma, CK5/6, p53.

The role of CD146 in serous ovarian carcinoma.

PURPOSE: The heterogeneous phenotype of epithelial ovarian cancer (EOC) explains the unpredictable behaviour in terms of response to therapy, time to progression and survival. In this context, CD146, a cell adhesion molecule, has been focused on as a marker of poor prognosis in various solid cancers, being also capable to modulate the activity of endothelial cells. Therefore, we proposed to investigate its role in serous ovarian carcinoma. METHODS: The study included 101 patients diagnosed with EOC and treated within "Ion Chiricuta" Oncology Institute by optimal surgical debulking followed by platinum-based chemotherapy. Clinico-pathological characteristics were collected from patient files. CD146 expression was assessed by immunohistochemistry in serous ovarian carcinoma primary tumours, taking into account both staining intensity and the percentage of positive tumor cells. Expression of CD146 in endothelial cells of tumour microvessels was also evaluated. CD34 immunostaining was used for intratumoral microvessel density estimation. RESULTS: CD146 positivity in tumor cells was objectified in 49.5% of samples and 37.1% presented a high CD146 endothelial expression. Our analysis showed that CD146 was as reliable as CD34 for microvascular density estimation. The distribution of cases according to CD146 tumor expression was similar regardless of age, initial serum CA125 level, FIGO stage, presence/absence of malignant ascites. Multivariate analysis confirmed that expression of CD146 in tumor cells was a negative prognostic factor for overall survival, significantly asociated with a higher risk of chemotherapy resistance. CONCLUSIONS: Although CD146 immunoreactivity in tumor cells did not correlate with the routinely used clinico-pathological parameters, expression of CD146 in tumor cells was an independent pronostic factor for survival in serous ovarian carcinomas. Moreover, CD146 might be regarded as a novel biomarker of tumor neovasculature.

Soluble sPD-L1 and Serum Amyloid A1 as Potential Biomarkers for Lung Cancer.

BACKGROUND: The objective of this prospective study was to evaluate whether soluble programmed cell death-1/programmed cell death-ligand 1 (PD-1/PD-L1) and serum amyloid A1 (SAA1) are potential diagnostic, predictive or prognostic biomarkers in lung cancer. METHODS: Lung cancer patients (n=115) with advanced metastatic disease, 101 with non-small cell lung cancer, NSCLC (77 EGFR wild-type NSCLC patients on chemotherapy, 15 EGFR mutation positive adenocarcinoma patients, 9 patients with mPD-L1 Expression ≥50% NSCLC - responders to immunotherapy), and 14 patients with small cell lung cancer (SCLC) were examined. ELISA method was used to determine sPD-L1 and SAA1 concentrations in patients' plasma. RESULTS: Significantly higher blood concentrations of sPD-L1 and SAA1 were noted in lung cancer patients compared with a healthy control group. In PD-L1+ NSCLC patients, a significantly higher sPD-L1 level was noticed compared to any other lung cancer subgroup, as well as the highest average SAA1 value compared to other subgroups. CONCLUSIONS: It seems that sPD-1/PD-L1 might be a potential biomarker, prognostic and/ or predictive, particularly in patients treated with immunotherapy. Serum amyloid A1 has potential to act as a good predictor of patients' survival, as well as a biomarker of a more advanced disease, with possibly good capability to predict the course of disease measured at different time points.

Electrochemical Biosensors as Potential Diagnostic Devices for Autoimmune Diseases.

An important class of biosensors is immunosensors, affinity biosensors that are based on the specific interaction between antibodies and antigens. They are classified in four classes based on the type of employed transducer: electrochemical, optical, microgravimetric, and thermometric and depending on the type of recognition elements, antibodies, aptamers, microRNAs and recently peptides are integrating parts. Those analytical devices are able to detect peptides, antibodies and proteins in various sample matrices, without many steps of sample pretreatment. Their high sensitivity, low cost and the easy integration in point of care devices assuring portability are attracting features that justify the increasing interest in their development. The use of nanomaterials, simultaneous multianalyte detection and integration on platforms to form point-of-care devices are promising tools that can be used in clinical analysis for early diagnosis and therapy monitoring in several pathologies. Taking into account the growing incidence of autoimmune disease and the importance of early diagnosis, electrochemical biosensors could represent a viable alternative to currently used diagnosis methods. Some relevant examples of electrochemical assays for autoimmune disease diagnosis developed in the last several years based on antigens, antibodies and peptides as receptors were gathered and will be discussed further.

Decoding the Emerging Patterns Exhibited in Non-coding RNAs Characteristic of Lung Cancer with Regard to their Clinical Significance.

Lung cancer continues to be the leading topic concerning global mortality rate caused by can-cer; it needs to be further investigated to reduce these dramatic unfavorable statistic data. Non-coding RNAs (ncRNAs) have been shown to be important cellular regulatory factors and the alteration of their expression levels has become correlated to extensive number of pathologies. Specifically, their expres-sion profiles are correlated with development and progression of lung cancer, generating great interest for further investigation. This review focuses on the complex role of non-coding RNAs, namely miR-NAs, piwi-interacting RNAs, small nucleolar RNAs, long non-coding RNAs and circular RNAs in the process of developing novel biomarkers for diagnostic and prognostic factors that can then be utilized for personalized therapies toward this devastating disease. To support the concept of personalized medi-cine, we will focus on the roles of miRNAs in lung cancer tumorigenesis, their use as diagnostic and prognostic biomarkers and their application for patient therapy.

Surgical scar endometriosis: a series of 14 patients and brief review of literature.

BACKGROUND AND AIMS: Endometriosis is a commonly encountered disorder in women of reproductive age, consisting of the presence of active ectopic endometrial tissue outside the endometrial cavity. Surgical scar endometriosis is a rare condition representing about 2% of all endometriosis cases. The purpose of this study was to assess the main characteristics, diagnostic tools and therapeutic options in abdominal wall endometriosis (AWE). METHODS: We have reviewed a series of fourteen cases with histopathological confirmation of AWE that were managed in our institution. RESULTS: The main characteristic of AWE were emphasized, showing that 78.57% of the patients had at least one previous caesarian section and that in only 57.14% of all cases an accurate diagnosis of AWE was established preoperatively. CONCLUSION: A direct relationship between gynecological and obstetrical surgery and AWE is well established and as the caesarian section rates increase constantly, the awareness regarding AWE should also be increased.

Mechanical suture in rectal cancer.

BACKGROUND AND AIMS: Colorectal cancer is one of the most frequent digestive malignancies, being the third cause of death by cancer, despite early diagnosis and therapeutic progress made over the past years. Standard treatment in these patients is to preserve the anal sphincter with restoration of intestinal function by mechanical colorectal anastomosis or coloanal anastomosis, and to maintain genitourinary function by preservation of hypogastric nerves. METHODS: In order to emphasize the importance of this surgical technique in the Fourth Surgical Clinic of the CF Clinical Hospital Cluj-Napoca, we conducted a prospective observational interventional study over a 3-year period (2013-2016) in 165 patients hospitalized for rectal and rectosigmoid adenocarcinoma in various disease stages, who underwent Dixon surgery using the two techniques of manual and mechanical end-to-end anastomosis. For mechanical anastomosis, we used Covidien and Panther circular staplers. The patients were assigned to two groups, group A in which Dixon surgery with manual end-to-end anastomosis was performed (116 patients), and group B in which Dixon surgery with mechanical end-to-end anastomosis was carried out (49 patients). RESULTS: Mechanical anastomosis allowed to restore intestinal continuity following low anterior resection in 21 patients with lower rectal adenocarcinoma compared to 2 patients in whom intestinal continuity was restored by manual anastomosis, with a statistically significant difference (p<0.000001). The double-row mechanical suture technique is associated with a reduced duration of surgery (121.67 minutes for Dixon surgery with mechanical anastomosis, compared to 165.931 minutes for Dixon surgery with manual anastomosis, p<0.0001). CONCLUSION: The use of circular transanal staplers facilitates end-to-end anastomosis by double-row mechanical suture, allowing to perform low anterior resection in situations when the restoration of intestinal continuity by manual anastomosis is technically not possible, with the aim to preserve the anal sphincter, to restore intestinal function and maintain genitourinary function through preservation of hypogastric nerves.

Endobronchial ultrasound - one year of experience in clinical practice.

BACKGROUND AND AIM: Endobronchial ultrasound (EBUS) is a recent minimally invasive, safe examination method for the mediastinum, with a good diagnostic precision. This method makes possible real time examination with transbronchial fine needle aspiration, diagnostic transbronchial needle aspiration (TBNA) and staging of non-small pulmonary tumors, as well as diagnosis of mediastinal and hilar adenopathies of various causes. METHODS: We present the experience of the Bronchoscopy Department of the Pulmonology Clinic of Cluj-Napoca with EBUS-TBNA as a tool for the diagnosis and staging of tumors in contact with the bronchial wall and mediastinal and hilar adenopathies of unknown etiology. During the period August 2014 - January 2016 we examined 152 patients with no direct or indirect signs of lung tumor in traditional bronchoscopy. Rapid on site evaluation (ROSE) was available for all patients. RESULTS: Our study is a retrospective study of 152 EBUS-TBNA examinations. The average age of our patients was 54.43 years and 64% came from urban and 36% from rural background. EBUS-TBNA brought the final histological confirmation (tumors, sarcoidosis, limphoma) in 82.8% of the cases. A tumor confirmation was obtained in 95% of the patients who were suspected of having tumor. For a better understanding of the importance of this method in the daily clinical practice we present a case of peripheral pulmonary neoplasm with mediastinal and hilar adenopathies, where the contribution of EBUS-TBNA to a rapid diagnosis was essential. CONCLUSION: By the introduction of this method in our country one year ago, we can diagnose patients with lung and mediastinal tumors, which cannot be diagnosed by traditional bronchoscopy. This brings a valuable contribution to the improvement of lung cancer staging and diagnostic.

The use of EBUS-TBNA and ROSE in the diagnosis of lung cancer.

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive method for diagnosing and staging of lung cancer. EBUS-TBNA obtained small specimens. Rapid on-site examination (ROSE) is a rapid, real-time examination method. The aim of our study is to evaluate the impact of ROSE on adequate specimen sampling, rapid results and high diagnostic rate. We present the experience of the Department of Bronchology, "Leon Daniello" Clinic of Pulmonology, Cluj-Napoca, Romania, with EBUS-TBNA as a tool for diagnostic of adenopathies of unknown etiology. We evaluated the diagnostic capacity of ROSE for malignant tumors, by considering the histopathological examination as the diagnostic "gold standard". In our retrospective and descriptive study, we analyze the data of 147 EBUS-TBNA examinations with ROSE and histopathological exam, performed for diagnostic purposes for hilar and mediastinal adenopathies of unknown origin. The age of the patients varied from 21 to 80 years, with an average age of 54.36 years. There were 98 male patients, representing 66.66% of the group. From the total of 90 cases of malignancy, 72 (80%) cases were identified as a primary lung tumor, 13 (14.44%) cases were identified as lymphoma, and five cases as malignant tumor of extrapulmonary origin. The sensitivity of the ROSE is 85.71%. By the introduction of this method, EBUS-TBNA with ROSE, in our country, we can diagnose patients with lung and mediastinal tumors, which cannot be diagnosed by traditional bronchoscopy. This brings a valuable contribution to the improvement of lung cancer diagnostic.

Diagnostic reevaluation of 17 cases of pheochromocytoma - a retrospective study.

A rare neuroendocrine tumor, the pheochromocytoma (PCC) raises problems due both the limited experience of the researchers in this field and its pathogenic mechanisms, still not fully elucidated. The malignant potential of this tumor cannot be predicted based on its macro- or microscopic aspects, but on the presence of metastases. The aims of this study were: (1) the reevaluation of data for a pertinent and complete tumor diagnostic and prognostic pattern; (2) the statistical correlation of all investigated parameters with the malignant form and the survival rate in order to obtain a possible predictor of malignancy; (3) the potential identification of initially diagnosed benign tumors that become malignant in time. The retrospective study was conducted on 17 patients diagnosed with pheochromocytoma. We investigated: the personal data, the associated neuroendocrine syndromes, the clinical, the laboratory, the macro- and microscopic data [location, size, Hematoxylin-Eosin (HE) pheochromocytoma of the adrenal gland scaled score (PASS score), and immunohistochemical aspects] and the survival rate (analyzed by Kaplan-Meier method and Log-Rank test). The influence of diagnostic parameters on malignancy was calculated taking into consideration the survival rate. By reevaluation of the 17 cases, we tried to emphasize the value of a complex diagnosis pattern for PCCs, based on the correlation between clinical data, laboratory findings and microscopic features. A significant statistical difference between benign and malignant forms was not registered, but there were parameters as age, association with neuroendocrine syndromes, PASS score and specifically Ki-67 mitotic index that had a powerful impact on the survival rate and could be consider as possible predictors of malignancy. The potential of PCC malignant transformation was revealed in our study, by two cases that have metastasized in time.

Primary peritoneal serous psammocarcinoma: a case report.

BACKGROUND: Psammocarcinomas (PCas) are rare epithelial tumors, usually originating in the ovaries or the peritoneum. These tumors are morphologically characterized by extensive psammomatous calcifications, invasiveness and low-grade cytological features. CASE REPORT: We present the case of a 54-year-old woman who was referred to our department with an umbilical tumor and increasing abdominal girth. The patient had had an umbilical hernia for more than 20 years. The CA 125 level was normal. The CT scan showed small peritoneal nodules at the level of the Douglas pouch, including the posterior wall of the uterus, and the entire colon, as well as large nodules located on the caecum and the sigmoid colon. We performed partial enterectomy, total colectomy with ileo-rectal anastomosis, omentectomy, total histerectomy and bilateral adnexectomy, pelvic peritonectomy of the Douglas pouch. Pathology findings were consistent with F.I.G.O. stage IIIC peritoneal PCa. The patient received adjuvant chemotherapy with Taxol and Carboplatin. To date, twelve months after surgery, the follow-up shows no evidence of disease. CONCLUSION: Standardized treatment protocols are hindered by the rarity of the PCas. However, literature concludes that optimal debulking is mandatory, whereas the efficacy of adjuvant chemotherapy remains to be elucidated.

[Esophageal pathology with respiratory impact]. / Patologie esofagiana cu rasunet asupra aparatului respirator.

We present some of digestive diseases: achalazia, esophageal diverticula and esophageal fistula, which in their evolution determine respiratory symptoms: dispnea, cough and imitate until confusion respiratory diseases. The diagnosis is most of the time difficult and it needs special investigations. A better knowledge of these diseases helps us to avoid mistakes in diagnosis.

[Update in bronchoscopic techniques]. / Update tehnici bronhoscopice.

Bronchoscopy is a central technique in diagnosing lung cancer, but also in different therapeutic approaches. The most common indication for bronchoscopy is for tissue sampling and determining the extent of lung cancer. Established diagnostic techniques are forceps biopsy, aspiration or brush cytology sampling, or needle aspiration. Laser therapy, electrocautery, cryotherapy and stenting are well-described techniques for the palliation of symptoms due to airway involvement in patients with advanced stages. Newer technologies, with an established role in clinical practice, are endobronchial ultrasound, autofluorescence bronchoscopy, and electromagnetic navigation. Other technologies, such as magnification, narrow-band imaging and confocal fluorescence microendoscopy, are in development for the use within the airways.