Search Results (90)

Background and Objectives: Traumatic hemorrhage is a leading cause of death. Our aim was to examine the effect of adenosine, lidocaine and magnesium (ALM) resuscitation therapy with and without fresh frozen plasma (FFP) or fresh whole blood (FWB) in a rat model of non-compressible hemorrhage. Materials and Methods: Anesthetized adult male Sprague-Dawley rats (439 ± 46 g) randomly assigned to (1) Shams (surgical trauma and liver isolation only without hemorrhage) (n = 34), (2) Saline controls (n = 34), or (3) ALM therapy (n = 34), underwent liver resection and uncontrolled bleeding. After 5 h 3% NaCl ± ALM bolus and 0.9% NaCl ± ALM drip fluid resuscitation, each group was randomized to receive no transfusion (NT) (n = 10 per treatment group), FFP (n = 12), or FWB (n = 12), and monitored for 72 h. Survival, hemodynamics, lactate, hematology, coagulation, platelet function, and lung histopathology were measured. Results: Sham, Saline and ALM NT survival were 50%, 0% and 100%. Sham survival increased to 75% with FFP, but not FWB (50%), and only marginally in the Saline group (8% and 17%, respectively). ALM protection was lost after 1–2 days with FFP and FWB (8% and 0% survival). Mortality was associated with acute lung injury, inflammation, activation of innate immunity, intrinsic hypocoagulopathy, and metabolic acidosis. Survival was associated with maintained platelet count and aggregation. Acute phase protein fibrinogen increased ~2.5 times in both survivors and non-survivors. Conclusions: ALM therapy without FFP or FWB transfusion significantly improved survival, reduced lung injury, preserved platelet function, and decreased immune and metabolic dysfunction. Blood products administered 5 h after injury did not significantly improve survival after non-compressible hemorrhage. Surgical trauma (laparotomy and liver isolation) also contributed to poor outcomes. The trauma and transfusion-related multi-system failure requires further investigation. Full article

Background/Objectives: Carrier-based dry powder inhaler (DPI) formulations remain the predominant platform for respiratory drug delivery. However, integrated development frameworks that align upstream particle engineering with downstream manufacturing are underdeveloped. This study aimed to develop a comprehensive Quality-by-Design (QbD) strategy that systematically connects jet milling, formulation design, and blending scale-up for carrier-based DPI products containing micronized crystalline active pharmaceutical ingredient (API). Methods: Phenytoin was selected as a model API to investigate process–formulation–performance relationships. Jet milling parameters were optimized to generate three distinct API particle size distributions while monitoring solid-state integrity. A design of experiments (DoE) evaluated the impact of API particle size and lactose fines level on aerodynamic performance (fine particle fraction, FPF) and powder processability (flowability, compressibility). High-shear and low-shear blending techniques were compared, and a novel V-shell blending scale-up methodology was developed based on maintaining particle fall velocity and total strain across multiple scales (one-, two-, and eight-quart). Results: Optimized jet milling produced inhalation grade API particles with controlled amorphous content localized to high-energy processes. DoE analysis identified a design space in which API Dv90 of 2.9–4.5 µm and coarse lactose <96% maximized both aerosolization and blend flowability. Low-shear blending achieved superior lung delivery (FPF 62.6 ± 1.7%) compared with high-shear micing (50.1 ± 1.5%). The particle-velocity-based scale up strategy produced statistically equivalent FPF and ED across all scales (p < 0.01), with content uniformity (RSD ≤ 5%) and variability comparable to commercial DPIs. Conclusions: This integrated QbD framework demonstrates that the co-optimization of particle size engineering, formulation composition, and blending dynamics is essential for achieving robust and scalable DPI products. The approach offers a material-sparing, efficient pathway from API characterization through commercial scale manufacturing and is broadly applicable to respiratory drug development. Full article

Background/Objectives: No effective intervention currently exists for non-compressible pulmonary injury, especially in a prehospital setting. Visco-liquids like trisilanol i-octyl POSS could remedy this. POSS resists hemorrhage and activates clotting; this can be augmented with kaolin (22.5%; PK) or chitin (10%; PC). Methods: We tested the efficacy of POSS, PK, and PC in treating incisional lung wounds in swine (39 ± 1 kg; n = 10). An incisional wound was made in the lung via a left thoracotomy, allowed to bleed freely for 30 s, and then no treatment (UNT), gauze with compression (GC), or POSS, PK, or PC was applied (1.5 mL). Each treatment was applied once per animal for a total of 5 wounds. Wounds were observed for 10 min for hemostasis and pneumostasis; GC treatments were assessed at 3 min intervals. Results: POSS and PC produced hemostasis in 8 of 10 wounds; GC: 7 (all significant from UNT); PK: 5 and UNT: 1. PK was not different from any group. POSS (2 ± 0.3 min) and PC (1.4 ± 0.4 min) clotted more quickly than GC (8 ± 3 min); PK was intermediate (3.8 ± 2 min) and not different from any other group. Pneumostasis was achieved in all POSS, PC, and PK, and only after hemostasis in the GC group. Conclusions: Because both POSS and PC provided quick and lasting hemorrhage and pneumatic control in this model, without need for compression, these results support the concept that these types of liquid POSS compounds could prove to be efficacious in prehospital treatment of non-compressible trauma wounds. Full article

Background and Clinical Significance: Adults suffering from cerebellar metastases are often at high risk for rapid deterioration of their neurological status because the posterior fossa has limited compliance and the location of these metastases are close to the brain stem and important cerebrospinal fluid (CSF) pathways. In this paper, we present a longitudinal, patient-centered report on the history of an elderly individual who suffered from cognitive comorbidities and experienced a sudden loss of function in her cerebellum. Our goal in reporting this case is to provide a comparison between the patient’s pre-operative and post-operative neurological examinations; the imaging studies she had before and after surgery; the surgical techniques utilized during her operation; and the outcome of her post-operative course in a way that will be helpful to other patients who have experienced a similar situation. Case Presentation: We report the case of an 80-year-old woman who initially presented with progressive ipsilateral limb-trunk ataxia, impaired smooth pursuit eye movement, and rebound nystagmus, but preserved pyramidal and sensory functions. Her quantitative bedside assessments included some of the components of the Scale for the Assessment and Rating of Ataxia (SARA), and a National Institute of Health Stroke Scale (NIHSS) score of 3. These findings indicated dysfunction of the left neocerebellar hemisphere and possible dentate nucleus involvement. The patient’s magnetic resonance imaging (MRI) results demonstrated an expansive mass with surrounding vasogenic edema and marked compression and narrowing of the exits of the fourth ventricle which placed the patient’s CSF pathways at significant risk of occlusion, while the aqueduct and inlets were patent. She then underwent a left lateral suboccipital craniectomy with controlled arachnoidal CSF release, preservation of venous drainage routes, subpial corticotomy oriented along the lines of the folia, stepwise internal debulking, and careful protection of the cerebellar peduncles and dentate nucleus. Dural reconstruction utilized a watertight pericranial graft to restore the cisternal compartments. Her post-operative intensive care unit (ICU) management emphasized optimal venous outflow, normoventilation, and early mobilization. Histopathology confirmed the presence of metastatic carcinoma, and staging suggested that the most likely source of the primary tumor was the lungs. Immediately post-operation, computed tomography (CT) imaging revealed a smooth resection cavity with open foramina of Magendie and Luschka, intact contours of the brain stem, and no evidence of bleeding or hydrocephalus. The patient’s neurological deficits, including dysmetria, scanning dysarthria, and ataxic gait, improved gradually during the first 48 h post-operatively. Upon discharge, the patient demonstrated an improvement in her limb-kinetic subscore on the International Cooperative Ataxia Rating Scale (ICARS) and demonstrated independent ambulation. At two weeks post-operation, CT imaging revealed decreasing edema and stable cavity size, and the patient’s modified Rankin scale had improved from 3 upon admission to 1. There were no episodes of CSF leakage, wound complications, or new cranial nerve deficits. A transient post-operative psychotic episode that was likely secondary to her underlying Alzheimer’s disease was managed successfully with short-course pharmacotherapy. Conclusions: The current case study demonstrates the value of anatomy-based microsurgical planning, preservation of venous and CSF pathways, and targeted peri-operative management to facilitate rapid recovery of function in older adults who suffer from cerebellar metastasis and cognitive comorbidities. The case also demonstrates the importance of early multidisciplinary collaboration to allow for timely initiation of both adjuvant stereotactic radiosurgery and molecularly informed systemic therapy. Full article

Background: Pediatric thoracic magnetic resonance imaging (MRI) has evolved into a valuable diagnostic modality that offers high-resolution morphological and functional assessment. While conventional radiography and computed tomography (CT) remain standard, their radiation exposure poses significant risks in children requiring repeated imaging. Technological innovations have addressed prior MRI limitations such as low lung proton density and motion artifacts, expanding its role in pediatric thoracic imaging. Methods: A review of the recent literature was performed, focusing on technical advancements, key MRI sequences and clinical applications in pediatric thoracic imaging. Emphasis was placed on ultrashort echo time (UTE), phase-resolved functional lung (PREFUL) MRI, hyperpolarized xenon-129 MRI, radial imaging, compressed sensing, parallel imaging and respiratory gating techniques. Results: Modern MRI sequences provide both detailed anatomic visualization and quantitative functional assessment of the pediatric thorax. UTE and PREFUL enable evaluation of lung parenchyma, ventilation, and perfusion, while hyperpolarized gas imaging offers high-resolution functional mapping. Radial, compressed sensing and parallel imaging reduce motion artifacts and acquisition times, enhancing feasibility in uncooperative children. Clinical indications include assessment of congenital malformations, chronic lung disease like cystic fibrosis, infectious and inflammatory disorders, tumors and selected traumatic injuries. Conclusions: Recent technical advances have established pediatric thoracic MRI as a versatile, patient-friendly alternative, as well as a complementary method to CT in selected clinical scenarios. Ongoing developments in acquisition speed, motion compensation and functional imaging are expected to further improve diagnostic accuracy and clinical utility, supporting broader adoption in routine pediatric thoracic evaluation. Full article

Background: The American Society of Clinical Oncology (ASCO) established recommendations for palliative care (PC), and they still remain the most trusted source overall. The standard published by C. Earle (defined in solid tumors) for referral to PC is > 55%. However, these rates remain unclear in general onco-hematology. Our referral rate reaches 60%; while it meets the standard, there are significant differences between ST and HM. Several authors have already pointed out these discrepancies. Arguing in some cases its possible relationship with the different behavior of professionals with different pathologies. Objective: The primary objective of this work is to understand the role that PC plays in onco-hematology and to determine the profile of patients referred to PC. Therefore, the article aims to establish some recommendations related to the results of prevalent characteristics. Methods: The Mortality Subcommittee (MS) includes and registers in a database all cancer patients who died in hospital undergoing systemic anticancer therapy (SACT) in their last 30 days of life (SACT ≤ 30 d). PC, in turn, works on relieving symptoms related to the disease and the patient. To understand the impact of PC in the MS database patients, we reviewed the literature for symptoms related to palliative care activity. Subsequently, we selected some signs and symptoms, by consensus with our PC specialists, in order to add them to the MS database and register them retrospectively. We measured the percentage of patients who registered these symptoms based on the data found in their electronic records. The results include the comparison by group: between patients referred or not to the PC program (PCP), and between the pathologies ST and HM. We used the programming language R (version 4.2) in our statistical analysis, including the “compareGroups” package (version 4.6), applying the pertinent tests based on the distribution of the data. Results: We completed the records on the 1681 patients from the period 2020–2023. 59.4% were men, the average age was 65.5 years, and 73.5% had ST and 26.5% had HM. Patients with lung cancer predominate (28.5%), with 71% of them being in the stage IV, followed by leukemia (9.76%). 60% are in progression of their disease, and 77% have advanced disease (AD). The average therapeutic aggressiveness indicators were SACT < 30 d: 38.9% (ST: 33.4%; HM: 70.97%); SACT < 14 d: 16.36% (ST: 13.76%; HM: 31.56%); the change in therapeutic regimen was 22% (ST: 20.8%; HM: 25.1%). The referral rate to PCP was 59.7% (ST: 68.2% and HM: 36.3%). Late referral (PCP ≤3 days before death) occurred in 29.2% of all patients, being 29% for ST cases and 30.4% for HM cases. Regarding the recording of signs and symptoms: psycho-emotional and analgesia regimens (including opioids) are better recorded in the PCP group (p < 0.001); the more physical symptoms (dyspnea, bleeding, infections, and severe symptoms) do not present statistically significant differences, although the severe symptoms in the PCP group are more disabling (cerebral involvement, spinal cord compression, vertebral crushing). The number of bags of blood products transfused is significantly lower in the PCP group (average 6.9 vs. 12.7). The total number of symptom variables with significant statistical differences was 13 for ST and 8 for HM. Conclusions: In this cohort, patients visited by PC had a better record of psycho-emotional symptoms. We consider that patients who are in any of the following situations should be referred to PC: initial diagnosis of stage IV lung cancer, leukemia; patients with advanced disease; presence of pain requiring opioids; psychoemotional symptoms; need for >7 to 15 transfusions of blood products and, if there are disabling symptoms. PC improves professional interest in the psycho-emotional and fragility situation of these patients. According to our data (in terms of the number of variables with significant differences by pathology group), we observed that hematologists tend to take on palliative tasks more frequently than their oncologist peers, who delegate them to PC in order to have more time dedicated to their specific field. Full article

Fetal lower urinary tract obstruction (LUTO) and pleural effusion are conditions that can disrupt fetal growth and lead to fetal death. LUTO inhibits the formation of amniotic fluid, which is vital for lung development, while pleural effusions can compress the fetal heart, potentially causing fatal cardiac failure. To manage these conditions, a fetal shunt (vesico-amniotic shunt) is placed inside the fetal bladder. This paper presents a study on a new design incorporating a Tesla valve in the shunt. Six groups of Tesla valves with loop angles of 50 degrees and 60 degrees, and different end dimensions, are examined and evaluated in terms of the urine flow rate from the fetal bladder into the amniotic cavity, the pressure buildup between the two sides, and their potential in developing fetal bladder muscles. A mathematical method is used to compare diode characteristics, analyze flow rates, identify the Tesla valve angle, determine the Reynolds number, and assess diodicity. The Computational Fluid Dynamics (CFD) method is also employed to verify calculation results and simulate fluid behavior inside the Tesla valve. Combining the calculations and simulations, a 50-degree Tesla valve with specific dimensions showed the best performance and will be the optimal design for the fetal shunt. Full article

We study motif-based optimization for sparse multilayer perceptrons (MLPs), where weights are shared and updated at the level of small neuron groups (‘motifs’) rather than individual connections. Building on Sparse Evolutionary Training (SET), our approach reduces the number of unique parameters and redundant multiply–accumulate operations by exploiting block-structured sparsity. Across Fashion-MNIST and a lung X-ray dataset, our Motif-SET improves training/inference efficiency with modest accuracy trade-offs, and we provide a principled recipe to choose motif size based on accuracy and efficiency budgets. We further compare against representative modern sparse training and compression methods, analyze failure modes such as overly large motifs, and outline real-world constraints on mobile/embedded targets. Our results and ablations indicate that motif size $m=2$ often offers a strong balance between compute and accuracy under resource constraints. Full article

The enhancement of drug delivery into the lung surfactant is facilitated by research on the interaction between drugs and the lung surfactant. Drug designers must have a thorough theoretical understanding of a drug before performing clinical tests to reduce the experimental cost. The current study uses a coarse-grained molecular dynamics (MD) approach with the MARTINI force field to parameterize the corticosteroid drug mometasone furoate, which is used to treat lung inflammation. Here, we investigate the accurate parametrization of drug molecules and validate the parameters with the help of umbrella sampling simulations. A collection of thermodynamic parameters was studied during the parametrization procedure. The Gibbs free energy gradient was used to calculate the partition coefficient value of mometasone furoate, which was approximately 10.49 based on our umbrella sampling simulation. The value was then matched with the experimental and predicted the partition coefficient of the drug, showing good agreement. The drug molecule was then delivered into the lung surfactant monolayer membrane at the alveolar air–water interface, resulting a concentration-dependent drop in surface tension while controlling the underlying continual compression–expansion of alveoli that maintains the exhalation–inhalation respiratory cycle. The dynamical properties of the monolayer demonstrate that the drug’s capacity to diffuse into the monolayer is considerably diminished in larger clusters, and this effect is intensified when there are more drug molecules present in the monolayer. The monolayer microstructure analysis shows that the drug concentration controls monolayer morphology. The results of this investigation may be helpful for corticosteroid drug delivery into the lung alveoli, which can be applied to comprehend how the drug interacts with lung surfactant monolayers or bilayers. Full article

With the growing adoption of CLO 3D in the fashion industry and educational settings, the need for accurate material representation and fit simulation in virtual environments is increasing. This study aimed to evaluate whether CLO 3D, without the aid of physical samples, can reliably simulate clothing pressure for compression wear made from different materials. Unlike previous CLO 3D studies that focused on design or pattern accuracy, this study critically examined material-specific simulation limitations and proposed technical enhancements. Two types of leggings with varying spandex content were tested across five yoga poses using the CLO 3D software(version 2024.2.214). The results showed that CLO 3D did not detect differences in clothing pressure caused by variations in spandex content. Furthermore, the pressure values remained constant across different poses for both fabrics, failing to reflect realistic mechanical differences. The highest total clothing pressure was recorded in the Lunge pose (277.02 kPa), and the lowest in the Plow pose (241.37 kPa). These findings suggest that the current simulation engine lacks sensitivity to fabric-specific mechanical properties and movement-based variation. To address these limitations, this study proposes five optimization functions for CLO 3D, including material property input, technical textile databases, environmental condition settings, AI-based comfort prediction, and data management tools. These proposals are expected to strengthen the scientific validity, functional realism, and user-centered applicability of CLO 3D in designing sportswear, medical compression garments, and customized apparel. Full article

The azygos lobe (AL), an additional lung lobe most commonly found in the right apical lung region, is a rare anatomical variant present in approximately 1% of the population. It is embryological in origin and may form if the azygos vein fails to migrate medially over the lung. While it is normally clinically silent, it can have surgical and clinical implications. An AL can be the source of infection or disease, such as squamous cell carcinoma, and can also compress the upper lobe and lead to obstruction, infarction, and necrotic tissue. Additionally, it can present as an unforeseen surgical obstacle, specifically during a thoracotomy, and can be mistaken for a thoracic mass on radiographic imaging, potentially leading to unnecessary interventions. In this case report, a 38-year-old male donor with a history of Ogilvie’s syndrome, multiple traumatic brain injuries (TBIs), and chronic respiratory failure presented with an AL during routine donor dissection. The cause of death was listed as prostate cancer, hypertension, atrial fibrillation, and type II diabetes mellitus. The AL, located on the posterior apical surface of the right lung, measured 5 cm in width and 8 cm in length. The left lung showed signs of atrophy and discoloration, possibly the result of pollution exposure or smoking earlier in life. In this article, we describe the incidence, historical classification, embryology, and physiology associated with an AL and its clinical implication for this donor. Full article

Mycobacterial spindle cell pseudotumors (MSCPs) are rare lesions characterized by the proliferation of spindle-shaped histiocytes caused by mycobacterial infections. MSCPs have been reported in the lung, lymphatic system, and skin of immunodeficient patients. We present the case of a spindle cell pseudotumor of the pancreas in a 30-year-old male with advanced human immunodeficiency virus (HIV) infection, which led to biliary stricture, splenomegaly, chronic pancreatitis, portal hypertension, compression of the hepatic artery and portal vein, and ascites. This was the patient’s third mycobacterial infection diagnosis. The MSCP was diagnosed via endoscopic biopsy after two prior non-diagnostic biopsies of the pancreatic lesion. Following 18 months of tailored antimycobacterial therapy, the pancreatic mass resolved radiographically with normalization of liver tests and sustained clinical improvement, and there has been no relapse more than 8 months after treatment completion. This case highlights the presentation of an MSCP in a unique anatomic location not previously documented and the challenges encountered with diagnosis and management. Full article

Poorly differentiated thyroid malignancy, a rare histological type of aggressive thyroid malignancy with associated difficulties and gaps in its histological and molecular characterization, might lead to challenging clinical presentations that require a prompt multimodal approach. This case study involved a 56-year-old, non-smoking male with a rapidly developing goiter (within 2–3 months) in association with mild, non-specific neck compressive symptoms. His medical history was irrelevant. A voluminous goiter with substernal and posterior extension up to the vertebral bodies was detected using an ultrasound and computed tomography (CT) scan and required emergency thyroidectomy. He had normal thyroid function, as well as negative thyroid autoimmunity and serum calcitonin. The surgery was successful upon “Y” incision, which was used to give better access to the retrosternal component in order to avoid a sternotomy. Post-operatively, the subject developed hypoparathyroidism-related hypocalcemia and showed a very high serum thyroglobulin level (>550 ng/mL). The pathological report confirmed poorly differentiated, multifocal thyroid carcinoma (with an insular, solid, and trabecular pattern) against a background of papillary carcinoma (pT3b, pN0, and pM1; L1; V2; Pn0; R1; and stage IVB). The subject received 200 mCi of radioiodine therapy for 6 weeks following the thoracic surgery. Whole-body scintigraphy was performed before radioiodine therapy and showed increased radiotracer uptake at the thyroid remnants and pre-tracheal levels. Additionally, single-photon emission computed tomography combined with CT (SPECT/CT) was performed, and confirmed the areas of intense uptake, in addition to a moderate uptake in the right and left pulmonary parenchyma, suggesting lung metastasis. To conclude, an overall low level of statistical evidence exists regarding poorly differentiated malignancy in substernal goiters, and the data also remains scarce regarding the impact of genetic and molecular configurations, such as the BRAF-positive profile, in this specific instance. Furthermore, multimodal management includes additional diagnosis methods such as SPECT/CT, while long-term multilayered therapy includes tyrosine kinase inhibitors if the outcome shows an iodine-resistant profile with a poor prognosis. Awareness remains a key factor in cases of a poorly differentiated carcinoma presenting as a rapidly growing goiter with substernal extension in an apparently healthy adult. A surgical approach, while varying with the surgeon’s skills, represents a mandatory step to ensure a better prognosis. In addition to a meticulous histological characterization, genetic/molecular features provide valuable information regarding the outcome and can further help with the decision to use new anti-cancer drugs if tumor response upon radioiodine therapy is no longer achieved; such a development is expected in this disease stage in association with a BRAF-positive configuration. Full article

Pulmonary embolism (PE) is an under-recognised yet serious complication in patients with acute ischaemic stroke (AIS), contributing significantly to morbidity and mortality. The interplay of traditional risk factors—such as immobility, endothelial dysfunction, and hypercoagulability—with AIS-specific conditions, including atrial fibrillation, malignancy, and reperfusion therapies, complicates both diagnosis and management. Despite available prophylactic strategies, including low-molecular-weight heparin and intermittent pneumatic compression, their use remains limited by bleeding concerns and a lack of tailored guidelines. This review synthesises the current evidence on the incidence, risk factors, pathophysiology, diagnostic approaches, and preventive strategies for PE in AIS, identifying critical gaps in risk stratification and clinical decision-making. We propose a novel mechanistic framework—the Brain–Lung Thromboinflammatory Axis Hypothesis—which posits that stroke-induced systemic inflammation, neutrophil extracellular trap (NET) formation, and pulmonary endothelial activation may drive in situ pulmonary thrombosis independent of deep vein thrombosis. This conceptual model highlights new diagnostic and therapeutic targets and underscores the need for stroke-specific VTE risk calculators, biomarker-guided prophylaxis, and prospective trials to optimise prevention and outcomes in this vulnerable population. Full article

Since the COVID-19 pandemic, the utilization of transthoracic ultrasonography (TTU) in the evaluation of pulmonary field artefacts has become standard practice among clinicians. However, there is a considerable lack of knowledge regarding the assessment of diaphragm mobility in the context of various lung diseases. Although numerous conditions are known to affect diaphragm mobility, including neurological, cardiovascular, and infectious diseases, it appears that pulmonary diseases may also limit the mobility of this major respiratory muscle. Despite the evidence of diaphragm mobility disorders in patients diagnosed with lung cancer, there is a discrepancy in the literature regarding the function of the diaphragm in individuals with chronic obstructive pulmonary disease (COPD). A shared aetiological factor frequently results in the co-occurrence of the aforementioned diseases. It is, however, possible to detect patients whose obstructive airway disease is caused only by the compression of infiltrative and nodal lesions rather than COPD. Bilateral TTU of diaphragmatic mobility in correlation with other available pulmonary function tests and radiological imaging may prove to be a valuable approach to isolating lung cancer patients with COPD overdiagnosis. Conversely, the overdiagnosis of COPD has been implicated in the potentially unnecessary and harmful use of inhaled medications with their adverse effects (e.g., cardiac arrhythmias, limb tremor, cough, and pneumonia), the failure to decrease obstruction in cases of other lung disorders, and the potential to contribute to the delayed diagnosis of the underlying condition responsible for the respiratory symptoms. This paper aims to provide a comprehensive overview of the utilization of ultrasound in the evaluation of diaphragm movement impairments for the detection of obstructions while also delineating the underlying limitations of this technique. Moreover, we propose a diagnostic algorithm for the purpose of excluding unilateral obstruction resulting from infiltrative neoplastic masses based on the ultrasound assessment of diaphragmatic mobility. Full article