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Abstract Rationale Growing evidence suggests that compromised lung health may be linked to dementia and worsening cognitive ability. Objectives To test the hypothesis that impaired lung function or lung disease in midlife is associated with greater risk of incident dementia and mild cognitive impairment (MCI) later in life. Methods A total of 14,184 Atherosclerosis Risk in Communities study participants who underwent spirometry and were asked about lung health (1987–1989) were followed. Dementia and MCI were defined by hospitalization diagnosis codes (1987–2013) in the whole cohort and with adjudication among 42% who attended a comprehensive neurocognitive examination (2011–2013). Measurements and Main Results In analysis using adjudicated outcomes, odds of dementia or MCI were higher among participants with restrictive (multivariable-adjusted odds ratio, 1.58; 95% confidence interval, 1.14–2.19) and obstructive lung disease (multivariable-adjusted odds ratio, 1.33; 95% confidence interval, 1.07–1.64), compared with those without disease or respiratory symptoms. Associations were similar in analyses restricted to nonsmokers, and present for both Alzheimer’s disease–related dementia and cerebrovascular etiologies. Low FEV1% predicted and FVC% predicted were also associated with increased dementia risk. Conclusions Midlife lung disease and reduced lung function were associated with modestly increased odds of dementia and MCI later in life. Magnitudes of association were more pronounced for restrictive impairment than for obstructive lung disease. These associations were present in smokers and nonsmokers. If the observed associations are causal, policy and public health efforts to reduce smoking and improve air quality may have the added benefit of preventing the development of dementia and MCI.

Background Sleep’s impact on the human immune system and inflammatory responses makes it a potential risk factor for lung function impairment. However, the relationship between sleep duration and lung function impairment in middle-aged and young adults has been rarely investigated. Methods A total of 9,284 aged 20–64 years were categorized into four groups according to sleep duration (≤ 6 h, 7 h, 8 h, and ≥ 9 h), with 7 h as the reference, by using the U.S. NHANES data, 2007–2012. Forced expiratory volume in the 1 s (FEV 1 ), forced vital capacity (FVC), FEV 1 to FVC (FEV 1 /FVC) ratio, peak expiratory flow (PEF), and forced expiratory flow at 25–75% (FEF 25 − 75% ) were measured by spirometry. Restrictive impairment was defined as baseline FVC < 80% predicted and obstructive impairment as FEV 1 /FVC < 0.70. Generalized linear regression and logistic regression were performed to estimate the associations between sleep duration and lung function. Results Compared with 7 h of sleep duration, shorter and longer sleep duration were associated with decreases in FEV 1 (≤ 6 h: β=-0.010, 95% CI=-0.014 to -0.006; 8 h: β=-0.005, 95% CI=-0.009 to -0.001), FVC (≤ 6 h: β=-0.018, 95% CI=-0.014 to -0.007; 8 h: β=-0.005, 95% CI=-0.009 to -0.002), and PEF (≤ 6 h: β=-0.006, 95% CI=-0.010 to -0.002; 8 h: β=-0.007, 95% CI=-0.011 to -0.002; ≥ 9 h: β=-0.012, 95% CI=-0.020 to -0.004). Similarly, shorter (≤ 6 h: OR = 1.346, 95% CI = 1.065 to 1.700) and longer (≥ 9 h: OR = 1.827, 95% CI = 1.236 to 2.700) sleep duration were associated with increased risks of restrictive impairment. Moreover, the aforementioned associations were more pronounced among male participants. Conclusions Compared with 7 h of sleep duration, shorter and longer sleep duration were associated with impaired lung function among adults aged 20–64 years, and these associations were stronger among males.

Objective: To determine the patterns of pulmonary function impairment among patients with previously treated pulmonary tuberculosis (TB) at a secondary care hospital in Kohat, Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine, Divisional Headquarters Teaching Hospital, Kohat, Khyber Pakhtunkhwa, Pakistan, from Aug 2024 to Jan 2025. Methodology: A total of 139 post-tuberculosis patients who had completed the full course of anti-TB therapy with microbiological cure were included. Pulmonary function was assessed using a portable MiniSpir S spirometer, and results were categorized as normal, obstructive, restrictive, or mixed ventilatory patterns according to American Thoracic Society (ATS) and European Respiratory Society (ERS) guidelines. Data were analyzed using IBM SPSS Statistics version 27. Results: The mean age of participants was 52.9±13.5 years, with females comprising 54% of the sample. Most participants (74.8%) belonged to the middle-income group, and none were smokers. Spirometry revealed 56.8% normal, 33.8% restrictive, 8.6% obstructive, and 0.7% mixed ventilatory patterns. Shortness of breath was reported by 39.6% of participants and showed a significant association with both obstructive and restrictive patterns (p<0.001). A positive family history of tuberculosis was also significantly associated with pulmonary dysfunction (p = 0.04). Conclusion: A substantial proportion of post-TB patients exhibited persistent pulmonary function impairment, predominantly of the restrictive type. These findings highlight the need for routine post-treatment pulmonary evaluation and the development of context-specific rehabilitation guidelines for tuberculosis survivors in resource-limited healthcare settings.

Background Emerging epidemiological evidence implicates pulmonary dysfunction in cardiovascular pathogenesis, yet its arrhythmogenic potential remains poorly defined. Objectives We aimed to assess the link between ventilatory parameters, pulmonary disease phenotypes and risk of incident arrhythmias across diverse populations. Methods We analyzed data from 17,684 adults in two prospective cohort studies-the Atherosclerosis Risk in Communities (ARIC; n = 12,929) and Cardiovascular Health Study (CHS; n = 4,755). Adjudicated arrhythmia diagnoses (atrial fibrillation/flutter [AF/AFL], ventricular arrhythmias [VAs], high-grade atrioventricular [AV] block, and premature atrial/ventricular complexes [PAC/PVC]) were identified via hospitalization records and mortality data. Multivariable-adjusted Cox proportional hazards models quantified associations between forced expiratory volume in 1 s (FEV1%) predicted and forced vital capacity (FVC%) predicted quartiles with arrhythmia risk, adjusting for traditional cardiovascular risk factors. Results Over a median follow-up of 12.6 years, impaired FEV1% and FVC% corresponded to a graded increase in arrhythmia risk. Compared to the highest quartile, the lowest FEV1% predicted quartile had elevated hazards for any arrhythmias (HR 1.32, 95% CI 1.23–1.42), AF/AFL (HR 1.68, 1.52–1.85), VAs (HR 1.55, 1.29–1.86), high-grade AV block (HR 1.37, 1.08–1.73), and PAC/PVC (HR 1.42, 1.20–1.69). Similar trends were observed for FVC% predicted quartiles. These associations remained consistent in never-smoking individuals and across cohorts. Obstructive spirometry pattern was associated with the strongest arrhythmia risk, while restrictive ventilatory patterns showed relatively lower risk elevations. No association was observed with sick sinus syndrome. Conclusions Reduced pulmonary function suggested independent associations with incident arrhythmias across supraventricular, ventricular, and conduction system pathologies in two historical cohorts. These findings suggest that spirometric indices could potentially represent novel independent indicators for arrhythmia development worthy of further validation in contemporary settings,, with associations distinct from conventional cardiometabolic risk factors.

Respiratory symptoms and lung function impairments are concerns in the woodworking industry. In Ethiopia, the woodwork industry has been growing; however, there is limited data on pulmonary function, respiratory symptoms, and risk factors among woodworkers. This study aimed to assess the prevalence of impaired lung function and respiratory symptoms and determine their associated risk factors among woodworkers in Gondar City, Ethiopia. A comparative cross-sectional study was conducted, involving 185 woodworkers and 176 controls. Spirometry was used for Lung function tests. The data were collected using a questionnaire in Kobo Toolbox software. Statistical analyses, including ANOVA, t-test, and logistic regression were done in SPSS version 26. Almost all participants (96.4%) were male. The proportions of obstructive, restrictive, and mixed lung function impairments in woodworkers and control groups were 7.6% vs. 2.8%, 4.86% vs. 3.98%, and 1.08% vs.0%, respectively. The proportion of chronic respiratory symptoms in woodworkers and control groups was 35.5% vs. 12.7% with the proportion of cough (19.9% Vs 6.6%), phlegm (21.1% Vs 5.8%), wheezing (9.4% Vs 3.9%), shortness of breath (19.9Vs 6.6%), and breathlessness (13.3% Vs 8.3%). In woodworkers, and pooled models, the absence of a local exhaust ventilation system, working more than eight hours per day, being unable to use filter masks, and being unable to do physical exercise were significantly associated with respiratory symptoms. Forced Expiratory Volume in 1 s/Forced Vital Capacity ratio (FEV 1 /FVC ratio) ( P  = 0.001) and Mid-Expiratory Flow between 25% and 75% (MEF 25% - 75% ) significantly decreased with work experience ( P  = 0.001). Woodworkers had higher rates of obstructive, restrictive, and mixed lung function impairments and more respiratory symptoms. Prioritizing workplace ventilation and the use of respiratory protective devices is crucial for mitigating these risks.

Lung reactions to exposure to dust, gases, and fumes at work places have been studied in different populations. The emission level of pollutants that emit particulate matter less than 10 micrometers in size (PM 10) has been found very high in Ahmedabad. Hence, petrol pump workers in Ahmedabad are likely to get exposed to a high level of air pollution along with petrol and diesel vapors. Both of these factors can affect the respiratory health of petrol pump workers. A cross-sectional observational study was conducted at 53 different petrol pumps of Ahmedabad. A total of 227 petrol pump workers underwent pulmonary function testing. Their spirometry parameters were compared with 227 age-matched, healthy controls. A significant reduction (P < 0.001) was found in the spirometry parameters, such as, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiratory flow (FEF25-75), and peak expiratory flow rate (PEFR) in petrol pump workers, as compared to the controls. The mean values of FEV1/FVC (%) were significantly increased (P < 0.001). A decline in FVC was not significantly different among the workers according to the duration of exposure. As the duration of exposure increased, there was a progressive decline in FEV1/FVC (%) and FEF25-75. The study concludes that the deleterious effects of air pollution and petrol/diesel vapor inhalation on the lung function of petrol pump workers results in a restrictive type of lung function abnormality. The pattern of respiratory impairment changes to a mixed type as the duration of exposure increases.

Case series. The objective of this study was to investigate the change in pulmonary function in adult patients with a spinal deformity who underwent spinal corrective surgery. Degenerative lumbar and/or thoraco-lumbar deformities are is often prominent in adult spinal deformity cases, whereas a thoracic deformity involving the chest wall is inconspicuous. A lumbar spine deformity could affect the pulmonary function; however, few reports have investigated pulmonary function in adult patients with a spinal deformity. This study included 14 adult patients with a spinal deformity who underwent posterior corrective fusion (3 males, 11 females; mean age, 67.4 years). We measured percent vital capacity (%VC) and percent forced expiratory volume in 1 second (%FEV1) before surgery and six months after surgery. We investigated the change in pulmonary function after corrective surgery and the correlation between radiographic parameters and pulmonary function. Mean preoperative %VC and %FEV1 values were 99.9% and 79.3%, respectively. Two cases were diagnosed with restrictive impairment, and two cases were diagnosed with obstructive impairment before surgery. %VC improved in the restrictive impairment cases six months after surgery. However, %FEV1 did not improve significantly after surgery in the obstructive impairment cases. Restrictive impairment was improved in adult patients with a spinal deformity by corrective spinal surgery. However, spinal surgery did not improve obstructive impairment.

Patients with hemodialysis suffer with protein-energy wasting and uremic myopathy lead to lack of physical activity and poor functional performance. However, ventilation abnormality in patients undergone hemodialysis remains controversial regarding the respiratory impairment. Therefore, the study aimed to determine the effect of duration of dialysis on respiratory function. A multicenter study with cross-sectional study was designed in four hemodialysis outpatient clinics. Respiratory muscle strength (i.e., maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)) pulmonary function test (i.e., forced vital capacity (FVC), forced expiratory volume in one second (FEV ) and FEV /FVC ratio), functional capacity (6-minute walk test) and sensation of breathlessness were assessed prior to dialysis. A total of 100 hemodialysis patients were recruited with 38 females and 62 males. An average of duration of hemodialysis was 5.93± 4.96 years. Decreased MIP values, FEV values, FVC values, %FEV and %FVC were noted in patients with long duration of dialysis (defined as ≥ 5 years of dialysis) compared to those with short duration of dialysis (p < .05). In addition, increased sensation of breathlessness was observed in patients with long duration of dialysis (  < .05). Furthermore, participants with long duration of dialysis had an increased risk of ventilatory restriction (OR 6.093,  = .007).

Background The association between glycemic control and short-, and long-term lung health remains controversial. This study aimed to investigate the relationship between glucose control and overall lung health in a national cohort. Methods The analysis included 5610 subjects from NHANES 2007–2012. We assessed the correlation of glycemic status with respiratory symptoms (cough, sputum, wheeze, and exertional dyspnea), lung function (forced expiratory volume in 1-s (FEV1), forced vital capacity (FVC)), and obstructive or restrictive lung disease (RLD). Furthermore, we determined all-cause mortality in patients with restrictive lung disease by linking data to the National Mortality Index records up to December 31, 2019. Results The study involved the examination of respiratory symptoms, pulmonary function tests, and mortality analyses encompassing 3714, 3916, and 173 subjects, respectively. Multifactorial regression analyses revealed that a 1% increase in blood glucose was associated with a reduction in effect sizes (β) for FVC and FEV1 by -1.66% (-2.47%, -0.86%) and -1.94% (-2.65%, -1.23%), respectively. This increase also exhibited correlations with an elevated risk of exertional dyspnoea, restrictive ventilation dysfunction, and all-cause mortality, presenting odds ratios (ORs) of 1.19 (1.06, 1.33), 1.22 (1.10, 1.36), and 1.61 (1.29, 2.01), respectively. Regarding glycemic control, patients with improved control demonstrated stronger associations with early lung damage, significantly correlating with reduced FVC (β -10.90%, [-14.45%, -7.36%]) and FEV1 (β -9.38%, [-12.90%, -5.87%]). Moreover, they experienced a notably higher risk of exertional dyspnoea (adjusted OR 2.09, [1.35- 3.24]), while the diabetic group with poorer glycemic control showed more significant connections with advanced lung damage. This group exhibited significant associations with an increased risk of restrictive ventilatory dysfunction (adjusted OR, 2.56, [1.70–3.86]) and all-cause mortality (hazard ratios [HRs] 2.65, [1.05–6.67]), all compared to the reference group with normal glycemic metabolism. Conclusions Elevated blood glucose exhibited an inverse correlation with both long-term and short-term lung health. A negative L-shaped relationship was observed between glycemic control and early lung injury, along with a linearly negative association concerning late-stage lung damage. Given the cross-sectional nature of this study, a longitudinal investigation is needed to validate our findings.

Background The spread of COVID-19 infection increased the number of patients who underwent pulmonary resection for lung cancer after COVID-19 infection. It is unclear how previous infection with COVID-19 affects perioperative complications and acute exacerbation of interstitial pneumonia after surgery in patients with interstitial pneumonia. Case presentation An 80-year-old man was referred to our hospital because of a tumor in his left lung. Chest computed tomography showed a 28-mm nodule in the lower lobe of the left lung and usual interstitial pneumonia in bilateral lungs. Bronchoscopic examination was performed, which diagnosed squamous cell carcinoma. Pulmonary function testing revealed restrictive ventilatory impairment, and we planned to perform basal segmentectomy of the left lung. However, before the planned surgery, the patient contracted symptomatic COVID-19. Chest computed tomography revealed ground-glass opacities owing to COVID-19. The patient was admitted for surgery 7 weeks after COVID-19 infection. Preoperatively, pulmonary function testing was repeated, which revealed decreased % vital capacity (%VC) and % diffusing capacity for carbon monoxide (%DLco). The 6-min walk test indicated a distance of 500 m, and the percutaneous oxygen saturation at the end of the test was 94%. Basal segmentectomy of the left lung was performed by video-assisted thoracoscopic surgery. The patient’s postoperative course was favorable, and he was discharged without the need for oxygen inhalational therapy 12 days after the surgery. Pathological examination of the resected specimen revealed usual interstitial pneumonia in the non-cancerous areas of the lung. Additionally, the infiltration of immature fibroblasts in the alveoli and perivascular infiltration of inflammatory cells were observed, which were consistent with fibrotic change after inflammation owing to COVID-19. Three months after the surgery, the patient was alive without recurrence or acute exacerbation of the interstitial pneumonia. Pulmonary function testing 6 weeks after surgery revealed decreased %VC and %DLco. Testing 12 weeks after surgery revealed persistently decreased %VC and improved %DLco (Table 1 ). Table 1 Pulmonary function test results before and after COVID-19 infection and 6 and 12 weeks after surgery VC (ml) %VC (%) %DLco (%) Before COVID-19 infection 2070 71.9 74.9 7 weeks after COVID-19 infection 1700 59.6 51.9 6 weeks after surgery 1500 52.6 53.1 12 weeks after surgery 1510 53.0 61.7 %VC % vital capacity, %DLco % diffusing capacity for carbon monoxide Conclusion We successfully performed basal segmentectomy of the left lung for lung cancer 7 weeks after COVID-19 infection in a patient with severe interstitial pneumonia and restrictive ventilatory impairment.