Search Results (2,001)

Background: Chronic obstructive pulmonary disease (COPD) and acute myocardial infarction (AMI) frequently coexist and share several biological pathways and risk factors. Although COPD is associated with worse outcomes after AMI, the prognostic value of objective pulmonary function has not been well characterized. The aim of this study was to evaluate the association between airflow-obstruction severity and five-year all-cause mortality after AMI among patients with COPD. Methods: This single-center retrospective cohort study was restricted to adult post-AMI patients (2002–2017) with a background diagnosis of COPD and documented spirometry; therefore, the final cohort represents a selected subgroup of the source COPD-AMI population. Airflow obstruction was categorized according to forced expiratory volume in one second (FEV1) as Mild, Moderate, Severe, or Very Severe (according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD)). The outcome was all-cause mortality during up to five years of follow-up. Results: Among 1594 patients hospitalized with AMI and a COPD diagnosis, 169 patients with available spirometry were included in this selected analytical cohort (mean age 66.76 ± 9.86 years, 76.9% male). During follow-up, 65 patients died, corresponding to an overall five-year mortality rate of 38.5%. Mortality increased progressively across obstruction categories: 19.0%, 33.3%, 40.0%, and 70.8% in Mild, Moderate, Severe, and Very Severe, respectively (p for trend <0.001). In multivariable analysis, adjusted hazard ratios for mortality were: 2.49 (95% CI 0.86–7.24), 3.38 (95% CI 1.09–10.46), and 5.23 (95% CI 1.62–16.89) for Moderate, Severe, and Very Severe, compared with Mild obstruction. Conclusions: Among patients with COPD who survived hospitalization for AMI, more severe airflow obstruction was associated with substantially higher five-year all-cause mortality. These findings support the potential role of spirometry-based risk stratification and highlight the need for integrated cardiopulmonary follow-up after AMI. Full article

The Taklamakan Desert, the primary source of sand and dust in China, has a significant impact on PM_2.5 concentrations in the urban belt around the Tarim Basin. In this study, moderate-resolution imaging spectroradiometer (MODIS) images and machine learning algorithms were used to simulate PM_2.5 concentrations and analyze deaths from ischemic heart disease (IHD), chronic obstructive pulmonary disease (COPD), lung cancer (LC), and stroke (STK) attributed to PM_2.5. From 2015 to 2024, the aerosol optical depth (AOD) showed a decreasing trend, and the spatial distribution pattern gradually increased from west to east. The counties and cities with higher average PM_2.5 concentrations during the 2024 dust-prone season were Awati County, Alar City, Moyu County, and Aksu City, with average concentrations of 89.7 μg/m³, 88.8 μg/m³, 86.0 μg/m³, and 84.1 μg/m³, respectively. PM_2.5 concentrations during the non-dust season were significantly lower (approximately 50%) than those during the dust-prone season. Among the four major fatal diseases, STK and IHD accounted for the majority of attributable deaths, with proportions exceeding 80% of the total. The results show that PM_2.5 concentrations can be accurately monitored over a large scale, addressing the shortage of fixed monitoring stations, and providing a theoretical basis for sustainable development of ecological environment, health-risk management and control in the urban belt around the Tarim Basin. Full article

Background and Objectives: Oxidative stress and nitric oxide (NO)-related inflammatory activity contribute to chronic obstructive pulmonary disease (COPD), particularly during acute exacerbation of COPD (AECOPD). Myeloperoxidase (MPO) reflects neutrophil-related oxidative activity, whereas NO is involved in airway inflammation, endothelial regulation, and systemic inflammatory responses. This study compared serum MPO and NO levels among patients with AECOPD, patients with stable COPD, and healthy controls, and explored their discriminatory performance for distinguishing AECOPD from stable COPD. Materials and Methods: This cross-sectional comparative observational study prospectively enrolled 90 participants: 30 patients with AECOPD, 30 patients with stable COPD, and 30 healthy adult controls. COPD was confirmed by post-bronchodilator spirometry. Serum MPO and NO levels were measured using commercially available enzyme-linked immunosorbent assay kits. Group comparisons, exploratory subgroup analyses, correlation analyses, regression models, and receiver operating characteristic (ROC) curve analyses were performed. Results: Serum NO and MPO levels increased stepwise from healthy controls to stable COPD and AECOPD. Median serum NO levels were 109.79, 170.05, and 227.95 µmol/L, respectively, and median serum MPO levels were 4.14, 8.00, and 9.98 ng/mL, respectively (both p < 0.001). GOLD stage 3–4 disease was associated with higher levels of both biomarkers than GOLD stage 1–2 disease (both p < 0.001). In COPD-only exploratory logistic regression, serum NO and MPO were associated with AECOPD status. ROC analysis showed AUC values of 0.911 for serum NO and 0.811 for serum MPO, with no significant AUC difference by DeLong’s test (p = 0.187). Conclusions: Serum MPO and NO levels were progressively higher across healthy control, stable COPD, and AECOPD states. These exploratory findings suggest that systemic oxidative and NO-associated inflammatory activity may reflect COPD clinical state; however, sample-specific ROC cut-offs require external validation before diagnostic use. Full article

Background: Chronic obstructive pulmonary disease (COPD) disproportionately affects older adults. While targeted biologic therapies have shown efficacy in type 2 eosinophilic endotypes, elderly patients remain underrepresented in pivotal clinical trials. This narrative review examines the pathophysiological rationale, efficacy data, and unique geriatric challenges of biologic therapies in older adults. Methods: A literature search was conducted in PubMed and Scopus for phase II and III randomized controlled trials (RCTs) and observational studies evaluating biologic agents (anti-IL-5, anti-IL-4/IL-13, and anti-alarmins) in COPD, focusing on populations aged ≥ 65 years, comorbidities, and frailty. Discussion: Phase III data for dupilumab and mepolizumab indicate significant reductions in annualized exacerbations in patients with blood eosinophils ≥ 300 cells/μL. However, the mean age in the landmark trials (65 years) is a decade lower than the real-world average. Age-related immune remodeling—specifically immunosenescence and inflammaging—coexists with disease-specific pathways, potentially altering therapeutic responses. Furthermore, clinical trials systematically exclude older individuals with severe multimorbidity, physical frailty, cognitive impairment, and malnutrition. Conclusions: Biologics provide a precise, mechanism-based approach, yet evidence in the oldest-old remains limited. Future management should utilize the treatable traits framework, shifting selection criteria from chronological age to biological age metrics, including frailty status and functional reserve. Full article

Background/Objectives: This study aimed to compare structural and functional parameters between chronic obstructive pulmonary disease (COPD) patients and healthy controls, assess associations with pulmonary function, and identify factors independently associated with COPD status. Methods: A cross-sectional study was conducted in 89 participants (COPD: n = 45; controls: n = 44). Structural parameters included forward shoulder posture (FSP), scapular rotation, scapular distance (SD), and pectoralis minor index, measured bilaterally. Functional parameters included maximum inspiratory and expiratory pressures (MIP/MEP), chest expansion at three thoracic levels, spinal angles, and spirometry (%FVC, %FEV1, FEV1/FVC, FEF_25–75%, PEFR). Univariate and stepwise multivariate logistic regression identified variables independently associated with COPD. Results: COPD patients were older and exhibited lower anthropometric measures. Scapular rotation was greater in COPD (p < 0.05 bilaterally), while SD was significantly reduced (p < 0.001 bilaterally). MIP, MEP, and chest expansion at all three levels were significantly impaired in COPD (p < 0.05). All spirometric parameters were markedly lower in COPD (all p < 0.001). SD was positively associated with spirometric indices on both sides (p < 0.01). FSP was inversely associated with MIP, MEP, and chest expansion (p < 0.05). In multivariate logistic regression, age (OR 1.280, p = 0.018), %FVC (OR 0.875, p = 0.029), and FEF_25–75% (OR 0.909, p < 0.001) were independently associated with COPD status. Conclusions: Patients with COPD demonstrated reduced SD and increased scapular rotation. SD was significantly associated with pulmonary function, whereas FEF_25–75% and %FVC emerged as independently associated variables of COPD status. Collectively, these findings underscore the clinical relevance of integrating targeted scapulothoracic and respiratory rehabilitation strategies to optimize functional outcomes and support overall respiratory health and well-being. Full article

High-throughput metagenomic sequencing and advances in mucosal immunology have refuted the traditional physiological concept of a sterile respiratory tract. The oral cavity has been recognized as a dynamic determinant of systemic health. As in other parts of the body, recent studies also suggest that pulmonary health may be linked to oral health. Under eubiotic conditions, the oral microbiome maintains local immunological homeostasis and colonization resistance. Oral dysbiosis, characterized by sequential shifts in microbial communities and the proliferation of the pathogenic red complex (Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia), induces a state of chronic systemic inflammation, potentially involved in an infectious axis between the oral cavity and the lung. This review evaluates the tripartite systemic pathways of metastatic infection, metastatic injury, and metastatic inflammation that govern the translocation of oral pathobionts and their bioactive components, including lipopolysaccharides, outer membrane vesicles, and matrix metalloproteinases, to the lower respiratory tract via microaspiration and hematogenous circulation. The clinical implications across the chronic respiratory disease spectrum are examined, with a focus on how deficits in oral microbial diversity influence chronic obstructive pulmonary disease (COPD) pathogenesis, modulate the pulmonary virome and mycobiome, and stimulate maladaptive trained immunity. Furthermore, the contribution of biological aging is assessed, highlighting the roles of immunosenescence, inflammaging, and physiological reflex decline within the broader mucosal continuum. Finally, the clinical translation of this axis is analyzed, emphasizing the integration of saliva-based point-of-care nano-theranostics, metatranscriptomic profiling, and targeted interventions—such as professional oral biofilm management in intensive care settings and precision microbiome engineering—to preserve respiratory function and restore immune homeostasis. Full article

Background: Hypertension and diabetes commonly coexist in patients with chronic obstructive pulmonary disease (COPD), but their associations with arterial blood gas parameters remain insufficiently characterized, particularly after accounting for measured differences in baseline characteristics. This study aimed to examine the associations between coexisting hypertension and diabetes and selected arterial blood gas parameters in older patients with COPD. Propensity score matching (PSM) was used to improve the comparability of the study groups and reduce confounding from measured baseline covariates. Patients and Methods: A retrospective cross-sectional study was conducted involving 1030 patients. The comorbidity group comprised COPD patients with both hypertension and diabetes (n = 340), while the COPD-only group refers to COPD patients without hypertension or diabetes (n = 690). Propensity score matching (PSM) was estimated using a regression model with covariates including age, sex, marital status, BMI, temperature, and pulse. Balance was assessed using standardized mean difference (SMD), and linear regression models were adopted to evaluate the association between coexisting hypertension and diabetes and each blood gas indicator (PCO₂, PO₂, SaO₂). Results: We performed 1:1 nearest-neighbor matching and successfully generated 340 matched pairs, forming a total matched cohort of 680 patients; all unmatched participants from the original 1030 subjects were excluded from subsequent outcome comparisons. Covariate balance was optimized for most baseline indicators after PSM, although mild residual imbalance remained in age and BMI after matching. The comorbidity group demonstrated a statistically significant reduction in PCO₂ (B: −2.54, 95% CI: −4.52 to −0.56) compared to the COPD-only group, while no significant differences were observed in PO₂ (B: −2.48, 95% CI: −7.6 to 2.64) or SaO₂ (B: −1.16, 95% CI: −2.67 to 0.35). In addition, a sensitivity analysis adjusting for age and BMI was conducted to evaluate the robustness of the findings. Conclusions: After propensity score matching, coexisting hypertension and diabetes were associated with lower PCO₂ levels in elderly COPD patients, while no significant associations were found for PO₂ or SaO₂. Full article

Background and Clinical Significance: Pulmonary disease caused by nontuberculous mycobacteria (NTM) represents an important diagnostic challenge in tuberculosis-endemic settings because its clinical, radiological, and microbiological features may overlap with those of pulmonary tuberculosis (TB). Accurate distinction between these conditions is essential to avoid diagnostic delay and inappropriate treatment. Case Presentation: We present two cases that illustrate the heterogeneity of imaging patterns associated with NTM disease. The first case involved a 55-year-old woman with previously treated pulmonary tuberculosis who presented with chronic productive cough, recurrent mild hemoptysis, and progressive nodular-bronchiectatic and cavitary abnormalities. Mycobacterium avium was repeatedly isolated from independently collected respiratory specimens and identified using a line probe assay (LPA). The second case involved a 65-year-old man with severe chronic obstructive pulmonary disease (COPD), bronchiectasis, previous tuberculosis, and extensive bilateral fibrocavitary lung disease. Respiratory specimens were acid-fast bacilli-positive, whereas GeneXpert MTB/RIF repeatedly failed to detect the Mycobacterium tuberculosis complex. Repeated cultures identified Mycobacterium xenopi, including isolates from two sputum specimens and one bronchial aspirate. Treatment was subsequently adapted according to species identification and multidisciplinary assessment. These cases illustrate two major phenotypes of pulmonary NTM disease: nodular-bronchiectatic disease caused by M. avium and fibrocavitary disease caused by M. xenopi. They emphasize that persistent acid-fast bacilli (AFB) positivity with negative GeneXpert MTB/RIF results should prompt consideration of NTM alongside other differential diagnoses, followed by mycobacterial culture and species-level identification. Conclusions: The diagnosis of pulmonary NTM disease requires integration of clinical manifestations, radiological evolution, and repeated microbiological confirmation. Early species identification, multidisciplinary treatment selection, and close follow-up may reduce diagnostic delays and support appropriate individualized management. Full article

Understanding how clinical pathways evolve over time is essential for characterizing care processes. It also helps identify potential shifts in diagnostic and organizational practices. This study provides a descriptive analysis of patient trajectories for four major respiratory conditions: lung cancer, interstitial fibrosis, chronic obstructive pulmonary disease (COPD), and pneumonia. Trajectories were compared between a pre-COVID-19 period (2018–2019) and a COVID-19 period (2020–2022) in a specialized hospital. Using process mining applied to administrative event logs, we examined three aspects of care: the structure and sequencing of activities, the timing of transitions between care encounters, and imaging timeliness. The analysis spanned inpatient, emergency department, and outpatient settings. Indicators of care duration and transition timing revealed heterogeneous temporal patterns. Several conditions showed shorter intervals in the COVID-19 period, whereas others varied little. Activity-level analyses complemented these findings. Process maps indicated stable structural components in many pathways, together with differences in timing and execution. In the emergency department, care shifted toward bedside radiography, whereas CT chest volumes remained relatively stable across periods and settings. Imaging timeliness stayed consistently high in the emergency department and relatively stable for most inpatient conditions. Outcome-related indicators, including 30-day readmission and prolonged care trajectories, showed only modest differences between periods. Overall, the study demonstrates the value of process mining for describing real-world clinical pathways and identifying temporal variations in care. These results provide a foundation for future work that integrates richer clinical information and analytical approaches capable of assessing causal relationships. Full article

Chronic respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, cystic fibrosis, and chronic bronchitis, are characterized by persistent airway inflammation and mucus hypersecretion, leading to airway remodeling and progressive pulmonary dysfunction. Although current therapies improve disease control, they often fail to adequately target the complex molecular mechanisms underlying chronic airway diseases and may cause adverse effects during long-term use. Natural products have therefore emerged as promising multitarget therapeutic agents because they simultaneously regulate oxidative stress, inflammatory signaling, epithelial dysfunction, and mucus production. Recent evidence demonstrates that marine-derived bioactive compounds and plant-derived phytochemicals modulate key signaling pathways, including nuclear factor-kappa B (NF-κB), mitogen-activated protein kinases (MAPKs), phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), Janus kinase/signal transducer and activator of transcription (JAK/STAT), the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, and nuclear factor erythroid 2-related factor 2 (Nrf2), thereby suppressing airway inflammation, oxidative stress, goblet cell differentiation, and MUC5AC overexpression. Advances in nanoformulation, pulmonary drug delivery, multi-omics, artificial intelligence-assisted drug discovery, and network pharmacology are expected to accelerate clinical translation. Collectively, natural products represent promising candidates for the development of evidence-based functional foods, nutraceuticals, and novel therapeutic strategies for chronic respiratory diseases. Full article

Background: Non-group 1 pulmonary hypertension, also known as secondary pulmonary hypertension (SPH), is predominantly observed among females. However, there is a significant lack of data concerning factors associated with hospitalization among patients diagnosed with SPH. This study aims to provide clinicians with vital insights for the identification of high-risk groups and for the more effective management of contributory risk factors within the female population affected by SPH. Methods: Using the 2019 National Inpatient Sample, we identified female admissions with SPH (n = 648,190), accounting for 3.8% of the total 17,236,228 female admissions. An Artificial Neural Network (ANN) analysis was conducted to evaluate predictive factors. We randomly allocated 3,319,543 patients into training and testing datasets at a ratio of 70:30, comprising 2,323,696 (70%) for training and 995,847 (30%) for testing, to calibrate and validate the performance of the ANN algorithm. Model performance was assessed by comparing misclassification rates between training and testing sets and by the area under the receiver operating characteristic curve (AUC); only internal validation was performed. Results: Females hospitalized with SPH were generally of older age, with a median of 75 years compared to 58 years, and more frequently identified as White (67.7% versus 65.5%) or Black (20.5% versus 15.5%) relative to those without SPH. They also demonstrated a higher prevalence of most atherosclerotic cardiovascular disease (ASCVD) risk factors or their equivalents, including complicated hypertension (50.6% versus 17.8%), diabetes with chronic complications (30.6% versus 13.7%), and hyperlipidemia (50.8% versus 29.2%), as well as other comorbidities such as COPD (43.4% versus 20.2%) and CKD (43.3% versus 14.0%), and exhibited increased all-cause mortality (4.5% versus 1.8%) (p < 0.001). Our ANN model achieved an AUC of 0.823, indicating good predictive capability. The rates of incorrect predictions were comparable in both the testing and training cohorts, at 3.8% each. The factors most strongly associated with a coded SPH diagnosis included age at admission, complicated hypertension, chronic kidney disease, chronic obstructive pulmonary disease, uncomplicated hypertension, prior VTE, race, arthropathies, and AIDS. Conclusions: Our ANN model identified demographic and comorbidity factors associated with a coded SPH diagnosis among hospitalized females, with good discrimination (AUC = 0.823). Because the model classifies the presence of an existing diagnosis rather than predicting future hospitalization, and was validated only internally, external and prospective validation is required before clinical application. Once validated, these factors could support individualized, sex-specific risk stratification for high-risk female populations, consistent with the goals of personalized medicine. Full article

Background/Objectives: Exacerbations of chronic obstructive pulmonary disease (COPD) are a common reason for emergency department (ED) attendance and hospital admission. Acute respiratory worsening is non-specific, and previous spirometric confirmation may be unavailable at presentation. We aimed to translate current recommendations into an ED-specific clinical pathway that standardizes safety-critical steps without replacing individualized clinical judgment. Methods: We performed a targeted synthesis of international and Spanish guidance and key studies relevant to ED diagnosis, severity assessment, pharmacological treatment, respiratory support, antimicrobial stewardship, and disposition. The evidence base was updated in June 2026, and the pathway was reviewed by a multidisciplinary clinical group. Results: The revised pathway comprises four stages: (1) verify previous COPD confirmation, identify an acute exacerbation-like syndrome, and assess alternative or concomitant diagnoses; (2) grade acute severity using point-of-care variables and separately assess patient vulnerability; (3) provide severity-adjusted treatment with early reassessment; and (4) determine disposition and follow-up. It incorporates controlled oxygen, individualized bronchodilator delivery, explicit criteria for systemic corticosteroids and antibiotics, assessment of risk for Pseudomonas aeruginosa, non-invasive ventilation (NIV), and a defined adjunctive role for high-flow nasal cannula (HFNC). Patients without previous post-bronchodilator spirometry are classified as having suspected COPD and require confirmation after recovery. Conclusions: This evidence-informed pathway is a preliminary clinical framework, not a diagnostic rule or validated decision instrument. It is intended to support, rather than replace, professional judgment. Feasibility, acceptability, diagnostic safety, and clinical impact require prospective evaluation, beginning with a pilot implementation study. Full article

Background/Objectives: Chronic obstructive pulmonary disease (COPD) is a heterogeneous syndrome with substantial variability in clinical progression and survival. Although neutrophil-to-lymphocyte ratio has been widely studied, evidence regarding neutrophil-to-monocyte plus lymphocyte ratio (NMLR) remains limited. This study evaluated whether baseline peripheral blood neutrophil-to-monocyte plus lymphocyte ratio (NMLR), a composite marker of systemic inflammation, was independently associated with long-term all-cause mortality in patients with COPD managed in primary care. Methods: We conducted a retrospective population-based cohort study using electronic health records from the Lleida Health Region (Spain) between 1 January 2014 and 31 December 2023. Patients with spirometry-confirmed COPD and available baseline complete blood counts were included. Baseline NMLR was calculated as (absolute neutrophil count + absolute monocyte count)/absolute lymphocyte count using the first valid blood sample obtained after cohort entry. Patients were categorized into NMLR quartiles. Associations with all-cause mortality were assessed using multivariable Cox proportional hazards regression models adjusted for age, sex, smoking status, lung function, and baseline comorbidity burden. Results: A total of 2644 patients were included, contributing 19,231 person-years of follow-up. During a median follow-up of 8.8 years, 1085 deaths occurred. Mortality increased progressively across NMLR quartiles, from 28.3% in the lowest quartile to 60.2% in the highest quartile. In fully adjusted analyses, patients in the highest quartile had higher all-cause mortality than those in the lowest quartile (hazard ratio [HR] 2.00; 95% confidence interval [CI] 1.66–2.40; p < 0.001). When modeled continuously, each doubling of baseline NMLR was associated with a 34% increase in mortality risk (HR 1.34; 95% CI 1.26–1.42). Conclusions: Elevated baseline NMLR was independently associated with increased long-term mortality in COPD. As an inexpensive and routinely available inflammatory biomarker, NMLR may improve mortality risk stratification and support future evaluation of risk-stratified follow-up strategies in primary care. External validation is required before implementation in routine clinical practice. Full article

Background: Pulmonary hypertension (PH) is a common complication of chronic obstructive pulmonary disease (COPD), termed COPD-associated pulmonary hypertension (COPD-PH), and is associated with worse clinical outcomes. The efficacy and safety of pulmonary vasodilators in COPD-PH remain uncertain. Methods: We performed a systematic review and meta-analysis of randomized studies evaluating pulmonary vasodilators in adults with COPD-PH. Fifteen studies were identified, with 11 contributing to quantitative analyses. Outcomes included six-minute walk distance (6MWD), mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), partial pressure of arterial oxygen (PaO₂), and systolic pulmonary arterial pressure (sPAP). Results: Pulmonary vasodilators significantly reduced mPAP (MD −3.88 mmHg, 95% CI −7.23 to −0.53) and PVR (SMD −0.90, 95% CI −1.70 to −0.10). However, no significant improvements were observed in 6MWD or PaO₂. An exploratory composite hemodynamic score supported an overall hemodynamic benefit. Subgroup analyses suggested a more favorable profile for nitric oxide donors, whereas endothelin receptor antagonists were associated with worsened oxygenation. Conclusions: Pulmonary vasodilators improve pulmonary hemodynamics in COPD-PH but do not consistently improve exercise capacity or oxygenation. Current evidence does not support routine use outside specialized centers or clinical trials, and treatment effects appear to vary by drug class. Full article

This study examines the long-term associations between ambient air pollutants and the burden of major respiratory and infectious diseases in this geographically sensitive region. A retrospective analysis was conducted using ICD-10-coded hospital records of patients diagnosed with asthma, chronic obstructive pulmonary disease (COPD), bronchitis, and tuberculosis from January 2020 to June 2026. These data were integrated with in situ air quality measurements, including PM₁₀, PM_2.5, and SO₂, as well as satellite-derived Aerosol Optical Depth (AOD) from MODIS. Disease incidence was stratified by year, sex, and age groups (0–85+ years) to assess demographic susceptibility patterns. Respiratory diseases constituted a substantial public health burden over the study period. Asthma showed a marked female predominance (≈29,700 females vs. ≈16,000 males) and a bimodal age distribution with peaks in early childhood (0–5 years) and mid-adulthood (35–50 years). COPD was predominantly observed in males (≈8300 males vs. ≈5500 females), with a higher median age range (≈67–70 years). Bronchitis exhibited a similar bimodal pattern, disproportionately affecting both pediatric and elderly populations, while overall case numbers declined over time. Tuberculosis incidence was approximately threefold higher in males than females, with notable age-related divergence, affecting younger females (≈30–32 years) and middle-aged males (≈42–45 years). The findings suggest a spatial–temporal correspondence between elevated pollutant concentrations and respiratory disease prevalence in the Iğdır Basin. The observed sex- and age-specific disparities underscore the potential value of region-specific environmental health strategies, strengthened air quality management, and continuous epidemiological surveillance in enclosed basin environments. Full article