Search Results (95)

Background and objectives: Numerous studies and meta-analyses have established the efficacy of telemonitoring for blood pressure and other components of metabolic syndrome in improving disease management. Nevertheless, the adoption of telemonitoring technologies is often hindered by personal, technological, and systemic barriers. In Slovakia, where patient–physician contact rates are high, there is limited research on patients’ perspectives regarding telemedicine adoption for cardiovascular risk management. The objective of this study was to examine patients’ perspectives on and perceived obstacles to the use of telemonitoring for arterial hypertension and dyslipidemia in Slovakia. Methods: This cross-sectional, questionnaire-based survey targeted a cohort of 18,053 patients. The survey instrument was designed to gather data on several key areas: patient demographic characteristics, blood pressure measurement habits, the utilization of smart technologies, perceived benefits and barriers to telemonitoring, and patients’ knowledge of their lipid profiles and cardiovascular risk factors. Statistical analysis included chi-square tests, ANOVA, and effect size calculations with 95% confidence intervals (CI). Results: A total of 1787 patient responses (9.9%) were collected. Among the respondents, 67.4% (n = 1204) had arterial hypertension, while 7.9% (n = 95) were on non-pharmacological therapy. Only 21.2% (n = 255) of hypertensive patients measured their blood pressure daily, with a significantly higher proportion of men than women (28.6% vs. 12.7%, p = 0.011, Cohen’s d = 0.42). The most frequent users of blood pressure monitoring were in the 31–45 age group (p = 0.001, η² = 0.08). A total of 19.4% (n = 347) of respondents used wearable devices, and 6.3% (n = 113) used blood pressure monitors connected to an application. Smart technology use was significantly more common in the 31–45 age group (p = 0.01, Cramer’s V = 0.15). Moderate interest in telemedicine was expressed by 69.8% (n = 1247) of respondents, though only 27.4% (n = 490) showed strong interest. The majority of patients (73.8%, n = 1319) did not know their LDL-C levels, and 45.7% (n = 817) of those who did had elevated levels. Conclusions: The findings suggest that while interest in telemedicine methods for the management of arterial hypertension and dyslipidemia exists among Slovak patients, it is more moderate than initially assumed. Importantly, expressed willingness to participate in a study should not be directly equated with readiness to adopt new technologies in daily practice. Successful integration of telemonitoring into the Slovak healthcare system will therefore require not only patient engagement but also active support from healthcare providers to overcome practical and motivational barriers. These findings highlight the need for targeted implementation strategies that address the specific barriers identified in the Central and Eastern European healthcare context. Full article

The COVID-19 pandemic has underscored the need for telemedicine to ensure continuity of pediatric care during health emergencies. This paper presents NS-Assist, a hybrid web–mobile decision support system for managing Idiopathic Nephrotic Syndrome (INS) in children. The system combines rule-based reasoning and fuzzy inference to assist clinicians in diagnosis, treatment adjustment, and relapse monitoring, while enabling caregivers to record and track daily health data. Implemented using Spring Boot, ReactJS, and Flutter with a secure MySQL database, NS-Assist integrates medical expertise with computational intelligence to support remote decision-making. A pilot evaluation involving 40 participants, including clinicians and caregivers, showed improved communication, reduced consultation time, and enhanced follow-up continuity. These results highlight the system’s potential as a reliable and adaptable framework for pediatric telemedicine in resource-constrained and emergency settings. Full article

Background: Extended telemonitored follow-up after acute coronary syndrome (ACS) has been shown to optimize secondary prevention outcomes. However, its impact on patient experience and outpatient visits remains unclear. Methods: This observational, retrospective, longitudinal study included 75 consecutive patients who underwent 10-month telemonitored follow-up after ACS and 50 consecutive patients who received standard care. Lipid parameters at hospital admission and 12 months post-discharge, patient experience (measured using the IEXPAC scale), and outpatient visits were evaluated. Results: The mean patient age was 58.0 years in the telemonitored group and 60.8 years in the control group, with males comprising 87% and 92%, respectively. The telemonitored group showed significant decreases in triglyceride levels (p < 0.011), VLDL cholesterol (p = 0.003), triglyceride/HDL ratio (p = 0.007), and remnant cholesterol levels (p = 0.018). The IEXPAC score was significantly higher in the telemonitored group (7.9 ± 1.5) compared to the standard care group (6.0 ± 1.9, p < 0.001). Higher ratings were observed across all domains: patient-professional productive interaction, the new patient-healthcare system relational model, and self-care. The telemonitored group also had fewer visits to Cardiology (1.0 ± 1.2 vs. 1.7 ± 1.0; p < 0.001) and Primary Care (7.1 ± 4.6 vs. 9.4 ± 5.2; p = 0.014). Conclusions: Extended telemonitored follow-up after ACS significantly enhances patient experience, improves lipid-related cardiovascular risk, and reduces outpatient visits to Primary Care and Cardiology compared to standard follow-up. These findings support the broader implementation of this healthcare pathway. Full article

The increasing use of UAVs has reshaped urban logistics, enabling sustainable alternatives to traditional deliveries. To address critical issues inherent in the system, the proposed study presents the design and evaluation of an innovative unmanned aerial vehicle (UAV) prototype that integrates advanced electronic components and artificial intelligence (AI), with the aim of reducing environmental impact and enabling autonomous navigation in complex urban environments. The UAV platform incorporates brushless DC motors, high-density LiPo batteries and perovskite solar cells to improve energy efficiency and increase flight range. The Deep Q-Network (DQN) allocates energy and selects reference points in the presence of wind and payload disturbances, while an integrated sensor system monitors motor vibration/temperature and charge status to prevent failures. In urban canyon and field scenarios (wind from 0 to 8 m/s; payload from 0.35 to 0.55 kg), the system reduces energy consumption by up to 18%, increases area coverage by 12% for the same charge, and maintains structural safety factors > 1.5 under gust loading. The approach combines sustainable materials, efficient propulsion, and real-time AI-based navigation for energy-conscious flight planning. A hybrid methodology, combining experimental design principles with finite-element-based structural modelling and AI-enhanced monitoring, has been applied to ensure structural health awareness. The study implements proven edge-AI sensor fusion architectures, balancing portability and telemonitoring with an integrated low-power design. The results confirm a reduction in energy consumption and CO₂ emissions compared to traditional delivery vehicles, confirming that the proposed system represents a scalable and intelligent solution for last-mile delivery, contributing to climate resilience and urban sustainability. The findings position the proposed UAV as a scalable reference model for integrating AI-driven navigation and renewable energy systems in sustainable logistics. Full article

Artificial intelligence (AI) enhances anesthesiology by introducing adaptive systems that improve clinical precision, safety, and responsiveness. This review examines the integration of AI in anesthetic practice, with a focus on closed-loop systems that exemplify autonomous control. These platforms integrate continuous physiologic inputs, such as BIS, EEG, heart rate, and blood pressure, to titrate anesthetic agents in real time, providing more consistent and responsive management than manual methods. Predictive algorithms reduce intraoperative hypotension by up to 40%, and systems such as McSleepy demonstrate greater accuracy in maintaining anesthetic depth and shortening recovery times. In critical care, AI supports sedation management, reduces clinician cognitive load, and standardizes care delivery during high-acuity procedures. The review also addresses the ethical, legal, and logistical challenges to widespread adoption of AI. Key concerns include algorithmic bias, explainability, and accountability for machine-generated decisions and disparities in access due to infrastructure demands. Regulatory frameworks, such as HIPAA and GDPR, are discussed in the context of securing patient data and ensuring its ethical deployment. Additionally, AI may play a transformative role in global health through remote anesthesia delivery and telemonitoring, helping address anesthesiologist shortages in resource-limited settings. Ultimately, AI-guided closed-loop systems do not replace clinicians; instead, they extend their capacity to deliver safe, responsive, and personalized anesthesia. These technologies signal a shift toward robotic anesthesia, where machine autonomy complements human oversight. Continued interdisciplinary development and rigorous clinical validation will determine how AI integrates into both operating rooms and intensive care units. Full article

Background and Objective: Health services management faces increasing complexity, particularly in developing countries such as Brazil. Digital tools play a central role in optimizing health service operations, yet synthesized evidence on manager-focused applications remains limited. This study aimed to survey digital innovations for management within the Brazilian context. Methods: We systematically reviewed the complete proceedings of the Brazilian Symposium on Computing Applied to Health (SBCAS) from 2001 to 2024, identifying 26 studies that met eligibility criteria based on managerial relevance. Results: Applications identified predominantly addressed hospital management (e.g., resource scheduling and process optimization) and public health surveillance (e.g., disease prediction and monitoring), employing technologies such as machine learning and simulation. These tools primarily leveraged structured administrative data from national health information systems, reflecting existing data infrastructure capabilities. The reported implications suggest improvements in decision-making through optimized resource allocation (e.g., ICU beds and staffing), streamlined operational processes (e.g., bottleneck identification), enhanced planning and monitoring capabilities (e.g., endemic disease control and telemonitoring programs), and more timely, targeted public health surveillance (e.g., georeferenced analysis). Conclusions: The identified research aligns with global digital health trends but is also tailored to the complex realities of the healthcare system. Despite significant technical advancements, these digital solutions predominantly remain at the prototype stage, highlighting a gap between academic innovation and real-world deployment. Realizing the benefits of these tools will require a concerted effort to move beyond technical validation, focusing on implementation science, supportive policies, and strategic partnerships to integrate these solutions into managerial practice. Full article

Novel K band wearable sensors and antennas for Telemonitoring, Telehealth and Telemedicine Systems, Internet of Things (IoT) systems, and communication sensors are discussed in this paper. Only in a limited number of papers are K band sensors presented. One of the major goals in the evaluation of Telehealth and Telemedicine and wireless communication devices is the development of efficient compact low-cost antennas and sensors. The development of wideband efficient antennas is crucial to the evaluation of wideband and multiband efficient Telemonitoring, Telehealth and Telemedicine wearable devices. The advantage of the printed wearable antenna is that the feed and matching network can be etched on the same substrate as the printed radiating antenna. K band slot antennas and arrays are presented in this paper the sensors are compact, lightweight, efficient, and wideband. The antennas’ design parameters, and comparison between computation and measured electrical performance of the antennas, are presented in this paper. Fractal efficient antennas and sensors were evaluated to maximize the electrical characteristics of the communication and medical devices. This paper presents wideband printed antennas in frequencies from 16 GH to 26 GHz for Telemonitoring, Telehealth and Telemedicine Systems. The bandwidth of the K band fractal slot antennas and arrays ranges from 10% to 40%. The electrical characteristics of the new compact antennas in the vicinity of the patient body were measured and simulated by using electromagnetic simulation techniques. The gain of the new K band fractal antennas and slot arrays presented in this paper ranges from 3 dBi to 7.5 dBi with 90% efficiency. Full article

The growing challenges in healthcare services, such as hospital congestion and a persistent shortage of medical personnel, significantly impede effective service delivery. This particularly presents significant challenges for the continuous monitoring of patients with chronic diseases. In comparison, Internet of Things (IoT) based telemonitoring systems offer a promising solution to alleviate these challenges. However, transmitting sensitive and confidential patient health data requires a strong focus on end-to-end security. This includes securing sensitive data within the patient’s home network, during internet transmission, at the endpoint system, and managing sensitive data. In this study, we propose a secure and scalable architecture for a remote health monitoring system that integrates telemedicine technology with the IoT. The proposed solution included a portable remote health monitoring device, an IoT Gateway appliance (IoT GW) in the patient’s home, and an IoT Application Gateway Endpoint (App GW Endpoint) on a cloud infrastructure. A secure communication channel was established by implementing a multi-layered security protocol stack that uses HTTPS over Quick UDP Internet Connection (QUIC), with a focus on optimal security and compatibility, prioritizing cipher suites for data confidentiality and device authentication. The cloud architecture is designed based on the Well-Architected Framework principles to ensure security, high availability, and scalability. Our study shows that storing patient health information is reliable and efficient. Furthermore, the results for processing and transmission times clearly demonstrate that the additional encryption mechanisms have a negligible effect on data transmission latency, while significantly improving security. Full article

Background/Objectives: Patients with inappropriate sinus tachycardia (IST) and postural orthostatic tachycardia syndrome (POTS) exhibit complex clinical profiles due to autonomic dysfunction. While sinus node sparing (SNS) hybrid ablation is emerging as a promising therapy, there are no established guidelines worldwide for post-procedure patient management and care is mainly based on telemonitoring. In contrast, our hybrid cardiac rehabilitation (HCR) program integrates inpatient care and home-based telerehabilitation. We aim to evaluate the implementation of the HCR program, patient acceptance and adherence, and the effectiveness of the Malmö POTS scoring system in monitoring disease progression and rehabilitation outcomes. Methods: Patients underwent a personalized HCR program after SNS. The program included early mobilization, psychological support, respiratory therapy, and structured exercise. Clinical outcomes were assessed using symptom burden (Malmö POTS score), ECG parameters, exercise duration, perceived exertion, and rehabilitation adherence. Results: All patients completed the inpatient phase, and 87% completed the home-based phase. In the early postoperative period, pericarditis, anemia, and benign rhythm disturbances were mild and self-limiting. The Malmö POTS score decreased from 65.3 to 25.7. Lower perceived exertion early in the program correlated with clinical improvement. At the 2-month follow-up, 81% of patients no longer met the clinical criteria for IST/POTS without the use of medications. The program was evaluated as safe, feasible, and well-tolerated, with high patient satisfaction. Conclusions: A well-organized hybrid cardiac rehabilitation program after SNS is feasible, safe, and well-tolerated in IST/POTS patients. The Malmö POTS score may support outcome monitoring. The integration of individualized training and telemedicine represents a promising development for patients post-SNS ablation. While this study demonstrates feasibility and potential benefits, further controlled studies are needed to evaluate its impact on long-term recovery and symptom control. Full article

Heart failure (HF) is a major global health challenge, characterized by high morbidity, mortality, and frequent hospital readmissions. Despite the advent of guideline-directed medical therapies (GDMTs), the burden of HF continues to grow, necessitating a shift toward comprehensive, multidisciplinary care models. Heart Failure Disease Management Programs (HF-DMPs) have emerged as structured frameworks that integrate evidence-based medical therapy, patient education, telemonitoring, and support for social determinants of health to optimize outcomes and reduce healthcare costs. This review outlines the key components of HF-DMPs, including patient identification and risk stratification, pharmacologic optimization, team-based care, transitional follow-up, remote monitoring, performance metrics, and social support systems. Incorporating tools such as artificial intelligence, pharmacist-led titration, and community health worker support, HF-DMPs represent a scalable approach to improving care delivery. The success of these programs depends on tailored interventions, interdisciplinary collaboration, and health equity-driven strategies. Full article

Background and Objectives: Heart failure (HF) represents a major public health challenge worldwide, with rising prevalence, high morbidity and mortality rates, and substantial healthcare costs. Non-invasive telemonitoring has emerged as a promising adjunct in HF management, yet its clinical effectiveness remains unclear. Materials and Methods: In this systematic review, we summarize randomized controlled trials (RCTs) between 2004 and 2024 examining the efficacy of non-invasive telemonitoring on mortality, readmission, and quality of life (QoL) in HF. In addition, we characterize the heterogeneity of features of different telemonitoring interventions. Results: In total, 32 RCTs were included, comprising 13,294 participants. While some individual studies reported benefits, non-invasive telemonitoring demonstrated mixed effects on mortality, readmission rates, and QoL. The most common modality for interfacing with patients was by mobile application (53%), followed by web portals (22%), and stand-alone devices (19%). Periodic feedback (63%) was more common than continuous feedback (31%) or on-demand feedback (6%). Clinician reviews of patient telemonitoring data was event-triggered (44%) more commonly than based on a prespecified timeline (38%). In most designs (90%), patients played a passive role in telemonitoring. Conclusions: Non-invasive telemonitoring interventions for HF exhibited considerable variation in duration and system design and had a low rate of patient engagement. Future work should focus on identifying telemonitoring-responsive subgroups and refining telemonitoring strategies to complement traditional HF care. Full article

Background/Objectives: Remote telemedical management (RTM) in heart failure (HF) patients with cardiac implantable electronic devices (CIED) is a reliable approach to follow device-specific and heart failure-related parameters. However, while some positive outcome data is available, results are inconclusive. We aimed to assess the benefits of continuous remote telemonitoring (RTM) compared to the in-person visit (IPV) in reducing all-cause mortality, heart failure hospitalizations (HFH), cardiovascular (CV) deaths, and the occurrence of inappropriate therapy. Methods: The study comprised a systematic review and meta-analysis of randomized controlled trials (RCTs) testing RTM (device-related or other non-invasive telemonitoring systems) vs. IPV for the management of HF patients. The main endpoints were all-cause and CV mortality. Risk of bias and level of evidence were assessed. Hazard ratios (HRs), odds ratios (ORs) and 95% confidence intervals (CI) were calculated. CENTRAL, EMBASE and MEDLINE were searched, and only randomized controlled studies were included. Results: Sixteen RCTs were identified, comprising a total of 11,232 enrolled patients. Seven studies evaluated all-cause mortality, resulting in an OR 0.83 (95% CI 0.72 to 0.96). When CV mortality was assessed, the RTM group showed a significant benefit compared to the IPV group (OR 0.81, 95% CI 0.67 to 0.97). The risk of bias ranged from “low” to “some concerns” for most outcomes, and the certainty was low to moderate depending on the specific outcomes. Conclusions: RTM proved to be superior in reducing all-cause and CV mortality compared to IPV; however, there is a clear need to have standardized alert actions to achieve the mortality benefit. Full article

Background/Objectives: In 2010, approximately 60.5 million people were affected by glaucoma, making it the leading cause of permanent vision impairment globally. With the rise of telehealth tools and technological advancements in glaucoma care, this review aims to provide an up-to-date analysis regarding remote monitoring systems in glaucoma management. Methods: A systematic literature search (in compliance with PRISMA guidelines) was conducted across six databases (CINAHL, MEDLINE, PsycINFO, Web of Science, Scopus, and Cochrane Library) and one grey literature source (Google Scholar), covering the period from 2000 to 2024. Relevant studies meeting predefined inclusion criteria were identified and analyzed. Results: The search identified 21 eligible studies focusing on various glaucoma telemonitoring tools. Several studies demonstrated the potential for continuous remote intraocular pressure (IOP) monitoring and highlighted the effectiveness of home-based visual field-testing technologies (e.g., Melbourne Rapid Fields, Eyecatcher, and VF-Home), which showed results closely matching in-clinic tests. All 21 studies underwent risk of bias assessment with appropriate tools based on study design, and none showed a high overall risk of bias, indicating robust methodology. Conclusions: Glaucoma telemonitoring tools are feasible and cost-effective, helping to reduce patient travel and waiting times and improving patient satisfaction. However, periodic in-person examinations remain necessary to optimally monitor disease progression and adjust treatments. Future directions should focus on interdisciplinary collaboration and the development of advanced algorithms (including artificial intelligence) to further enhance patient outcomes in teleglaucoma care. Full article

Background: Interdialytic weight gain (IDWG), defined as the accumulation of salt and water intake between dialysis sessions, is a critical parameter of fluid management and a marker of adherence to dietary and fluid restrictions in hemodialysis patients. Excessive IDWG has been strongly associated with increased cardiovascular risk, including left ventricular hypertrophy, cardiac dysfunction, and cerebrovascular complications. Additionally, it necessitates more aggressive ultrafiltration, potentially compromising hemodynamic stability, impairing quality of life, and escalating healthcare costs. Despite international guidelines recommending an IDWG target of <4–4.5% of body weight, many patients struggle to achieve this due to barriers in adhering to dietary and fluid restrictions. This review explores the current state-of-the-art strategies to mitigate IDWG and evaluates emerging diagnostic and therapeutic perspectives to improve fluid management in dialysis patients. Methods: A literature search was conducted in PubMed/MEDLINE, Scopus, and Web of Science to identify studies on IDWG in hemodialysis. Keywords and MeSH terms were used to retrieve peer-reviewed articles, observational studies, RCTs, meta-analyses, and systematic reviews. Non-English articles, case reports, and conference abstracts were excluded. Study selection followed PRISMA guidelines, with independent screening of titles, abstracts, and full texts. Data extraction focused on IDWG definitions, risk factors, clinical outcomes, and management strategies. Due to study heterogeneity, a narrative synthesis was performed. Relevant data were synthesized thematically to evaluate both established strategies and emerging perspectives. Results: The current literature identifies three principal strategies for IDWG control: cognitive–behavioral interventions, dietary sodium restriction, and dialysis prescription adjustments. While educational programs and behavioral counseling improve adherence, their long-term effectiveness remains constrained by patient compliance and logistical challenges. Similarly, low-sodium diets, despite reducing thirst, face barriers to adherence and potential nutritional concerns. Adjustments in dialysate sodium concentration have yielded conflicting results, with concerns regarding hemodynamic instability and intradialytic hypotension. Given these limitations, alternative approaches are emerging. Thirst modulation strategies, including chewing gum to stimulate salivation and acupuncture for autonomic regulation, offer potential benefits in reducing excessive fluid intake. Additionally, technological innovations, such as mobile applications and telemonitoring, enhance self-management by providing real-time feedback on fluid intake. Biofeedback-driven dialysis systems enable dynamic ultrafiltration adjustments, improving fluid removal efficiency while minimizing hemodynamic instability. Artificial intelligence (AI) is advancing predictive analytics by integrating wearable bioimpedance sensors and dialysis data to anticipate fluid overload and refine individualized dialysis prescriptions, driving precision-based volume management. Finally, optimizing dialysis frequency and duration has shown promise in achieving better fluid balance and cardiovascular stability, suggesting that a personalized, multimodal approach is essential for effective IDWG management. Conclusions: Despite decades of research, IDWG remains a persistent challenge in hemodialysis, requiring a multifaceted, patient-centered approach. While traditional interventions provide partial solutions, integrating thirst modulation strategies, real-time monitoring, biofeedback dialysis adjustments, and AI-driven predictive tools represent the next frontier in fluid management. Future research should focus on long-term feasibility, patient adherence, and clinical efficacy, ensuring these innovations translate into tangible improvements in quality of life and cardiovascular health for dialysis patients. Full article

Background: Due to technological advancements, the demand for easily accessible and convenient healthcare services is rising globally. Thus, telehealth is gaining momentum that was previously unheard of. The Kingdom of Saudi Arabia (KSA) actively embraces digital innovation in the healthcare industry through its ambitious Vision 2030 initiative. This study aimed to assess the perceived usability of telehealth for personalized healthcare among the KSA adult population in the post-COVID-19 era. Methods: This cross-sectional study used a convenience sample of 975 adults from the general population in KSA. A digital survey was used for data collection through Survey Monkey software. It contained two sections: personal and health data and the Telehealth Usability Questionnaire (TUQ). The data was collected over three months (July–September 2024) and investigated using the multinomial logistic regression analysis. Results: This study showed that 59.8% of the participants have initiated telehealth service use before the COVID-19 pandemic, and the most frequently used services are the issuance of sick leave (30.6%), tele-prescription (29.0%), virtual consultation (20.0%), tele-mental health services (19.4%), telemonitoring (18.6), and tele-referral (18.2%). A high total telehealth usability score was observed among 60.4% of the participants: 72.7% perceive telehealth as highly useful, 76.4% perceive it as easy to use, 60.1% have high satisfaction and intention for future use, 57.4% perceive high interface quality, and 51.8% perceive a high interaction quality. Conversely, 45.8% perceive low reliability of the telehealth system. Multinomial logistic regression showed that low education (AOR = 2.04; 95% CI = 1.16–4.85) and using virtual consultation (AOR = 0.98; 95% CI = 0.38–0.99) were predictors of low telehealth usability. However, being female (AOR = 1.67; 95% CI = 1.27–2.55), being in higher education (AOR = 1.47; 95% CI = 1.02–2.34), and living in the central KSA region (AOR = 1.37; 95% CI = 1.10–2.23) were predictors of high telehealth usability. Working status, income, and presence of chronic disease were not statistically significant predictors. Conclusions: Telehealth services have been highly usable in KSA even before the COVID-19 pandemic, with commonly used asynchronous services. Many social, technological, and system-related factors could affect the user experience and system reliability. Hence, telehealth developments are recommended to overcome such barriers, with future initiatives focusing on the flexibility and convenience of telehealth systems. Full article