A 28-year-old woman developed drug-induced tachycardia in the left lateral decubitus (LLD) position following intravenous administration of glycopyrrolate. The tachycardia was unresponsive to esmolol, labetalol, and fentanyl but resolved unexpectedly after the tidal volume was reduced from 8 to 6 mL/kg. Drug-induced tachycardia or arrhythmia occurring in the LLD position under mechanical ventilation may be attenuated by adopting a low tidal volume ventilation strategy (6 mL/kg).

Purpose
Endoscopic vacuum therapy (EVT) has emerged as a highly effective approach for managing gastrointestinal transmural defects and may offer advantages over traditional methods, such as stenting. This study evaluated the clinical outcomes of EVT for gastrointestinal transmural defects resulting from leakages, perforations, and fistulas.
Methods
We retrospectively reviewed patients who underwent EVT for gastrointestinal transmural defects at Ewha Womans University Medical Center between February 2018 and September 2025 and analyzed clinical outcomes, adverse events, and risk factors associated with adverse events.
Results
Fourteen patients were included (mean age, 63.9 years; 85.7% male). Stomach surgery was the most common etiology (50.0%), and malignancy accounted for 71.4% of cases. The median number of EVT sessions was 2.5, and the mean interval from the index event to the first EVT session was 10.5 days. EVT achieved a 100% technical success rate, with no 30-day mortality; there was 1 in-hospital death (7.1%), 2 cases of stricture (14.3%), and 1 major bleeding event (7.1%). Adverse events were observed more frequently in patients who underwent ≥3 EVT sessions (57.1%) compared with those who underwent <3 sessions, in whom no adverse events occurred.
Conclusion
This study suggests that EVT is a safe and effective treatment for gastrointestinal transmural defects, with high technical success rates. The number of EVT sessions and the timing of treatment initiation appeared to be associated with complications and overall clinical outcomes.

Purpose
Human papillomavirus is the dominant etiological factor underlying atypical cervical squamous epithelial cell abnormalities and cervical carcinoma. Currently, only a limited number of drugs targeting specific biomarkers in cervical cancer are available. This study aimed to assess the expression of estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2), and the Ki-67 proliferative index (Ki-67) in p16-positive cervical squamous premalignant and malignant lesions, which may help clarify the potential role of targeted therapies in cervical cancer. Methods: In p16-positive, histologically proven premalignant and malignant cervical lesions, ER, HER2, and Ki-67 expression were evaluated according to predefined criteria. Results: p16 showed strong nuclear and cytoplasmic positivity in 54 of 56 cases. Patchy nuclear positivity was mainly observed in low-grade squamous intraepithelial lesion (LSIL) cases (2/56). Ki-67 demonstrated a variable proliferative index ranging from 5% to 95% across all cases, with higher indices predominantly observed in squamous cell carcinomas (SCC). ER positivity in LSIL, high-grade squamous intraepithelial lesion, and SCC was 100% (2/2), 66.7% (10/15), and 46.15% (18/39), respectively. HER2 expression was predominantly negative, observed in 78.6% (44/56) of cases, equivocal in 17.8% (10/56), and positive in 3.6% (2/56). Both HER2-positive cases were SCC. ER and HER2 interpretations were analyzed and were not significantly correlated with clinical or pathological parameters. Conclusion: ER positivity decreased with progression of cervical squamous lesions, and HER2 expression was rare in cervical squamous neoplasia. No statistically significant correlation was identified between ER or HER2 expression and clinicopathological parameters. The findings of the current study may help fill gaps in the existing literature and provide essential foundational knowledge for optimizing emerging therapeutic strategies, including ER- and HER2-related therapies.

Cardiovascular disease, particularly ischemic heart disease, remains a leading cause of death worldwide. Although advances in pharmacological and device-based therapies have improved clinical outcomes, effective strategies for myocardial repair and regeneration remain limited. T-cadherin, a glycosylphosphatidylinositol-anchored atypical cadherin, has recently been identified as a functional receptor for both low-density lipoprotein cholesterol and adiponectin, a cardioprotective adipokine. Notably, the interaction between T-cadherin and adiponectin has emerged as a key regulator of exosome biogenesis and paracrine signaling within cardiovascular tissues. Exosomes are nanosized extracellular vesicles that carry protective molecular cargo, including microRNAs and proteins, and contribute to anti-inflammatory, antifibrotic, and angiogenic effects in the ischemic myocardium. However, their clinical translation is challenged by factors such as variability in yield, heterogeneity of exosome populations, and inefficient tissue targeting. Enhancing endogenous exosome production through the T-cadherin–adiponectin pathway may therefore offer a novel cell-free therapeutic strategy. This review explores the biological roles of T-cadherin and adiponectin in cardiovascular diseases, their regulatory influence on exosome formation, and the future potential of leveraging this axis for myocardial repair and regeneration.

Perioperative pain management has shifted from standardized, procedure-based protocols toward individualized, patient-centered approaches. Inadequate pain control can result in short-term adverse outcomes, including delayed ambulation, prolonged hospitalization, and increased complications, as well as long-term sequelae such as chronic persistent postsurgical pain. Early models of preemptive and preventive analgesia emphasized pain relief primarily through the use of opioids. Growing concern about opioid-related adverse effects established the basis for multimodal and opioid-sparing strategies. Nevertheless, with the onset of the global opioid crisis, heightened awareness of the risks of opioid overuse has fueled interest in opioid-free techniques. However, evidence does not demonstrate that opioid-free methods are superior to opioid-sparing approaches. This underscores the importance of returning to the central goals of enhanced recovery after surgery: early restoration of function and reduction of complications. Within this framework, personalized pain management has emerged as a practical paradigm that tailors interventions to individual characteristics, including comorbidities, psychological status, pain sensitivity, and recovery objectives. This review outlines the rationale, current practices, and future directions of personalized perioperative pain management and proposes a framework for integrating new strategies into clinical care.

Citations

• Beauty and Fatality: A Forensic Perspective on Periprocedural Deaths after Aesthetic Procedures, and Insights for Death Investigation and Public Health Safety
  Sohyung Park, Sung Wook Choi, Duk Hoon Kim, Minjung Kim, Min Jee Park, Jung Sik Jang, Seon Jung Jang, Jeong Hwa Kwon, Yooha Don, Hyejeong Kim
  Korean Journal of Legal Medicine.2025; 49(4): 133.     CrossRef

The integration of regional anesthesia (RA) with general anesthesia (GA) has become a central component of multimodal strategies to improve perioperative pain management. This approach not only enhances analgesic efficacy but also reduces opioid requirements and mitigates opioid-related adverse effects. By targeting peripheral or neuraxial nociceptive pathways, RA attenuates the surgical stress response and decreases central sensitization, complementing the systemic actions of GA. The combined application of RA and GA has shown substantial benefits across a wide range of surgical procedures, including abdominal, thoracic, orthopedic, and pediatric operations. Reported advantages include improved hemodynamic stability, enhanced pulmonary function, earlier ambulation, faster gastrointestinal recovery, and greater patient satisfaction. Moreover, recent evidence indicates a positive association between effective postoperative pain control and long-term outcomes, such as reduced incidence of persistent postsurgical pain, better functional independence, and even improved immune function and survival following cancer surgery. The development of sustained-release local anesthetic delivery systems, which provide localized and prolonged analgesia, further extends the benefits of RA-GA integration into the postoperative period. This review summarizes the mechanistic rationale, clinical applications, and future directions of RA-GA combinations in modern surgical care, with special emphasis on their role in enhanced recovery after surgery protocols.

Citations

• Results and Future Perspectives of the Sustainable Anesthesia Project: A Large-Scale, Real-World Implementation Study at the Largest Spanish Private Healthcare Provider
  Juan Acha-Ganderias, María del Pino Henríquez-de Armas, Luis Enrique Muñoz-Alameda, Ion Cristóbal, Cristina Caramés, Leticia Moral-Iglesias
  Healthcare.2026; 14(3): 300.     CrossRef
• Effect of transcutaneous electrical nerve stimulation on patients after coronary artery bypass grafting: a systematic review and meta-analysis
  Enyu Zhang, Jihe Kang, Yan Liu, Lulu Wang, Bo Wan, Xiaoling Li
  Frontiers in Cardiovascular Medicine.2026;[Epub]     CrossRef

Generative artificial intelligence (GenAI), including large language models such as GPT-4 and image-generation tools like DALL-E, is rapidly transforming the landscape of medical education. These technologies present promising opportunities for advancing personalized learning, clinical simulation, assessment, curriculum development, and academic writing. Medical schools have begun incorporating GenAI tools to support students’ self-directed study, design virtual patient encounters, automate formative feedback, and streamline content creation. Preliminary evidence suggests improvements in engagement, efficiency, and scalability. However, GenAI integration also introduces substantial challenges. Key concerns include hallucinated or inaccurate content, bias and inequity in artificial intelligence (AI)-generated materials, ethical issues related to plagiarism and authorship, risks to academic integrity, and the potential erosion of empathy and humanistic values in training. Furthermore, most institutions currently lack formal policies, structured training, and clear guidelines for responsible GenAI use. To realize the full potential of GenAI in medical education, educators must adopt a balanced approach that prioritizes accuracy, equity, transparency, and human oversight. Faculty development, AI literacy among learners, ethical frameworks, and investment in infrastructure are essential for sustainable adoption. As the role of AI in medicine expands, medical education must evolve in parallel to prepare future physicians who are not only skilled users of advanced technologies but also compassionate, reflective practitioners.

Citations

• Using virtual reality to support the transition from preclinical to clinical training in paediatric dentistry
  Marion Lautier, Faustine Béal, Amélie Reibel Domergue, Sophie Jung, François Clauss, Marion Strub
  BMC Medical Education.2026;[Epub]     CrossRef
• Generative and Large-Scale Artificial Intelligence in Exercise and Sports Medicine: A Narrative Review
  Bokyoung Kim, Junseok Kang, Yun Jae Jung, Jihyun Ahn
  The Asian Journal of Kinesiology.2026; 28(1): 58.     CrossRef

South Korea is experiencing a rapid demographic transition, with the proportion of older adults projected to exceed 20% by 2025. This unprecedented pace has intensified the demand for healthcare and social support, creating complex challenges in the management of multimorbidity, frailty, and functional dependency. Historically, Korea has relied on a rigid, provider-centered model, with healthcare financed through National Health Insurance and long-term care through long-term care insurance. Although these systems expanded service availability, they also entrenched fragmentation between long-term care hospitals and nursing homes. Recent reforms mark a paradigm shift toward person-centered, integrated care. The Community Care pilot programs (2019–2022) and the Integrated Community Care Support Act (2024) introduced coordinated models that link healthcare, housing, and social services under local government leadership. Evidence from domestic and international studies underscores the risks of prolonged institutionalization and highlights the benefits of integrated approaches, including reduced hospitalizations, improved functional independence, and higher satisfaction among older adults and their families. At the same time, experiences from Korea and Japan suggest that institutional care remains indispensable for individuals with high medical needs or at the end of life, emphasizing the need for balanced strategies. Successful implementation of the 2026 reforms will require redefining the role of institutions, expanding community-based alternatives, developing a professional care manager workforce, achieving interoperability of data systems, and undertaking financing reforms to align incentives. Beyond structural change, embedding a cultural ethos that values dignity, autonomy, and personhood will be essential. Korea’s evolving model not only responds to urgent demographic challenges but also offers lessons for other aging societies.

Globally, rapid population aging—particularly in Korea—has extended life expectancy but not proportionally extended healthy life expectancy, resulting in longer periods of illness or disability and a higher demand for complex medical and social care. Therefore, prolonging healthy life and improving health-related quality of life have become primary objectives in geriatric medicine and rehabilitation. Geriatric rehabilitation is a critical intervention aimed at optimizing the functioning of older adults and pre-morbidly frail individuals who have lost independence due to acute illness or injury. For many older patients, the goal shifts from complete recovery to achieving a new equilibrium, maximizing autonomy despite greater dependency. Geriatric rehabilitation also targets key geriatric syndromes such as frailty, recognizing it as a dynamic and potentially reversible state that provides a crucial “time window” for intervention. This review summarizes the core principles and structural elements essential for geriatric rehabilitation, emphasizing the implementation challenges within the Korean healthcare system. Unlike the European consensus, which supports structured inpatient and outpatient services with seamless transitions of care guided by Comprehensive Geriatric Assessment, the Korean healthcare system remains fragmented and heavily centered on acute hospitals. This highlights the urgent need for a systematic model to integrate care facilities and strengthen interprofessional collaboration to support community-based “aging in place.” Effective geriatric rehabilitation requires multidisciplinary teams and multifaceted approaches to optimize quality of life, social participation, and independent living. Despite its importance, substantial awareness gaps and policy barriers persist, underscoring an urgent call to action.

Diabetes mellitus is a complex chronic disease with a rapidly increasing global prevalence. For this condition, non-pharmacological lifestyle modification is as important as pharmacological treatment. This review aims to comprehensively examine lifestyle prescriptions for diabetes across multiple domains to integrate current insights and understanding. In medical nutrition therapy, which is central to diabetes treatment and management, excessive carbohydrate intake should be restricted, while individualized consumption of high-quality carbohydrates, protein, and unsaturated fatty acids is recommended. Intake of added sugars and sodium should also be limited. Physical activity should similarly be tailored to the individual, with a combination of aerobic exercise and resistance training recommended. Careful consideration of hypoglycemia risk and diabetes complications is essential. Additional strategies include limitations on uninterrupted sedentary time to less than 30 minutes, maintenance of a healthy body weight, smoking cessation, alcohol abstinence, sleep health improvements, and attention to psychosocial care. In primary care settings, patient-specific assessment, multidisciplinary lifestyle prescriptions, and education to support behavior modification are expected to play a pivotal role in the treatment and management of diabetes.

Hypertension is one of the leading chronic diseases globally and a major contributor to cardiovascular morbidity and mortality. Despite advances in pharmacological therapy, medication alone remains limited in achieving optimal control. This review synthesizes recent hypertension management guidelines, including those from the European Society of Cardiology (ESC, 2024), American Heart Association/American College of Cardiology (AHA/ACC, 2025), Taiwan Society of Cardiology/Hypertension Society (2022), and Korean Society of Hypertension (KSH, 2018). All guidelines consistently emphasize sodium restriction, weight reduction, regular exercise, moderation of alcohol intake, smoking cessation, and adoption of healthy dietary patterns such as the Dietary Approaches to Stop Hypertension, Mediterranean, or culturally adapted diets. The ESC 2024 guideline elevates lifestyle modification to Class I, Level A, specifying targets for sodium (<2 g/day) and potassium (≥3.5 g/day). The AHA/ACC 2025 guideline provides quantitative estimates, reporting approximately 1/1 mm Hg blood pressure reduction per kilogram of weight loss, and incorporates newer strategies such as glucagon-like peptide-1 receptor agonists and bariatric surgery when lifestyle measures alone are insufficient. Taiwan’s 2022 guideline frames recommendations under the S-ABCDE (sodium restriction, alcohol limitation, body weight reduction, cigarette cessation, diet adaptation, exercise adoption) mnemonic and uniquely includes genetic factors such as ALDH2 polymorphisms. The KSH 2018 guideline emphasizes salt restriction (<6 g/day), maintaining a body mass index <25 kg/m2, and adherence to traditional Korean diets. Lifestyle modification remains the cornerstone of hypertension prevention and management, particularly in primary care. Future directions should focus on integrating these approaches with pharmacotherapy, digital health strategies, and personalized prescriptions.

This study aimed to provide a comprehensive understanding of aging with disability among polio survivors who continue to live with long-term sequelae. Although poliomyelitis has been eradicated in most regions, survivors entering older age face a dual challenge, as age-related decline overlaps with pre-existing impairments, creating a need for integrated management strategies. This narrative review examined the epidemiology, clinical manifestations, and late effects of polio, with particular attention to post-polio syndrome, secondary musculoskeletal disorders, and other systemic conditions. International and Korean studies were compared to highlight similarities and contextual differences. Polio survivors frequently experience accelerated functional decline due to post-polio syndrome, fatigue, pain, musculoskeletal disorders (e.g., arthritis, osteoporosis, fractures), and cardiopulmonary dysfunction. Approximately 64% report major falls, with 35% sustaining fractures, often at vulnerable sites such as the hip or distal femur. Psychological distress, sleep disturbances, metabolic syndrome, and cardiovascular disease are also prevalent, further compounding frailty. In Korea, where most survivors are now over 60 years of age, epidemiological patterns differ from those of Western cohorts; however, systematic investigations remain limited. Polio survivors exemplify the dual burden of aging and long-term disability, underscoring the need to move beyond fragmented, symptom-focused care toward integrated, life course–oriented approaches. Anticipating and managing late effects, strengthening preventive strategies, and ensuring equitable healthcare access are essential for maintaining function, independence, and quality of life. Lessons drawn from polio survivors offer valuable insights for understanding aging with disability more broadly.

Fragility fractures, particularly hip fractures, represent a major public health concern among older adults and are associated with high morbidity, mortality, functional decline, and socioeconomic burden. Cognitive impairment is common in older adults with hip fractures and contributes to increased fracture risk, poor postoperative outcomes, delayed recovery, and higher rates of institutionalization. This review aimed to examine rehabilitation strategies for older adults with hip fractures, with a specific focus on considerations for those with cognitive impairment. Evidence suggests that individuals with mild-to-moderate cognitive impairment can achieve meaningful functional gains through structured, intensive, multidisciplinary rehabilitation programs incorporating progressive resistance training, balance and mobility exercises, and individualized approaches tailored to cognitive and physical abilities. However, the implementation of such programs is often hindered by insufficient staff training and awareness in dementia-specific rehabilitation, limited resources, and the lack of standardized protocols defining eligibility, intensity, and adaptation. Optimizing outcomes requires structured, tailored rehabilitation protocols, enhanced staff education, interprofessional collaboration, and proactive management of delirium and secondary fracture prevention through fracture liaison services, while concurrently addressing systemic barriers such as resource constraints. Integrated, coordinated care across the continuum is essential to maximize recovery, independence, and quality of life in older adults with hip fractures and cognitive impairment.

Pediatric anesthesia presents unique challenges due to children’s distinct physiological and anatomical characteristics, including variations in drug metabolism, airway structure, and respiratory and circulatory regulation. Despite significant advances in patient safety that have reduced anesthesia-related mortality over recent decades, the declining pediatric population has made specialized training and clinical practice increasingly difficult. This narrative review addresses practical aspects of pediatric anesthesia, emphasizing patient monitoring, airway management, and recent clinical advances. Oxygen supply targets in children require careful titration to ensure adequate tissue oxygenation while avoiding oxygen toxicity and its associated complications, such as bronchopulmonary dysplasia and retinopathy of prematurity. Quantitative monitoring of neuromuscular blockade, such as with train-of-four stimulation, is essential to prevent postoperative respiratory complications. Temperature monitoring is equally critical in pediatric surgery because children and neonates are highly susceptible to intraoperative hypothermia. Airway management in infants and young children is complicated by anatomical differences, and while video laryngoscopy offers advantages, evidence for its benefits in neonates remains inconclusive. Extubation strategies must be individualized, taking into account risks such as laryngospasm and airway obstruction, as both deep and awake extubation have demonstrated comparable safety profiles. Emerging modalities, such as transfontanelle ultrasonography, provide real-time cerebral blood flow assessment and enhance perioperative brain monitoring. Regional anesthesia techniques in neonates and infants reduce exposure to general anesthetics and facilitate faster recovery but require meticulous technique and monitoring to ensure safety. Multidisciplinary collaboration and effective communication with parents are essential to achieving optimal outcomes.

멘델 무작위화(Mendelian randomization, MR) 연구는 조절 가능한 노출(modifiable exposure)이 건강결과에 미치는 인과효과(causal effect)를 더 잘 이해하게 해 주지만, 그 근거는 종종 보고가 불충분함으로 인하여연구 결과의 해석과 적용에 한계가 있을 수 있다. 보고지침은 흔히 무슨 연구를 하고 무엇을 발견했는지 독자가 쉽게 이해하도록 돕는다. STROBE-MR(관찰연구의 멘델 무작위화를 활용한 보고지침)은 MR 연구를 명확하고 투명하게 보고하도록 돕는다. STROBE-MR을 논문 작성에 활용하면 독자, 심사자, 학술지 편집인이 MR 연구의 보고 품질과 완성도를 평가하는 데 도움이 될 것이다. 이 글은 STROBE-MR 체크리스트 20개 항목의 의미와 근거를 설명하고, 각 항목마다 사례를 제시해 독자가 잘 이해할 수 있는 논문 작성법을 설명하려고 하였다.

Purpose
This review aims to synthesize the most up-to-date evidence on effective lifestyle prescriptions for managing patients with obesity in the primary care setting.
Methods
A comprehensive literature search was conducted through June 2025 using major domestic and international databases, including PubMed, Google Scholar, and RISS, as well as the websites of relevant academic societies. The search strategy employed keywords such as “obesity,” “primary care,” “lifestyle intervention,” “diet,” “exercise,” and “behavioral therapy” in both English and Korean.
Results
Effective obesity management should be grounded in the new paradigm of adiposity-based chronic disease, which focuses on preventing and treating the medical complications associated with excessive fat accumulation. The essential components of a successful lifestyle prescription comprise 3 pillars: diet, exercise, and behavioral therapy. An individualized dietary plan that achieves an energy deficit of 500–750 kcal is fundamental. Exercise prescriptions should recommend a combination of aerobic and resistance training, along with strategies to minimize sedentary time. In behavioral therapy, high-intensity behavioral counseling, the 6A model (ask, assess, advise, agree, assist, arrange), self-monitoring, and cognitive-behavioral therapy techniques have all demonstrated efficacy.
Conclusion
Primary care physicians are not only capable but also uniquely positioned to lead long-term, patient-centered obesity management. Their comprehensive and integrative perspective makes them one of the most efficient and scalable resources in addressing the obesity epidemic.

Citations

• Building on a strong foundation: a new chapter for the Ewha Medical Journal
  Ji Yeon Byun
  Ewha Medical Journal.2026; 49(1): e1.     CrossRef

Patients with congenital insensitivity to pain and anhidrosis (CIPA) exhibit an inability to perceive pain, recurrent fractures, self-mutilation, and impaired thermoregulation, which lead to severe complications and high morbidity. Children with CIPA often sustain multiple unnoticed fractures that may be mistaken for child abuse because of the presence of fractures at different stages of healing. If unrecognized or inadequately managed, these injuries can cause permanent damage. We report the case of a 9-year-old boy who presented with recurrent fractures, chronic osteomyelitis, heterotrophic ossification, and gangrene. This case underscores the need for heightened awareness among healthcare providers regarding the clinical manifestations and management challenges of CIPA. It also emphasizes the importance of early diagnosis, meticulous follow-up, and a multidisciplinary approach to optimize outcomes and prevent severe complications in affected children.

Purpose
Internal ribosome entry site (IRES) elements, present in both viral and cellular messenger RNAs (mRNAs), facilitate cap-independent translation by recruiting ribosomes to internal regions of mRNA. This study aimed to investigate the impact of inserting G-quadruplex and hairpin structures into the 5' untranslated region (UTR) and poly(A) sequences on the translation efficiency of the encephalomyocarditis virus (EMCV) IRES, using an IRES-based RNA platform encoding OX40L, 4-1BBL, and GFP.
Methods
G-quadruplex and hairpin structures, derived from HIV-1 (human immunodeficiency virus type 1) or custom-designed, were synthesized and inserted into the 5' UTR and poly(A) tail regions of EMCV IRES vectors. These constructs were amplified by polymerase chain reaction, ligated into plasmids, and transcribed in vitro. B16 melanoma, TC-1 tumor, and HEK293 cells were transfected with these RNA constructs. Protein expression levels were assessed at 6, 12, and 24 hours post-transfection by flow cytometry and fluorescence microscopy. Statistical analyses employed one-way analysis of variance with the Dunnett test.
Results
The insertion of G-quadruplex and hairpin structures altered RNA secondary structure, significantly reducing protein expression. In the 5' UTR, the G-quadruplex nearly abolished OX40L expression (1.18%±0.41% at 6 hours vs. 18.23%±0.16% for control), while the hairpin structure reduced it (16.29%±1.46% vs. 22.84%±1.17%). In the poly(A) tail region, both structures decreased GFP expression across all cell lines (4.86%±1.35% to 7.27%±0.32% vs. 39.56%±2.07% in B16 cells).
Conclusion
Inserting G-quadruplex and hairpin structures into EMCV IRES UTRs inhibits translation efficiency, suggesting the need for precise RNA structure modeling to enhance IRES-mediated translation.

Citations

• Efficacy and safety of respiratory strength and endurance training in patients with myotonic dystrophy type 1 (DM1): a randomized controlled trial
  Stephan Wenninger, Eva Heidsieck, Corinna Wirner-Piotrowski, Marko Mijic, Natalia Garcia-Angarita, Kristina Gutschmidt, Daniel H. Mendelshohn, Benedikt Schoser
  Journal of Neurology.2025;[Epub]     CrossRef
• New developments in women’s health research and implications for nursing
  Sue Kim
  Women's Health Nursing.2025; 31(4): 291.     CrossRef

The study aims to examine the 20-year developmental trajectory of medical education at Ewha Womans University College of Medicine (2004–2025). It analyzes educational support documents, self-evaluation reports, and Curriculum Committee meeting minutes to illuminate both the direction and significance of Ewha’s medical education reforms. Key milestones include the formal establishment of the Medical Education Office in 2004 and the subsequent founding of the Department of Medical Education in 2005. Major innovations over this period encompass the expansion of objective structured clinical examinations and the introduction of problem-based learning modules. Additional advancements include the establishment of the Ewha Medical Simulation Center and Learning Resource Center, as well as the reversion to an undergraduate medical college format in 2015. The college has also prioritized faculty development workshops and medical education seminars, implemented the Ewha Social Active Communication program, and introduced team-based learning. Noteworthy initiatives include the enhancement of student research capacity and the launch of a dedicated medical education newsletter. In 2022, the Medical Education Office was reorganized as the Ewha Center for Medical Education, marking a new era of integrated leadership and expanded educational initiatives. Ewha has consistently achieved high accreditation statuses, reflecting ongoing excellence in curriculum development, assessment, and faculty development. This progress demonstrates the dedication and collaboration of both faculty and staff, resulting in a robust educational framework. The institution’s continuous growth serves not only as a testament to past achievements but also as a foundation for future advancements in Ewha’s medical education, with the ultimate aim of cultivating women leaders in Korean healthcare.

Purpose
This study developed and validated a deep learning model for the automated early detection of androgenetic alopecia (AGA) using trichoscopic images, and evaluated the model’s diagnostic performance in a Korean clinical cohort.
Methods
We conducted a retrospective observational study using 318 trichoscopic scalp images labeled by board-certified dermatologists according to the Basic and Specific (BASP) system, collected at Ewha Womans University Medical Center between July 2018 and January 2024. The images were categorized as BASP 0 (no hair loss) or BASP 1–3 (early-stage hair loss). A ResNet-18 convolutional neural network, pretrained on ImageNet, was fine-tuned for binary classification. Internal validation was performed using stratified 5-fold cross-validation, and external validation was conducted through ensemble soft voting on a separate hold-out test set of 20 images. Model performance was measured by accuracy, precision, recall, F1-score, and area under the curve (AUC), with 95% confidence intervals (CIs) calculated for hold-out accuracy.
Results
Internal validation revealed robust model performance, with 4 out of 5 folds achieving an accuracy above 0.90 and an AUC above 0.93. In external validation on the hold-out test set, the ensemble model achieved an accuracy of 0.90 (95% CI, 0.77–1.03) and an AUC of 0.97, with perfect recall for early-stage hair loss. No missing data were present, and the model demonstrated stable convergence without requiring data augmentation.
Conclusion
This model demonstrated high accuracy and generalizability for detecting early-stage AGA from trichoscopic images, supporting its potential utility as a screening tool in clinical and teledermatology settings.

Citations

• How Can Clinicians Leverage Vibe Coding for Machine Learning and Deep Learning Research?
  Yoonhwan Lee, Sun Huh
  Endocrinology and Metabolism.2025; 40(5): 659.     CrossRef

Purpose
This study aimed to assess the spatiotemporal associations between air pollution and emergency room visits for cardiovascular and cerebrovascular diseases in South Korea using a graph autoencoder (GAE). A multivariate graph-based approach was used to uncover seasonal and regional variations in pollutant–disease relationships.
Methods
We collected monthly data from 2022 to 2023, including concentrations of 6 air pollutants (SO2, NO2, O3, CO, PM10, and PM2.5) and emergency room visits for 4 disease types: cardiac arrest, myocardial infarction, ischemic stroke, and hemorrhagic stroke. Pearson correlation coefficients were used to construct adjacency matrices, which, along with normalized feature matrices, were used as inputs to the GAE. The model was trained separately for each month and region to estimate the strength of pollutant–disease associations.
Results
The pollutant–disease network structures exhibited clear seasonal variations. In winter, strong associations were observed between O3, NO2, and all disease outcomes. In spring, PM2.5 and PM10 were strongly linked to cardiac and stroke-related visits. These connections weakened during summer but became more pronounced in autumn, especially for NO2 and cardiac arrest. Urban areas displayed denser and stronger associations than non-urban areas.
Conclusion
Our findings underscore the necessity for season- and region-specific air quality management strategies. In winter, focused control of O3 and NO2 is needed in urban areas, while in spring, PM mitigation is required in urban and selected rural regions. Autumn NO2 control may be especially beneficial in non-urban areas. Spatiotemporally tailored interventions could reduce the burden of air pollution-related emergency room visits.

Purpose
This study aimed to describe mortality trends in the Republic of Korea in 2022 by analyzing total deaths, crude and age-standardized mortality rates, as well as age- and sex-specific patterns and changes in cause-specific mortality. The analysis updates previous reports with newly available data from 2022.
Methods
A repeated cross-sectional analysis was performed using nationwide death certificate data collected through municipal administrative offices. Deaths occurring in 2022 were aggregated from reports filed over a 16-month period, spanning January 2022 to April 2023. Causes of death were classified according to the World Health Organization’s International Classification of Diseases. Quality assurance was ensured through administrative record linkage across 22 databases and validation using an independent infant mortality survey. Descriptive statistics were employed to summarize the findings.
Results
In 2022, Korea recorded 372,939 deaths (the highest annual total since 1983), corresponding to a crude death rate of 727.6 per 100,000 population. This increase contributed to a net population decline of 123,751. Mortality rates rose across most age groups, with particularly marked increases among those aged 1–9 and those aged 80 or older. Coronavirus disease 2019 (COVID-19) became the third leading cause of death (31,280 deaths; 61.0 per 100,000), driven largely by the Omicron variant and heightened infection rates among older adults. Pancreatic cancer overtook stomach cancer in the mortality rankings. There were sharp increases in deaths attributed to Alzheimer’s disease and diabetes. Although deaths from intentional self-harm declined, suicide remained a significant cause of death among younger individuals.
Conclusion
Korea experienced a record-high mortality rate in 2022, largely due to the impacts of COVID-19 and ongoing population aging. Notable shifts in cause-specific mortality were observed, including increases in deaths from Alzheimer’s disease, diabetes, and pancreatic cancer, underscoring evolving public health challenges.

Purpose
This study evaluated the feasibility and performance of a deep learning approach utilizing the Korean Medical BERT (KM-BERT) model for the automated classification of underlying causes of death within national mortality statistics. It aimed to assess predictive accuracy throughout the cause-of-death coding workflow and to identify limitations and opportunities for further artificial intelligence (AI) integration.
Methods
We performed a retrospective prediction study using 693,587 death certificates issued in Korea between January 2021 and December 2022. Free-text fields for immediate, antecedent, and contributory causes were concatenated and fine-tuned with KM-BERT. Three classification models were developed: (1) final underlying cause prediction (International Classification of Diseases, 10th Revision [ICD-10] code) from certificate inputs, (2) tentative underlying cause selection based on ICD-10 Volume 2 rules, and (3) classification of individual cause-of-death entries. Models were trained and validated using 2021 data (80% training, 20% validation) and evaluated on 2022 data. Performance metrics included overall accuracy, weighted F1 score, and macro F1 score.
Results
On 306,898 certificates from 2022, the final cause model achieved 62.65% accuracy (F1-weighted, 0.5940; F1-macro, 0.1503). The tentative cause model demonstrated 95.35% accuracy (F1-weighted, 0.9516; F1-macro, 0.4996). The individual entry model yielded 79.51% accuracy (F1-weighted, 0.7741; F1-macro, 0.9250). Error analysis indicated reduced reliability for rare diseases and for specific ICD chapters, which require supplementary administrative data.
Conclusion
Despite strong performance in mapping free-text inputs and selecting tentative underlying causes, there remains a need for improved data quality, administrative record integration, and model refinement. A systematic, long-term approach is essential for the broad adoption of AI in mortality statistics.

Non‑operative management, particularly the watch and wait (WW) strategy, has emerged as an alternative to total mesorectal excision for selected patients with locally advanced rectal cancer who achieve a clinical complete response (cCR) after neoadjuvant treatment. This narrative review examines oncologic outcomes, functional and quality‑of‑life benefits, diagnostic challenges, and surveillance requirements associated with WW compared to radical surgery. Evidence from randomized trials and international registries indicates that WW provides overall and disease-free survival rates comparable to those of surgery, provided that stringent selection criteria and intensive surveillance are maintained for 3 to 5 years. Local regrowth occurs in 15%–40% of patients—most commonly within 24 months—but salvage surgery is curative in over 90% of cases and restores oncologic equivalence. Nevertheless, distant metastasis is more frequent in patients who experience regrowth, underscoring the importance of early detection and the need for optimized systemic therapy. Accurate determination of cCR remains the primary limitation; digital rectal examination, high‑resolution magnetic resonance imaging, and endoscopy, even when combined, cannot reliably exclude microscopic residual disease. Total neoadjuvant therapy increases cCR rates to 30%–60% and expands the pool of WW candidates, but also intensifies the need for standardized response definitions and surveillance algorithms. WW offers organ preservation and quality‑of‑life improvements without compromising survival in carefully selected patients, provided that multidisciplinary teams ensure rigorous response assessment and lifelong monitoring. Future advances in imaging, molecular biomarkers, and individualized risk stratification are expected to further enhance the safety of WW and expand eligibility to a broader patient population.

Citations

• Assessing the quality of large generative models for basic healthcare applications
  R. V. Reshetnikov, I. A. Tyrov, Yu. A. Vasilev, Yu. F. Shumskaya, A. V. Vladzymyrskyy, D. A. Akhmedzyanova, K. Yu. Bezhenova, M. D. Varyukhina, M. V. Sokolova, I. A. Blokhin, D. A. Voytenko, O. I. Mynko, M. R. Kodenko, O. V. Omelyanskaya
  Medical Doctor and Information Technologies.2025; (3): 64.     CrossRef
• Role of Medical Editors in the Age of Generative Artificial Intelligence
  Sun Huh
  Healthcare Informatics Research.2025; 31(4): 317.     CrossRef

Citations

• Clinical Reformation in the Age of Artificial Intelligence: Safeguarding the Ethical Centre of Medicine
  Ian Io Lei, Wojciech Marlicz, Ramesh P. Arasaradnam, Anastasios Koulaouzidis
  Mayo Clinic Proceedings: Digital Health.2026; 4(1): 100310.     CrossRef
• Time to modernise research in geriatric oncology: Reflections from the 2025 International Society of Geriatric Oncology Annual Meeting
  Sophie Pilleron
  Journal of Geriatric Oncology.2026; 17(2): 102837.     CrossRef
• Role of Medical Editors in the Age of Generative Artificial Intelligence
  Sun Huh
  Healthcare Informatics Research.2025; 31(4): 317.     CrossRef

Citations

• Leaving behind fond memories, I am stepping away from my role as editor of the Ewha Medical Journal after finalizing this issue's theme
  Sun Huh
  Ewha Medical Journal.2025; 48(4): e51.     CrossRef

Citations

• Leaving behind fond memories, I am stepping away from my role as editor of the Ewha Medical Journal after finalizing this issue's theme
  Sun Huh
  Ewha Medical Journal.2025; 48(4): e51.     CrossRef

Chronic obstructive pulmonary disease (COPD) is a leading cause of respiratory morbidity and mortality, most often linked to smoking. However, growing evidence indicates that previous tuberculosis (TB) infection is also a critical risk factor for COPD. This review aimed at providing a comprehensive perspective on TB-COPD, covering its epidemiologic significance, pathogenesis, clinical characteristics, and current management approaches. Tuberculosis-associated chronic obstructive pulmonary disease (TB-COPD) is characterized by persistent inflammatory responses, altered immune pathways, and extensive structural lung damage—manifested as cavitation, fibrosis, and airway remodeling. Multiple epidemiologic studies have shown that individuals with a history of TB have a significantly higher likelihood of developing COPD and experiencing worse outcomes, such as increased breathlessness and frequent exacerbations. Key pathogenic mechanisms include elevated matrix metalloproteinase activity and excessive neutrophil-driven inflammation, which lead to alveolar destruction, fibrotic scarring, and the development of bronchiectasis. Treatment generally follows current COPD guidelines, advocating the use of long-acting bronchodilators and the selective application of inhaled corticosteroids. Studies have demonstrated that indacaterol significantly improves lung function and respiratory symptoms, while long-acting muscarinic antagonists have shown survival benefits.

Citations

• Beyond the Lungs: Cardiovascular Risk in COPD Patients with a History of Tuberculosis—A Narrative Review
  Ramona Cioboata, Mihai Olteanu, Denisa Maria Mitroi, Simona-Maria Roșu, Maria-Loredana Tieranu, Silviu Gabriel Vlasceanu, Simona Daniela Neamtu, Eugen Nicolae Tieranu, Rodica Padureanu, Mara Amalia Balteanu
  Journal of Clinical Medicine.2026; 15(2): 661.     CrossRef
• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef
• History of Pulmonary Tuberculosis Accelerates Early Onset and Severity of COPD: Evidence from a Multicenter Study in Romania
  Ramona Cioboata, Silviu Gabriel Vlasceanu, Denisa Maria Mitroi, Ovidiu Mircea Zlatian, Mara Amalia Balteanu, Gabriela Marina Andrei, Viorel Biciusca, Mihai Olteanu
  Journal of Clinical Medicine.2025; 14(17): 5980.     CrossRef
• Bidirectional Association Between Tuberculosis and Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis
  Jingyuan Feng, Minghao Hu, Hongfei Duan
  Journal of Clinical Medicine.2025; 14(21): 7639.     CrossRef
• Immune Mechanisms of the Comorbid Course of Chronic Obstructive Pulmonary Disease and Tuberculosis
  Stanislav Kotlyarov, Dmitry Oskin
  BIOCELL.2025; 49(9): 1631.     CrossRef
• Chronic Obstructive Pulmonary Disease in Never-Smokers—A Distinct Entity Within the COPD Spectrum
  Andreea-Nicoleta Mălăescu, Florin-Dumitru Mihălțan, Ancuța-Alina Constantin
  Life.2025; 16(1): 43.     CrossRef

Lung cancer remains a leading cause of cancer-related mortality worldwide. Low-dose computed tomography (LDCT) screening has demonstrated efficacy in reducing lung cancer mortality by enabling early detection. In several countries, including Korea, LDCT-based screening for high-risk populations has been incorporated into national healthcare policies. However, in regions with a high tuberculosis (TB) burden, the effectiveness of LDCT screening for lung cancer may be influenced by TB-related pulmonary changes. Studies indicate that the screen-positive rate in TB-endemic areas differs from that in low-TB prevalence regions. A critical challenge is the differentiation between lung cancer lesions and TB-related abnormalities, which can contribute to false-positive findings and increase the likelihood of unnecessary invasive procedures. Additionally, structural lung damage from prior TB infections can alter LDCT interpretation, potentially reducing diagnostic accuracy. Nontuberculous mycobacterial infections further complicate this issue, as their radiologic features frequently overlap with those of TB and lung cancer, necessitating additional microbiologic confirmation. Future research incorporating artificial intelligence and biomarkers may enhance diagnostic precision and facilitate a more personalized approach to lung cancer screening in TB-endemic settings.

Citations

• Utilizing radial endobronchial ultrasound-guided lung biopsy to diagnose pseudotumoral tuberculosis in sputum-negative immunocompetent adults
  Bryan Leonard Maniago Quizon, Ralph Elvi Villalobos, Mithi Kalayaan Zamora, Manuel Peter Paul C Jorge
  BMJ Case Reports.2026; 19(2): e271088.     CrossRef
• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef

The Mycobacterium avium complex (MAC), comprising M. avium and M. intracellulare, constitutes the predominant cause of nontuberculous mycobacterial pulmonary disease (NTM-PD) in Korea, followed by the M. abscessus complex. Its global prevalence is increasing, as shown by a marked rise in Korea from 11.4 to 56.7 per 100,000 individuals between 2010 and 2021, surpassing the incidence of tuberculosis. Among the older adult population (aged ≥65 years), the prevalence escalated from 41.9 to 163.1 per 100,000, accounting for 47.6% of cases by 2021. Treatment should be individualized based on prognostic indicators, including cavitary disease, low body mass index, and positive sputum smears for acid-fast bacilli. Current therapeutic guidelines recommend a 3-drug regimen—consisting of a macrolide, rifampin, and ethambutol—administered for a minimum of 12 months following culture conversion. Nevertheless, treatment success rates are only roughly 60%, and over 30% of patients experience recurrence. This is often attributable to reinfection rather than relapse. Antimicrobial susceptibility testing for clarithromycin and amikacin is essential, as resistance significantly worsens prognosis. Ethambutol plays a crucial role in preventing the development of macrolide resistance, whereas the inclusion of rifampin remains a subject of ongoing debate. Emerging therapeutic strategies suggest daily dosing for milder cases, increased azithromycin dosing, and the substitution of rifampin with clofazimine in severe presentations. Surgical resection achieves a notable sputum conversion rate of approximately 93% in eligible candidates. For refractory MAC-PD, adjunctive therapy with amikacin is advised, coupled with strategies to reduce environmental exposure. Despite advancements in therapeutic approaches, patient outcomes remain suboptimal, highlighting the urgent need for novel interventions.

Citations

• Bidirectional pathogenesis between non-tuberculous mycobacteria and bronchiectasis: clinical insights, diagnostic challenges and future directions—Perspectives from South Asia
  Amresh Kumar Singh, Sneha Singh, Nandini Singh, Priyanka Gaur, Ashwini Kumar Mishra, Raj Kishore Singh, Sushil Kumar
  Frontiers in Tuberculosis.2026;[Epub]     CrossRef
• Molecular epidemiology of non-tuberculous mycobacteria in clinical samples from Jiangxi Province, 2021–2023
  Zhan Qiu Mao, Huilie Zheng, Hui Qiong Yang, Qian Zhong Liu, Yu Hong Xiong, Zhen Qiong Liu, Qi Long Zhang
  BMC Microbiology.2026;[Epub]     CrossRef
• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef
• Understanding recurrence in Mycobacterium avium complex pulmonary disease: genotypic strategies to support clinical decision-making
  Minh Phuong Trinh, Sung Jae Shin, Min-Kyoung Shin, Mark Nicol
  Journal of Clinical Microbiology.2025;[Epub]     CrossRef

Purpose
This study aimed to analyze dementia-related death statistics in Korea between 2013 and 2023.
Methods
The analysis utilized microdata from Statistics Korea’s cause-of-death statistics. Among all recorded deaths, those related to dementia were extracted and analyzed using the underlying cause-of-death codes from the International Classification of Diseases, 10th revision.
Results
The number of dementia-related deaths increased from 8,688 in 2013 to 14,402 in 2023. The crude death rate rose from 17.2 per 100,000 in 2013 to 28.2 per 100,000 in 2023, although the age-standardized death rate declined from 9.7 to 8.7 over the same period. The dementia death rate is 2.1 times higher in women than in men, and mortality among individuals aged 85 and older exceeds 976 per 100,000. By specific cause, Alzheimer’s disease accounted for 77.1% of all dementia deaths, and by place, the majority occurred in hospitals (76.2%), followed by residential institutions including nursing homes (15.3%) in 2023.
Conclusion
The rising mortality associated with dementia, especially Alzheimer’s disease, highlights a growing public health concern in Korea. These findings support the need for enhanced prevention efforts, improved quality of care, and targeted policies addressing the complexities of dementia management. It is anticipated that this empirical analysis will contribute to reducing the social burden.

Citations

• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef

Citations

• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef

Recent advancements in tuberculosis treatment research emphasize innovative strategies that enhance treatment efficacy, reduce adverse effects, and adhere to patient-centered care principles. As tuberculosis remains a significant global health challenge, integrating new and repurposed drugs presents promising avenues for more effective management, particularly against drug-resistant strains. Recently, the spectrum concept in tuberculosis infection and disease has emerged, underscoring the need for research aimed at developing treatment plans specific to each stage of the disease. The application of precision medicine to tailor treatments to individual patient profiles is crucial for addressing the diverse and complex nature of tuberculosis infections. Such personalized approaches are essential for optimizing therapeutic outcomes and improving patient adherence—both of which are vital for global tuberculosis eradication efforts. The role of tuberculosis cohort studies is also emphasized, as they provide critical data to support the development of these tailored treatment plans and deepen our understanding of disease progression and treatment response. To advance these innovations, a robust tuberculosis policy framework is required to foster the integration of research findings into practice, ensuring that treatment innovations are effectively translated into improved health outcomes worldwide.

Citations

• Protocol of a Nationwide Observational Cohort Study for Long-Term Impacts on Lung Health and Life after Tuberculosis in Korea (LIFE-TB)
  Chiwook Chung, Jinsoo Min, Doosoo Jeon, Yong-Soo Kwon, Jeongha Mok, Hyung Woo Kim, Youngmok Park, Young Ae Kang
  Tuberculosis and Respiratory Diseases.2026; 89(1): 86.     CrossRef
• Research hotspots, intellectual structures, and emerging themes in national tuberculosis program studies: a multi-dimensional analysis of global trends and directions
  Siddig Ibrahim Abdelwahab, Manal Mohamed Elhassan Taha, Hazem Mathkour, Edrous Alamer, Saleh Mohammad Abdullah, Saeed Alshahrani, Nizar A. Khamjan, Abdullah Farasani, Ahmed S. Alamer, Jobran M. Moshi, Khaled A. Sahli, Mohammed Jeraiby, Marwa Qadri, Abdulw
  Journal of Public Health.2026;[Epub]     CrossRef
• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef

Purpose
The standardized uptake value (SUV) is a key quantitative index in nuclear medicine imaging; however, variations in region‐of‐interest (ROI) determination exist across institutions. This study aims to standardize SUV evaluation by introducing a deep learning‐based quantitative analysis method that enhances diagnostic and prognostic accuracy.
Methods
We used the Swin UNETR model to automatically segment key organs (breast, liver, spleen, and bone marrow) critical for breast cancer prognosis. Tumor segmentation was performed iteratively based on predefined SUV thresholds, and prognostic information was extracted from the liver, spleen, and bone marrow (reticuloendothelial system). The artificial intelligence training process employed 3 datasets: a test dataset (40 patients), a validation dataset (10 patients), and an independent test dataset (10 patients). To validate our approach, we compared the SUV values obtained using our method with those produced by commercial software.
Results
In a dataset of 10 patients, our method achieved an auto‐segmentation accuracy of 0.9311 for all target organs. Comparison of maximum SUV and mean SUV values from our automated segmentation with those from traditional single‐ROI methods revealed differences of 0.19 and 0.16, respectively, demonstrating improved reliability and accuracy in whole‐organ SUV analysis.
Conclusion
This study successfully standardized SUV calculation in nuclear medicine imaging through deep learning‐based automated organ segmentation and SUV analysis, significantly enhancing accuracy in predicting breast cancer prognosis.

Heart failure (HF) represents a significant global health burden characterized by high morbidity, mortality, and healthcare utilization. Traditional in-person care models face considerable limitations in providing continuous monitoring and timely interventions for HF patients. Telemedicine—defined as the remote delivery of healthcare via information and communication technologies—has emerged as a promising solution to these challenges. This review examines the evolution, current applications, clinical evidence, limitations, and future directions of telemedicine in HF management. Evidence from randomized controlled trials and meta-analyses indicates that telemedicine interventions can improve guideline-directed medical therapy implementation, reduce hospitalization rates, improve patient engagement, and potentially decrease mortality among HF patients. Remote monitoring systems that track vital signs, symptoms, and medication adherence allow for the early detection of clinical deterioration, enabling timely interventions before decompensation occurs. Despite these benefits, telemedicine implementation faces several barriers, including technological limitations, reimbursement issues, digital literacy gaps, and challenges in integrating workflows. Future directions include developing standardized guidelines, designing patient-centered technologies, and establishing hybrid care models that combine virtual and in-person approaches. As healthcare systems worldwide seek more efficient and effective strategies for managing the growing population of individuals with HF, telemedicine offers a solution that may significantly improve patient outcomes and quality of life.

Citations

• Telemonitoring in Heart Failure: A Review of Monitoring Techniques and Clinical Outcomes
  Sara Szukalska, Marta Karczewska, Kamil Wróblewski, Karolina Lichwala, Lukasz Siwek, Angelika Samborska, Barbara Balajewicz, Paulina Wróblewska
  Cureus.2026;[Epub]     CrossRef
• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef
• Impact of Telemedicine Technologies on Treatment Adherence in Patients with Chronic Heart Failure: a Systematic Review and Meta-Analysis
  A. A. Garanin, O. A. Rubanenko, Yu. A. Trusov, D. V. Senyushkin, A. V. Kolsanov
  Kardiologiia.2025; 65(10): 27.     CrossRef