Asthma is a prevalent chronic disease, contributing significantly to the global burden of disease and economic costs. Despite advances in treatment, inadequate disease management and reliance on reliever medications lead to preventable deaths. Telemedicine, defined as the use of information and communication technology to improve healthcare access, has gained global attention, especially during the COVID-19 pandemic. This systematic review examines the effectiveness of home monitoring systems in managing severe asthma. A systematic literature search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library, focusing on studies from 2014 to 2024. Fourteen studies involving 9093 patients were analyzed. The results indicate that telemedicine, through tools such as mobile applications and portable spirometers, positively impacts asthma control, self-management, and quality of life. Home spirometry, in particular, shows strong agreement with clinic spirometry, offering a feasible alternative for continuous monitoring. Digital coaching and machine learning-based telemedicine applications also demonstrate significant potential in improving asthma outcomes. However, challenges such as technology accessibility, data privacy, and the need for standardized protocols remain. This review highlights the promise of telemedicine in asthma management and calls for further research to optimize its implementation and address existing barriers.

Background/Objectives: Obstructive sleep apnea (OSA) is a highly prevalent disorder that significantly impacts quality of life and daily functioning. While continuous positive airway pressure (CPAP) therapy is effective, long-term adherence remains a challenge. This single-arm observational study aimed to evaluate clinical outcomes and adherence patterns during telemedicine-supported CPAP therapy and identify distinct phenotypic response clusters in Romanian patients with OSA. Methods: This prospective observational study included 86 adults diagnosed with OSA, treated with ResMed Auto CPAP devices at “Victor Babeș” University Hospital in Timișoara, Romania. All patients were remotely monitored via the AirView™ platform and received monthly telephone interventions to promote adherence when necessary. Clinical outcomes were assessed through objective telemonitoring data. K-means clustering and t-distributed stochastic neighbor embedding (t-SNE) were employed to explore phenotypic response patterns. Results: During telemedicine-supported CPAP therapy, significant clinical improvements were observed. The apnea–hypopnea index (AHI) decreased from 42.0 ± 21.1 to 1.9 ± 1.3 events/hour. CPAP adherence improved from 75.5% to 90.5% over six months. Average daily usage increased from 348.4 ± 85.8 to 384.2 ± 65.2 min. However, post hoc analysis revealed significant concerns about the validity of self-reported psychological improvements. Self-esteem changes showed negligible correlation with objective clinical measures (r < 0.2, all p > 0.1), with only 3.3% of variance being explained by measurable therapeutic factors (R² = 0.033). Clustering analysis identified four distinct adherence and outcome profiles, yet paradoxically, patients with lower adherence showed greater self-esteem improvements, contradicting therapeutic causation. Conclusions: Telemedicine-supported CPAP therapy with structured monthly interventions was associated with substantial clinical improvements, including excellent AHI reduction (22-fold) and high adherence rates (+15% after 6 months). Data-driven phenotyping successfully identified distinct patient response profiles, supporting personalized management approaches. However, the single-arm design prevents definitive attribution of improvements to telemonitoring versus natural adaptation or placebo effects. Self-reported psychological outcomes showed concerning patterns suggesting predominant placebo responses rather than therapeutic benefits. While the overall findings demonstrate the potential value of structured telemonitoring for objective CPAP outcomes, controlled trials are essential to establishing true therapeutic efficacy and distinguishing intervention effects from measurement bias.

Background and Objectives: Fibrosing interstitial lung diseases (ILDs) may predispose to neurocognitive impairment through chronic hypoxemia and systemic inflammation, yet data integrating pulmonary physiology, disease severity, and cognition are limited. We aimed to compare global cognitive performance between adults with fibrosing ILD and contemporaneous non-ILD clinic comparators, explore differences across ILD subtypes, and identify physiologic and clinical predictors of low MMSE scores. Materials and Methods: In this single-center cross-sectional study, 45 adults with fibrosing ILD and 32 non-ILD participants from university-affiliated pulmonology clinics completed the Mini-Mental State Examination (MMSE) and standardized lung function testing (including diffusing capacity, DLCO%). Comorbidity (Charlson index), inflammatory markers (C-reactive protein), and GAP (Gender–Age–Physiology) severity were recorded. Associations with MMSE and MMSE < 24 were examined using correlations and multivariable logistic regression. Results: Mean MMSE was lower in ILD than in non-ILD participants (23.9 ± 3.6 vs. 26.8 ± 2.8; p < 0.001), and MMSE < 24 occurred in 33.3% versus 12.5%, respectively. Within ILD, the usual interstitial pneumonia (UIP) pattern showed the lowest MMSE scores. DLCO% and total lung capacity correlated positively with MMSE (r = 0.44 and r = 0.34, respectively). In multivariable models, ILD diagnosis remained associated with MMSE < 24 (odds ratio [OR] 2.72, 95% CI 1.14–6.48), and each 10-percentage-point decrement in DLCO% increased the odds of MMSE < 24 (OR 1.42, 95% CI 1.11–1.92). GAP ≥ 4 was also associated with impaired cognition (OR 2.91, 95% CI 1.13–7.57). Conclusions: Fibrosing ILD, particularly with reduced diffusing capacity and higher GAP stage, is associated with lower MMSE scores and a higher frequency of values below a conventional impairment threshold. Prospective studies incorporating comprehensive neuropsychological testing are needed to determine whether and how neurocognitive assessment should be integrated into routine ILD care.

Background: Several cohort studies have demonstrated a link between subclinical carotid atherosclerosis and obstructive chronic airflow limitation. These conditions exhibit common risk factors associated with unhealthy lifestyles, as well as analogous pathophysiological mechanisms, including chronic low-degree systemic inflammation. Purpose: The aim of this study was to investigate the association between airflow obstruction and carotid intima–media thickness (c-IMT), together with the influence of inflammatory biomarkers on this relationship, in patients diagnosed with chronic obstructive pulmonary disease (COPD). Methods and Patients: This study is cross-sectional and includes 106 patients with stable COPD. All patients underwent evaluation through spirometry, carotid ultrasound, and assessment of inflammatory biomarkers, including C-reactive protein, fibrinogen, and erythrocyte sedimentation rate. The relationship between carotid subclinical atherosclerosis and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage of COPD was assessed. Additionally, we compared patients with two positive biomarkers of inflammation with those who had no positive inflammatory biomarkers. Results: Significant statistical differences were observed in carotid intima–media thickness values associated with the severity of airflow obstruction, with measurements of 1.03 mm in COPD stage 1–2 GOLD, 1.07 mm in COPD GOLD 3, and 0.96 mm in GOLD 4 (p = 0.04). However, no direct correlation with forced expiratory volume in the first second (FEV1) was identified. The post hoc analysis revealed a notable increase in carotid wall thickness for the early stages of COPD. C-IMT demonstrated a significant association with inflammation parameters, muscle dysfunction, body composition, and lipid profile. The comparison of groups exhibiting two positive inflammatory biomarkers with those with no positive inflammatory markers revealed significant differences in age, c-IMT, exercise tolerance, and COPD symptoms. Conclusions: Subclinical carotid atherosclerosis is evident from the early stages of obstructive airflow limitation. Carotid intima–media thickness is significantly higher in patients with positive inflammatory biomarkers.

Background and Objectives: Severe asthma poses significant clinical and economic burdens, with adherence to monitoring and treatment remaining a challenge despite biologic therapies. This pilot study aimed to evaluate the feasibility of telemedicine-based home monitoring using the AioCare system in patients with severe asthma and to determine if weekly reminder messages improved adherence compared to standard monitoring. Materials and Methods: In this prospective, single-center randomized controlled pilot study, 30 adults with severe asthma were assigned to either a reminder group (weekly SMS or in-app messages) or a control group without reminders. All participants performed weekly home spirometry for 12 weeks using the AioCare system. Lung function parameters, Asthma Control Test (ACT) scores, adherence to monitoring, and patient satisfaction were assessed. Longitudinal data were analyzed using mixed-effects and generalized estimating equation models. Results: Adherence to home monitoring was significantly higher in the reminder group (11.47 ± 0.92 vs. 9.13 ± 3.16 sessions; p = 0.044). Overall, patient satisfaction was higher in the intervention group (p = 0.0044), with universal endorsement of the reminders and perceived educational benefit. No significant between-group differences were observed in lung function parameters. ACT scores showed a favorable trend in both groups, with a medium between-group effect size favoring the intervention (d = 0.42), although this did not reach statistical significance. Conclusions: Home monitoring with reminders is feasible, safe, and enhances adherence and satisfaction in severe asthma, although it did not significantly affect short-term changes in lung function or symptom control. Larger, longer-term studies are warranted to determine whether these engagement benefits translate into improved long-term clinical outcomes.

Background and Objectives: Interstitial lung diseases (ILDs) have been increasingly linked to neurological manifestations, including cognitive dysfunction and motor impairments, yet the prevalence and severity of these associations remain underexplored. We aimed to (1) compare the frequency of neurological symptoms between patients with and without ILD; (2) evaluate differences in cognitive and motor function scores; (3) perform subgroup analyses based on MoCA (Montreal Cognitive Assessment) scores; and (4) identify potential risk factors for neurological involvement. Methods: In this cross-sectional study, we enrolled 77 patients (40 with ILD and 37 without ILD). We recorded demographic data, smoking status, and body mass index (BMI). Neurological symptoms (tremor, diminished reflexes, paresthesia, etc.) were documented. Cognitive assessments included the MoCA and Symbol Digit Modalities Test (SDMT). Motor function was evaluated via the Berg Balance Scale (BBS), Timed Up and Go (TUG), Single-Leg Stance (SLS), and Grooved Pegboard Test (GPT). Results: Neurological symptoms were more prevalent in ILD (42.5%) than in non-ILD patients (16.2%; p = 0.003). Tremor appeared in 35% of ILD vs. 11% of non-ILD (p = 0.007). ILD patients showed lower mean SLS scores (7.2 ± 3.1 vs. 9.1 ± 3.8 s, p = 0.03) but similar TUG times (10.3 ± 2.1 vs. 9.6 ± 2.3 s, p = 0.20). MoCA scores < 26 were more common in those with ILDs (45% vs. 19%; p = 0.01). Among ILD participants, those with MoCA < 26 had significantly higher rates of tremor (51% vs. 24%, p = 0.04). Logistic regression revealed ILD diagnosis (OR = 3.12, 95% CI: 1.27–7.65, p = 0.013), older age (OR = 1.09 per year, p = 0.02), and smoking history (OR = 2.01, p = 0.05) as independent risk factors for neurological involvement. Conclusions: Our findings suggest that ILD is associated with a higher burden of neurological symptoms and subtle impairments in cognition and motor performance. Recognizing and addressing these manifestations may improve patient management, underscoring the importance of an integrative, multidisciplinary approach.