y These authors have contributed equally to this work.With excellent short-term survival in liver transplantation (LT), we now focus on long-term outcome and report the first European single-center 20-year survival data. Three hundred thirty-seven LT were performed in 313 patients (09/88-12/92). Impact on long-term outcome was studied and a comparison to life expectancy of matched normal population was performed. A detailed analysis of 20-years follow-up concerning overweight (HBMI), hypertension (HTN), diabetes (HGL), hyperlipidemia (HLIP) and moderately or severely impaired renal function (MIRF, SIRF) is presented. Patient and graft survival at 1, 10, 20 years were 88.4%, 72.7%, 52.5% and 83.7%, 64.7% and 46.6%, respectively. Excluding 1-year mortality, survival in the elderly LT recipients was similar to normal population. Primary indication (p < 0.001), age (p < 0.001), gender (p ¼ 0.017), impaired renal function at 6 months (p < 0.001) and retransplantation (p ¼ 0.034) had significant impact on patient survival. Recurrent disease (21.3%), infection (20.6%) and de novo malignancy (19.9%) were the most common causes of death. Prevalence of .2%, p < 0.001), p ¼ 0.01) and HBMI (33.2-45%, p ¼ 0.014) increased throughout follow-up, while prevalence of HLIP (78.0-47.6%, p < 0.001) declined. LT has conquered many barriers to achieve these outstanding long-term results. However, much work is needed to combat recurrent disease and side effects of immunosuppression (IS).

Being able to manage and adjust insulin doses is a key part of managing type-1 diabetes. Children and adolescents with type-1 diabetes mellitus often have serious difficulties with this dosage adjustment. Therefore, this paper aims to investigate the impact of using novel mobile, web and communication technologies in assisting their therapy and treatment. A trial was conducted in the north-eastern part of Germany to evaluate the impact of the “Mobil Diab”, a mobile diabetes management system, on the clinical outcome. 68 subjects aged between 8 and 18 years, divided randomly into control and intervention groups, were included into the study. Metrics such as changes in the quality of metabolic control, changes in psychological parameters, usability and acceptance of the technology were used for evaluation purpose. Metabolic control was mainly assessed by the mean HbAlc. Analysis showed a good acceptance of the proposed system. An overall improvement in mean levels of HbA1c was observed, however further studies will be conducted to prove evidence of the weight and BMI improvements. Moreover, initial indications of positive impact on the improvement in psychological parameters were presumed based on the result of the conducted study. The system appeared to be an efficient and time saving tool in diabetes management.

Mobile telemedical applications are of crucial importance today as they do offer the potential to improve the quality of the health care related services. It has been proven that the leading cause of several illnesses and diseases are stress and the lack of fitness practices. Based on that, a system capable of estimating and monitoring both stress and fitness levels without a physical consultation of a medical specialist is presented in this work. A correlation between physiological parameters and stress or fitness is explored in the developed intelligent expert system. In order to enable the implementation of such a complex system, a flexible Telematics Platform is conceived. This Telematics Platform does guarantee a secure data communication involving encryption and a suitable visualization of the fitness and stress assessment results on both the patient's mobile phone and on a web-based portal. Moreover, the platform is scalable and can therefore be easily extended in order to support different kinds of telemedical applications. The system presented in this paper does enable the efficient and cost-effective stress and fitness monitoring of patients while being at home or practicing their daily jobs with their subsequent eventual mobility.

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Positive feedback from both medical care providers and patients confirms a high potential for mobile teledermatology as a means of dermatological healthcare delivery.