This study was focussed on a comprehensive investigation on the state of pollution of the Danube and Sava Rivers in the region of Belgrade. Different complementary analytical approaches were employed covering both i) organic contaminants in the river water by target analyses of hormones and neonicotinoids as well as non-target screening analyses and ii) heavy metals in the sediments. Finally, some common water quality parameters were analysed. The overall state of pollution is on a moderate level. Bulk parameters did not reveal any unusual observations. Moreover, quantification of preselected organic contaminants did not indicate to elevated pollution. More significant contaminations were registered for chromium, nickel, zinc and partially copper in sediments with values above the target values according to Serbian regulations. Lastly, non-target screening analysis revealed a wider spectrum of organic contaminants comprising pharmaceuticals, technical additives, personal care products and pesticides. The study presented a comprehensive view on the state of pollution of the Sava and Danube Rivers and is the base for setting up further monitoring programs. As a superior outcome, it was illustrated how different chemical analyses can result in different assessments of the river quality. A comparison of target and non-target analyses pointed to potential misinterpretation of the real state of pollution.

Background This article provides a summary of the 2011 ERA–EDTA Registry Annual Report (available at www.era-edta-reg.org). Methods Data on renal replacement therapy (RRT) for end-stage renal disease (ESRD) from national and regional renal registries in 30 countries in Europe and bordering the Mediterranean Sea were used. From 27 registries, individual patient data were received, whereas 17 registries contributed data in aggregated form. We present the incidence and prevalence of RRT, and renal transplant rates in 2011. In addition, survival probabilities and expected remaining lifetimes were calculated for those registries providing individual patient data. Results The overall unadjusted incidence rate of RRT in 2011 among all registries reporting to the ERA–EDTA Registry was 117 per million population (pmp) (n = 71.631). Incidence rates varied from 24 pmp in Ukraine to 238 pmp in Turkey. The overall unadjusted prevalence of RRT for ESRD on 31 December 2011 was 692 pmp (n = 425 824). The highest prevalence was reported by Portugal (1662 pmp) and the lowest by Ukraine (131 pmp). Among all registries, a total of 22 814 renal transplantations were performed (37 pmp). The highest overall transplant rate was reported from Spain, Cantabria (81 pmp), whereas the highest rate of living donor transplants was reported from Turkey (39 pmp). For patients who started RRT between 2002 and 2006, the unadjusted 5-year patient survival on RRT was 46.8% [95% confidence interval (CI) 46.6–47.0], and on dialysis 39.3% (95% CI 39.2–39.4). The unadjusted 5-year patient survival after the first renal transplantation performed between 2002 and 2006 was 86.7% (95% CI 86.2–87.2) for kidneys from deceased donors and 94.3% (95% CI 93.6–95.0) for kidneys from living donors.

Francois Gremy (1929 2014) has a Master’s in Physical Sciences, a Master’s in Mathematics (1, 2). He was interned in Paris Hospitals as a Doctor of Medicine, and late he become University Professor at several universities in France. Diploma of Higher Education in Theory of Probabilities he received from the Statistical Institute of Paris (1, 2). Early in his career he worked at the Faculty of Medicine of Tours. This experience led him to the Faculty of Medicine, Pitié-Salpêtrièr, where for 23 years, he was professor of Biophysiques, Biostatistics and Medical Informatics, a hospital biologist and Department Head of Medical Informatics in Paris Hospitals, as well as Director of the U-88’s Research Unit: ‘Public Health and Economical and Social Epidemiology’ at INSERM. In the Faculty of Medicine at Montpellier-Nimes, Professor Grémy was Professor of Biostatistics and Medical Informatics, and Department Head of Bioinformatics at the Regional University Hospital Center, Montpellier. Between 1990 and 1996, in the same center, Professor Grémy was Professor of Public Health and Department Head of Medico-Hospital Economy and Preventive Actions. He was President of the Board of Directors of the National School of Public Health of Rennes, member of the National Universities’ Council of the High Committee of Public Health, and of the Scientific Council of PM.S–I. He founded in 1967 the International Medical Informatics Association (IMIA). He is also the co-founder of the European Federation for Medical Informatics, and served as a member in the European Commissions’ activities evaluating informatics technologies in medicine. His scientific career, is distinguished because of his significant contribution as a researcher and as a forerunner in the field. His influence has ranged from hard sciences to clinical medicine, and he is recognized as a philosopher among medical informaticians. He acquired specific competence in Cardiology and Neurology, especially in neurophysiology. But he also got degrees in mathematics, biophysics, and more recently philosophy. He created the first laboratory for Medical informatics in the mid-60s at the Pitié-Salpêtrière School of Medicine in Paris. As founder of IFIP TC4 that gave rise to IMIA he is considered to be the IMIA father and a key European figure in the field. During MEDINFO 2004 Conference in San Francisco Francois Gremy received the first IMIA Award of Excellence for his outstanding contributions to IMIA and to health informatics. François was one of the founders of IMIA and his extensive research especially during his time at the University of Montpellier had left a lasting impression on his colleagues, students and friends in Europe and many other parts of the world. Francis Gremy was not only a pioneer in the Medical/Health informatics as new field, he had a holistic view on the large variety of medical informatics applications, with humanistic values to be respected and ethical guidelines to propose to follow. His ability to clarify complex matters and his sense of humor were part of his great teacher talents, associated to his very open mind to perform research in a multidisciplinary approach. His social engagement was also exceptional. He was an emblematic figure who opened new roads leading to patient centered Medical informatics, one of the best examples of the French culture, a Master and a friend (2).” As the first President of IMIA and for his collaboration when he was President of the School of Public Health of Rennes, Université Catholique de Louvain, acknowledged his key-role in the development of Medical informatics by nominating him “Doctor Honoris Causa” (2). François Grémy deals with evaluation of health information systems, where he was involved and describes the evolution of his personal ideas. He proposes the main distinction between systems where the user(s) remain(s) external from the running program, from the ones where the user(s) interacting with the program become(s) the main component of the system (1). Francois Gremy "addresses conventional methods of evaluation used in Medical Technology Assessment, how the whole knowledge in anthropology may contribute strongly to evaluation, and how the subjectivity of the user(s), how he (or they) react(s) with the computing machinery, is a main key to the success or failure of the whole system. He asserts that the temptation of the eradication of subjectivity as a condition for progress is deleterious for our civilization threatened by a comeback of barbarity, and is scientifically wrong (1).” His honors include the Janssen Prize from the Academy of Medicine; Silver Core International Federation for Information Processing; Chevalier Legion of Honor; Prize in Medicine and Public Health from the Institute of Health Sciences; and an Honorary Doctorate from Catholic University in Louvain, Belgium (2).

ABSTRACT Background. Although prescribing antipsychotics to patients with schizophrenia is advised by national and/or international evidence-based practice guidelines, the implementation of the guidelines in clinical practice is still matter of concern. Objective. The aim of our study was to estimate schizophrenia guideline adherence and identify eventual barriers to its implementation in Montenegro. Method. This study used focus group methodology. The focus group was composed of two psychiatrists, one psychologist, one pharmacist from a community pharmacy, one pharmacist from the State reimbursement fund, one pharmacist from a drug wholesaler and the chief investigator, a clinical pharmacologist. The focus group took place in Podgorica, Montenegro, in 2013. The analysis of recordings was performed using an iterative, qualitative technique and a constant comparison method. Results. The most important barriers to the implementation of evidence-based guidelines for the treatment of schizophrenia in Montenegro are non-adherence to medication, low level of psychiatrist-patient concordance, restrictive procedures for prescribing atypical antipsychotics, lack of availability of newer antipsychotics and some dosage forms, and mixing primary, secondary and tertiary care services within a tertiary care psychiatric institution. Conclusion. Addressing the barriers identified by this focus group and avoiding the consequences of poor adherence would be the first SAŽETAK Uvod. Mada je propisivanje antipsihotika pacijentima sa šizofrenijom regulisano nacionalnim i/ili međunarodnim smernicama dobre kliničke prakse, zasnovanim na dokazima, primena ovih smernica u praksi je daleko od željene. Cilj. Cilj naše studije je bio da proceni koliko se psihijatri u Crnoj Gori pridržavaju smernica prilikom propisivanja antipsihotika, i da identifi kuje eventualne prepreke za njihovu punu primenu. Metod. U studiji je korišćena matodologija fokus grupe. Fokus grupu su sačinjavali dva psihijatra, jedan psiholog, jedan farmaceut iz vanbolničke apoteke, jedan farmaceut iz Fonda zdravstvenog osiguranja, jedan farmaceut predstavnik veledrogerije i glavni istraživač, klinički farmakolog. Sastanak fokus grupe je održan u Podgorici, Crna Gora, tokom 2013. godine. Analiza fonografskih zapisa sa sastanka je rađena iterativnom kvalitativnom tehnikom i metodom stalnog poređenja. Rezultati. Najvažnije prepreke za punu primenu vodiča za lečenje šizofrenije su ne-pridržavanje propisanoj terapiji, nedovoljno učešće pacijenata u donošenju odluka o njihovom lečenju, komplikovana administrativna procedura za propisivanje atipičnih antipsihotika, nedostupnost novijih antipsihotika i nekih doznih formi, kao i pomešanost primarnih, sekundarnih i tercijernih zdravstvenih usluga u bolnicama namenjenim samo za tercijernu zaštitu. Conclusion. Obraćanje pažnje na prepreke za primenu smernica koje je identifi kovala focus grupa i popravljanje adherence pacijenata su prvi koraci ka boljem planiranju psihijatrijske zdravstvene zaštite u Crnoj Gori.

The prion diseases are rare neurodegenerative conditions that cause complex and highly variable neuropsychiatric syndromes, often with remarkably rapid progression. Prominent behavioral and psychiatric symptoms have been recognized since these diseases were first described. While research on such symptoms in common dementias has led to major changes in the way these symptoms are managed, evidence to guide the care of patients with prion disease is scarce. The authors review the published research and draw on more than 10 years' experience at the U.K. National Prion Clinic, including two large prospective clinical research studies in which more than 300 patients with prion disease have been followed up from diagnosis to death, with detailed observational data gathered on symptomatology and symptomatic treatments. The authors group behavioral and psychiatric symptoms into psychotic features, agitated features, and mood disorder and describe their natural history, showing that they spontaneously improve or resolve in many patients and are short-lived in many others because of rapid progression of global neurological disability. Diagnostic category, disease severity, age, gender, and genetic variation are or may be predictive factors. The authors review the observational data on pharmacological treatment of these symptoms in the U.K. clinical studies and make cautious recommendations for clinical practice. While nonpharmacological measures should be the first-line interventions for these symptoms, the authors conclude that there is a role for judicious use of pharmacological agents in some patients: antipsychotics for severe psychosis or agitation; benzodiazepines, particularly in the late stages of disease; and antidepressants for mood disorder.