Artificial intelligence in forensic medicine and forensic dentistry.

This review article aims to highlight the current possibilities for applying Artificial Intelligence in modern forensic medicine and forensic dentistry and present the advantages and disadvantages of its use. For this purpose, the relevant academic literature was searched using PubMed, Web of Science and Scopus. The application of Artificial Intelligence in forensic medicine and forensic dentistry is still in its early stages. However, the possibilities are great, and the future will show what is applicable in daily practice. Artificial Intelligence will improve the accuracy and efficiency of work in forensic medicine and forensic dentistry; it can automate some tasks; and enhance the quality of evidence. Disadvantages of the application of Artificial Intelligence may be related to discrimination, transparency, accountability, privacy, security, ethics and others. Artificial Intelligence systems should be used as a support tool, not as a replacement for forensic experts.

On aging and aged care in Serbia.

Serbia is a demographically old nation, with 17.4 % of its residents being aged 65 years and older in 2011. The previous two decades of turbulent history have significantly affected the demographic picture of this country, and their ramifications remain visible in Serbia's economic, political, cultural, and health spheres. Major demographic forces behind population aging in Serbia can be attributed to lower fertility rates, migrations, and declining mortality (reflecting improvements in overall health leading to a longer life expectancy). In Serbia, low fertility and migrations appear to play major roles, although the relative contribution of recent migrations cannot be measured with accuracy. Patterns of demographic aging vary considerably across different geographic, socioeconomic, and cultural settings. The common denominator throughout present day Serbia is extensive political and economic transition. One would expect that, given sufficient time, this process will result in improved population health, and yet, at this stage outcomes of major health care reform in Serbia are somewhat perplexing. For the second consecutive year, Serbia's health care system has been ranked at the very bottom of the scale among 34 European countries. It is then no surprise that the elderly represent particularly vulnerable population segment. This paper discusses some of the issues relevant to these demographic patterns of aging and aged care in contemporary Serbia, focusing on the period after 2000.

Nonsteroidal anti-inflammatory drugs: as inappropriate pharmacotherapy in the elderly?

Nonsteroidal anti-inflammatory drugs (NSAID) are one of the most used groups of drugs in elderly population. The aim of this study was to establish the frequency of reported disorders while using NSAID in elderly patients. A multi-centric study was conducted with a standard questionnaire for all geriatrician outpatients who were using NSAID. It has been found that out of 421 patients, 320 reported some kind of disorder; 287 of them used other drugs beside NSAID, 33 used only NSAID during the study. It has been concluded that frequency of reported disorders was significantly higher among patients who used another drug beside NSAID, and statistically most frequent reported disorders were gastrointestinal.

Biogerontology in Serbia.

UNLABELLED: Aging is caused by gradual accumulation of cell and tissue damage. Accumulation of damage begins early and continues progressively throughout life, resulting after several decades in the overt frailty, disability and diseases associated with aging. In Serbia during the last few years, several different institutions participated in the investigation in the aging process: (1) Changes in hormone signaling with aging-the age-related increase in insulinemia and glucose metabolism deregulation was found to be attributed to changes in insulin signaling as demonstrated on murine models. (2) Changes in immunological response in aging-along with involution of thymic lymphoepithelial tissue, it has been demonstrated on a murine model that early thymocyte differentiational steps within the CD4-8-double negative developmental stage are age-sensitive. (3) Changes in cholesterol metabolism and oxidative processes in aging-the beneficial effect of long-term dietary restriction on ageing, was explained as effect on cholesterol metabolism. (4) Alzheimer's disease-the connection between neurodegenerative processes associated to the Alzheimer's disease and the function of the Na-K-ATPase which is known to be altered by ageing has been experimentally shown. CONCLUSION: The recent work of Serbian investigators suggest some new evidence that aging process influences the hormone signaling, immunological response, cholesterol metabolism and oxidative processes.

Acute geriatric units.

Together with increase of population of elderly people, there is an increase of the number of hospital admission for emergencies, especially for elderly people. Serbia shares this need for Acute Geriatric Units (AGU). The National Programme of Health Care of Elderly People Improvement is planning to open the Geriatric Ward in every regional general hospital in Serbia. But in cities with several hospitals, there is a waste need for geriatric ward capable of taking acute care. So, there is a need for geriatric wards in Serbia nowadays. The main targerts for AGU should be: the comprehensive geriatric assessment, prevention of development of worsening of delirium, decubital wounds, incontinence, improving mobility and early planning of discharge. The multidisciplinary team, which includes physicians, nurses, physiatrist and social worker, is the best solution for getting this target day by day. Thus, one of the distinctive features of Acute Geriatric Units should be comprehensive geriatric assessment, the prevention of geriatric syndrome and early planning of discharging the elderly patient.

Self-perception of health (SPH) in the oldest-old subjects.

SPH is a subjective and objective assessment of personal health. It is important in evaluation of health status in the elderly as it has capacity to predict mortality, functional declining, and health-care demands. A lot of research has been published about SPH in the elderly, but little is known about SPH in the very old, especially in comparison with the "younger-old" (YO) population. The study has aimed to investigate SPH in 240 elderly patients and compare the data between the "oldest-old" (OO) (aged >or= 90 years; n=52) and the YO (aged 60-74 years; n=188) subjects. Results have shown that the OO group of patients had better SPH than their YO counterparts. Our findings implicate that very old persons belong to a special sub-group of elderly, the "successfully aged", probably due to their genetic stability, distinctive lifestyle, or both.

Aging in Serbia.

Serbia has one of the largest elderly population segments in the World, with 17.2% of its citizens estimated to be 65 years and older in 2007. In the period of last 50 years, important demographic changes had occurred in Serbia. In 2002, Serbian demographic situation for the first time reached the point where the number of the older exceeded the number of the youngest. In 2007 this tendency continues to persist, with 22.1% of Serbians estimated to be 60 years or older, and 21.7% to be 20 years or younger. For the same year, life expectancy at birth was estimated to 70.7 years for the male, and 76.2 years for the female Serbian newborns. Elderly represent major consumers of health services, and yet, not always do they receive the quality of care they are entitled to. Family still holds a predominant role in providing social support and care for their elderly members. During the last 30 years, number of long term care facilities (primarily aimed at old people not competent of independent living) has gone up in Serbia from 35 to 43. Yet, they provide accommodation and care to only a small number of residents, ranging from 5996 in 1976 to 12,160 in 2005. Such institutions are named "Homes for the elderly" or "Geronto centers". The aims of aged care reform in Serbia include not only better education for the medical and other affiliated stuff, but, also, improvements in intersectoral collaboration, structural reforms of the social and health care systems, innovative capacity building, and the promotion of concepts that would replace, or at least ease the burden off the traditional family.

Is there such thing as "reversible dementia" (RD)?

RD is an extremely important problem for the practice of geriatricians. Rationale for this review had come from our question: could we increase and improve the cognitive function of our patients by treating some of "internal medicine" diseases at our hospital. Our clinical experience is telling us that it might be so. We administered the mini mental state examination (MMSE) test on 77 patients to check, if there is a relation between mental state and physical health. Patients were treated with appropriate cardiological, pulmonological and other needed therapies. Results indicate that recovering from the main disease increases the MMSE scores. This leads to the conclusion that successful treatment of patients can be followed and also confirmed by the results of the MMSE test. We have also observed that damaged physical health can inflict cognitive functions, no matter how old a person is.

Is there such thing as "vaccine against aging"?

Problem could be found in the fact that very often we look for one deciding, definitive reason for the process of aging. It is a sort of search for a big discovery, like a fountain of youth or such. More and more authors are trying to explain the unknowns in the understanding of these observations about ageing, by adding the statement that there are two subgroups in the general population. This acknowledgement of two subpopulations explains why there are numerous cases that can not be explained or defined or fitted in these basic observations about caloric restrictions and the delay of reproduction. The identification of those two groups would allow us to find more realistic results in studies, and therefore a more efficient therapy of certain diseases. This hypothesis does not contradict theories of aging that we have accepted (at least not the majority of accepted theories), and this hypothesis also does not contradict the fact that there is a large interindividual variability. This hypothesis doubts, and claims there are exceptions to the starting assumption of geriatrics and gerontology's that: "parallel to the aging process the functions of all organs and organ systems lessen". In future we could use one of these screening tools to detect genetic instable population: the cytokinesis-block micronucleus assay, expression of hTERT, the component of the enzyme telomerase, identification of the "longevity" genes like daf-16, p53, THO, HSP70 or the level of insulin-growth factor-I. This would enable us to correct genetic instability in this population with "vaccine of youth", making the human race living 30 years longer with excellent life quality.

The principles of chemotherapy of colorectal cancer in elderly.

The prevalence of colorectal cancer (CRC) increases significantly with age, with 40% of patients in Europe being older than 74 years of age at the time of initial diagnosis. The individualized management of the older-aged patient with cancer is based on the answers to the following questions: 1) will the patient die of cancer or with cancer; 2) will the patient suffer cancer-related morbidity; and 3) is the patient able to handle the toxicity of treatment? More than chronological age, the following parameters are important when elderly patients are to be treated with antineoplastic agents: general condition, liver function, kidney function and bone marrow status. Frail elderly with malignant disease should not be treated with cytostatic therapy. In the case of fit elderly, the standard chemotherapy (i.e. FOLFOX) regimen could be administered. In elderly ineligible for combination chemotherapy, the capecitabine used orally, as a single-agent therapy, is an important therapeutic option for colorectal cancer.