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M Izakovic

Publications and source records attributed to M Izakovic.

3 recordsLinked to original sources

Free radicals, metals and antioxidants in oxidative stress-induced cancer.

Oxygen-free radicals, more generally known as reactive oxygen species (ROS) along with reactive nitrogen species (RNS) are well recognised for playing a dual role as both deleterious and beneficial species. The "two-faced" character of ROS is substantiated by growing body of evidence that ROS within cells act as secondary messengers in intracellular signalling cascades, which induce and maintain the oncogenic phenotype of cancer cells, however, ROS can also induce cellular senescence and apoptosis and can therefore function as anti-tumourigenic species. The cumulative production of ROS/RNS through either endogenous or exogenous insults is termed oxidative stress and is common for many types of cancer cell that are linked with altered redox regulation of cellular signalling pathways. Oxidative stress induces a cellular redox imbalance which has been found to be present in various cancer cells compared with normal cells; the redox imbalance thus may be related to oncogenic stimulation. DNA mutation is a critical step in carcinogenesis and elevated levels of oxidative DNA lesions (8-OH-G) have been noted in various tumours, strongly implicating such damage in the etiology of cancer. It appears that the DNA damage is predominantly linked with the initiation process. This review examines the evidence for involvement of the oxidative stress in the carcinogenesis process. Attention is focused on structural, chemical and biochemical aspects of free radicals, the endogenous and exogenous sources of their generation, the metal (iron, copper, chromium, cobalt, vanadium, cadmium, arsenic, nickel)-mediated formation of free radicals (e.g. Fenton chemistry), the DNA damage (both mitochondrial and nuclear), the damage to lipids and proteins by free radicals, the phenomenon of oxidative stress, cancer and the redox environment of a cell, the mechanisms of carcinogenesis and the role of signalling cascades by ROS; in particular, ROS activation of AP-1 (activator protein) and NF-kappaB (nuclear factor kappa B) signal transduction pathways, which in turn lead to the transcription of genes involved in cell growth regulatory pathways. The role of enzymatic (superoxide dismutase (Cu, Zn-SOD, Mn-SOD), catalase, glutathione peroxidase) and non-enzymatic antioxidants (Vitamin C, Vitamin E, carotenoids, thiol antioxidants (glutathione, thioredoxin and lipoic acid), flavonoids, selenium and others) in the process of carcinogenesis as well as the antioxidant interactions with various regulatory factors, including Ref-1, NF-kappaB, AP-1 are also reviewed.

Animals↗

Effective management of hospitalized patients--established role of hospitalists in the USA.

OBJECTIVES: Summarize and present benefits of effective management of inpatients in US hospitals by hospitalists and discuss the possible implications for healthcare system in Slovakia. BACKGROUND: Inpatient or hospital-based internal medicine started to separate from traditional office-based medicine about a decade ago. Today, hospitalist programs are an integral part of most progressive hospitals in the US and the value of such programs is well documented. METHODS: Literature review and analysis of Mercy Medical Center-North Iowa hospitalist program. RESULTS: Hospitalists improve the quality of care for hospitalized patients, use fewer resources and decrease the length of stay. In 1998 there were 2,000 hospitalists and in 2005 there were more than 15,000 hospitalists in more than 1,800 programs throughout the US. It is projected that by the end of the decade there will be more than 30,000 hospitalists in the US. Mercy Hospital started its hospitalist program in 1999 with one hospitalist and by July 2006 the program will expand to six physicians. The average daily census for a hospitalist is 20 patients and the average length of stay is 3 days. In 2003, with 874 median new admits and consults per year per hospitalist, one hospitalist was able to save approximately dollars 400,000/year compared to the traditional internal medicine model. CONCLUSION: Hospitalists are the fastest growing specialty in the US. In addition to the care of medical illnesses including subspecialty and surgical consults, hospitalists also serve as stewards of hospital systems. They improve quality, patient safety, efficient use of resources and reduce variation in diagnostic and therapeutic approaches (Tab. 2, Fig. 3, Ref. 10).

Hospitalists↗