<p> </p> <p>Regardless of the fascinating progress of humanity, biotechnology and medicine, the outbreak of the global pandemic of the SARS-CoV-2 virus has shown us that we are just as vulnerable as in previous eras when communicable diseases decimated the world’s population. But the discoveries made so far at the molecular level allow us to connect knowledge interdisciplinary and find solutions and therapeutic strategies where there seems to be no link. It was the previous coronavirus infections that served as a homologous model for finding the connection between the SARS-CoV-2 virus and autophagy. Autophagy, a conserved universal process of all eukaryotic cells responsible for cell survival under stressful circumstances, has been shown to play a significant role in viral invasions. It contributes to both direct and indirect antiviral responses such the elimination of viruses, the presentation of their antigens, and the reduction of inflammatory responses. The autophagy machinery of host cells can, however, be suppressed, evaded, or used by viruses to their benefit. Therefore, autophagy has an ambiguous role in coronavirus-related infections, especially in COVID-19.</p> <p> </p>

<p><strong>Aim<br /></strong> To synthesize evidence about the influence of individual antimicrobial stewardship programs (ASP) related to the prevention of Clostridium difficile (C. difficile) infection on primary and secondary outcomes. <br /><strong>Methods <br /></strong>Relevant databases such as Medline, PUBMED, COCHRANE library and EBSCO were searched from 1 April to 27 April 2017. Additional studies were reached by the manual search for original articles in relevant journals. We included all randomized controlled, quasi-experimental and observational studies, published in the English language from 2007 onward, that evaluated effectiveness of ASP in preventing and controlling C. difficile associated disease (CDAD) among adult inpatients.<br /><strong> Results<br /></strong>Implementation of ASP interventions was associated with CDAD incidence reduction in 62.5% studies, but no significant differences were reported for the duration of hospitalization, readmission and mortality rate. Improvements in prescribing patterns (decreased antimicrobial use or increased rational use) and microbial outcomes (decreased rates of selected antimicrobial-resistant bacteria) were reported. Evidence on the effects of ASP is mainly limited to the results of studies low in methodological quality with great heterogeneity of outcomes, interventions, and units in which CDAD incidence data were reported. <br /><strong>Conclusion<br /></strong>Despite the low strength of evidence of reviewed studies, consistency of findings suggest the positive impact of antimicrobial stewardship programs on the prevention and control of nosocomial CDAD. The significance of this problem imposes randomized control trial use as the best instrument to provide highquality evidence. Further studies need to systematically analyse changes in all antibiotic use and its outcomes.</p>

U oblasti javnog zdravstva mnogo je nerazjašnjenih pitanja koja su čestoprouzrokovana kompleksnim, međusobno uslovljenim pojavama, što namećepotrebu za sve češćom primjenom kvalitativnih naučnih istraživanja.Ovakava istraživanja se, prije svega, fokusiraju na način na koji pojedinci iligrupe shvataju svijet oko sebe i omogućavaju formiranje njihovih stavovai prakse povodom određenih istraživačkih pitanja. Kako je cilj kvalitativnihistraživanja razumijevanje nekog aspekta društvenog života, ona se prevashodnobave analizom riječi, umjesto brojeva, što dobijene rezultate činikomplikovanijim za interpretaciju. Pružajući osnovni uvid u način formulisanjaistraživačkog pitanja, odabir uzorka, prikupljanje i analizu dobijenihpodataka, ovaj rad će kroz nekoliko jednostavnih koraka omogućiti sagledavanjemetoda kvalitativnih istraživanja.

Kratak sadržajClostridium difficile je Gram-pozitivni, sporogeni bacil koji se danas smatra jednim od najznačajnijih uzročnika bolnički stečenih dijareja, a sva oboljenja izazvana ovom bakterijom poznata su pod nazivom "bolesti povezane sa C. difficile" (engl. Clostriduim difficile-associated disease, CDAD). Iako učestalost ovih oboljenja varira od zemlje do zemlje, na globalnom nivou se beleži značajan porast incidencije CDAD, što predstavlja veliki javnozdravstveni problem. Cilj ovog preglednog rada je da se na osnovu novijih podataka iz literature ukaže na najbitnije faktore rizika za nastanak CDAD. Faktori rizika za CDAD mogu se podeliti u sledeće grupe: (1) lekovi (antibiotici, imunosupresivi, lekovi koji vrše supresiju lučenja želudačne kiseline i hemioterapija), (2) faktori rizika vezani za organizam domaćina (starost iznad 65 godina, komorbiditeti), (3) faktori povezani sa mikroorganizmom (sposobnost C. difficile da adherira za odgovarajuće intestinalne receptore i produkuje toksine), i (4) faktori sredine (skoriji ili produžen boravak u hospitalnim uslovima, česte hospitalizacije). Poznavanje svih poznatih i potencijalnih faktora rizika za nastanak ovakvih infekcija uz adekvatno sprovođenje nadzora nad njima, ključni su elementi preventivnih stategija koje mogu značajno da smanje incidenciju CDAD.