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APRESENTA PREFERENCIALMENTE A MINIATURA PARA EXPANDIR OU
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NA AUSÊNCIA DA MINIATURA, APRESENTA A IMAGEM PADRÃO
<p>The pandemic due to COVID-19, an infection caused by the SARS-CoV-2 coronavirus initiated in Wuhan(China) in 2019, overlapped with a pre-existing pandemic, that of Type2 Diabetes Mellitus(DM2)(<spanclass="ref"><supclass="xref xrefblue">1</sup><spanclass="refCtt closed"><span>1 Anghebem MI, Rego FGM, Picheth G. COVID-19 and Diabetes: two distinct pandemics and their relationship. Rev Bras Anal Clin. 2020;52(2):154-9. doi: http://doi.org/10.21877/2448-3877.20200001</span><br><ahref="http://doi.org/10.21877/2448-3877.20200001" target="_blank">http://doi.org/10.21877/2448-3877.202000...
<p>The UK Prospective Diabetes Study(UKPDS) showed that DM2 control prevents chronic complications(<spanclass="ref"><supclass="xref xrefblue">3</sup><spanclass="refCtt closed"><span>3 UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837-53</span></span></span>). In view of COVID-19, new knowledge reiterates the importance of controlling DM2, now focusing on preventing the severe form of an acute infectious disease.</p>
<p>DM2 is defined by changes in glucose homeostasis and by a chronic inflammation condition, but it also induces changes in the immune system, making the patient affected by this disease more susceptible to infections, including those caused by viruses such as SARS-CoV-2. DM2 also causes activation of the renin-angiotensin-aldosterone system and endothelial damage, with a consequent increase in the risk of thrombosis. However, COVID-19 is a disease that can cause hyperinflammation and has been associated with an increased risk of occurrence of thromboembolic phenomena, especially pulmonary thromboembolism, more frequently observed in patients with severe pneumonia admitted to intensive care units(ICUs)(<spanclass="ref"><supclass="xref xrefblue">4</sup><spanclass="refCtt closed"><span>4 Lim S, Bae JH, Kwon, HS, Nauck MA. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol. 2021;17:11-30 https://doi.org/10.1038/s41574-020-00435-4</span><br><ahref="https://doi.org/10.1038/s41574-020-00435-4" target="_blank">https://doi.org/10.1038/s41574-020-00435...
<p>La pandemia de COVID-19, una infección causada por el coronavirus SARS-CoV-2, que comenzó en Wuhan (China) en 2019, se superpuso a una pandemia preexistente, la de Diabetes Mellitus tipo 2 (DM2)(<spanclass="ref"><supclass="xref xrefblue">1</sup><spanclass="refCtt closed"><span>1 Anghebem MI, Rego FGM, Picheth G. COVID-19 and Diabetes: two distinct pandemics and their relationship. Rev Bras Anal Clin. 2020;52(2):154-9. doi: http://doi.org/10.21877/2448-3877.20200001</span><br><ahref="http://doi.org/10.21877/2448-3877.20200001" target="_blank">http://doi.org/10.21877/2448-3877.202000...
<p>El UK Prospective Diabetes Study (UKPDS) demostró que el control de la DM2 previene las complicaciones crónicas(<spanclass="ref"><supclass="xref xrefblue">3</sup><spanclass="refCtt closed"><span>3 UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837-53</span></span></span>). Ante el COVID-19, hay nuevos conocimientos que reiteran la importancia de controlar la DM2, que ahora se enfocan en la prevención de la forma severa de una enfermedad infecciosa aguda.</p>
<p>La DM2 es definida por cambios en la homeostasis de la glucosa y por un cuadro de inflamación crónica, pero también induce cambios en el sistema inmunológico, haciendo que el paciente afectado por esta enfermedad sea más susceptible a infecciones, incluso a las causadas por virus como el SARS-CoV-2. La DM2 también provoca la activación del sistema renina-angiotensina-aldosterona y daño endotelial, con un consecuente aumento del riesgo de trombosis. El COVID-19 es una enfermedad que puede causar hiperinflamación y se ha asociado con un mayor riesgo de aparición de fenómenos tromboembólicos, especialmente tromboembolismo pulmonar, que se observa con mayor frecuencia en pacientes con neumonía grave ingresados en unidades de terapia intensiva (UTI)(<spanclass="ref"><supclass="xref xrefblue">4</sup><spanclass="refCtt closed"><span>4 Lim S, Bae JH, Kwon, HS, Nauck MA. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol. 2021;17:11-30 https://doi.org/10.1038/s41574-020-00435-4</span><br><ahref="https://doi.org/10.1038/s41574-020-00435-4" target="_blank">https://doi.org/10.1038/s41574-020-00435...
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