OBJECTIVE:To analyze the association between patients with diabetes mellitus and the increased severity and its complications that arise with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.METHODS: This is a complementary review of literature in which 14 articles published in 2020 were selected. These reviewed articles were written in both Portuguese and English available in the SciELO and PubMed databases. This review also involved searching on websites of international and national organizations in order to gather information published by these bodies about diabetic population and coronavirus disease (COVID-19)-infected individuals. DISCUSSION:The presence of comorbidities in SARS-CoV-2-infected individuals causes an increase in the expression level of angiotensinconverting enzyme 2, facilitating the entry of the virus into the cell. Diabetes causes metabolic and vascular changes, thus weakening the immune system through the inhibition of the innate immune system and the secretion of various inflammatory cytokines. This hyperinflammation can lead to multiple organ failure. The interaction between this comorbidity and COVID-19 can worsen preexisting diabetes or predispose the onset of diabetes in non-diabetic individuals. CONCLUSIONS: Diabetes mellitus is related to the increased severity and complications of COVID-19. The association between diabetes and COVID-19 creates a devastating double pandemic, as it worsens the prognosis of COVID-19.
ARTIGO ORIGINAL Violência contra a mulher em tempos de COVID-19: o papel do médicoViolence against women in times of COVID-19: the role of the doctor Violencia contra la mujer en tiempos del COVID-19: el papel del médico ResumoMétodo: Pesquisa documental realizada em documentos oficiais e auxílio de literatura científica acessória atual sobre o papel do médico em meio ao aumento da violência contra a mulher durante o isolamento social. Objetivo: Analisar com base em documentos oficiais o papel do médico frente a violência doméstica no distanciamento social. Discussão: Foi observado que grande parte dessas mulheres não têm o auxílio correto por parte dos profissionais de saúde. A falta de sensibilidade e experiência da equipe para com esse tipo de circunstância, prejudica toda a dinâmica desse atendimento, e faz com que essa paciente continue sofrendo por falta acolhimento do serviço de saúde. Por este motivo, além de praticar medidas já existentes é função do médico auxiliar e informá-la de maneira efetiva sobre ações que a ajudem a sair da situação em segurança. Conclusão: Apesar do médico ter um papel essencial, a violência doméstica é um problema de diversas esferas e deve contar com ajuda de toda sociedade. Práticas educativas e um olhar mais atento a essas vítimas já era necessário, e agora com o seu cárcere se faz imprescindível.
INTRODUCTION: Primary health care is a set of interventions that promotes initial contact with the health system, whereas those of medium and high complexity include hospitals, outpatient clinics, urgent and emergency services, exams and procedures. Lately, there has been a phenomenon of voluntary diversion from primary care to medium and high complexity care in pediatrics. OBJECTIVE: To present some reasons why the aforementioned phenomenon occurs, its consequences, and to cite intervention proposals taken to reverse this. METHODS: A literary review was carried out on the topic of articles found in databases, such as LILACS, BIREME and PubMed. DISCUSSION: This spontaneous deviation has, among its various causes, notions such as easier access, convenience and faster resolution in emergency services or even the lack of perception of what is an urgency. In addition, it is believed that parents prefer emergency care because they find a greater variety of specialties and, consequently, greater resolution, in one place. CONCLUSION: The substitution for medium and high complexity care has had repercussions not only for the child’s health, but also for the health system itself. Therefore, urgent and emergency services are not used as they should and do not have the capacity to meet the needs of their patients, given that the complaints prioritized in these services are acute, and many diagnoses that could be made through a longitudinal monitoring is not done due to the need for immediate resolution.
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