Takotsubo syndrome as an outcome of the use of checkpoint inhibitor therapy in patients with COVID-19.

Takotsubo Syndrome (TS) is a heart disease caused by extreme exposure of the body to physical or psychological stress. In the context of COVID-19, the virus can be a significant source of stress, with particular attention being paid to the cytokine storm as a cause of damage to the body. New research shows that the production of specific cytokines is linked to the activation of immune checkpoint proteins such as PD-1, PD-L1, and CTLA-4 on T cells. Although initially beneficial in combating infections, it can suppress defense and aid in disease progression. Therefore, checkpoint inhibitor therapy has been highlighted beyond oncological therapies, given its effectiveness in strengthening the immune system. However, this treatment can lead to excessive immune responses, inflammation, and stress on the heart, which can cause Takotsubo Syndrome in patients. Several studies investigate the direct link between this therapy and cardiac injuries in these patients, which can trigger TS. From this perspective, we must delve deeper into this treatment and consider its effects on the prognosis against SARS-CoV-2 infection.

O uso da tecnologia no ensino da anatomia humana: revisão sistemática da literatura de 2017 a 2020 / The use of technology in human anatomy teaching: a systematic review of the literature from 2017 to 2020

RESUMO: A tecnologia destaca-se como agente de avanço, principalmente na área da saúde. O estudo da anatomia humana nos cursos de medicina permanece tradicionalista com palestras teóricas e dissecção de cadáveres, por isso, metodologias tecnológicas parecem auxiliar o ensino, tornando-o interativo. Assim, o objetivo do estudo é analisar as perspectivas do uso de tecnologias no ensino da anatomia humana para inseri-las na graduação em medicina. Realizou-se uma revisão sistemática da literatura abrangendo artigos publicados entre janeiro de 2017 a março de 2020 nas bases de dados eletrônicas PubMed e Science Direct. Elencaram-se três critérios de inclusão: estudos com estudantes de medicina ou direcionado aos estudantes de medicina, estudos com residentes de medicina e estudos que avaliam o uso do desenvolvimento tecnológico no ensino da anatomia humana; e três de exclusão: estudos com animais, estudos com estudantes de outros cursos da área da saúde e estudos envolvendo área ou técnica cirúrgica específica. Onze artigos foram lidos na íntegra. Como resultado smartphones, código de resposta rápida (QR), realidade virtual (VR), modalidades impressas tridimensionais (3DP), próteses em 3D e outras tecnologias beneficiaram os alunos no aprendizado anatômico, os quais relataram instrumento atraente, de fácil manejo e acessível mesmo distante do laboratório. Além disso, demonstrou-se maior interesse dos acadêmicos em associar métodos tradicio-nais com as novas tecnologias. As tecnologias se mostraram eficazes no ensino da anatomia humana, visto que a maior parte dos estudos comprovou seu potencial enriquecedor nas avaliações que atingiram resultados iguais e melhores do que o ensino com as práticas tradicionais. (AU)

ABSTRACT: Technology stands out as an advancing agent, especially in the area of health. The study of human anatomy in medical courses remains traditionalist with theoretical lectures and dissection of cadavers, so technological methodologies seem to assist the teaching, making it interactive. Thus, the objective of the study is to analyze the per-spectives of the use of technologies in the teaching of the human anatomy to insert them in undergraduate medical courses. A systematic review of the literature was carried out covering papers published between January 2017 and March 2020 in the electronic databases PubMed and Science Direct. Three inclusion criteria were listed: studies with medical students or targeted to medical students, studies with medical residents, and studies that evaluate the use of technological development in the teaching of human anatomy; and three exclusion criteria: studies with animals, studies with students from other health courses, and studies involving specific surgical area or technique. Eleven papers were read in full. As a result, smartphones, rapid response code (QR), virtual reality (VR), three-dimensional printed modalities (3DP), 3D prostheses, and other technologies benefited the students in anatomical learning, who reported an attractive instrument, easy to handle, and accessible even far from the laboratory. Technologies have proven to be effective in teaching human anatomy, given that most studies have proven their enriching potential in assessments that have achieved similar and better results than teaching with traditional practices. (AU)