His physical defects: thickening of the bone, short stature and bone fragility (pycnodysostosis) inheritance of family endogamy marginalized Toulouse-Lautrec, an educated bourgeois, cultured and intellectual who preferred to travel through the secondary paths of life in the neighborhood of Montmartre, famous for its cabarets, parties and prostitutes, a place where the artist felt comfortable even though they were full of misery and imperfections Despite being a misfit social, he became, through his work, a social chronicler of the Parisian belle epoque. Key words: pycnodysostosis, endogamy, Toulouse-Lautrec, belle epoque, painting, posters

Plastic has become very popular in recent years due to its durability and properties. Despite its many advantages, humanity has developed a certain dependence on this material, which represents an increase in its use and in turn, in waste. One of the most widely used plastic polymers is the polystyrene (PS), as is used in a wide range of applications due to its low cost and easy production, although after the useful life of the plastic, it is considered as waste. When plastic is exposure to atmospheric conditions such as UV radiation, it degrades and fragments giving rise to microplastics (MPs), which are defined as small particles that do not exceed 5 mm, representing a threat to the environment because when they degrade the properties decay, a dimensional change is generated, and they can also be easily transported not only to the environment but also to organisms. This review article focuses on highlighting the main pathways that MPs follow when interacting with humans and the potential effects of PS-MPs on the cytoskeleton, as well as highlighting the need for more studies in this regard. Key words: Cells; cell-plastic contact; emerging pollutants; polymers; microplastics.

The electrocardiographic diagnosis of acute myocardial infarction (AMI) in patients with pacemakers has always been a problem in clinical practice, causing delays in management and worse clinical outcomes. Although complete left bundle branch block (LBBB) and right ventricular pacing can produce electrocardiogram (ECG) abnormalities, specific morphological changes often allow the diagnosis of AMI or an old infarction. Case report A 76-year-old patient with history of permanent pacemaker implantation due to a 3rd-degree atrioventricular block was admitted for chest pain. Upon admission, he was hemodynamically stable but with ECG showing pacemaker rhythm with LBBB fulfilling 2 points of Sgarbossa criteria (discordant elevation of the ST segment > 5 mm in leads V2 to V3) and ST/S ratio < - 0.25 in leads V3-V4. Laboratories showed elevated troponins, integrating diagnosis of AMI, and moving on to urgent coronary angiography. A lesion on the anterior descending coronary artery was documented, and a drug-eluting stent was successfully implanted. The patient was discharged stable, asymptomatic, and with pharmacological management for secondary prevention. ECG identification of an AMI in patients with pacemakers is essential to initiate reperfusion therapy. Guideline recommendations are constantly changing, but an algorithm that uses hemodynamic instability and the modified Sgarbossa criteria (MSC) to decide these patients; management could be a high-sensitivity tool and allow physicians to make the best decisions without waiting for laboratory results. MSC, which are more sensitive than the original criteria, continue to be helpful in the diagnosis of AMI. Clinicians should carefully choose the appropriate MSC cut-off (ST/T Ratio -0.20 and -0.25) on a case-by-case basis. Keywords: Acute myocardial infarction, Electrocardiogram, Pacemaker, Left bundle branch block, Acute coronary syndrome

Abstract. Plastic is one of the most important pollutants human produces. Degradation of plastic is giving rise to microplastics, waste that threatens several species, including ours. According to the United Nations (UN), more than 430 million tons of this material are generated every year. In addition to affecting the Earth's ecosystems, also has repercussions on human health. staining Key words: microplastics, nanoplastics, waste, ecosystem, extinction

Abstract: This is a case with a transvaginal ultrasound approach after IUD placement. The patient presented dysmenorrhea and continuous bleeding the following month. Keywords: uterus, IUD, ultrasound, imaging, diagnosis

Taste is relevant because it has allowed us to discriminate between what is food and what is not, and even what can be toxic or dangerous when ingested. The search for new flavors is resent in history of mankind. Since ancient times, the spices provided new taste experiences to make meals more palatable or as a means of preserving food; the search for spices was a motivation to make voyages that led to the discovery of new lands and continents. More recently, a viral pandemic that damages the olfaction and taste senses made us to remember the relevance of the senses. Small structures, called taste buds, located in the papillae, of the tongue, are responsible of the sense of taste. There are four types of papillae that identify five tastes and one whose existence has not yet been fully proven. Taste alterations have different etiologies which will be commented on this review. Key words: ageusia, atmospheric pollution, taste, taste buds, tongue

Introduction: The Objective Structured Clinical Evaluation (OSCE) is an instrument that allows evaluating clinical reasoning among physical therapy students, considering that knowing the correlation between their performance and their self-evaluation, as well as their level of satisfaction with this instrument, is essential. Objectives: To determine the correlation between performance and self-evaluation (perceived performance) of physical therapy students in an OSCE designed to assess clinical reasoning, and to evaluate their level of satisfaction with this instrument. Materials and methods: Analytical cross-sectional study conducted in 159 physical therapy students from a university in Chile who participated in an 11-station OSCE. Performance checklists and answer sheets were used for performance evaluation (passing score: 70% of the maximum score per station and in the OSCE). Two perception surveys were also used, one for self-evaluation of performance (for each station) and another to determine the students’ level of satisfaction with the OSCE. The correlation between performance in the OSCE (overall score, score by station, and score by type of station) and perceived performance was determined using the Spearman’s correlation coefficient. Results: The level of satisfaction with the OSCE was high in 57.23% of the students. The correlation between the total score in the OSCE and perceived performance was significant, but weak (Rho=0.31; p<0.001). In students with a low satisfaction level with the OSCE, the correlation between performance and perceived performance was not significant (Rho=0.15; p=0.23), while in those with high satisfaction level it was significant and moderate (Rho=0.48; p<0.001). Conclusions: Most students reported a high level of satisfaction with the OSCE. However, in most stations, the correlation between observed and perceived performance was weak and very weak.

Introduction: Lack of physical activity and high obesity rates in children and adolescents are major public health concerns. Active school transport is a strategy that can contribute to achieving recommended physical activity levels. Objective: To determine the relationship between the use of active school transport by children from the Colombian Caribbean region and their parents’ perception of barriers to active school transport. Materials and methods: Cross-sectional study conducted in 2019 with data from 3 067 primary school children from the Colombian Caribbean region. Data were obtained by administering an ad hoc questionnaire (questions on how children commuted to school and about their academic and sociodemographic characteristics) and the Active School Transport Barriers scale to the parents or legal guardians of the children. A multivariate logistic regression analysis was performed in which Odds ratios (OR) and their respective 95% confidence intervals (95%CI) were calculated to determine the relationship between the modality of transportation to school (active/passive) and the barriers to active school transport perceived by the students’ parents. Results: A total of 51.3% of the schoolchildren actively transported to school. Factors such as considering that the roads are not appealing (OR=1.64; 95%CI: 1.39-1.94), that there are dangerous road crossings on the route (OR=1.29; 95%CI: 1.1-1.54), that the distance between home and school is very long (OR=1.83; 95%CI: 1.5-2.1), and that the traffic on the route is heavy, (OR=1.5; 95%CI: 1.2-1.8) increased the probability of passive transportation (i.e., using motor vehicles). Conclusion: In the present study, long distances between home and school, aesthetics of roads, heavy traffic on the route, and insecurity of road crossings, among others, were identified as barriers to the use of active school transport.

Psychological distress in women who are mothers is a serious public health concern that greatly affects the physical, social, and emotional development of their babies. Often, mothers with mental health issues do not receive the care they require, not only because of the persistent social stigma associated with mental illness, but also due to a lack of resources. From the perspective of our perinatal and child-rearing psychiatry practice, and based on the available literature, we reflect on the care received by those women, who are now mothers, during their own childhoods and its impact on how they currently experience motherhood. Early attachments have a deep impact on both memory and behavior throughout our lifetimes. When they become mothers, women may update their own childcare experiences, a phenomenon known as “psychic transparency” and mobilize the lessons they received as infants about relationships, care, and emotional regulation. The anxiety and frustration faced by mothers today seem to arise, partially, from the conflict between the parenting style they want to offer their babies (warm and conscious) and the one they received at a time when prevailing theories discouraged breastfeeding and skin-to-skin contact. Taking care of mothers’ emotional states and supporting their relationship with their babies is a necessary and urgent public health measure, which has intergenerational repercussions in mental health.

The new severe acute respiratory syndrome due to coronavirus type 2 (SARS-CoV-2), which causes COVID-19 disease, was detected for the first time in December 2019. Where it has been seen that there is a prothrombotic state with involvement of the Central Nervous, with involvement of large vessels such as the middle cerebral artery, is due to mechanisms induced by the infection itself, hypercoagulable state and endothelial damage. Neurological manifestations in COVID-19 are found in 36% of patients. Case description: This is a 36-year-old male patient with fever, cough and general malaise. A COVID test was performed, which came out positive. His condition was getting worse adding photophobia, right hemiparesis and deviation of the corner of the mouth to the left, which is why he went to the doctor, arriving 8 hours after the onset of the clinical picture, where a simple skull tomography was performed, showing extensive infarction of the left middle cerebral artery with malignant cerebral edema. He was transferred to emergency surgical management where a left decompressive craniectomy was performed. After this, mechanical respiratory assistance with intubation and anti-cerebral edema measures were maintained, achieving ventilatory progression; however, a tracheostomy and gastrostomy were performed due to poor predictors of extubation. He was kept under post-surgical observation, leaving him with 3/5 right hemiparesis, without any other deficit, therefore, he was discharged home. Discussion: The case presented was managed with decompressive craniectomy, resulting in an improvement in survival, as reported in the literature where it is recommended that such management should be performed early. Conclusions: This report reveals that patients with COVID-19 present in young men in the fourth and fifth decade of life, without comorbidities, that recieved early treatment with decompressive hemicraniectomy, improved their life prognosis, consistent with the cases presented in the literature. Keywords: COVID-19; brain infarction; decompressive craniectomy; hypercoagulability.