Thirty-five patients (23 males) with asymptomatic hyperuricemia for at least two years underwent two-dimensional ultrasonography of knees and ankles. Urate deposits (tophi) in tendons, synovium, and other soft tissues were detected in 12 patients (34%). Increased vascularity (inflammation) was evident in 8 of these patients (23%). Tophi were more frequently found in knees than in ankles and were especially prevalent in the distal patellar tendon. The presence of tophi was unrelated to the known duration of hyperuricemia (mean, 5 years). Ultrasonography allows detection of tophi and inflammation in a third and in a fourth, respectively, of asymptomatic hyperuricemic patients.

This study was designed to examine the hypothesis that some environmental factors increase the risk for insulin-dependent diabetes mellitus. Data on dietary history was collected from 80 diabetic children from the Santiago de Chile Registry and from 85 nondiabetic control subjects who were comparable in terms of age, sex, and ethnic characteristics. Early exposure was defined as the ingestion of food sources other than maternal milk before 3 months of age. To define genetic susceptibility to insulin-dependent diabetes mellitus each subject was typed in terms of HLA DQA1 and DQB1, and the possible conformation of susceptible heterodimers was considered as a risk marker. Fewer children were exclusively breast fed in the diabetic group than in the control group (21.55 +/- 15.05 vs 33.95 +/- 20.40 weeks, P<0.01). In addition, exposure to cow's milk and solid foods occurred earlier in the diabetic group than in the control group (15.90 +/- 10.95 vs 21.15 13.65 and 16.85 +/- 10.25 vs 21.20 +/- 12.35 weeks, P<0.05). Our data show that a short duration of breast-feeding and early exposure to cow's milk and solid foods may be important factors in the development of insulin-dependent diabetes mellitus. The high relative risk observed in individuals genetically predisposed indicates an interaction effect between genetic and environmental components.

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RESUMEN El artículo ofrece un análisis relacional de los enfoques y categorías de programas educativos generados en torno al patrimonio inmaterial, derivado de un estudio financiado por el Ministerio de Economía y Competitividad y los Fondos Feder (UE) en el marco del proyecto de investigación EDU2015-65716-C2-2-R, y se enmarca en las acciones del Plan Nacional de Educación y Patrimonio. Este análisis se desarrolla dentro de un proceso evaluativo con una muestra de 202 programas educativos, que tiene como finalidad detectar el estado de la cuestión, así como sus fortalezas y debilidades. El estudio muestra cómo los programas analizados abordan todos los ámbitos educativos, y presentan una amplia gama de tipologías. También se observan tendencias relacionales entre el tipo de público y tipo de programa. Por otro lado, se denotan deficiencias en torno al alto porcentaje de programas detectados sin diseño educativo. Este aspecto nos plantea la necesidad de generar nuevas prospectivas para la educación patrimonial, que garanticen su función activadora de los procesos de identización y de la sociedad hacia su patrimonio. Palabras clave: educación patrimonial, patrimonio cultural inmaterial, evaluación de programa, UNESCO, Instituto del patrimonio cultural de España.

The objective of this study was to illustrate the wide spectrum of subcutaneous emphysema in the emergency room; to show the key findings on computed tomography, plain radiographs, and echography; and to discuss the differential diagnoses. Subcutaneous emphysema is a common finding in emergency department imaging studies. It has a great importance due to its broad casualty, some of them totally benign, but others potentially lethal. We retrospectively reviewed our database of emergency pathology, analyzing its origins and associated features. SE was associated to traumatic, iatrogenic, or infectious causes (necrotizing fasciitis, Fournier gangrene). It also was found associated with thoracic (causing pneumothorax and pneumomediastinum) and abdominal pathology related to intraperitoneal and retroperitoneal gas. Diagnostic difficulties and differential diagnoses are emphasized. Radiologists must be aware of abnormal gas in soft tissue because it may be the main or unique sign leading to an underlying pathology, which can be lethal.