The systematic assessment of large population-based surveys addressing the prevalence of Helicobacter pylori infection may provide robust evidence for understanding the trends in the exposure to this major risk factor across settings with distinct patterns of gastric cancer variation. Our aim was to describe the prevalence of H. pylori infection in different countries and periods, through systematic review of the literature. We searched PubMed from inception up to September 2013 to identify original studies reporting on the prevalence of H. pylori, and only those evaluating samples with national coverage were included. We identified 37 eligible studies including data for 22 countries. The prevalences were higher in Central/South America and Asia, and at least two-fold higher in countries with high gastric cancer incidence. In most countries presenting data for different time periods, the prevalences were usually lower in the most recent surveys. However, there was little variation in settings where prevalences were already low. Among countries with high prevalence of H. pylori infection there is an ample scope for reducing its burden in the next decades, whereas further declines in settings with already low prevalences will require more intensive efforts.

Portugal has the highest gastric cancer mortality rates in Western Europe, along with high prevalences of Helicobacter pylori infection. Monitoring their trends is essential to predict the burden of this cancer. We aimed to quantify time trends in gastric cancer mortality in Portugal and in each administrative region, and to compute short-term predictions, as well as to describe the prevalence of H. pylori infection, through a systematic review. Joinpoint analyses were used to identify significant changes in sex-specific trends in gastric cancer age-standardized mortality rates (ASMR) and to estimate annual percent changes (APC). The most recent trends were considered to compute estimates up to 2020 by adjusting Poisson regression models. We searched PubMed and IndexRMP to identify studies carried out in Portugal reporting the prevalence of H. pylori. Gastric cancer mortality has been decreasing in Portugal since 1971 in men (from ASMR=55.3/100 000; APC=-2.4, 95% confidence interval: -2.5 to -2.3) and since 1970 in women (from ASMR=28.0/100 000; APC=-2.8, 95% confidence interval: -2.9 to -2.7), although large regional differences were observed. Predicted ASMR for 2015 and 2020 were 18.8/100 000 and 16.7/100 000 for men and 8.5/100 000 and 7.4/100 000 for women, respectively. The prevalence of H. pylori varied from almost 5% at 0.5-2 years to just over 90% at 70 years or more. No consistent variation was observed since the 1990s. The downward trends in mortality rates are expected to remain in the next decades. The high prevalence of H. pylori infection across age groups and studies from different periods shows a large potential for decrease in the burden of gastric cancer in Portugal.

The relation between lifestyles and gastric cancer has been investigated thoroughly; however few studies have addressed the impact of these exposures on prognosis. Therefore, we quantified the association between prediagnosis smoking, alcohol intake and other dietary exposures and the survival of gastric cancer patients through a systematic review and meta-analysis. We searched Pubmed and EMBASE up to April 2011 and computed summary hazard ratio estimates and respective 95% confidence intervals (95% CIs) through a random-effects meta-analysis (DerSimonian and Laird). Heterogeneity was quantified using the I2 statistic. Seven articles, providing data from 6856 cases evaluated in seven countries (Canada, Japan, Italy, USA, Korea, Iran and Sweden), were eligible for meta-analysis. The summary hazard ratio was 1.08 (95% CI: 0.90-1.30) for smoking (current vs. never smokers, seven studies; I2=56.2%) and 1.13 (95% CI: 1.00-1.28) for alcohol consumption (drinkers vs. nondrinkers, five studies; I2=13.2%). Only two studies assessed the effect of other dietary factors. This study summarizes the best evidence available on the relation between prediagnosis lifestyles and the survival of gastric cancer patients. Alcohol drinkers have lower survival, but results on the effect of smoking lack consistency and there is almost no information on the effects of dietary factors.

Copper slag is a copper industry waste that is essentially used as an abrasive for metals to remove coatings or paintings, due to its hardness, sieve distribution and rough surface, mainly in the naval industry. After the wearing process, copper slag retains most of its original properties, and remaining an environmental problem. Chemical composition of copper slag presents a high Fe, Si and Al oxide content what makes it a pozzolanic material. Thus, it is possible to use it as a partial replacement for sand and after triturating it into very small particles as a replacement for cement. After a chemical, physical, mineralogical, and environmental characterization of copper slag, its use as a partial replacement of sand on mortars was investigated. The experimental program was developed to evaluate the effect of several percentages of sand substitution in mortars. For mortars 25, 50 and 75 % of sand replacement by volume was studied. A standard 1/3 cement/sand ratio, by weight, with cement type CEM 42.5 I, was used. The type of sand and the effect of washing the slag were also investigated. Strength was measured at 7, 28, 60 and 90 days. Results obtained until now indicate that a reduction of strength occurs when the slag content increases. Additionally, it was observed a delay of the hardening process by the addition of the copper slag. As a conclusion, the use of copper slag as a sand replacement seemed to be a practical option.

Objective: To quantify the association between breast-feeding and Helicobacter pylori infection, among children and adolescents. Design: We searched MEDLINE TM and Scopus TM up to January 2013. Summary relative risk estimates (RR) and 95 % confidence intervals were computed through the DerSimonian and Laird method. Heterogeneity was quantified using the I 2 statistic. Setting: Twenty-seven countries/regions; four low-income, thirteen middleincome and ten high-income countries/regions. Subjects: Studies involving samples of children and adolescents, aged 0 to 19 years. Results: We identified thirty-eight eligible studies, which is nearly twice the number included in a previous meta-analysis on this topic. Fifteen studies compared ever v. never breast-fed subjects; the summary RR was 0·87 (95 % CI 0·57, 1·32; I 2 = 34·4 %) in middle-income and 0·85 (95 % CI 0·54, 1·34; I 2 = 79·1 %) in high-income settings. The effect of breast-feeding for ≥ 4-6 months was assessed in ten studies from middle-income (summary RR = 0·66; 95 % CI 0·44, 0·98; I 2 = 65·7 %) and two from high-income countries (summary RR = 1·56; 95 % CI 0·57, 4·26; I 2 = 68·3 %). Two studies assessed the effect of exclusive breastfeeding until 6 months (OR = 0·91; 95 % CI 0·61, 1·34 and OR = 1·71; 95 % CI 0·66, 4·47, respectively). Conclusions: Our results suggest a protective effect of breast-feeding in economically less developed settings. However, further research is needed, with a finer assessment of the exposure to breast-feeding and careful control for confounding, before definite conclusions can be reached. Keywords Helicobacter pylori Breast-feeding Child AdolescentHelicobacter pylori infection has been classified a definite human carcinogen for almost two decades and is well accepted as the single most important risk factor for non-cardia gastric cancer (1,2) . Although the prevalence of infection has been decreasing in many of the more economically developed countries (3,4) , it was estimated to be responsible for nearly one-third of the 2 million cases of cancer occurring worldwide due to infections in 2008 (5) .H. pylori infection is acquired mainly during childhood and adolescence (6)(7)(8) ; once obtained, and in the absence of a specific treatment, it can persist for decades (9) . Therefore, understanding the role of modifiable exposures that may be targeted to decrease the rate of H. pylori infection during childhood is of key importance to prevent its occurrence. Factors that promote interpersonal contact or are associated with poor hygienic conditions, including being born in a setting with a high prevalence of infection (10) , having parents with a low education level (11) , sharing a room with other subjects (12) or attending a childcare institution (13) , have been consistently associated with H. pylori infection in the early years of life. Breast-feeding has long been recognized as protective against gastrointestinal and respiratory diseases (14,15) , and a role in the infection with H. pylori may be postulated.A pr...