Helicobacter pylori (H. pylori) infection is present in more than half the world's population and has been associated with several gastric disorders, such as gastritis, peptic ulceration, and gastric adenocarcinoma. The clinical outcome of this infection depends on host and bacterial factors where H. pylori virulence genes seem to play a relevant role. Studies of cagA and vacA genes established that they were determining factors in gastric pathogenesis. However, there are gastric cancer cases that are cagA-negative. Several other virulence genes have been searched for, but these genes remain less well known that cagA and vacA. Thus, this review aimed to establish which genes have been suggested as potentially relevant virulence factors for H. pylori-associated gastrointestinal diseases. We focused on the cag-pathogenicity island, genes with adherence and motility functions, and iceA based on the relevance shown in several studies in the literature.

DNA methylation in gastric cancer seems to be influenced by the presence of interleukin polymorphisms and by the H. pylori cagA/vacAs1m1 strains.

Occupation and factors associated with exposure to the sun among beach workersOcupação e fatores associados a exposição solar em trabalhadores de praias

OBJECTIVE:To assess the prevalence and factors associated with orolabial lesions caused by sun exposure in beach workers. METHODS:Cross-sectional study with 362 beach workers from fi ve urban beaches in the city of Natal, northeastern Brazil, from August to December 2010. All subjects completed a validated questionnaire to collect personal, occupational, and health-related information and underwent an orolabial clinical examination by trained examiners. Potential associations between sociodemographic, occupational, and health-related variables and the presence of orolabial lesions were assessed using the chi-square test at a 5% signifi cance level. The multivariate analysis was performed using Poisson regression. RESULTS:Of the 362 workers examined, 27.1% had orolabial lesions. Of these, 76.8% were males, 61.6% dark or black skinned, 94.5% informal workers, and 85.4% reported sun exposure. Most (81.1%) reported using sun protection methods including sunscreen (38.7%), lip balm (15.3%), and cap/hat (72.4%). Twenty-eight percent reported smoking and 48% regular drinking. Sun protection with cap/hat was associated with orolabial lesions caused by sun exposure. CONCLUSIONS:There was found a high prevalence of orolabial lesions in workers exposed to sunlight that was associated with the use of a cap/hat as a sun protection method.

Thirty cases of human kala-azar were diagnosed by iliac crest biopsy and myeloculture. Histological analysis of 12 patients showed diffuse thickening of reticulin fibers. To the best of our knowledge, this is the third report describing secondary bone marrow fibrosis (myelofibrosis-like) associated with kala-azar. Patients with positive bone marrow fibrosis (pbmf = 12) were compared to patients without detectable bone marrow fibrosis (wbmf = 18). There were no significant differences in clinical and blood parameters following treatment. All patients showed regression of hepatosplenomegaly. Our findings suggest that associated bone marrow fibrosis is transient and did not interfere in the evolution of treated patients.

In general, most workers reported using some form of photoprotection in the oral and perioral regions, and those exposed to direct solar radiation effectively confirmed this.

The results showed some susceptibility differences between tumors of different locations. There was an increased risk relationship between three repair enzyme SNPs and cardia tumors, and the G allele of the cytokine gene TNF negatively influenced the development of non-cardia tumors. Helicobacter pylori strains seemed to be different in the cardia region, where they were less virulent than those located in the distal region of the stomach.

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