BackgroundIt has been suggested that distal gastric carcinoma (GC) in younger patients has a more aggressive outcome than in older patients, however this is a controversial issue. The aim of this study was to compare clinicopathological features between younger and older patients with GC in Northeastern Brazil.MethodsA total of 207 patients with distal GC (41 patients ≤45 years, considered younger group, and 166 > 45 years, considered older group) were evaluated prospectively during a 6 year period.ResultsThe mean patient age in the young group was 37.41 years old and 64.43 years in the older group. No significant difference was found regarding gender, area of residence, history of alcohol consumption, chronic tobacco smoking. Prevalence of first-degree GC history was 12.5% (7.3% in younger group vs. 13.9% in older; p <  0.46). The most frequent symptom was gastric pain and weight loss. Diffuse infiltrative cancer was more frequently seen in younger patients (70.70% vs. 33.70%, respectively; p <  0.01), as was histologically less differentiated tumors (63.40% vs. 33.10%; p <  0.01) and stage IV of GC (48.80% vs. 30.70%; p <  0.015). Five-year survival, evaluated in 82 patients, was lower in younger patients (p = 0.045); however, after adjusting for stage of GC in the multivariate analysis, this association did not remain significant. Family history of GC and gender had no impact on survival.ConclusionsYounger patients showed higher prevalence of diffuse type of Lauren and lower survival that was attributed to higher rate of advanced stage of GC. Gastric cancer screening strategies should also be considered in younger individuals, especially in areas of high prevalence. Further studies are warranted to determine risk factors associated with gastric cancer in young adults.

Factors linked to remain and to gain H. pylori infection in a poor region were increased number of children in the household and the male gender. Also, the acquisition rates were higher than the loss rates, which lead to an increase in the infection prevalence with age.

The transmission of H. pylori occurs from infected mothers to their offspring and among siblings, notably from younger siblings to the older ones.

RESUMOSíndrome de Bloom é uma doença autossômica recessiva caracterizada por eritema telangiectásico em face, fotossensibilidade e retardo de crescimento pré e pós-natal. A mutação do gene BLM, traz uma instabilidade cromossômica importante, responsável pelas manifestações da síndrome e pela maior susceptibilidade a neoplasias. Há um registro mundial de pacientes com um total de 255 casos, sendo 16 do Brasil. Diante da raridade da síndrome, apresentamos o caso de duas irmãs, filhas de pais consanguíneos, ambas com baixa estatura, apresentando máculas eritematosas com telangiectasias em nariz e região perioral, micrognatismo, dolicocefalia, hipoplasia malar, face triangular, nariz proeminente, máculas hipocrômicas e manchas café com leite em tronco e membros inferiores. O diagnóstico é clínico e pode ser confirmado por citogenética. Os portadores apresentam fenótipo típico com telangiectasias em áreas fotoexpostas. Ainda não há tratamento específico, porém, deve-se oferecer suporte clínico e melhoria da qualidade de vida e diminuição de estigmas.Palavras chave: Síndrome de Bloom. Eritema telangiectásico congênito. Eritema. Telangiectasia. ABSTRACTBloom's syndrome is an autosomal recessive disorder characterized by telangiectatic erythema in the face, photosensitivity and growth retardation. BLM gene mutation brings an important chromosomal instability, responsible for the manifestations and the higher susceptibility to cancer. A global registry of patients comprises a total of 255 cases, 16 from Brazil. Due to the rarity of the syndrome, we present the case of two sisters, daughters of consanguineous parents, both with short stature and erythematous macules with telangiectasias in the nose and perioral region, micrognathia, dolichocephaly, malar hypoplasia, triangular face, prominent nose, hypochromic macules and café au lait spots on the trunk and lower limbs. The diagnosis is clinical and can be confirmed by cytogenetics. The patients have typical phenotype with telangiectasias on sun-exposed areas. There is still no specific treatment, however, supportive care should be offered, associated with an improvement of the quality of life and reduction of stigma.

RESUMOA Leucemia Linfocítica Crônica (LLC) é caracterizada pela proliferação e acúmulo progressivo de linfócitos relativamente maduros, funcionalmente incompetentes e monoclonais na corrente sanguínea, medula óssea e tecidos linfáticos. Na maioria dos casos, um único clone de linfócitos B passa por transformação maligna, mas uma pequena porcentagem dos casos envolve linfócitos T monoclonais. É doença predominantemente do idoso, com idade mediana ao diagnóstico de 70 anos. Apresentamos paciente de 78 anos, que procurou atendimento com queixa de astenia e linfadenomegalias em cadeias cervicais e epitrocleares, apresentando úlcera e aumento volumétrico de lábio inferior à esquerda, de surgimento recente. ABSTRACTChronic lymphocytic leukemia (CLL) is a disorder characterized by a proliferation and progressive accumulation of relatively mature lymphocytes functionally incompetent and monoclonal antibodies in the blood, bone marrow and lymphatic tissues. In most cases, a single clone of B-lymphocytes undergoes malignant transformation, but a small percentage of cases involve monoclonal T-lymphocytes. CLL is a disease that predominantly affects the elderly, with the median age of diagnosis at 70 years. We herein report a case of 78-year-old patient who sought medical assistance complaining of asthenia and lymphadenomegaly on cervical and epitrochlear chains, with ulcer and increased volume on the left of lower lip, of recent onset.

RESUMOmalignidade e que se caracteriza pelo crescimento lento. Acomete preferencialmente adultos, estima-se que a incidência desse Palavras-chave:ABSTRACT case in a 3-year-old boy, emphasizing the importance of the correct and early diagnosis due to the high rates of recurrence of this

O lúpus bolhoso é uma dermatose sistêmica rara, decorrente da presença de anticorpos contra o colágeno tipo VII da junção dermo-epidérmica. A doença de Kikuchi-Fujimoto pode se associar, embora raramente, ao lúpus e caracteriza-se por uma linfangite histiocitária necrotizante.  Paciente masculino, 22 anos, com lesões vésico-bolhosas orais, no abdome, nádegas e axilas, além de adenomegalias dolorosas, bicitopenia, proteinúria, FAN fortemente positivo e serosites. O anatomopatológico sugeriu dermatite herpetiforme, mas a imunofluorescência direta revelou depósito linear de IgG e IgA na zona de membrana basal. A biópsia de linfonodo mostrou infiltrado linfohistiocitário CD8+ e CD68+ com necrose coagulativa. Os achados permitiram o diagnóstico de lúpus bolhoso associado à doença de Kikuchi-Fujimoto e o paciente respondeu satisfatoriamente ao tratamento empregado.