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Objective: Operative link on gastritis assessment (OLGA) staging for gastritis ranks the risk for gastric cancer (GC) in progressive stages (0-IV). This prospective study aimed at quantifying the cancer risk associated with each gastritis stage., Design: A cohort of 1755 consecutive patients with dyspepsia underwent initial (T-0) oesophagogastroduodenoscopy with mapped gastric biopsies, OLGA staging and assessment of Helicobacter pylori infection. Patients were followed for 55 months (median); patients with stages II III and IV underwent a second endoscopy/restaging (T-1), and those with stages 0 and I were followed clinically and through in-depth clinical and record checking. Endpoints were OLGA stage at T-1 and development of gastric epithelial neoplasia., Results: At T-0, 77.6% of patients had stage 0, 14.4% stage I, 5.1% stage II, 2.1% stage III and 0.85% stage IV. H. pylori infection was detected in 603 patients at T-0 and successfully eradicated in 602 of them; 220 had a documented history of H. pylori eradication; and 932 were H. pylori naïve-negative. Incident neoplastic lesions (prevalence=0.4%; low-grade intraepithelial neoplasia (IEN)=4; high-grade IEN=1; GC=2) developed exclusively in patients with stages III-IV. The risk for epithelial neoplasia was null in patients at stages 0, I and II (95% CI 0 to 0.4), 36.5 per 1000 person-years in patients at stage III (95% CI 13.7 to 97.4) and 63.1 per 1000 person-years in patients at stage IV (95% CI 20.3 to 195.6)., Conclusions: This prospective study confirms that OLGA staging reliably predicts the risk for development of gastric epithelial neoplasia. Although no neoplastic lesions arose in H. pylori- naïve patients, the H. pylori eradication in subjects with advanced stages (III-IV) did not abolish the risk for neoplastic progression., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

One hundred and eighteen cases of S. stercoralis infection were detected by stool examination among 4203 patients seen over a period of three years at the Division of Infectious Diseases (IRCCS, San Matteo, University of Pavia) of a University Hospital in Northern Italy. Because chronic strongyloidiasis is often asymptomatic, a 3 per cent prevalence in this selected population indicates that the parasitosis may be much more frequent in the general population of the area. Parasite-specific humoral responses were studied in 48 patients. Strongyloides-specific IgG and IgA antibodies were found by ELISA in the serum of 40 (83.3 per cent) and 43 (89.5 per cent) patients, respectively, and specific IgE antibodies were detected by RAST in 39 (81.3 per cent). The specific IgG antigen recognition patterns of these patients were compared by immunoblotting with those of North and South American and Thai patients, and differences among the groups suggested the existence of separate geographic strains of S. stercoralis. This was further supported by the virtual absence in our patients of the larva currens, a common and highly characteristic sign of strongyloidiasis in subjects infected in southeast Asia. More awareness of the epidemiologic and clinical features of strongyloidiasis, with the use of serologic tests to screen candidates for immunosuppression, may result in the early detection of chronic uncomplicated strongyloidiasis and in the prevention of fatal opportunistic hyperinfections.