[Human hydatidosis in Sardinia. Epidemiologic study of the cases operated on from 1974 to 1981]

A retrospective survey of surgical cases to obtain baseline data on hydatid disease in Sardinia from 1974 to 1981 revealed an annual mean rate of 11.1/100.000 population. However, real prevalence is obviously higher, since infection is not always synonymous with disease and surgical incidence should be regarded as the figure that counts. Information on sex, age, residence, occupation, cyst location, number of re-operations was collected to assess the public health impact to hydatidosis within the island. The obtained results indicate that not all population is at equal risk, being hydatid disease most prevalent in rural areas and particularly in the districts where sheep-breeding is highly diffused (annual mean rate greater than 20/100.000 population). The highest rate was observed in farmers and shepherds (34.2/100.000) respect to retired (14.1/100.000), housewives (10.9/100.000), employed in services (8.9/100.000) and students (8.3/100.000). Over 55% of the cysts were found in the liver, about 30% in the lung and 15% in other sites. A correlation between age and cyst location and between profession and cyst location was shown. Pulmonary cysts were prevalent in children and young people, hepatic in grown-up people, whereas nearly the same hepatic and pulmonary frequency was observed in shepherds. Comparisons between previous surveyed periods were done and results were discussed, suggesting the need of a continuous and well-planned control programme.

Rice flour, breath hydrogen, and malabsorption

In contrast to the incomplete intestinal absorption of many dietary carbohydrates in healthy humans, it has been suggested that rice flour is completely absorbed. The aims of this study were (a) to confirm efficient absorption of rice flour in healthy individuals, (b) to evaluate a "rice breath hydrogen (H2) test" in the investigation of patients with suspected malabsorption, and (c) to compare H2 results with quantitative fecal fat excretion. The test meal consisted of 100 g of carbohydrate in the form of rice pancakes. End expiratory breath samples were collected at 30-min intervals over 8 h and the H2 concentration was analyzed by gas chromatography. Three-day stool fat collections were performed on a 70-g fat intake. The results of the experiment indicated that healthy controls (n = 23) produced minimal H2 [mean increase (delta) +/- SE] = 6.9 +/- 1.4 parts per million (ppm). Patients with pancreatic disease produced 43.2 +/- 8.0 ppm. Complete or partial correction was achieved in each of 6 subjects with oral pancreatic supplements. Twenty-two patients with a variety of small bowel diseases produced a mean increase of 73.2 +/- 21.4 ppm. Breath H2 excretion was maximal in patients with bacterial overgrowth. Disease controls (n = 10) with diarrhea of colonic origin did not produce significant H2. The sensitivity of the rice-breath H2 test compared favorably with quantitative fecal fat excretion. Within individuals, there was a lack of correlation between breath H2 data (an index of CHO malabsorption) and daily stool weight that reflects the presence or absence of diarrhea. This lack of correlation supports the concept that the endogenous microflora salvage considerable quantities of unabsorbed carbohydrate.