Evaluation of leukocyte esterase and nitrite strip tests to detect spontaneous bacterial peritonitis in cirrhotic patients

AIM： To investigate the diagnostic efficacy of leukocyte esterase and nitrite reagent strips for bedside diagnosis of spontaneous bacterial peritonitis （SBP）. METHODS： A total of 63 consecutive patients with cirrhotic ascites （38 male, 25 female） tested between April 2005 and July 2006 were included in the study. Bedside reagent strip testing was performed on ascitic fluid and the results compared to manual cell counting and ascitic fluid culture. SBP was defined as having a polymorphonuclear ascites count of ≥ 250/mm^3. RESULTS： Fifteen samples showed SBP. The sensitivity, specificity, positive and negative predictive values of the leukocyte esterase reagent strips were; 93%, 100%, 100%, and 98%, respectively. The sensitivity, specificity, positive and negative predictive value of the nitrite reagent strips were 13%, 93%, 40%, and 77%, respectively. The combination of leukocyte esterase and nitrite reagents strips did not yield statistically significant effects on diagnostic accuracy. CONCLUSION： Leukocyte esterase reagent strips may provide a rapid, bedside diagnostic test for SBP.

Anti-inflammatory efficiency of levobupivacaine in an experimental colitis model

AIM:To investigate the efficiency of levobupivacaine in treating experimentally induced colitis in rats.METHODS:Colitis was induced by trinitrobenzene sulfonic acid and ethanol in 30 rats under general anesthesia,and 10 rats were used as a sham group.Subsequent to induction of colitis,rats were divided into three groups;budesonide group received 0.1 mg/kg budesonide,levobupivacaine group received 10 mg/kg levobupivacaine and saline group received 1 mL saline solution via rectal route for 7 d.In the sham group,only routine rectal catheterization was performed without use of any material.At the end of 7 d,laparotomy and total colectomy were performed for histopathological ex-amination in all rats and blood samples were drawn for measurement of tumor necrosis factor(TNF)-αand interleukin(IL)-6 following cardiac puncture.Macroscopic and microscopic evaluations of the specimens were performed by a pathologist blinded to group assignment of the rats.RESULTS:Weight loss(P=0.016)and macroscopic examination scores(P=0.001)were significantly higher in saline group than others.Histopathological scoring was comparable between all colitis groups(P=0.350).There was no significant difference in TNF-αlevels and IL-6 levels(P=0.150).CONCLUSION:The significant improvement in macroscopic scores suggests that levobupivacaine may have topical anti-inflammatory effects in an experimental colitis model;however,this finding was not supported by microscopic findings.