JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/1471-230X-10-20 (2010)

Reviewer's report
Title:Chromosomal imbalances are uncommon in Chagasic megaesophagus
Version: 4Date:8 January 2010
Reviewer: Clara Isabel González
Reviewer's report:
The authors have answered my points sufficiently well to allow their manuscript
to be published.
Discretionary revisions:
a) The study analyzed tissues obtained from patients with diagnosis of chagasic
megaesophagus. However, the authors did not mention how the diagnosis was
established and confirmed.
OK. Include a sentence related to the diagnosis of Chagas Disease.
b) Highlight the data in the frequency of Chagas disease in Brazil and South
America and its appearance in non-endemic areas.
OK.
c) The number of cases in each category as gender, alcoholism and tabaquism is
too small to evaluate the risk factors. Mention the limitation of the low number of
samples.
OK.
d) Reduce the number of references to those which are essential.
OK. Check if all the references are correct, on page 11 the reference 69 is
mentioned, when the total is 53.
Minor essential revision:
a) In the current form, table 1 is very difficult to read and understand, review it.
Some abbreviations are not defined; an example is “T”.
OK.
b) Tables 2 and 3 are misconfigured, therefore, it is suggested to correct its
formatting in the revised manuscript.
OK.
c) Figure 1 F shows lower resolution compared to the other quadrants.
OK.
d) The resolution of figure 2 could be improved especially in quadrants C and D.
OK.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-19 (2010)

Reviewer's report
Title:Chlamydia trachomatis antigens in enteroendocrine cells of the small
bowel in patients with irritable bowel syndrome
Version: 1Date:14 September 2009
Reviewer: Lena Öhman
Reviewer's report:
Review comments on
Chlamydia trachomatis antigens in enteroendocrine cells of the small bowel in
patients with irritable bowel syndrome.
The authors have investigated the presence of Chlamydia trachomatis in the
small bowel in patients with irritable bowel syndrome. They have performed
staining of jejunal biopsies, but also examined the presence of Chlamydia
trachomatis proteins using western blot and Chlamydia trachomatis DNA using
PCR analysis.
The authors report convincing data of Chlamydia trachomatis antigen presence
in the intestinal mucosa of IBS patients, whereas most healthy controls are
negative for the same antigen.
The study is design in sound, the number of patients is sufficient and data is well
presented. The paper is well written and the findings are clearly stated.
Discretionary revisions
I would prefer a table or figure demonstrating the main finding of the article
(number of C. trachomatis positive patients and controls, and statistics), which is
well described in the first section of “results”. This may very well be
complemented by the current figure 1, showing examples of specific stainings.
It is very difficult to see the arrows described in the figure legend (are there really
any?) in figure 1.
The word macrophages might perhaps be included in the title of the paper?
The word “MOMP” needs an explanation in the abstract.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-10-19 (2010)

Reviewer's report
Title:Chlamydia trachomatis antigens in enteroendocrine cells of the small
bowel in patients with irritable bowel syndrome
Version: 1Date:4 October 2009
Reviewer: Maurizio Gabrielli
Reviewer's report:
I read with great interest the paper by Dlugosz and coll. It reports the novel
finding of chlamydial antigens in enteroendocrine cells and macrophages of the
small bowel mucosa in patients with IBS. The limit of the study (it was unable to
prove the presence of viable microrganisms) is clearly indicated. For this reason
furthers studies to clarify the possible role of such antigens in the pathogenesis
of IBS are strongly required. However the paper is well written, the results are
novel and interesting.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-19 (2010)

Reviewer's report
Title:Chlamydia trachomatis antigens in enteroendocrine cells of the small
bowel in patients with irritable bowel syndrome
Version: 2Date:29 December 2009
Reviewer: Mark Pimentel
Reviewer's report:
I have one more request from the authors. They previously published in a small
number of IBS subjects that they showed myenteritis (less than 10 patients). Now
that they have dozens of patients, they should show the results of their original
hypothesis in this larger group. Are their results from previous study holding up in
this large population. My guess is that they are not since they do not reveal those
results here.
Review for 10.1186/1471-230X-10-18 (2010)

Reviewer's report
Title:Management of an extrasphincteric fistula in an HIV-positive patient by
using fibrin glue: a case report with tips and tricks
Version: 1Date:19 September 2009
Reviewer: C. Neal Ellis
Reviewer's report:
Thank you for the opportunity to review this manuscript and I would like some
clarification.
1. There is data to suggest that the best results with fibrin sealant occur after a
period of seton drainage to allow acute inflammation and side tracts to resolve. In
your manuscript you mention that a seton was used to manage the fistula. Could
ypu describe this more? Was it placed at the time of surgery to assist with
catheter insertion or had in been in place for some period of time? If so, how
long?
2. Was there any acute purulence or inflammation of the fistula at the time of
used of the fibrin sealant?
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-18 (2010)

Reviewer's report
Title:Management of an extrasphincteric fistula in an HIV-positive patient by
using fibrin glue: a case report with tips and tricks
Version: 1Date:30 September 2009
Reviewer: Francis Seow-Choen
Reviewer's report:
This is an interesting but simple report of an experience with the use of fibrin glue
in treating a complex fistula in a patient with HIV. The authors rightly stress that
simple but accurate steps are needed if good results are to be obtained.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests
Review for 10.1186/1471-230X-10-17 (2010)

Reviewer's report
Title:Carcinoid tumor of the minor papilla in complete pancreas divisum
presenting as recurrent abdominal pain
Version: 2Date:22 December 2009
Reviewer: Takeru Wakatsuki
Reviewer's report:
It is very rare and interesting case report, and discussion is reasonable.
Author said that the concomitant pancreas divism led to an early diagnosis
because obstruction of the minor papilla due to the carcinoid tumor. However the
relationship between carcinoid tumor and dorsal pancreatic duct is unclear.
Minor Essential Revisions
1: Please show the detail relationship between carcinoid tumor and dorsal
pancreatic duct by histopathologically or EUS finding.
2: About Fig.3, sentence and Fig. labels are disagreement. Please confirm again.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-10-17 (2010)

Reviewer's report
Title:Carcinoid tumor of the minor papilla in complete pancreas divisum
presenting as recurrent abdominal pain
Version: 2Date:23 December 2009
Reviewer: Takayuki Aimoto
Reviewer's report:
This paper demonstrates a very rare case with carcinod tumor of the minor
papilla in complete pancreas divisum. Thi is a very interesting case report and
well-described. So this paper is worth publishing in this journal. However, there
are some points that the autohr should revise before final decision.
Minor essential revisions
1.In this paper, although EUS was reported to be useful for detecting a small
tumor of the minor papilla, there were no EUS images of the carcinoid tumor in
this paper. This author should add this figure.
2.The author confused the explanation of Figure 3A,B with these images. Correct
figure legends and the text.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-10-16 (2010)

Reviewer's report
Title:A candidate probiotic with unfavorable effects in subjects with irritable
bowel syndrome: a randomized controlled trial
Version: 1Date:15 June 2009
Reviewer: Filippo Cremonini
Reviewer's report:
Comment to Authors
Ligaarden and colleagues report on the lack of efficacy and comment on
potential unfavorable effects of L.plantarum MF1298 in a randomized,
double-blind, placebo crossover trial of 16 IBS patients. The methods are
rigorous and the study is performed in an evolving area of experimental
treatment. My concerns are as follows:
1. The Authors report on “aggravation” of symptoms. While one hand I feel it
would be more cautious to report on the lack of benefit, assuming this study is
appropriately powered, I believe that, when comparing the results to the baseline,
there is no actual “aggravation” or significant negative change that can justify the
hype put on the “potential unfavorable effects” of a this probiotic species
2. When found, the significant differences are quite small, and I question what
the clinical relevance of these would be, when we have a 2-pts. Difference in a
scale with a range of 14.
3. The differences in composite scores are not mirrored by clear, understandable
effects on individual symptoms/bowel habit changes. This is possibly due, as in
part the Authors acknowledge, to the heterogeneity of the sample in terms of
bowel habit predominance. This lack of a specific symptom to point to weakens
the argument of the “toxicity” of the probiotic in question, as one would have to
understand first what would specifically define such toxicity.
4. The length of treatment is too short to overcome the fluctuations in symptoms
which are typical in IBS patients, thus limiting the internal validity of the trial itself
5. Which one of the “ideal" characteristics of a probiotic is more useful to target
putative pathophysiological determinants of IBS? The superficial reader might be
“tricked” into believing that “The Best Probiotic” we have actually worsens IBS,
which is a risky argument. All I see here is that a probiotic that showed promise
in the lab failed to improve IBS in a small, crossover trial. Considering the size
needed in IBS clinical trials to show significant effects on symptoms, global relief
(see classical studies on tegaserod, alosetron, etc) this way of interpreting results
poses the risk of throwing away the baby with the water.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-16 (2010)

Reviewer's report
Title:A candidate probiotic with unfavorable effects in subjects with irritable
bowel syndrome: a randomized controlled trial
Version: 1Date:20 August 2009
Reviewer: Joanna Stewart
Reviewer's report:
The crossover design of this study is appropriate and the analysis, while simple
is adequate given the assumptions of carryover and period effect were
investigated separately and little evidence was found of an effect of either.
Minor essential revisions.
When reporting results 3 out of the 4 variables displaying small p values are
reported in the text, however stool consistency is not mentioned. There needs to
be consistency it what is reported. However, as IBS score is constructed form the
7 symptom scores and diarrhea from the 2 stool characteristic scores these tests
are certainly all very related. It would be preferable to not report the p values for
the individual items from which these 2 composite measures have been
constructed. ie remove the p values for all but weeks of relief, IBS score and
diarrhoea (but retain the other columns for these variables)
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-16 (2010)

Reviewer's report
Title:A candidate probiotic with unfavourable effects in subjects with irritable
bowel syndrome: a randomised controlled trial
Version: 2Date:12 November 2009
Reviewer: Joanna Stewart
Reviewer's report:
Discretionary. The authors have complied with my suggestion of not quoting the
individual item p values in the text because of their correlation with the combined
scores. However I had also suggested these p values (ie for the individual items)
would be better removed from table 1 while leaving the other 3 columns for these
items. This has not been done and I am prepared to leave it to the discretion of
the authors.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-16 (2010)

Reviewer's report
Title:A candidate probiotic with unfavourable effects in subjects with irritable
bowel syndrome: a randomised controlled trial
Version: 2Date:2 December 2009
Reviewer: Filippo Cremonini
Reviewer's report:
No further revision advised
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-15 (2010)

Reviewer's report
Title:IkappaBalpha polymorphism at promoter region (rs2233408) influences the
susceptibility of gastric cancer in Chinese
Version: 1Date:13 November 2009
Reviewer: Mauro Magnani
Reviewer's report:
Major Compulsory Revisions
In this study, the athors investigate the association of a genetic variant at
promoter region of IkB -alpha gene and the susceptibility of gastric cancer. In
addition, association with patient outcome was also evaluated.
Since several polymorphisms of NFKBIA gene have been mentioned in the
introduction, the authors should explain more clearly why the rs2233408 variant
in the promoter region has been chosen among the others.
Minor Essential Revisions
The results suggest that heterozygotes and homozygotes for T allele were
associated to reduced gastric cancer risk compared to homozygotes CC, at least
for the intestinal-type. However, given the very small number of cases that were
taken into consideration for both the diffuse and the mix gastric cancer types, the
authors should not exclude the same association. In my opinion the authors
should include additional cases in this analysis.
Finally, the T heterozygotes were associated to non-cardiac gastric cancer
compared to cardiac gastric cancer. In addition, the authors could not establish
any association between rs2233408 polymorphism and patient outcome.
Discretionary Revisions
On the whole the article is clear and well structured but I suggest a language
revision.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-10-15 (2010)

Reviewer's report
Title:IkappaBalpha polymorphism at promoter region (rs2233408) influences the
susceptibility of gastric cancer in Chinese
Version: 2Date:25 January 2010
Reviewer: Laura Ottini
Reviewer's report:
The Authors have answered points sufficiently well to allow their manuscript to be
published.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-14 (2010)

Reviewer's report
Title:Prevalence of Helicobacter pylori infection among new outpatients with
dyspepsia in Kuwait
Version: 1Date:26 November 2009
Reviewer: Sonja E. E Steigen
Reviewer's report:
The paper is well written and easy to comprehend. It has a clear purpose; to
recognize the prevalence of Helicobacter pylori in dyspeptic patients. This is
important for clinical follow-up.
The relationship between HP and dyspepsia is controversial as the author’s state
in the paper, and many harbouring HP infection are non-dyspetic. In a population
based study from Norway* they reported that H. pylori infection was 10.5%
higher in women with dyspepsia than in women without dyspepsia. In contrast,
men without dyspepsia had a non-significant 6.4% higher prevalence of H. pylori
infection, than men with dyspepsia. The middle-age woman (40-49 years) with
dyspepsia in the Norwegian group seemed to have a much higher prevalence of
HP than for men (32% vs 12%). Also the younger agegroup had a higher
percentage, but not as striking. The findings from Norway should probably be
incorporated into the discussion as they have some degree of similarity.
Some small spelling mistakes.
*Changes in the prevalence of dyspepsia………… Asfeldt et al Eur J Epidemiol
2008
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-14 (2010)

Reviewer's report
Title:Prevalence of Helicobacter pylori infection among new outpatients with
dyspepsia in Kuwait
Version: 1Date:6 December 2009
Reviewer: Michael Selgrad
Reviewer's report:
1. The authors did not present data about the symptom relief or healing rates. I
wonder if the test and treat strategy is useful in clinical practice for symptom
relief?
2. A further question needs to be answered: How many patients (infected with H.
pylori) needed an upper-GI-endoscopy? Do the authors have data about the
eradications rates in the infected patients?
3. Was there a higher rate of endoscopy in the older patients (older than 50
years?)
4. Is the test and treat strategy also useful in patients older than 50 years or
would they benefit from a direct endoscopy? Detection of stomachs with atrophy
or intestinal metaplasia that require a close follow-up.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I have no competing interests to declare
Review for 10.1186/1471-230X-10-11 (2010)

Reviewer's report
Title:Combined sedation with midazolam / propofol for gastrointestinal
endoscopy in elderly patients
Version: 1Date:4 November 2009
Reviewer: Spiros Ladas
Reviewer's report:
The authors of this retrospective study compared the rate side effects of iv
sedation with midazolam/ fendanyl/propofol for GI endoscopy between elderly
patients > 70 and a younger age group. Despite that elderly patients had
significant more co-morbidity, sedation associated complications were not
significantly different between the 2 groups.
Comments
The study is well written and the analysis of the data is appropriate. However, my
feeling is that the elderly patient group received too much sedation. Did they
really need it?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-11 (2010)

Reviewer's report
Title:Combined sedation with midazolam / propofol for gastrointestinal
endoscopy in elderly patients
Version: 1Date:19 November 2009
Reviewer: Shajan Peter
Reviewer's report:
Reviewer Comments:
The authors present a retrospective study to assess the role of combined
sedation with midazolam/propofol in elderly patients and concluded that
compared to the younger age group, elderly patients required a lower dose of
combination sedation for gastrointestinal endoscopic procedures
Comments:
Major Compulsory Revisions
• Single center retrospective data : selection bias can’t be avoided, need to be
mentioned in limitations
• Please mention the desired level of sedation? mild, moderate
• Who administered the sedation is not clear from the methodology?
• Recovery times, quality of recovery, and satisfaction with care are not recorded
as this may be important when administering a benzodiazepine, even though a
fixed dose was administered in this study and this should be mentioned in the
limitations.
• The mean dose of combination will vary with each procedure, the authors have
provided and overall total dose required. It would be nice to provide these details
too in the table.
• Clearly, there are more patients with higher ASA scores in the >70 group, which
therefore would result in lower titrated doses of sedation and explain increased
sensitivity in this group.
• Though the mean doses are significantly lower in the elderly group, the range
(SD) is large in both the groups
• To prove, that combination helps in decreasing propofol levels in the elderly,
this has to be ideally compared with single sedation propofol vs. combo in the
same age group population.
• In discussion, please remove the sentence mentioning randomized studies on
sedation for cardioversion in patients with atrial fibrillation as its less relevance to
this study.
Minor Essential Revisions
• Discussion: last sentence, after thus please add coma
• Conlusion last sentence: These findings………………..
Overall Comments:
This study has been overall well done though it has its limitations as it being
retrospective in nature; it adds to the growing data to the safety profile of propofol
sedation in elderly though the dosing will be less as compared to the younger
population. Adequate training for administration will be required to handle any
events during sedation in this age group.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-10-13 (2010)

Reviewer's report
Title:The role of MR imaging in detection of hepatic iron overload in patients
with cirrhosis of different origins.
Version: 1Date:12 August 2009
Reviewer: Paul E Sijens
Reviewer's report:
The topic is interesting and the size of the study is good (44 patients with liver
cirrhosis of whom 20 with elevated iron concentration according to non-MRI
methods used as gold standard).
Major Compulsory Revisions:
My problem with the design of this study is that the results of MRI and the
alternative methods are presented in a semi-quantitative manner. Why didn’t the
authors use a method such as that of Gandon et al. (refs 10,11) to come up with
the liver iron concentrations or T2* values according to MRI to be compared with
the liver iron concentrations or other quantitative measures, such as the blood
ferritin concentrations, determined by the reference methods?
As correctly stated in “background” the efficacy of some of the reference
methods suffers from relatively low sample representativity in patients with liver
cirrhosis. So how good are they as gold standard, anyway?
The selection of liver volumes of interest is problematic. In Fig.1 a large central
liver area is used, but in Fig.2 and three other areas appearing to be selected as
dark as possible. This all looks extremely biased to me. To add to the confusion,
in the M&M description the authors speak of “randomly” selecting very small
VOIs away from big blood vessels. I would have preferred the analysis of a large
liver area, standardized to approximate the volume depicted in Fig.1.
To obtain a potentially publishable study, all MRI data should be reanalyzed and
be compared with the most quantitative amongst the alternative methods used,
preferably not the Scheuer’s grading scale. In order to assess whether of not
cirrhosis makes small-liver-sample methods less representative, it would be
necessary to include patients without cirrhosis in the study. Elsewhere it has
been shown that in a subgroup of patients without inflammation the correlation of
ferritin with MRI-Iron content was better than in all patients combined (Olthof et
al. MRI 2007;25:228). In analogy to that, I would expect that here the
histology-MRI correlation would be worse for cirrhotic patients than for
non-cirrhotic patients.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-13 (2010)

Reviewer's report
Title:The role of MR imaging in detection of hepatic iron overload in patients
with cirrhosis of different origins.
Version: 1Date:28 September 2009
Reviewer: Vincenzo Positano
Reviewer's report:
The authors apply the signal/ratio technique for evaluation of liver iron overload
in patients with cirrhosis. The paper is generally reasonably well written and
conclusions adequately supported by the data. Seems that the main novelty in
the paper is the feasibility of the signal/ratio technique in cirrhotic patients. This
point should be stated more clearly.
Signal/ratio technique is a well established technique (Gandon, Lancet 2004) and
a good correlation with quantitative iron content was demonstrated. However,
this technique today is almost completely overcome by quantitative techniques,
consisting of the direct calculation of T2 or T2* by fitting an appropriate decay
model to the average signal intensity at various echo times ( St Pierre Blood
2005, Wood Blood 2005, Anderson EHJ 2001, Positano MRI 2009, etc).
Calibration curves were evaluated for quantitative iron overload assessment for
these multiecho SE or GRE approaches and allows direct conversion of T2 or
T2* in quantitative iron content.
Authors should acknowledge this limitation in the discussion. Reference to
multi-echo techniques should be added to the introduction.
In conclusion, the study seems to involve an outdated technique and may be of
limited interest.
Detailed comments:
Major Compulsory Revisions:
Abstract:
Background: Changes in MR signal are an indirect consequence of change of
relaxation times T2 and T2*, that can be directly measured.
Methods: “20 patients were......”. This sentence should be moved in results
sub-section because it represents results of biopsy.
Introduction:
Please report recent results in iron overload assessment by multiecho SE and
GRE sequences for quantitative assessment of T2 and T2* values in liver.
Minor Essential Revisions:
Methods:
How patient were chosen? All patients with cirrhosis? Random sampled? Please
elaborate.
“The MR image analysis of iron overload .. was quantitative”. Really, quantitative
analysis should involve tissue characterization by T2 value measurement. The
proposed method is semi-quantitative.
Results and Discussion
“The live cirrhosis was diagnosed ...”. Off course because you selected only
patients with cirrhosis in the methods. Simply state “All patients were
classified....”
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-10-13 (2010)

Reviewer's report
Title:The role of MR imaging in detection of hepatic iron overload in patients
with cirrhosis of different origins.
Version: 2Date:16 December 2009
Reviewer: Paul E Sijens
Reviewer's report:
The methodology used remains weak (semiquantitative only) and outdated, but
otherwise the authors did a good job in their revision.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-13 (2010)

Reviewer's report
Title:The role of MR imaging in detection of hepatic iron overload in patients
with cirrhosis of different origins.
Version: 2Date:30 December 2009
Reviewer: Vincenzo Positano
Reviewer's report:
Authors have responded to all my requests.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-12 (2010)

Reviewer's report
Title:Assessing factors influencing return back to work after cholecystectomy: a
qualitative research
Version: 2Date:20 September 2009
Reviewer: Reza Malekzadeh
Reviewer's report:
I have reviewed the manuscript and the comments by both reviewers and I
recommend that this manuscript be accepted after revisions for BMC
Gastroenterology ;therefore you can ask the authors to
re-focus their manuscript to provide the qualitative data.
Best regards
Reza Malekzadeh M.D, AGAF.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I have no competing interests'
Review for 10.1186/1471-230X-10-12 (2010)

Reviewer's report
Title:Assessing factors influencing return back to work after cholecystectomy: a
qualitative research
Version: 2Date:20 October 2009
Reviewer: David I Watson
Reviewer's report:
I would tend to support publication, and the reviewer who supports this view. I
would make the following comments; however.
The terminology "Company Physician" is new to me. I suspect this a Netherlands
specific role. This highlights the fact that it will be difficult to generalise the
findings outside the Netherlands. The discussion should reflect the fact that this
study is specific to the Dutch health system, and that different patterns of care
and different systems in other countries could produce different outcomes.
Review for 10.1186/1471-230X-10-9 (2010)

Reviewer's report
Title:Prostaglandin E2-induced colonic secretion in patients with and without
colorectal neoplasia
Version: 3Date:8 December 2009
Reviewer: Markus Sjöblom
Reviewer's report:
The authors’ response is acceptable. The revised manuscript is clearer and the
quality is improved. The reviewer has no further comments.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-9 (2010)

Reviewer's report
Title:Prostaglandin E2-induced colonic secretion in patients with and without
colorectal neoplasia
Version: 3Date:15 December 2009
Reviewer: Jens Leipziger
Reviewer's report:
I have no further comments
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-9 (2010)

Reviewer's report
Title:Prostaglandin E2-induced colonic secretion in patients with and without
colorectal neoplasia
Version: 3Date:19 December 2009
Reviewer: Markus Bleich
Reviewer's report:
Thank you for careful revision of the manuscript.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-10-10 (2010)

Reviewer's report
Title:Inflammatory myoglandular polyp of the cecum: case report and review of
literature
Version: 1Date:19 October 2009
Reviewer: Shoji Hirasaki
Reviewer's report:
Major Compulsory Revisions
This is a case report of inflammatory myoglandular polyp (IMGP) of the cecum..
A quality of endoscopic and microscopic photographs is too poor to diagnose.
And this report has some serious concerns.
Major
1. In abstract, authors described that IMGPs must be considered different from
other nonneoplastic polyps of the large bowel. What kinds of nonneoplastic
polyps of the large bowel ? Inflammatory fibroid polyps or juvenile polyps etc?
2. Endoscopic view should be changed. A higher quality one. It is unclear wheter
this polyp is pedunculated and has partially ulcerated surface or not.
3. Histological findings of IFP (inflammatory fibroid poyp) and IMGP are different.
If authors claim that histological diagnosis of biospsy specimen is IFP, authors
should show histological feature of the biopsy specimen.
4. Why did authors think that anemia of this patient was due to this polyp? This
polyp did not reveal evident bleeding.
5. Which is the cause of anemia, autoimmune haemolytic anemia or this polyp?
6. Histological findings (figure 3) should be changed. A higher quality one which
reveals 1) inflammatory granulation tissue in the lamina propria; 2) proliferation of
smooth muscle from the muscolaris mucosae; 3) hyperplastic glands with
occasional cystic dilatation.
7. Authors described that IMGP must be differentiated from other non-neoplastic
polyps such as inflammatory cap polyps (ICP), inflammatory cloacogenic polyps,
polyps secondary to mucosal prolapse syndrome (MPS) and polypoid prolapsing
mucosal folds of diverticular disease in discussion. Don’t you think IMGP must be
differentiated from IFP?
8. In your institute, the large polyp (over 4cm?) is recommended to resect by
surgery? You could resect this polyp by endoscopic resection (including
piecemeal resection) because the biopsy specimen was diagnosed benign and
endoscopic findings did not reveal malignant findings. Couldn’t you avoid
surgery?
Minor
1 It must be considered different from other non-neoplastic polyps for its clinical
and hystopathological features #It must be considered different from other
non-neoplastic polyps for its clinical and histopathological features
2 Figure legends. In figure 2, authors should describe about IMGP feature.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests' below
Review for 10.1186/1471-230X-10-10 (2010)

Reviewer's report
Title:Inflammatory myoglandular polyp of the cecum: case report and review of
literature
Version: 1Date:27 October 2009
Reviewer: gabriel becheanu
Reviewer's report:
MAJOR COMPULSORY REVISIONS
1. The text (abstract) does not specify whether other lesions were identified on
colonoscopy, while FIGURE LEGENDS NUMBER 2 reveals a “little
adenomatous polyp below the IMGB, next to the ileo-cecal valve”; what is the
size of this polyp? And the grade of dysplasia?
2. Figures are incomplete, from a histopathological point of view:
- FIGURE LEGENDS 3 does not specify the type of IHC (what type of anti-body
was used? What method? Dilution? What was the magnification?)
- FIGURE 3 does not provide the characteristics of the myoglandular
inflammatory polyp. 1 -2 low power, HE stained images containing the
histological characteristics of the inflammatory myoglandular polyp would be
necessary; based only on Figure 3, from a personal point of view, there could be
an inflammatory polyp present (?) – the image is not conclusive for this type of
polyp.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-10 (2010)

Reviewer's report
Title:Inflammatory myoglandular polyp of the cecum: case report and review of
literature
Version: 2Date:4 December 2009
Reviewer: Shoji Hirasaki
Reviewer's report:
I think the authors have responded to my comments and questions. I would
however recommend linquistc revision by someone native to the English
language.
There are some mistakes in this manuscript, for example, in Discussion, third
paragraph, peduncolated (88.3%)# pedunculated (88.3%). In Discussion, fourth
paragraph, “As their experience is limited to 10 patients more cases are
required”#“As their experience is limited to 10 patients, more cases should be
studied”.
In Discussion, fifth paragraph, authors described that “Juvenile polyps do not
show###in young age.” and “Inflammatory fibroid polyp (IFP) mostly occur
###plasma cells and eosinophils.” But juvenile polyps occur in middle or old age.
Authors should describe about endoscopic characteristics of colonic IFP and
juvenile polyps. It is difficult to distinguish juvenile polyps from IMGPs by
endoscopic findings. Also, it is difficult to distinguish red colonic IFPs from IMGPs
by endoscopic findings. Refer this paper (Hirasaki S, et al. Inflammatory fibroid
polyp occurring in the transverse colon diagnosed by endoscopic biopsy. World J
Gastroenterol 2007 ;13:3765-6) and add related papers to your References.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests
Review for 10.1186/1471-230X-10-10 (2010)

Reviewer's report
Title:Inflammatory myoglandular polyp of the cecum: case report and review of
literature
Version: 2Date:22 December 2009
Reviewer: gabriel becheanu
Reviewer's report:
Major Compulsory Revisions
None
Minor Essential Revisions
None
Discretionary Revisions
The histological and immnunohistological pictures (figure 3, a - d) are not
convincing (in my opinion) for the positive histological diagnosis of an
inflammatory myoglandular polyp: the muscular hyperplasia is not prominent (anti
- actin reaction reveals very well the walls of the vessels, but few muscular
fibers), as well as glandular hyperplasia; only cystic dilatations of the glands are
obvious. Around the glands (dilated or not) there is no obvious muscular
hyperplasia.
In the same time, there is too much inflammation, diffuse, with granulation tissue,
superficial and profound.
Again, in my opinion, these figures are more consistent for the diagnosis of an
inflammatory polyp versus juvenile polyp.
Some other pictures in the literature are not concludent for the diagnosis of
IMGP.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-10-6 (2010)

Reviewer's report
Title:Anticoagulant therapy for nodular regenerative hyperplasia in a
HIV-infected patient
Version: 2Date:24 September 2009
Reviewer: abdul nadir
Reviewer's report:
All comments are major compulsory
1. The authors write in discussion that perhaps changing therapy from DDI to
another ARV resulted in improvement in portal hypertension. The exposure of
ARV medication to this patient needs to be clarified. The authors should provide
more history of ARV exposure including start date of ARV therapy, changes in
the ARV regimen over time and how that correlated with improvement of portal
hypertension. It is entirely possible that reversal of portal hypertension occurred
as a result of ARV therapy and not anticoagulation therapy.
2. This patient had peritoneal tuberculosis. Peritoneal tuberculosis is another
cause of ascites. The authors need to clarify the status of peritoneal TB. They
should also outline the relevant therapy used for TB and the timeline of use of TB
medications. I have not come across TB medications causing NRH and authors
should state that it is not an etiology particularly if the timeline between TB
therapy and symptoms was simulataneous. It will be prudent to include ascitis
fluid analysis as well to show that it was consistent with portal hypertension
based on a SAAG ratio.
3. Please provide the work up for liver disease in the case report. what were the
hepatitis viral serologies. Also was autoimmune work up done including ANA and
quantitative immunoglobulins. Autoimmune diseases have been associated with
NRH as well.
4. The status of HIV disease should also be mentioned with T cell count and HIV
viral load as this is pertinent as well.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests.
Review for 10.1186/1471-230X-10-6 (2010)

Reviewer's report
Title:Anticoagulant therapy for nodular regenerative hyperplasia in a
HIV-infected patient
Version: 3Date:16 November 2009
Reviewer: Vincent Mallet
Reviewer's report:
Major Compulsory Revisions: None
Minor Essential Revisions: in the Introduction is written "The central veins are
obliterated by the parietal thickening of the portal veins reducing the vascular
lumen and sinusoids are dilated." It is the obliteration of the small portal veins
that leads to the atrophy of the supplied acinus and to the hypertrophy of the
adjacent acinus. Sinusoidal dilatation is secondary to the increase in blood flow
(and not to congestion because of venous outflow blockage). Please check the
review of Reshamwala et al.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
None related to this report.
Review for 10.1186/1471-230X-10-6 (2010)

Reviewer's report
Title:Anticoagulant therapy for nodular regenerative hyperplasia in a
HIV-infected patient
Version: 3Date:24 November 2009
Reviewer: abdul nadir
Reviewer's report:
There are no further revisions
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-10-7 (2010)

Reviewer's report
Title:The Potential Therapeutic Effect of Melatonin in Gastro-esophageal Reflux
Disease
Version: 3Date:29 September 2009
Reviewer: Stanis&#322;aw Konturek
Reviewer's report:
Major Compulsory Revisions:
The data enclosed suggest that melatonin could inhibit gastric acid secretion in
humans with GERD but no secretory data have been included. Furthermore, the
drop of pH could result in the rise in gastrin release due to reduction in antral
autoregulation of gastric acid secretion and the rise of gastrin release. Again
plasma gastrin level was not measured in this report. Most important it is not
clear from this study whether functional improvement in GERD was also
accompanied by the adequate changes in histology of esophageal mucosa. I
would request the addition of the histological data of esophageal mucosa in
patients with GERD before and after treatment with melatonin.
Minor Essential Revisions:
Melatonin is a potent antioxidant acting, at least in part, via COX-prostaglandin
and NOS-nitic oxide systems (ref 27), that should be measured in esophageal
mucosa before and after melatonin therapy to determine the mechanism of
antiinflammatory action of this indole.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests' below. If your reply is yes to any,
please give details below.
Review for 10.1186/1471-230X-10-7 (2010)

Reviewer's report
Title:The Potential Therapeutic Effect of Melatonin in Gastro-esophageal Reflux
Disease
Version: 5Date:12 October 2009
Reviewer: Stanis&#322;aw Konturek
Reviewer's report:
Major Compulsory Revisions:
I read this revised paper, but, unfortunately, found that none of my major
compusatory revisions has been seriously considered and no additional
requested results have been included into the revised paper. (1) I requested that
gastric acid secretion should be measured in patients treated with melatonin
alone and with melatonin combined with gastric inhibitors. The answer was that
measurement of esophageal pH should be sufficiently refelect the decrease in
gastric HCl secretion by these drugs. (2) Since gastrin is potent contrictive agent
of the LES, the plasma levels of gastric should be measured, particularly that the
blood samples were taken for measurement of plasma levels of melatonin. No
data with plasma gastrin have been included. (3)I asked to include the data with
esophageal mucosal histology to see whether melatonin has direct ameliorating
effect on the inflammatory changes of esophageal mucosa. This request was
considered for future study (!).
Minor Essential Revisions:
Melatonin as potent antioxidant is known, at least from experimental studies in
animals, to affect the COX-PG and NOS-NO systems in the esophageal mucosa,
but again this was considered as future project of the study. Based on the facts
that actually none of my requests has been answered by including appropriate
data I would not recommend this the paper in the present for the publication in
BMC Gastroenterology Journal.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I do not have any non-financial competing interests in relation to this paper.