JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/1471-230X-13-163 (2013)

Reviewer's report
Title:Chemopreventive effects of berberine on intestinal tumor development in
APCmin/+ mice
Version: 2Date:3 June 2013
Reviewer: Michael Wargovich
Reviewer's report:
The manuscript reports the chemopreventve effects of berberine in the ApcMin
mouse model for intestinal cancer. There are problems with the data
presentation, omission of aspects of methodology, and language.
Methodology:
1) Source of berberine is not given.
2). Please describe in more detail how "random" fields for IHC quanititation were
chosen. Was the evaluator blinded to treatment?
3). How was protein extracted for westerns? Did this include epithelial and
non-epithelial cells?
4). Why do the authors use Ki-67 as loading control? Western blotting analysis,
line 6. This must be a mistake as it is not a constantly expressed protein.
Major Compulsory Revision
Data presentation:
1).Table 1; there is no data presentation by histological grade. I assume these
were all benign adenomas?
2). Figure 1- the authors measured cyclin D1 and cleaved caspase 3 but no data
is presented.
3). Figure 2- the westerns do not support the authors conclusions. It looks like
b-catenin was only marginally down-regulated; no change in KI-67, no change in
p-EGFR!
Language
The paper contains grammatical errors.Especially in the references cited.
Level of interest: An article of limited interest
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
Review for 10.1186/1471-230X-13-163 (2013)

Reviewer's report
Title:Chemopreventive effects of berberine on intestinal tumor development in
APCmin/+ mice
Version: 3Date:20 August 2013
Reviewer: Kshipra Singh
Reviewer's report:
Authors clarified all the concerns and manuscript is now acceptable for
publication.
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.
Review for 10.1186/1471-230X-13-163 (2013)

Reviewer's report
Title:Chemopreventive effects of berberine on intestinal tumor development in
APCmin/+ mice
Version: 3Date:21 August 2013
Reviewer: Michael Wargovich
Reviewer's report:
MInor essential revisons:
(a) Standardize format of reagent suppliers/manufacturers in the methodology
(b) Check that units are included (e.g. -80°C instead of -80)
(c) Check grammatical errors (subject-verb agreement, tenses, spelling, use of
articles)
(d) Figures:
a. 2, 3, 4: Include scale bar
b. 3, 4: Show graphical quantification beside the WB instead of just placing
values within the text
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
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-13-160 (2013)

Reviewer's report
Title:Prediction of symptomatic improvement after exposure-based treatment for
irritable bowel syndrome.
Version: 1Date:27 June 2013
Reviewer: Dennis Ougrin
Reviewer's report:
This article is well written with sound methodology and good English (a few
inevitable typos need correcting). Statistical analysis appears appropriate.
Discussion is written well and some of the limitations are discussed. However,
the article does not significantly contribute to the knowledge in the field. There
are few significant findings and it may be that the sample size is the main culprit.
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
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:
None
Review for 10.1186/1471-230X-13-160 (2013)

Reviewer's report
Title:Prediction of symptomatic improvement after exposure-based treatment for
irritable bowel syndrome.
Version: 1Date:19 July 2013
Reviewer: Wijnand Laan
Reviewer's report:
Major Compulsory Revisions
1. The following line in the introduction (?), page 5 is not clear to me:
As almost no studies of psychological treatment of IBS have used the presence
of psychological distress as inclusion criteria<….>. This has allowed for several
studies where measures of psychological distress have been used as predictors
of outcome after psychological treatment.
What are the authors trying to say, what has allowed for several studies?
2. The various ‘Measures’ sections on pages 9 to 12 are too long. Please list
them and add a reference for the readers who are interested in the individual
Chronbach alphas and possible scores but do not add all this information to the
body of the text.
3. A lot of participants suffer from co-morbid psychiatric disorders, approximately
71% ((15+39)/76=71%) of the participants suffered from a serious psychiatric
disorder. Given this information, how valid are the IBS diagnosis? Where they
made using Rome–III diagnostic criteria? Without proper diagnostic criteria I fear
there might be many ‘false positive’ patients suffering from IBS in the sample.
4. Many papers have yet been written on the subject, see the introduction:
We have found four studies that reported a positive association <....>. Eight
studies have reported the reverse association<....>. Finally, three studies
reported no association <....>.
The authors even state:
Thus, the results in this study largely follow the same pattern of previous
prediction studies in the IBS field, with no variable appearing as a clear and
consistent predictor of treatment outcome.
The question arises therefore what this study adds the literature, why should it be
published?
5. In the conclusion the authors state that:
This is information of high clinical relevance as it supports the use of ICBT for a
wide range of IBS patients.
I think this is an overstatement, also given point 6.
6. The authors did not write a review article but nevertheless reference 78
articles. I think this is too much for an original research article.
Minor Essential Revisions
1. The data was collected in a previously published RCT. Please add the Trial
Register number in the method sections so readers can quickly assess the aim
and methods as originally formulated.
2. In the ‘Participants’ section: it is not clear why only 93% of the original study
subjects were included.
3. Have the paper read by a native English speaker. The paper is not always
easy to read.
Discretionary Revisions
1. Please add line numbers when submitting an article, this makes it easier for a
reviewer to point to a phrase that is not clear.
2. The ‘Introduction’ heading is missing.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
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-13-160 (2013)

Reviewer's report
Title:Prediction of symptomatic improvement after exposure-based treatment for
irritable bowel syndrome.
Version: 2Date:11 October 2013
Reviewer: Wijnand Laan
Reviewer's report:
Major Compulsory Revisions:
None
Minor Essential Revisions:
1. Trial registration should not go into the abstract section, now it appears like the
paper describes a trial. Just add it to the methods section like this: This study
included 79 self-referred participants with a diagnosis of IBS who had
participated in a randomized controlled study (ClinicalTrials.gov: NCT01171053)
of ICBT for IBS, where they were randomized to either treatment (n=39) or
waiting list control (n=40) for 10 weeks [27].
2. The 'sentence' starting on line 2, page 7 does not make any grammatical
sense: 'Trial registration ClinicalTrials.gov NCT01171053'. Please rephrase it so
it contains at least one verb.
3. Line 24, page 16: The sentence reads like the main conclusion of the paper is
the fact that study is important (We believe the findings of the present study to be
important). I think the conclusions should be related to the results, not to whether
the study itself is important or not).
4. I feel the conclusion of a paper should be limited to a few lines only as is it
should present only the conclusion. Now the authors present a discussion within
the conclusions (line 6 and 7, page 17: However, it is possible that (....)). I would
strongly suggest to limit the number of lines in the conclusion section to a
maximum of five.
Discretionary Revisions:
5. Line 11 page 5: GSA should not be included in the [brackets] of the reference
but (get their own). This is repeated on further on in the paper several times, I do
not think is proper referencing to include the abbreviation in the citation brackets
as this is commonly done with author names. I will not make further remarks
regarding this.
6. The sentence starting on line 12, page 6 is obsolete given the sentence
starting on line 6 of the same page.
7. Line 12 page 7 (and throughout the whole paper): Table is not to be written
with a capital T.
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-13-159 (2013)

Reviewer's report
Title:Influence of NADPH oxidase on inflammatory response in the primary
intestinal epithelial cells from patients with ulcerative colitis
Version: 1Date:24 February 2013
Reviewer: Fabian Schnitzler
Reviewer's report:
1. More information about the activity of the IBD would have been helpful:
Endoscopic scoring, e.g. Mayo score and histologic scoring of the biopsies in the
19 patients with UC should be given in the paper.
2. The authors mentioned that patients receiving immunosuppressive therapy or
treated surgically were excluded from the study. Was there also steroid treatment
included? This should clarified in the patients and methods section of the paper.
3. Did the patients receive 5-ASA treatment? 5-ASA seem to reduce the
oxidative DNA damage in animal models. This should be addressed in the paper.
4. Furthermore no information was provided with respect to iron supplementation.
Therapeutic iron can increase iron-mediated oxidative stress in ulcerative colitis.
This information would be helpful.
5. Stimulation of colonic epithelial cells with bacterial endotoxin LPS significantly
increased the level of TNF- # and generation of ROS related to NADPH oxidase
activity in the colonic epithelial cells of UC patients.
NOD2/CARD15 seem to play a minor role in UC patients as seen in several
genetic studies because of low incidence of NOD2/CARD15 mutations in UC
patients. However, in this study information about the NOD2/CARD15 status of
the patients would have been interesting, as mutations in the NOD2/CARD15
gene have an influence on the LPS induced immune response.
6. Also information about TLR4 mutations would have been interesting. Toll-like
receptors (TLRs) are also linked to the recognition of pathogen-derived products,
including LPS and therefore mutations in the TLR4 receptor might have an
influence on the results of the presented study.
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 declare that I have no competing interests
Review for 10.1186/1471-230X-13-159 (2013)

Reviewer's report
Title:Influence of NADPH oxidase on inflammatory response in the primary
intestinal epithelial cells from patients with ulcerative colitis
Version: 1Date:15 June 2013
Reviewer: Priyanka P Trivedi
Reviewer's report:
Major Compulsory Revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interestes.
Review for 10.1186/1471-230X-13-159 (2013)

Reviewer's report
Title:Influence of NADPH oxidase on inflammatory response in primary
intestinal epithelial cells in patients with ulcerative colitis
Version: 3Date:7 October 2013
Reviewer: Priyanka P Trivedi
Reviewer's report:
The quality of the manuscript has now improved.
Level of interest: An article whose findings are important to those with closely
related research interests
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-13-157 (2013)

Reviewer's report
Title:Clinical Impact of a Gluten-Free Diet on Health-Related Quality of Life in
Fibromyalgia plus Irritable Bowel Syndrome Patients with Underlying Celiac
Disease
Version: 2Date:17 June 2013
Reviewer: Gabrio Bassotti
Reviewer's report:
Major Compulsory Revision
altthough this paper shows some interesting points, it also features a major flaw,
in that only Marsh3 CD patients were considered. Since there is presently ample
evidence that even lesser degrees of mucosal involvement (i.e., microscopic
enteritis) are associated with significant impairment of (micro)nutrients, the
authors should report all the various degrees of Marsh-Oberhuber classification
they found, with the associated biochemical abnormalities and the response to
GFD.
Minor Essential Revisions
how were the duodenal biopsy assessed, plòease give details, since this is
extremely important in the evaluation of CD patients
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Not suitable for publication unless extensively edited
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-13-157 (2013)

Reviewer's report
Title:Clinical Impact of a Gluten-Free Diet on Health-Related Quality of Life in
Fibromyalgia plus Irritable Bowel Syndrome Patients with Underlying Celiac
Disease
Version: 2Date:26 June 2013
Reviewer: fabiana zingone
Reviewer's report:
The authors report the effectiveness of the GFD on seven celiac patients with
IBS and fibromyalgia.
The paper is well written and the question posed by the authors well defined.
Among the study population composed of 229 IBS subjects (104 of these with
FMS), identified according to the inclusion and exclusion criteria, the authors
focalise their analysis on the seven patients with celiac disease detected during
the 6 years of the study. No information is reported on the other subjects.
Although the results on the effectiveness of the GFD on the IBS and fibromyalgia
in these celiac patients are statistically significant and relevant from a clinical
point of view, the sample size is too small and has a poor statistical power.
The authors report many findings in the tables and figures, but they do not
efficiently explain them in the result session; some findings are instead reported
in the discussion session.
Major comments:
1. The title should be changed reporting the number of celiac patients
considered: “Clinical Impact…. in seven celiac patients …”;
2. The introduction should focalize more on the celiac disease and on the
previous literature, reporting its association with IBS and fibromyalgia;
3. The methods should contain a better explanation of the tests and scales used
(ie FIQ, HAQ, SF36);
4. Table 1 and 2 should be removed and the results summarized in the text.
Considering the reduced number of patients, the authors could give a detailed
presentation of each of them in terms of symptoms and blood findings;
5. The results session should be improved with a better explanation of Table 3
and of Figures 1 and 2.
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-13-157 (2013)

Reviewer's report
Title:Clinical Impact of a Gluten-Free Diet on Health-Related Quality of Life in
Seven Fibromyalgia Syndrome Patients with Associated Celiac Diseasw
Version: 4Date:17 August 2013
Reviewer: fabiana zingone
Reviewer's report:
even though the study has been improved I believe the authors should increase
their study population and improve the study design before publication.
Level of interest: An article of limited interest
Quality of written English: Not suitable for publication unless extensively edited
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-13-158 (2013)

Reviewer's report
Title:Comfort, safety and quality of upper gastrointestinal endoscopy after 2
hours fasting: a randomized controlled trial
Version: 1Date:7 July 2013
Reviewer: mandana rafeey
Reviewer's report:
the question posed by the authors was well defined.
the methods are appropriate but didnot well described.
what about standard meal that given to all patients before endoscopy.
The outcome variables can be added were: endoscopic
visibility, pH of gastric content, the number of patients with fluid in the gastric
fundus.
The manuscript adhere to the relevant standards for reporting .
The discussion must be shorter .
The writing was acceptable
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:
NO
Review for 10.1186/1471-230X-13-158 (2013)

Reviewer's report
Title:Comfort, safety and quality of upper gastrointestinal endoscopy after 2
hours fasting: a randomized controlled trial
Version: 1Date:14 July 2013
Reviewer: Arjuna De silva
Reviewer's report:
The authors need to include in the study that at least two previous studied have
looked at this question. This is clearly not the first study.
Also the pH of the fluid needs to be checked as it is important.
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.
Review for 10.1186/1471-230X-13-158 (2013)

Reviewer's report
Title:Comfort, safety and quality of upper gastrointestinal endoscopy after 2
hours fasting: a randomized controlled trial
Version: 2Date:12 October 2013
Reviewer: Arjuna De silva
Reviewer's report:
The authors have made the necessary changes and have accepted the
limitations of the study.
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.
Review for 10.1186/1471-230X-13-158 (2013)

Reviewer's report
Title:Comfort, safety and quality of upper gastrointestinal endoscopy after 2
hours fasting: a randomized controlled trial
Version: 2Date:14 October 2013
Reviewer: mandana rafeey
Reviewer's report:
noting
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:
noting
Review for 10.1186/1471-230X-13-156 (2013)

Reviewer's report
Title:Limited utilization of serologic testing in patients undergoing duodenal
biopsy for celiac disease
Version: 2Date:15 May 2013
Reviewer: PAOLA IOVINO
Reviewer's report:
In this paper, Wiland et al. retrospectively evaluate the use of celiac serology in a
cohort of patients undergoing endoscopy who had been evaluated for duodenal
biopsy. Although authors are aware that guidelines suggest, in presence of a
clinical suspect of celiac disease, to perform sampling after/along with serological
tests, their conclusions were that most duodenal samples has been sent without
a prior evidence of positive tests that is in turn an evaluation of the adherence of
their institution to guidelines
Comments:
There are several missing information on the biopsy sampling. Could the authors
clarified if the biopsies were oriented and how many fragments were taken from
each patient and from which part of duodenum? In order to reduce confounding
factors, I would also suggest to use a standardized classification to categorize
duodenal histology (e.g. modified Marsh or Corazza Villanacci Classifications).
At the end of the introduction (Page 4), the authors state that they
“retrospectively examined the utilization of celiac serology in a cohort of patients
who had been sent for duodenal biopsy”. It is relatively unclear if the authors
focus their work only on the low adherence of their institution to published
guidelines (data that is already known in literature, Parakkal D. et al Do
gastroenterologists adhere to diagnostic and treatment guidelines for celiac
disease? J Clin Gastroenterol. 2012) or also on the presence of other diseases in
non duodenal samples (page 5) regardless of celiac serology.
As they state in the discussion, other non-duodenal histological findings are
common in CD patients, but it’s known that it is not mandatory multiple sampling.
Thus, could the authors better explain the value of those data? are they
suggesting to perform more biopsies in serological positive patients?
Next they examine the importance of “other” duodenal findings (non specific
duodenitis and partial villous atrophy and increased intraepithelial lymphocytes –
PVA IEL-) in serology negative patients. Again, could the authors please clarify
what they mean with “partial villous atrophy and increased intraepithelial
lymphocytes”? A partial villous atrophy can be classified according to Marsh
classification of CD lesions, as modified by Oberhuber et al, as type 3a lesion
(e.g. destructive lesion, characterized by mild villous flattening, with an increase
of IEL greater that 40 per 100 lymphocytes and crypt hyperplasia) or with error
sampling if the biopsies were not oriented.
I would suggest to review the paper according to the suggestions and reevaluate
more specifically their data.
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 have no competing interests
Review for 10.1186/1471-230X-13-156 (2013)

Reviewer's report
Title:Limited utilization of serologic testing in patients undergoing duodenal
biopsy for celiac disease
Version: 2Date:27 May 2013
Reviewer: Peter Green
Reviewer's report:
Major point that needs to be addressed is the failure to review and of the
pathology slides.
The ABSTRACT is misleading as only pathology reports were reviewed
We need a CONSORT flow chart of the number of patients/biopsies selected and
reviewed
Were any of the patients tested prior to being seen at the Cleveland Clinic. If this
is not known then we need that as a limitation of the study.
Why were only 161 charts reviewed? We need a chart to demonstrate where
patients were included/excluded in this study as requested above.
How was the celiac group different from the PVA-IEL group. Surely many of
these patients had celiac disease? PVA-IEL would be a Marsh IIIa celiac
classification.
How many biopsies were taken (biopsy pieces) in each group. Both according to
wheteher serologies were performed and according to diagnoses.
How many subjects had duodenal bu;lb biopsies taken? In how many were the
diagnosis made only in the bulb biopsies?
How many of the original biopsies were reviewed by the investigators?
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 have no competing interests
Review for 10.1186/1471-230X-13-156 (2013)

Reviewer's report
Title:Limited utilization of serologic testing in patients undergoing duodenal
biopsy for celiac disease
Version: 3Date:31 August 2013
Reviewer: PAOLA IOVINO
Reviewer's report:
The authors in their point-to-point reply adress all the questions arised. They also
made some changes to the manuscript as suggested.
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.
Review for 10.1186/1471-230X-13-156 (2013)

Reviewer's report
Title:Limited utilization of serologic testing in patients undergoing duodenal
biopsy for celiac disease
Version: 3Date:11 September 2013
Reviewer: Raffaella Nenna
Reviewer's report:
Major Compulsory Revisions:
1. As Authors affirmed: “ the proportion of biopsies from bulb vs. other duodenal
locations cannot be accurately determined”. This could lead to missed diagnosis.
This implies a limitation of the study that should be reported in the conclusions.
2. Introduction: page 3, lines 11-20. The three types of testing are neither
“SEQUENTIAL” steps, nor “options”. I believe that “tools” is a valid term.
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-13-153 (2013)

Reviewer's report
Title:Annular pancreas concurrent with pancreaticobiliary maljunction presented
with symptoms until adult age: case report with comparative data on pediatric
cases
Version: 1Date:7 September 2013
Reviewer: Hiroomi Okuyama
Reviewer's report:
I feel that this manuscript will likely be suitable for publication without revision.
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-13-153 (2013)

Reviewer's report
Title:Annular pancreas concurrent with pancreaticobiliary maljunction presented
with symptoms until adult age: case report with comparative data on pediatric
cases
Version: 1Date:17 September 2013
Reviewer: Julius Spicak
Reviewer's report:
Discretionary revisions
Basically, this is a well done case report contributing to our knowledge about
annular pancreas. It does not need much to add. I agree that annular pancreas is
a rare congenital anomaly that usually manifests in childhood by duodenal
obstruction, but even in adulthood this manifestation is probably more frequent
than pancreatitis. The first symptoms can appear even at the age above sixty.
What might be of note is the frequent association not only with PBMJ but also
with other malformations including duodenal diverticuklum, Ehlers Danlos
Syndrom etc. According to my opinion, the so called portal annular oancreas also
should be mentioned.
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 not competing interests
Review for 10.1186/1471-230X-13-152 (2013)

Reviewer's report
Title:A therapeutic barium enema is a practical option to control bleeding from
the appendix
Version: 2Date:12 October 2012
Reviewer: Roberto GRassi
Reviewer's report:
Major Compulsory Revisions
The manuscript, at least in its current form, does not meet the criteria for novelty
and scientific impact expected.
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-13-152 (2013)

Reviewer's report
Title:A therapeutic barium enema is a practical option to control bleeding from
the appendix
Version: 2Date:11 December 2012
Reviewer: Junichi Iwamoto
Reviewer's report:
This is an interesting and rare case report describing a therapeutic barium
enema to avoid an emergency operation in the case of bleeding from the
appendix.
The auhors have demonstrated for the first time that the therapeutic barium
enema is a useful procedure not only for the bleeding of colonic diverticulum but
also for the bleeding from the appendix.
Discretionary Revisions
The authors may add the short comment or speculation about the effectiveness
of the therapeutic barium enema for other etiological cases of appendix bleeding
shown in the table 1 such as angiodysplasia to the discussion section.
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-13-152 (2013)

Reviewer's report
Title:A therapeutic barium enema is a practical option to control bleeding from
the appendix
Version: 2Date:19 March 2013
Reviewer: nonthalee pausawasdi
Reviewer's report:
Major Compulsory Revisions
The manuscript by Konno et al. entitled “'A therapeutic barium enema is a
practical option to control bleeding from the appendix” presents a case of an
elderly male patient with appendiceal bleeding who was treated by injection of
200ml of 50W/V% barium into the orifice of the appendix using a spraying tube.
The authors proposed that bleeding stopped after such therapy and the patient
underwent appendectomy 2 weeks later to prevent recurrent bleeding. The
surgical specimen revealed an ulcer. No complications have been reported.
If bleeding was truly stopped due to the effect of barium without any
complication, this finding is perhaps noteworthy. However, more data are needed
before we can conclude that this is the case. Some issues should be addressed
or discussed to increase the strength of the paper.
These are listed below:
1. Was the anti-coagulant stopped on presentation? If so, this could have been
an important factor on hemostasis which the authors should discuss. And if it was
stopped, when was it restarted?
2. Was the barium injected or sprayed into the appendiceal orifice?
3. Can the authors comment on why you have chosen such volume and density
of barium in the study? Can you choose a high-density barium which have been
reported to be effective in controlling diverticular bleeding?
4. Many studies have demonstrated that barium remains in the diverticula for
more than 24 hours when used as therapeutic modality for diverticular bleeding.
Can authors explain why barium disappears relatively quickly in your study?
Minor Essential Revisions
1. Under case presentation, line 17 “but” does not need to be highlighted
2. Fig legend, Fig 3; “timorous”# should be tumorous
Level of interest: An article of limited interest
Quality of written English: Acceptable
Review for 10.1186/1471-230X-13-154 (2013)

Reviewer's report
Title:Risk Factors for Second Primary Malignancy of Esophagus in Newly
Diagnosed Head and Neck Cancer Patients: A Case-Control Study
Version: 2Date:12 April 2013
Reviewer: David Watson
Reviewer's report:
I have looked closely at this paper from a reviewer's perspective and I would be
happy to accept it without revision.
Review for 10.1186/1471-230X-13-154 (2013)

Reviewer's report
Title:Risk Factors for Second Primary Neoplasia of Esophagus in Newly
Diagnosed Head and Neck Cancer Patients: A Case-Control Study
Version: 4Date:13 October 2013
Reviewer: Keisuke Hori
Reviewer's report:
I have not received pint-by-point comment by the author for my review. But the
revised version of manuscript is acceptable.
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-13-151 (2013)

Reviewer's report
Title:The protective effect of VSL#3 on intestinal permeability in a rat model of
alcoholic liver disease
Version: 1Date:3 August 2013
Reviewer: akif alt&#305;nbas
Reviewer's report:
Dear Editor,
Chang et al. declared that they aimed to investigate the pathogenetic role of gut
– liver axis after acute alcohol administration in the alcohol related liver injury,
and the protective role of a probiotic mixture (VSL#3) and glutamin (an essential
amino acid resulted in intestinal mucosal atrophy with lacking).
To reach their aim, they administered alcohol via nasogastric tube to six different
groups of rat. Control group did not administered alcohol. To investigate the
protective role of VSL#3 and glutamin, they also administered VSL#3 and
glutamin seperately in to two groups, and to define their sinerjistic affect, both in
one group. And also, heat-killed VSL#3 and plasebo administered in another two
seperately groups. The investigated agents were all administered 30 min before
alcohol administration.
Alcohol related high small intestinal distrubtion was shown via
electron-microscopically, and the reduced mRNA of tight junction proteins by
using PCR and western blot.
And then, TNFalpha, endotoxin, ALT and AST levels in serum were all found to
be the highest level in only alcohol and plasebo groups, whereas the lowest level
in VSL#3 and glutamin combined group. And also, the levels of TNFalpha,
endotoxin, ALT and AST levels in serum were lower in the VSL#3, and glutamin
and heat-killed VSL#3 treated groups than alcohol group.
Minor essential revision
Even though the protocol of alcohol administration preffered in this study usually
resulted in alcohol related liver injury, the invetigators did not check out any
spesific findings of liver injury. So, they can only claim that VSL# and glutamin
may be protective role of acute alcohol consumption related intestinal injury, not
of liver injury. And also, it can not be understood why the investigators also
studied the severity of injury in the same rats.
In that reason, the authors should remove the words of liver injury from the text.
Instead, they pointed out that both VSL# and glutamin have protective role of
acute alcohol consumption related intestinal injury.
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-13-151 (2013)

Reviewer's report
Title:The protective effect of VSL#3 on intestinal permeability in a rat model of
alcoholic liver disease
Version: 1Date:29 August 2013
Reviewer: Svenja Sydor
Reviewer's report:
Reviewer’s comment
The manuscript of Chang et al. concerns with the effect of the probiotic mixture
VSL#3 on the intestinal permeability in a rat model of alcoholic liver disease. The
authors discovered that VSL#3 treatment regulates the ecological balance of the
gut microflora and prevents the passage of endotoxins and bacterial products
from the gut to portal circulation. Furthermore VSL#3-administration was
associated with reduced expression of the pro-inflammatory mediator TNF#.
Comments:
1. As mentioned in 2.3 the instruction for “Tachypleus Amebocyte Lysate assay”
and measurement of ALT and AST should be depicted more in detail.
2. It is adequate to show only two positions after decimal point. Values should be
changed within the text and the graphs (figures 2, 3, 4, 6,8).
3. Significant changes between groups should be indicated by e. g. asterisk or
p-values within the graphs.
4. The legend of the y-axis in figures 4, 6 and 8 should be labeled in a different
manner. Instead of “the expression of…” it could be changed to e. g.
“expression-level of…”, “expression (alt and ast)”, “% vs. control” or “foldchange”.
5. The differences between figures 6 and 8 must be emphasized within the
figure, e. g. within the axis (mRNA-expression/PCR or
protein-expression/western blot). It seems as if figures 6 and 8 are the same.
6. The paragraph describing results of tight junction expression (3.1.4) does not
represent the described figures. It is written:”In the glutamine (…), VSL#3 (…),
and heat-killed VSL#3 (…) groups the expression of tight junction proteins was
significantly lower than in alcohol group…” The figures show that tight junction
expression was lower in alcohol group than in glutamine, VSL#3 and heat-killed
VSL#3 groups. Please change this phrasing and change accordingly.
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-13-151 (2013)

Reviewer's report
Title:The protective effect of VSL#3 on intestinal permeability in a rat model of
alcoholic intestinal injury
Version: 2Date:1 October 2013
Reviewer: Svenja Sydor
Reviewer's report:
The authors reworked their manuscript according to the list of recommendations
whereby their work appears in a more clear and understandable manner.
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-13-151 (2013)

Reviewer's report
Title:The protective effect of VSL#3 on intestinal permeability in a rat model of
alcoholic intestinal injury
Version: 2Date:3 October 2013
Reviewer: akif alt&#305;nbas
Reviewer's report:
The manuscript can be accepted as its current form.
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-13-148 (2013)

Reviewer's report
Title:Treatment of chronic HCV genotype 1 infection with telaprevir: A Bayesian
mixed treatment comparison of fixed-length and response-guided treatment
regimens in treatment-naive and -experienced patients
Version: 1Date:4 August 2013
Reviewer: Johannes Wiegand
Reviewer's report:
Amanzada et al. performed a mathematical model to evaluate the efficacy of
different telaprevir based triple therapy regimens in chronically infected HCV
genotype 1 patients. The model is based on seven randomized controlled trials
including > 3.000 patients. The authors conclude that a short 24-weeks
fixed-length-treatment is not inferior to other (longer) therapeutical regimens and
should be further evaluated to reduce side effects and costs of therapy.
Minor Essential Revisions
1) Methods, page 7, please include the definition of the terms relapse, null- and
partial nonresponder
2) Results, page 13, efficacy in naïve patients: Treatment regimen E (12 weeks
triple Tx only) did not achieve significantly higher SVR rates compared to a
standard dual therapy for 48 weeks. Although SVR rates may not be statistically
different, it should be acknowledged that the 12 weeks triple regimen is much
shorter than the 48 weeks standard therapy and may therefore offer reduction of
side effects at equal efficacy. It will be crucial to correctly identify patients
suitable for this 12 weeks regimen. Thus, the authors should also include the role
of IL28B and low baseline viral load in their discussion. They should even
mention that these ideal naïve patients probably will not need triple therapy but
can be effectively treated with a conventional PEG-IFN/RBV standard therapy.
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-13-148 (2013)

Reviewer's report
Title:Treatment of chronic HCV genotype 1 infection with telaprevir: A Bayesian
mixed treatment comparison of fixed-length and response-guided treatment
regimens in treatment-naive and -experienced patients
Version: 1Date:7 September 2013
Reviewer: Pavel Strnad
Reviewer's report:
Chronic hepatitis C is a major health problem and although the current therapy
iseffective, it is associated with significant adverse effects. Therefore, it is
imperative to identify treatment regimen, which are both efficient and well
tolerated. To do so, Goralczyk et al. compared different telaprevir-containing
therapeutic schemes using a Bayesian mixed comparison.
This is an interesting and well-performed study which will be of interest to the
readers of BMC Gastroenterology. However, before this paper can be accepted,
a few things should be clarified (minor essential revisions):
- the description of the treatment schemes seeems to be inconsistent throughout
the manuscript: for example, Figure 1 suggests that group D was subjected to a
12 week treatment with TVR+IFN+RBV only while abstract describes it as a
treatment with TVR+IFN+RBV for 12 weeks followed by 12 weeks of RBV+IFN....
another discrepancies seem to be in the other figure legends... Please check the
complete manuscript for consistency.
- the manuscript contains multiple typos (page 8- "and and", legend Figure
5-"imputed", page 12, 1st line-"do not no how", page 17-"schema" etc). A
thourough language editing would be desirable.
- it was not quite clear to me whether the SVR rates refer to patients who entered
the study or to patients who completed the treatment... in fact, it would be good
to know whether both analyses yield similar results or not
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:
No competing interests.
Review for 10.1186/1471-230X-13-150 (2013)

Reviewer's report
Title:Interprovider Variation of Celiac Disease Testing in Childhood Chronic
Abdominal Pain
Version: 2Date:25 January 2013
Reviewer: steven L werlin
Reviewer's report:
Background:
I do not think there is a definition for chronic functional abdominal pain. The term
functional abdominal pain by itself is chronic abdominal pain. The authors should
use the Rome criteria
Methods:
‘Children who were subsequently diagnosed with a potential organic etiology as
determined by the pediatric gastroenterologist’; should instead be ‘Children who
were subsequently diagnosed with an (potential) organic etiology as determined
by the pediatric gastroenterologist’
In the second paragraph- >10 % weight loss would disqualify a patient being
labeled with functional abdominal pain and almost always qualify to be
investigated for celiac disease
Results:
First paragraph:
• 114 out of 160 is 71.3% and not 63.3%
• Can you stratify the results based on how many of these patients who had
celiac disease testing had weight loss
• Do any of the patients who got work-up for celiac disease testing have any
laboratory abnormalities (majority of the patients who get referred to
sub-specialties will have baseline labs like CBC and/or CMP) that initiated the
testing for celiac disease
Third paragraph
• Do the patients with celiac disease had any red flags like weight loss, lab
abnormalities
Discussion
Second paragraph:
• For reference 7 on racial predilection for celiac disease(7)only talks about celiac
disease in African Americans and does not compare different races. A more
appropriate reference would be an article by Rubio-Tapia et al. (Am J
Gastroenterol. 2012 Oct;107(10):1538-44; quiz 1537, 1545. doi:
10.1038/ajg.2012.219. Epub 2012 Jul 31)
Third paragraph:
• The authors should comment on frequency of celiac disease testing in
functional abdominal pain when 10% of children form their cohort has >10%
weight loss which by itself would disqualify them from being called functional
abdominal pain
• The study by Dhroove et al. included only patients with functional abdominal
pain and that is the reason they excluded the patients who do the fit with this
definition (chronic diarrhea, abdominal pain in certain locations and weight loss)
Fourth paragraph:
• The authors should not comment on prevalence of celiac disease in certain
population group since the study cohort does not fit with any particular group
(neither with FAP nor with chronic abdominal pain presenting to GI clinic as they
excluded the patients who had celiac testing by their primary physician)
Conclusions
• The conclusion to consider celiac disease testing in functional abdominal pain
patients could not be substantiated based on their patient cohort (see the above
comments in results and discussion)
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
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-13-150 (2013)

Reviewer's report
Title:Interprovider Variation of Celiac Disease Testing in Childhood Chronic
Abdominal Pain
Version: 2Date:21 May 2013
Reviewer: Craig Friesen
Reviewer's report:
This is a very well written study of a topic of clinical interest. The study has
certain limitations which are well discussed by the authors. That being said, the
data generated is unique in pediatrics and has informative value.
I have no compulsory or essential revisions. I have one discretionary revision:
The major conclusions of the study were that GI symptoms did not predict testing
and that Celiac disease occurred at a higher percentage than predicted in the
general population, both of which are supported. I think it is worth mentioning in
the discussion that there was a trend towards diarrhea, bloating, and flatus,
respectively, being associated with increased testing which would have the
possibility of increasing the % with abnormal testing in this study rather than
inferring that Celiac testing should be done routinely in all children with
AP-FGIDs.
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.