Review for 10.1186/1471-230X-11-51 (2011)

Reviewer's report
Title:Long-term follow-up of nonspecific small bowel ulcers with a benign course
and no requirement for surgery: are these a distinct group?
Version: 1Date:29 September 2010
Reviewer: Kazuhide Higuchi
Reviewer's report:
Comment
The paper was written in a careless manner. There are many mistakes in the
regulations and English grammars. Some sentences are put without a need.
This paper does not follow the general rules of writing a paper.
Most of the literature reported that the nonspecific small bowel ulcers are
associated with anaemia, hypoproteinemia and/or stenosis. However, in this
study, they only reported abdominal pain and diarrhea. I wonder if the data are
collected carefully or not.
Title (page 1) Grammar mistake
Long-term follow-up of nonspecific small bowel ulcers with a benign course and
no requirement for surgery: are these a distinct group?
Correct: is this
Abstract (page 2)
1- All seven patients (aged 54.7 years) presented
Q: Is this median age or mean age??
2-Keywords: where are the keywords?
Methods (page 3)
Inclusion criteria, exclusion criteria, are not written well.
What are the data you collected from the patients?
Results (page 5)
# You said in methods (page3) : We reviewed the medical records of all patients
who had undergone either balloon enteroscopy or ileoscopy in 2000–2005 at the
Chinese PLA General Hospital, a tertiary referral center located in Beijing, China.
So, how many patients did enteroscopy in this study?
# You said in results (page 5 line 3): The major indications for colonoscopy were
diarrhea and/or abdominal pain/discomfort.
So, how about the indication of enteroscopy?
You said in results (page 5 line 25): All the ulcers were identified by ileoscopy on
the first visit, when terminal ileum intubations (10–25 cm) were performed
routinely during colonoscopy.
So, how about enteroscopy results? It is a controversy!
I wonder enteroscopy was done or not in the present study!
(Page 5 line 11): Various empirical treatments were applied, including prebiotics
and 5-asalazine (5-ASA), except in two patients for whom no medication was
prescribed.
Q: What are the doses and what are the duration of treatment???
(Page 5 line 18): No patient had a history of chronic NSAID use before the initial
diagnosis.
Q: This sentence is an exclusion criterion, so why you mention it as a result. !!!
(Page 6 line 15): A final endoscopy showed persistent ulcers in more than half
the patients, whereas one patient (case 6) had recurrent ulcers and two patients
(case 2 and case 5) had self-limiting ulcers.
Q: you should mention the number and/or the percentage (%) because it is a
result not a discussion.
Discussion
-Not written well
(Page 8 line 1): Our case series is similar to the case reported by Borsch et al.,
which was assumed to be IBS before a diagnosis of nonspecific small bowel
ulcers was made [5].
The reference number [5] should be put after the name of the author.
(Page 8 last paragraph): Two patients became chronic aspirin users during
follow-up. their final results showed that, in this study, chronic aspirin use did not
interfere with the clinical course and no NSAID-related enteropathy ensued since
aspirin may be safer than other NSAIDs during enteropathy [35].
Q: why you put this reference here? I think you speak about your result!!
(Page 9 line 2): In our study, a variety of empirical medicines was used, including
5-ASA [18], probiotics, and herbal medicines. Probiotics seemed partly effective
in two patients with diarrhea, but they had no direct effect on the ulcer itself.
Q: why you put this reference here? I think you speak about your result!!
Tables
Table 1 (page 13): the first row is not regulated
Table 2 (page 14): -The first row is not regulated
-First time to see these abbreviations: TI & V
Other grammar mistakes
Abstract
(Results):
-Various empirical treatments were applied and most patients felt partly
improved, even relieved. But the gastrointestinal symptoms did not always
correlate with the presence of ulcers and the ulcers tended to be either persistent
(4 patients) or recurrent (1 patient)
Correction:
applied add coma (,) applied,
But Correct: However
Ulcers add coma (,) Ulcers,
Background (page 3)
The previous literature has shown that it is difficult to diagnose nonspecific small
bowel ulcers preoperatively because nearly all cases are identified with
laparotomy or during autopsy [3].
Correct: during the autopsy
The features of nonspecific small bowel ulcers are not fully understood and it is
still unclear whether nonspecific ulcers of the small intestine constitute a clinical
entity.
Correct add coma (,) not fully understood, and
Methods
(Page 3) The medical records for all patients were available in electronic form.
Correct in an electronic form.
(Page 4) Immunohistochemical staining or acid-fast staining was used when
lymphoma, tuberculosis, etc. were suspected.
Correct was
(Page 6) Repeated endoscopy
The details of the endoscopic follow-ups are shown in Table 3.
Correct follow-up
(Page 6) Outcomes
# But the endoscopic findings didn’t always change in parallel with the
symptoms, as shown in Table 1.
Correct However
# But finally her lesions healed again and the symptoms disappeared, which
can’t be attributed to any medication.
Correct However
Add coma (,) again,
(Page 7) Discussion
# Nonspecific small bowel ulcers affect both sexes and different reports have
shown different representation in the two sexes [2, 18].
Correct add coma (,) sexes,
shown a different
# Interestingly, one patient was accidentally diagnosed by ileoscopy during
surveillance for colon polyps and no gastrointestinal symptoms appeared later.
Our case series showed good prognoses.
Correct add coma (,) polyps,
# Page (9) In our study, a variety of empirical medicines was used, including
5-ASA [18], probiotics, and herbal medicines.
Correct were
# Probiotics seemed partly effective in two patients with diarrhea, but they had no
direct effect on the ulcer itself. Long-term 5-ASA therapy was prescribed in two
patients. However 5-ASA failed in both of them.
Correct both.
Conclusion
Prolonged follow-up showed that these ulcers can be either self-limiting or
persistent, but no serious complications appeared and no surgery was
necessary.
Correct add coma (,) appeared,
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.