JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/1471-230X-10-79 (2010)

Reviewer's report
Title:Mouse model of carbon tetrachloride induced liver fibrosis:
Histopathological changes and expression of CD133 and epidermal growth factor
Version: 1Date:16 December 2009
Reviewer: Frank Tacke
Reviewer's report:
Fujii et al describe experiments in which mice were treated with CCl4 per
gavage, resulting in liver fibrosis and tumor formation. They also found
upreguated gene expression of EGF, TGF, HSC markers and CD133 and
conclude that CD133 might be involved in fibrosis progression or tumor
formation.
Major Compulsory Revisions
1. It is very hard to believe that treatment with CCl4 per gavage leads to liver
fibrosis and HCC development. CCl4 has been extensively used in the literature
(typically i.p. injections for 6-8 weeks), but usually does not result in HCC. If this
should be true, the authors need to provide compelling experimental evidence.
To prove fibrosis formation: hydroxyproline assay, collagen or a-SMA Western
Blot, collagen immunohistochemistry. For tumor formation: clonal analysis,
macroscopic picture, gene profile from tumorous vs non-tumorous tissue.
2. The paper is solely descriptive, and the up-regulation of HSC-related genes in
a fibrosis model is not surprising. If the authors believe that they have HCC
development, they should differentiate gene expression profiles at time-point III
for tumorous vs non-tumorous tissue.
3. It is completely unclear if the upregulation of CD133 has anything to do with
HSC activation or proliferation. Therefore, clear immunohistochemical stainings
are needed to assess CD133 in liver tissue and assess co-staining with activated
HSC (e.g., by a-SMA staining). Many hematopoietic cells can express CD133 as
well, this should be tested. Furthermore, it would be helpful to isolate primary
cells from the treated livers, i.e. hepatocytes, HSC, endothelial cells and Kupffer
cells, to assess which cell type expresses CD133. The use of cell lines is not
helpful in this respect.
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-10-79 (2010)

Reviewer's report
Title:Mouse model of carbon tetrachloride induced liver fibrosis:
Histopathological changes and expression of CD133 and epidermal growth factor
Version: 2Date:20 April 2010
Reviewer: Frank Tacke
Reviewer's report:
The manuscript has been greatly improved after revision.
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-10-79 (2010)

Reviewer's report
Title:Mouse model of carbon tetrachloride induced liver fibrosis:
Histopathological changes and expression of CD133 and epidermal growth factor
Version: 2Date:26 April 2010
Reviewer: Biserka Radosevic-Stasic
Reviewer's report:
I found that the authors of the manuscript: «Mouse model of carbon tetrachloride
induced liver fibrosis: Histopathological changes and expression of CD133 and
epidermal growth factor» answered on all my queries and improved their original
data, answering on additional questions of the reviewers.
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-10-79 (2010)

Reviewer's report
Title:Mouse model of carbon tetrachloride induced liver fibrosis:
Histopathological changes and expression of CD133 and epidermal growth factor
Version: 2Date:10 May 2010
Reviewer: helene gilgenkrantz
Reviewer's report:
1. The new data showing CD133 and a-SMA immunohistochemistry in the same
area on serial sections are not really convincing. Particularly a-SMA staining
looks as an artefact in injured cells or area. Therefore it should only be indicated
that « CD133 positive cells could probably correspond to HSC ».
2. The new data showing phosphorylated EGFR expression shows a clear
up-regulation - in contrast to what has been seen with the non –phosphorylated
form of EGFR-. It is in correlation with PCNA expression and therefore probably
with cell proliferation. The discussion has bo be improved on this point.
3. Recent evidences suggest that Amhiregulin, that has been found up-regulated
in the new version, plays a unique role not only in liver fibrosis but also in liver
tumorigenesis and in the maintenance of the neoplastic phenotype of
hepatocarcinoma cells, particularly in humans. This point gives some clinical
relevance to the model developed here.
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-10-77 (2010)

Reviewer's report
Title:Hypoglycemia Following Upper Gastrointestinal Surgery: Case Report and
Review of the Literature
Version: 2Date:23 September 2009
Reviewer: Mary Korytkowski
Reviewer's report:
Brandon et al present a case report of a patient who experienced hypoglycemia
following a fundoplication procedure for repair of a hiatal hernia.
This is a brief report.
The abstract does not add anything as it is actually the case summary.
The novelty of this case is that symptoms occurred following a surgical procedure
that is not usually associated with hypoglycemia. The fact that his symptoms
were present pre-operatively suggests that this may not have been related to the
surgery. A discussion of the mechanisms by which this type of surgery could
worsen symptoms would be useful. Mechanisms following RNYGBP procedures
have been discussed previously but may not be relevant to fundoplication.
Although the CT scan was negative, a small insulinoma is not completely ruled
out and could be considered in the differential. Hypoglcyemia is not limited to the
fasting state in patients with insulinoma, and a negative 72 hour fast does not
absoutely eliminate this possiblity.
I would recommend that the abstract and case summary be combined and
condensed, that there be a discussion of proposed mechanisms as well as a
discussion of how Octreotide works and any prior studies using octreotide in
these patients.
The severity of the hypoglycemic event is also of interest. A blood glucose of 0.8
mmol/l without loss of consciousness is unusual.
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-10-77 (2010)

Reviewer's report
Title:Hypoglycemia Following Upper Gastrointestinal Surgery: Case Report and
Review of the Literature
Version: 2Date:20 November 2009
Reviewer: Henrik Christesen
Reviewer's report:
In this case report, a 14-y long history of hypoglycemia lead to the diagnosis of
NIPHS. A Nissen fundoplication was performed , after which symptoms
worsened. The hypoglycaemia responded to octreotide.
Major comments:
It is well-known that Nissen fundoplication may lead to lowering of postprandial
blood glucose, associated with increased GLP-1 response and hypersecretion of
insulin, although strict criteria for NIPHS have not been documented previously. It
is much likely, however, that this patient had NIPHS for a very long time,
aggravated by surgery. It is not clear, whether this is a description of NIPHS
detected after surgery, or NIPHS developed after surgery.
It is hard to see the importance of discerning between the effectiveness of
octreotide in NIPHS without any surgery or after Nissen fundoplication. No data
or theory argue for a difference.
The authors refer to gastric bypass hypoglycaemia consistent with NIPHS, but
also highlight symptoms that differ NIPHS from gastric bypass hyperinsulinemic
hypoglycaemia (HH). It is not clear whether they consider gastric bypass HH as
NIPHS or not, and whether they consider gastric bypass HH and
post-fundoplication NIPHS as the same type of hypoglycemia. If the same,
various medical treatments have been reported rendering little news from this
case description.
Overall, this case is most likely a NIPHS patient with aggravation post surgery. It
highlights that premorbidity may be important in some cases, but adds little to
explain the underlying disease. Although insulinoma is well excluded, a genetic
investigation would have been of interest, since three genes are known to be
involved in NIPHS-like postprandial hypoglycaemia with adult onset.
Minor comments:
A negative 72-h fast is not reported in the case, but in the Abstract only.
The patient’s BMI or abdominal circumference would be of interest.
The time between surgery and the worsening of hypoglycaemia or hospitalisation
due to hypoglycaemia should be given.
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-10-77 (2010)

Reviewer's report
Title:Hypoglycemia Following Upper Gastrointestinal Surgery: Case Report and
Review of the Literature
Version: 3Date:28 April 2010
Reviewer: Mary Korytkowski
Reviewer's report:
I assessed the authors' response to the other referees concerns and feel this is
sufficient.
Review for 10.1186/1471-230X-10-76 (2010)

Reviewer's report
Title:Computer-aided recording of automatic endoscope washing and
disinfection processes as an integral part of medical documentation for quality
assurance purposes
Version: 2Date:27 May 2010
Reviewer: Lawrence Muscarella
Reviewer's report:
No additional 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 am employed by a manufacturer of washer-disinfectors intended for
reprocessing flexible endoscopes, including gastrointestinal endoscopes.
Review for 10.1186/1471-230X-10-76 (2010)

Reviewer's report
Title:Computer-aided recording of automatic endoscope washing and
disinfection processes as an integral part of medical documentation for quality
assurance purposes
Version: 2Date:4 June 2010
Reviewer: Ottmar Leiss
Reviewer's report:
Although the authors comments on all major compulsory revisions, minor
essential revisions or discretionary revisions of the reviewers, they have done
this in a very minimalistic way.
The importance of the manual cleaning is underlined and stressed that the
computer program only documents the automatic cleaning and disinfection step.
Since only two different types of washer-disinfectors (BeliMed International and
Olympus washer-disinfectors EDT 2 and 3-similar in design) are used, I’m still
not convinced whether the conclusion of the authors that the electronic
documentation system ‘can be used in any washer-disinfector that documents
the procedures involved in the automatic cleaning process..’ is justified and
whether the concept discussed on page 7 that technological innovations and
‘additional systems are likely to be added’ is correct for new endoscopes but not
for new types of washer-disinfectors with single channel perfusion.
From a quality management point of view I have mentioned (see 6 of my review)
that a more careful discussion of the question whether we should focus on
process quality or outcome quality of reprocessing flexible endoscopes would be
helpful. Although standardized reprocessing is possible in special
washer-disinfectors using automatic single channel cleaning with enzymatic
cleaners and programmed disinfection with glutaraldehyde at higher temperature
(1), only microbiological controls of reprocessing quality are able to detect
equipment defects of flexible endoscopes (such as perforation of internal
channels) which affect the outcome of the reprocessing process and which would
be without surveillance cultures only recognized in working ups of nosocomial
infection outbreaks (2). In contrast to the US multi-society guideline (3) the
German (4) and recent European guideline for endoscope reprocessing (4) both
recommends regular surveillance cultures of endoscope reprocessing. Thus, the
presented computer-aided recording of automatic endoscope washing and
disinfection is a helpful tool to document process quality, but not a substitute for
outcome quality.
In summary, because of only minimal corrections I think that the improvement of
the revised manuscript is rather limited.
Nevertheless, I agree with publication in the present form.
Review for 10.1186/1471-230X-10-74 (2010)

Reviewer's report
Title:A survey of abnormalities in the colon and rectum in patients presenting
with haemorrhoids.
Version: 1Date:15 March 2010
Reviewer: Wilhelm Graf
Reviewer's report:
This is an observational study of patients undergoing colonoscopy for clinical
reasons with the purpose to detect colonic abnormalities in patients with
haemorrhoids. I have several questions and concerns.
1. I see no reson to exclude patients without haemorrhoids from the study, this
group should be an interesting control group for comparison.
2. The method of detecting haemorrhoids is not optimal nor well described.
Apparently, the main diagnostic tool is inspection, whereas it is best diagnosed
with anoscopy. The procedure for diagnosing haemorrhoids should be more
precise.
3. Some of the comparison the authors do are unwarranted, i.e. it is obvious that
patients with associated pathology are older and that sigmoidoscopy is less
effictive to detect proximal pathology.
4. Ethical permission for the study is not mentioned.
5. The authors conclude that colonoscopy is not necessary for patients below the
age of 50, however the number of patients in this group is too low to allow firm
conclusions.
6. Patients undergoing sigmoidsocopy were included in the study which is
questionable since the possibility to detect pathology is limited.
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-10-74 (2010)

Reviewer's report
Title:A survey of abnormalities in the colon and rectum in patients presenting
with haemorrhoids.
Version: 2Date:7 April 2010
Reviewer: Wilhelm Graf
Reviewer's report:
The authors have dealed with some of the requests by the reviewrs but not all. It
is a little bit suprising to read that the authors does not realize the need of a
reference group. The main message of the paper is the various findings of
concomittant pathology in pts with haemorrhoids, it might just be the average
findings in the entire material and it would therefore be of interest to relate their
findings to some kind of control group. One alternative would be to make a
random sample from pts without hameorrhoids during the same time period,
another alternative is a pure "healthy control" group, i.e. asymptomatic
individuals from the background population. It is also disturbing to find a
statistical comparison of detetection of polyps when performing a colonoscopy as
compared with sigmoidoscopy.
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-10-74 (2010)

Reviewer's report
Title:A survey of abnormalities in the colon and rectum in patients presenting
with haemorrhoids.
Version: 2Date:13 April 2010
Reviewer: Varghese P Thomas
Reviewer's report:
I have gone through the revised article and the authors have attempted to
answer some of the queries.
1. As such the paper is in a better shape with change in the title and it is
acceptable for publication with minor revisions
2. As the authors didnot remove data from sigmoidoscopy in their revised paper,
this could be mentioned as one of the limitations of the study.
Review for 10.1186/1471-230X-10-74 (2010)

Reviewer's report
Title:A survey of abnormalities in the colon and rectum in patients presenting
with haemorrhoids.
Version: 3Date:1 June 2010
Reviewer: Wilhelm Graf
Reviewer's report:
The manuscript is now considerably improved and the reference group adds
more quality to the paper, however the reference group should also include
patients in whom no abnormality was seen. I also believe that the reference
group should be mentioned in the abstract. Provided the corrections are made I
believe the paper is suitable for publication.
Review for 10.1186/1471-230X-10-75 (2010)

Reviewer's report
Title:Case report: Acute Pancreatitis Caused By Postcholecystectomic
Hemobilia.
Version: 3Date:2 January 2010
Reviewer: Young Koog Cheon
Reviewer's report:
Major Compulsory Revisions
Major points
1. The grammar in the manuscript has to be edited extensively for publication.
2. A more detailed description of selective angiography is needed. Was contrast
observed passing from the cystic duct to the CBD? During embolization, which
branch was the endocoil placed? Angiographic findings following embolization,
are also needed.
3. The discussion is long and general description of hemobilia is not needed,
especially the first part.
4. The authors should explain the possible mechanism of hemobilia occurred in
the first place, and if there is a way to prevent it from occurring, during surgery.
5. There were no figure legends. Add figure legends.
Minor points
1. Correct spelling a lot of words.
In abstract,,
Line 3,, but Acute… ->#but acute
Line 4, ..is yet not described. -># is not yet described.
Line 5, We present..--> We presented
Line 5, a 32 years old female, -># a 32-year-old female
Line 10, psoudoanevrism -># pseudoaneurysm
2. In Case report,
Amilase --># amylase
Amilase, Lipase are# need a unit and change to amylase, lipase
eozophagus --> # esophagus
Contrast enhanced abdominal tomography --># abdominal computerized
tomography
cathater -->#catheter
‘ductus choledochus’ means the sphincter of bile duct, and so you have to
change to “common bile duct”.
In last line of ‘Case report’. remaining # remant
3. In conclusion,
In first line of last paragraph,
…and Acute pancreatitis…. --># and acute pancreatitis…
4. If possible endoscopy figures of bleeding directly from the papillary orifice
should be added and replace the figure 1.
5. In figure 2, there are too many CT films. The 3rd and 4th CT findings are
enough in this manuscript.
6. Figures of selective angiography should be reduced. Figure 4 is not needed.
7. Remove the figure 7.
Level of interest: An article of importance in its field
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-10-75 (2010)

Reviewer's report
Title:Case report: Acute Pancreatitis Caused By Postcholecystectomic
Hemobilia.
Version: 3Date:23 January 2010
Reviewer: Nuno Almeida
Reviewer's report:
To the authors:
I appreciate reading and reviewing your manuscript entitled “Acute Pancreatitis
Following Hemobilia Caused by Right Hepatic Artery Psoudoaneurisma 5 Months
after Laparoscopic Cholecystectomy.” This case is interesting and documents
two possible late complications of a common surgical procedure but the spelling
and grammar need a major revision. Usually I give some suggestions about the
potential corrections that must be made but in this case it is virtually impossible
because I identified misspellings in all paragraphs. It is essential to review all
language before even considering further review and submission.
It is also important to note that the patient is identified in the CT images and it
seems that it has 50 years?? This is unacceptable! Please correct and present
only one image with the pseudoaneurysm clearly identified.
I hope these comments can be useful for you in the future.
Best wishes.
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-10-75 (2010)

Reviewer's report
Title:Case report: Acute Pancreatitis Caused By Postcholecystectomic
Hemobilia.
Version: 3Date:24 January 2010
Reviewer: vincenzo napolitano
Reviewer's report:
Major Compulsory Revisions:
1)There are a lot of language mistakes: the paper must be reviewed by a native
English speaker
2)Was the cholecystectomy performed in emergency ? if so, the
pseudoaneurysm is more frequent and the author should make a reference to
this
3)I think that the interest of the paper is better based on the management of the
hemobilia and its complication rather than on the cause of the acute pancreatitis.
The author should focus on this feature
4)The references are now “expired”, there are no any recent ones
5)ERCP is now considered an operative procedure rather than diagnostic and I
have not had this feeling reading the paper (the diagnosis has been made by the
gastroscopy).
6)I disagree with the sentence:” But hemobilia rising from a pseudoaneurysm
after cholecystectomy and causing acute pancreatitis was yet not described”
because the pseudoaneurysm is a well known cause of hemobilia and the biliary
clots can cause acute pancreatitis by obstruction
Minor Essential Revisions:
1)During US and CT scan was the pancreas examinated? Why the author did not
specificated this? The patient had an acute pancreatitis!
2)The author should give some information about the devices used to perform
embolization (coils, stent…) and compare the procedure with literature
3)Describe the medical management of the acute pancreatitis (drugs, devices,
score…)
4)Look at the n° 9 reference: it is incomplete.
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-10-75 (2010)

Reviewer's report
Title:Case report: Acute Pancreatitis Caused By Postcholecystectomic
Hemobilia.
Version: 3Date:7 February 2010
Reviewer: Thilo Welsch
Reviewer's report:
Halil Alis et al. present a case of postcholecystectomy hemobilia and consecutive
pancreatitis. Hemobilia resulted from a pseudoaneurysm of the right hepatic
artery.
Major compulsory revisions:
- In general, case reports should add new aspects to the current knowledge, but
the present case describes a foreseeable complication of postcholecystectomy
hemobilia (pancreatitis), and the management was standard.
- Frankly, the manuscript is written in an extremely bad English, and authors
should not submit an uncorrected text like this. The reader hardly finds one
correct sentence. Here are just some examples - eozophagus, blood cloth,
psoudoaneurismatic, %50 ...
- blood values are presented without units (except hemoglobin)
- Fig. 2 (CT scan): the quality of the scanned or photographed image is totally
unacceptable. In addition, one can read and identify the name of the patient.
- there are no figure legends in the manuscript
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
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-10-75 (2010)

Reviewer's report
Title:Case report: Acute Pancreatitis Caused By Postcholecystectomic
Hemobilia.
Version: 5Date:7 May 2010
Reviewer: Michael Kelly
Reviewer's report:
There are still some unanswered questions and there is still a lack of detail. The
authors now have a nice case report that I am sure will be publishable in a case
report journal but I am sorry to say that I do not think it is appropriate for BMC
gastroenterology.
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:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-10-75 (2010)

Reviewer's report
Title:Case report: Acute Pancreatitis Caused By Postcholecystectomic
Hemobilia.
Version: 5Date:11 May 2010
Reviewer: Young Koog Cheon
Reviewer's report:
1. Fugure legends should be written in seperate page.
2. The first part of discussion is long and tedious, so omit the first part and
shorten the second paragraph.
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-10-75 (2010)

Reviewer's report
Title:Case report: Acute Pancreatitis Caused By Postcholecystectomic
Hemobilia.
Version: 5Date:23 May 2010
Reviewer: Vincenzo Napolitano
Reviewer's report:
Major Compulsory Revisions
no revisions
Minor Essential Revisions
no revisions
Discretionary Revisions
no revisions
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-10-72 (2010)

Reviewer's report
Title:Gastric and intestinal barrier impairment in African adults: a randomised
controlled trial of micronutrient supplementation
Version: 2Date:20 January 2010
Reviewer: Giacomo Carlo Sturniolo
Reviewer's report:
The paper describes the effect of micronutrient supplementation on different
components of gastric and intestinal barrier in African patients with mixed
HIV-status.
Micronutrients seem to ameliorate hypochlorhydria but don’t affect intestinal
permeability and bacterial traslocation. Interestingly, the gastric mucosa in HIV
patients did not show severe atrophy at histology, so one can postulate that
mechanisms other than atrophy are involved in HIV-related hypochlorhydria.
The major limits of this works are: 1) the results have been published partially in
a previous work, 2) only one dose of micronutrients has been experimented,
whereas probably a higher dose could have different effects and 3) the number
of subjects varies greatly among the different tests.
MAJOR COMPULSORY REVISIONS
- The title should include HIV-status
- You should specify if the different number of subjects in the subgroups derives
from patients’ selection or spontaneous participatation
- Please explain or give the reference to explain the different role of the sugars
used for permeability test
- Page 7: "… antiretroviral therapy reverses hypochlorhydria". Unfortunately this
is not a randomized trial of antiretrovirals and therefore you can only observe the
difference among groups.
- Page 7: please give the statistical significance of the difference in gastric pH
among groups
- Page 8: Salmonella and Shigella infections have been mentioned in the results
but the method is not explained, and you should explain better the numbers
(198+357= 555 samples but the trial included 500 patients and gastric pH was
measured in 200 patients)
- Page 8: it would be interesting to know the proportion of patients with altered
intestinal permeability
- Page 9: it would be interesting to know more extensively the histological results,
apart from atrophy (normal mucosa? Gastritis? Others?)
MINOR ESSENTIAL REVISIONS
- Page 11: could you better explain the hypothesis of tropical enteropathy that
obscures the relationship between permeability and bacterial traslocation? You
should even specify if you found altered permeability and normal traslocation or
both normal
- Histological images in my opinion are not necessary.
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-10-72 (2010)

Reviewer's report
Title:Gastric and intestinal barrier impairment in African adults: a randomised
controlled trial of micronutrient supplementation
Version: 2Date:15 March 2010
Reviewer: john macfie
Reviewer's report:
This is a well written study describing a large prospective trial in African adults.
I have 3 minor points:
1. their measures of intestinal permeability only assess small intestinal (cf
colonic) permeability.They should discuss this in context barrier function and
bacterial translocation. I am not convinced that sugar probe techniques
accurately reflect alterations in barrier function
2. Use of LPS and antibodies as surrogate measures of barrier function should
also be justified intheir discussion (I think it's a sound approach but rationale
needs to be there)
3 I do not think their data permit the conclusion " that bacterial
translocation drives immune activation, but at least in Africa this is probably in
advanced rather than early HIV infection". This is supposition.
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 I have no competing interests
Review for 10.1186/1471-230X-10-72 (2010)

Reviewer's report
Title:Gastric and intestinal barrier impairment in tropical enteropathy and HIV:
limited impact of micronutrient supplementation during a randomised controlled
trial
Version: 3Date:17 May 2010
Reviewer: Henrik Friis
Reviewer's report:
I find that the revision and the cover letter acceptable, and have no further
comments.
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-10-72 (2010)

Reviewer's report
Title:Gastric and intestinal barrier impairment in tropical enteropathy and HIV:
limited impact of micronutrient supplementation during a randomised controlled
trial
Version: 3Date:27 May 2010
Reviewer: Giacomo Carlo Sturniolo
Reviewer's report:
In the form now submitted I think that the work is ready 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-10-73 (2010)

Reviewer's report
Title:Long-term follow-up with leukocytapheresis re-treatment in patients with
chronically active inflammatory bowel disease
Version: 1Date:21 March 2010
Reviewer: Abbi Saniabadi
Reviewer's report:
Manuscript number 1290099603578712 by DR Lindberg and colleagues, title:
Long-term follow-up with leukocytapheresis re-treatment in patients with
chronically active inflammatory bowel disease.
1. In this manuscript, DR Lindberg and colleagues describe an innovative
therapeutic intervention which they have used in patients with inflammatory
bowel disease, a debilitating chronic condition that afflicts millions throughout the
world. Essentially, it is a non-drug based therapeutic intervention which is most
intriguing. As virtually all known drugs used to treat gastrointestinal disorders can
cause serious adverse side effects, the strategy described here should be most
welcomed by both the physicians and patients. Further, none of the hitherto
reports has efficacy outcomes over a long period of time. Therefore, the
long-term observations by the authors should benefit the impact of this report as
well.
The manuscript is well written throughout.
2. My information suggests that the GMA used in this study removes myeloid
linage leucocytes (granulocytes and monocytes), regulatory lymphocytes are
spared. Accordingly, the title of this paper should read better as: “Long-term
follow-up with Granulocyte and Monocyte Apheresis re-treatment in patients with
chronically active inflammatory bowel disease.
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:
This is an academic report and in my view, the only beneficiaries are the patients
and the physicians in the area dealt with. This has been the basis of my
evaluation.
Review for 10.1186/1471-230X-10-73 (2010)

Reviewer's report
Title:Long-term follow-up with leukocytapheresis re-treatment in patients with
chronically active inflammatory bowel disease
Version: 2Date:5 May 2010
Reviewer: Eugeni EDM Domenech
Reviewer's report:
- The fact that 21 out of 25 CD patients had extensive colonic disease, and only
3/25 had small bowel involvement cannot be explained in the Discussion as this
"may indicate a higher risk for CD patients with colonic inflammation to become
chronic". Maybe, the authors preferred to try apheresis before performing a total
proctocolectomy with ileostomy. As the authors state in their comments, "this
reflection remains speculative", and many other hypothesis should be taken into
account.
- Table 2: explanations about statistical signficance are not clear as far as the
authors indicate the variable but not at which time (before tx, 10 weeks after tx,
20 weeks after tx) was the difference significant between groups (responders,
non-responders,...).
- Conclusion: I agree with the authors that feasibility and tolerance were
excellent. However, can it be stated that GMA did not induce "dependency" when
most patients relapsed soon after treatment discontinuation (wihtin the first 6
months as seen in the survival curves) and responded when treatment was
re-introduced? Isn't it the definition for steroid-dependency? In my opinion, the
main conclusion should be that scheduled maintenance therapy with GMA
should be evaluated in CD patients with chronic disease activity who respond to
an initial GMA course.
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-10-71 (2010)

Reviewer's report
Title:Hyperimmune Anti-HBs Plasma as Alternative to Commercial
Immunoglobulins for Prevention of HBV Recurrence After Liver Transplantation
Version: 1Date:9 November 2009
Reviewer: James Fung
Reviewer's report:
I enjoyed reading the study on the use of HIP in the prevention of HBV
recurrence after LT. The use of HBIG is still recommended in most centers in
combination with NA. Some studies have shown efficacy with combination NAs
only - however re-emergence of HBsAg (even with negative HBV DNA) in a small
proportion is likely a result of recurrent HBV and the negative HBV DNA is merely
secondary to the virus being suppressed by NAs.
Minor Comments:
1. The demographics (age/sex/ethnicity) of the 21 patients should be provided
2. The statistical tests used throughout the study should be described under the
section of data analysis
Major Comments"
1. Of the 21 patients, 19 (90%) had undetectable HBV DNA at the time of
transplantation. Were these patients already on oral NA treatment? The patients
underwent liver transplantation between 1989-2007, but NA was only available
from 1996.
2. 3 patients had fulminant HBV - how was hepatitis B diagnosed in these
patients (at least 1 patient would have had negative HBV DNA given that 19
patients had negative HBV DNA at the time of transplantation). Could these
patients have had acute infection with HBV rather than acute on chronic flare
leading to fulminant hepatitis. The authors should state the mode of diagnosis for
their 3 groups of patients (HBV, fulminant HBV, HBVHDV) - eg: HBsAg positive
for at least 6 months etc etc
3. One third of the patients developed hypersensitivity reactions - do the authors
recommend premeds to be given to all patients as 1/3 of these patients would
have had their HIP transfusions stopped initially and having to switch to HBIG.
4. Given the decline of anti-HBs levels in HIP with storage - do the authors
recommend testing before the administration of HIP to ensure the levels are
adequate or to perform a post-dose level routinely
5. Long term IV transfusion may be tedious. Initial treatment with HIP
(intra-operatively and for the first week as inpatient) and followed by lower dose
IM HBIG after the patient is discharged may be a logical/alternative option - can
the authors comment on potential different approaches
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-10-71 (2010)

Reviewer's report
Title:Hyperimmune Anti-HBs Plasma as Alternative to Commercial
Immunoglobulins for Prevention of HBV Recurrence After Liver Transplantation
Version: 1Date:9 November 2009
Reviewer: Lu-nan Yan
Reviewer's report:
Major Compulsory Revisions
1 The values of HBV DNA at transplantation should be expressed as mean ± SD.
2 The serologic HBV markers including HBsAg, anti- HBsAg, HBeAg, anti-
HBeAg, anti-HBcAg should be elaborated.
3 The prophylactic efficacies between the patients received only HIP and the
patients received HIP and NA should be compared.
Minor Essential Revisions
1 Hyperimmune plasma or HIP in the Methods of the Abstract should be
expressed as (hyperimmune plasma, HIP).
2 ”…, which is reduced to 0-10% at long-term after LT” in Introduction should be
replaced by “leading to HBV recurrence rate of 0-10% for long-term 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 declare that I have no competing interests
Review for 10.1186/1471-230X-10-71 (2010)

Reviewer's report
Title:Hyperimmune Anti-HBs Plasma as Alternative to Commercial
Immunoglobulins for Prevention of HBV Recurrence After Liver Transplantation
Version: 1Date:13 November 2009
Reviewer: George Papatheodoridis
Reviewer's report:
There is certainly need for cheaper HBIG alternatives for HBV liver transplant
patients and therefore the subject of this study is of interest.
The design is OK and the methods and results are presented satisfactorily.
Minor essential comments
The conclusions are based on a small number of patients and should be
considered as preliminary. So, further studies are required before definite
conclusions can be drawn on this attractive approach. Thus, the conclusions of
this study should be modified and become less definite in both the abstract and
main text.
In addition, the additional use of an antiviral should be also mentioned in the
conclusions: it is not the “use of HIP that may be effective” but the “use of HIP in
combination with an oral antiviral agent”.
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-10-71 (2010)

Reviewer's report
Title:Hyperimmune Anti-HBs Plasma as Alternative to Commercial
Immunoglobulins for Prevention of HBV Recurrence After Liver Transplantation
Version: 2Date:5 April 2010
Reviewer: Lu-nan Yan
Reviewer's report:
Discretionary Revisions - The revised manuscript has made remarkable
progress, however, some language in the article should be more concise,
especially in the part of "results".
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-10-71 (2010)

Reviewer's report
Title:Hyperimmune Anti-HBs Plasma as Alternative to Commercial
Immunoglobulins for Prevention of HBV Recurrence After Liver Transplantation
Version: 2Date:7 April 2010
Reviewer: James Fung
Reviewer's report:
Minor comments:
Page 4 1s paragraph under "Patients, hyperimmune plasma adminitration and
follow-up"
The statement "(two patients transplanted 1989 and 1993 presented detectable
HBV DNA prior LT)" needs to be rephrased
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-10-70 (2010)

Reviewer's report
Title:Sensitivity of intra-abdominal, intra-organ and intravascular pressures in
detecting changes induced by external abdominal pressure with and without
PEEP: an experimental study
Version: 2Date:28 September 2009
Reviewer: Jan De Waele
Reviewer's report:
Jakob et al. report the results of an animal study looking at the effect of changes
in IAP and PEEP on intra-abdominally and intra-thoracally measured pressures.
It is an interesting study, as it specifically looks at changes, and not absolute
values.
Introduction
* Dysfunction of the abdominal wall is mentioned, but the reference (13) only
refers to reduced flow in the wall.
* The references used in the introduction are not always correctly used. Ref 11 is
an editorial, and is not on hepatosplanchnic perfusion. Ref 7 is a review, I would
not use that here.
* According to the current consensus, ACS is defined as IAP>20 , not 25. ACS
means organ dysfunction, not an increased risk for it.
Third paragraph, last sentence (on other routes for pressure measurement) is a
repeat from the same paragraph.
Results.
* What happened to the animal in which no changes were found? What was the
problem? * Just deleting it from the experiment because you did not see what
you expected to see is a bit easy.
* Systemic hemodynamics in table 1. Please provide data from all time points.
* I found the figures very difficult to understand. Why present the data like this? I
would suggest to use boxplots of the IAP at every different location.
Discussion.
* Please discuss the fact that although changes are comparable, absolute values
are 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: 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-10-70 (2010)

Reviewer's report
Title:Sensitivity of intra-abdominal, intra-organ and intravascular pressures in
detecting changes induced by external abdominal pressure with and without
PEEP: an experimental study
Version: 2Date:4 October 2009
Reviewer: marja boermeester
Reviewer's report:
The authors performed an interesting study in pigs to evaluate different methods
to measure intra-abdominal pressure, induced by a 7 kg weight, with or without
PEEP.
Major comments:
This study with all its efforts misses out on the essential question at hand. What
is the effect of level of PEEP on the level of elevated intra-abdominal pressure?
In other words: at the same 'real' intra-abdomminal pressure what level is
measured at high or low PEEP level. This question is not answered by present
study set-up. Only one PEEP level was used during artificial elevated
intra-abdominal pressure, so no comparison can be made. A far more interesting
set-up would have been to artifically elevate intra-abdominal pressure and
measure at different PEEP settings (0, 5, 10, 15 PEEP). Now we still don't know
whether the - too strict - Burch criteria and the clinically adhered cut-off level of
25 mmHg is influenced by the level of PEEP necessary in a particular patient.
The message that we can measure intra-abdominal pressure in many ways
reliably does not answer the only really important question: what level under what
circumstances requires an intervention?
Statistical analysis is adequate.
Minor comments:
Figures 1 and 2 are uninformative and hard to interpretate. Use medians and
range for the group and depict as such. If baseline measurements differ that
much among the twelve pigs it will be apparent in the ranges, or the experimental
setting is inadequate.
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-10-70 (2010)

Reviewer's report
Title:Increasing abdominal pressure with and without PEEP: Effects on
intra-peritoneal, intra-organ and intra-vascular pressures
Version: 3Date:5 February 2010
Reviewer: Jan De Waele
Reviewer's report:
The authors adequately addressed all issues raised. The only thing that should
be added is details on the software program used for the Bland and ALtman
statistics.
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-10-70 (2010)

Reviewer's report
Title:Increasing abdominal pressure with and without PEEP: Effects on
intra-peritoneal, intra-organ and intra-vascular pressures
Version: 3Date:21 February 2010
Reviewer: Alexander Schachtrupp
Reviewer's report:
Discretionary Revisions:
The authors have clearly improved the manuscript by a detailed answer to
reviewers comments as well as by a detailed inclusion of the available literature.
It would certainly be desirable to have information about the influence of several
PEEP levels on a IAP relevant also for the diagnosis of ACS.
The publication of this data however, may be very useful for future studies as
background and hypothesis generation.
Minor comments:
All pressure transducers were simultaneously zeroed to a level corresponding to
the ventral border of the front leg.
As position of the animal may vary in comparison to other porcine studies the
usage of a small figure or a sketch is recommended.
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