JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/1471-230X-7-8 (2007)

Reviewer's report 
 Delayed diagnosis of coeliac disease increases cancer risk Title: 
 10  3 January 2007 Version: Date: 
 Eamonn M M Quigley Reviewer: 
Reviewer's report: 
General 
The key issue is that raised by the two reviewers; i.e., ascertainment bias. 
The authors have attempted to address this but, in truth, it can only be accurately addressed by a truly prospective study with age- and gender-matched controls. I would, therefore, ask the authors to tone down 
their conclusions; at best, they suggest an increased risk in relation to 
age at diagnosis, no more! The manuscript, in contrast to the response, does not clearly define the control population and how they were matched for age and gender with the 
patients; this is a critical issue and must be completely addressed in the 
manuscript. Otherwise we may be seeing little but age- and gender-related differences in cancer incidence. The other findings with regard to increased rates of lymphoma and adenoca 
are not new and merely confirmatory. 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore)
Review for 10.1186/1471-230X-7-8 (2007)

Reviewer's report 
 Delayed diagnosis of coeliac disease increases cancer risk Title: 
 11  13 February 2007 Version: Date: 
 Eamonn M M Quigley Reviewer: 
Reviewer's report: 
General 
I recommend acceptance. 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore)
Review for 10.1186/1471-230X-7-7 (2007)

Reviewer's report 
 Oxidised and reduced glutathione and related thiols in human gallbladder bile. Title: 
 1  20 September 2006 Version: Date: 
 Fiorella Piemonte Reviewer: 
Reviewer's report: 
General 
In this study Peters et al. measure some important thiols in human galdbladder bile. In my opinion some 
major criticism can be moved to the manuscript. 
1. The question posed could be interesting but it is not clear if the aim of the study is to analyze the 
oxidative status of the bile, or its thiol composition in physio-pathological conditions. 
2. The references cited are not updated and, consequently, the Introduction and Discussion sections appear poor and not sufficiently in-depth. 3. The Methods appear confuse and it is omitted the kind of column and the detection system used for 
HPLC studies 
4. The data often show a SD higher than the mean reported. Probably, it is not correct to group together patients with different diseases. Even the age range is too much large for having reliable results. 5. Regarding glutathione measurements, should be important to analyze all the forms of glutathione in 
galdbladder bile, including protein-bound glutathione, given the growing importance of this form as a marker 
of oxidative stress. 
6. Even the nomenclature is not much accurate: glutathione is GSH (not GLU), its oxidized form is GSSG (not oGLU). 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore) 
 Reject because scientifically unsound What next?: 
 An article of limited interest Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 Yes Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests.
Review for 10.1186/1471-230X-7-7 (2007)

Reviewer's report 
 Oxidised and reduced glutathione and related thiols in human gallbladder bile. Title: 
 1  25 September 2006 Version: Date: 
 Christos Georgiou Reviewer: 
Reviewer's report: 
The brief report titled ‘Oxidised and reduced glutathione and related thiols in human gallbladder bile’ by 
Wilbert HM Peters, Annie van Schaik, Joost Peters, and Harry van Goor presents very interesting, sound 
and well controlled data, based on adequately defined questions, on the composition of human gallbladder bile in terms of glutathione and related thiols. It is an original study because previous related studies were focused mainly on rats, which in addition lack a gallbladder as a reservoir of bile. 
The manuscript adheres to the relevant standards for reporting and data deposition, the title and the 
abstract accurately convey what has been found, and the discussion and conclusions are well balanced and 
adequately supported by the data. In general, the manuscript is concisely written, well documented, and 
experimentally well designed. 
 Accept without revision What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests
Review for 10.1186/1471-230X-7-7 (2007)

Reviewer's report 
 Oxidised and reduced glutathione and related thiols in human gallbladder bile. Title: 
 1  1 October 2006 Version: Date: 
 Derick Han Reviewer: 
Reviewer's report: 
General 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
The paper examines GSH and other thiol levels and redox status in human gallbladder. While the data is 
very valuable since it is from human samples, some caution must be taken since samples were taken from people with cancer and severe inflammatory disease. The data is insufficient to make statement such as “In 
contrast to earlier data on rodent bile, human bile did contain far less glutathione, whereas most thiols is 
present were in the oxidized state” in the abstract. Since the data was taken from people with disease states such statement are not valid. It is well accepted disease states affect GSH levels and redox state. Thus, the paper should stress that people with disease states have low GSH and greater oxidized thiols. 
Normal human GSH levels and redox state remains uncertain since control human samples can not be 
obtained. 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
Minor point: The authors should use accepted abbreviations for thiols in the table. For example glutathione 
should be labeled “GSH” and oxidized glutathione should be labeled “GSSG”. 
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Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interest.
Review for 10.1186/1471-230X-7-7 (2007)

Reviewer's report 
 Oxidised and total non-protein bound glutathione and related thiols in gallbladder bile of patients with Title: 
various gastrointestinal disorders. 
 2  30 October 2006 Version: Date: 
 Ignazio Grattagliano Reviewer: 
Reviewer's report: 
General 
The paper by Peters et al. has been greatly improved. The authors agreed with most of the comments raised and have consequently modified some crucial points of the manuscript. Some information required remain without an answer (i.e. exact typology of the patients). 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore) 
English should be improved. 
 Accept after minor essential revisions What next?: 
 An article of limited interest Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests.
Review for 10.1186/1471-230X-7-7 (2007)

Reviewer's report 
 Oxidised and total non-protein bound glutathione and related thiols in gallbladder bile of patients with Title: 
various gastrointestinal disorders. 
 2  30 October 2006 Version: Date: 
 Fiorella Piemonte Reviewer: 
Reviewer's report: 
General 
------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
1) the data should be presented as median and not as mean, given the extremely high SD. 
2) the thiol composition of gallbladder bile may be a reflection of some therapeutic trial. Indeed, the authors do not report any clinical information on the various patients and no data on the thiol composition in healthy subjects. 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 Yes Statistical review: 
Declaration of competing interests: 
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-7-7 (2007)

Reviewer's report 
 Oxidised and total non-protein bound glutathione and related thiols in gallbladder bile of patients with Title: 
various gastrointestinal disorders. 
 2  9 November 2006 Version: Date: 
 Derick Han Reviewer: 
Reviewer's report: 
General 
The paper is greatly improved. 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore) 
 Accept without revision What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests
Review for 10.1186/1471-230X-7-7 (2007)

Reviewer's report 
 Oxidised and total non-protein bound glutathione and related thiols in gallbladder bile of patients with Title: 
various gastrointestinal disorders. 
 3  15 December 2006 Version: Date: 
 Fiorella Piemonte Reviewer: 
Reviewer's report: 
General 
This paper could become interesting in future by increasing the number of patients and subdividing the results into the several tipology of the patients. 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore) 
 Reject because too small an advance to publish What next?: 
 An article of insufficient interest to warrant publication in a scientific/medical journal Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-7-7 (2007)

Reviewer's report 
 Oxidised and total non-protein bound glutathione and related thiols in gallbladder bile of patients with Title: 
various gastrointestinal disorders. 
 3  22 January 2007 Version: Date: 
 Rakesh Tandon Reviewer: 
Reviewer's report: 
General 
In my opinion, it is an interesting work with future implications. The findings 
are preliminary and the study is a pilot study. Thus, the small numbers do 
not bother me. We all know that for such a novel study it is difficult to 
gather a large number of patients. The importance of the study is that it opens an entirely new direction for future study and hence I recommend that it be published in BMC-series journal. 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore)
Review for 10.1186/1471-230X-7-6 (2007)

Reviewer's report 
 Gabexate in the prophylaxis of post-ERCP pancreatitis: A meta-analysis of randomized controlled Title: 
trials 
 1  15 November 2006 Version: Date: 
 Angelo Andriulli Reviewer: 
Reviewer's report: 
General 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
It is of relevance this topic being subjected to a meta-analysis from our oriental colleagues, as Gabexate is currently in use for the prophylaxis of post-ERCP pancreatitis in those countries. The negative results presented in the manuscript might contribute to a change in guidelines for the use of the drug. 
However, there are two substantial points to be addressed: 
- a thorough revision of English language, as some sentences are confusing or difficult to the immediate comprehension. 
- A relevant trial, although published in an Abstract form and therefore not yet available through Medline, is 
the one recently presented by Benvenuti and co-workers to the last meeting of the Italian Digestive week 
(Benvenuti S, Zancanella L, Piazzi L, Comberlato M, Chilovi F, Germanà B, Lecis P, Brosolo P, Ederle A. Prevention of post-ERCP pancreatitis with somatostatin versus gabexate mesilate: a randomized 
placebo-controlled multicenter study. Dig Liv Dis 2006;38:S15). This work needs to be included in the 
present meta-analysis because it adds clarity to a point addressed into the Authors’ Discussion section. In this trial Gabexate has been infused for longer than 12 hours and still negative results were achieved. These negative data are at odds with than Authors comment that “infusion over a longer period of time (12 
hours) of gabexate had been shown to be beneficial in trials that included all patients scheduled to undergo 
ERCP (page 10, line 8). 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of importance in its field Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 Yes Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. However, I have to make clear to have on publication a 
manuscript of mine dealing with some part of the topic of the work I've been asked to review.
Review for 10.1186/1471-230X-7-6 (2007)

Reviewer's report 
 Gabexate in the prophylaxis of post-ERCP pancreatitis: A meta-analysis of randomized controlled Title: 
trials 
 1  13 December 2006 Version: Date: 
 Chris Forsmark Reviewer: 
Reviewer's report: 
General: This meta-analysis is done the right way and the inclusion of only high quality studies makes the 
results quite convincing. I think you should be a little stronger in your conclusions- in the abstract you state 
the result "is credible to some extent" which is a very lukewarm endorsement of your results. I think it would 
be better to state directly that the analysis shows the drug is ineffective. 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached): The scientific approach is impeccable but the use of English is confusing in many areas. The 
manuscript will need revision by someone with strong editorial experience and clear command of the 
language. It would also be appropriatee to discuss the 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct): 
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Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article of importance in its field Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests
Review for 10.1186/1471-230X-7-6 (2007)

Reviewer's report 
 Gabexate in the prophylaxis of post-ERCP pancreatitis: A meta-analysis of randomized controlled Title: 
trials 
 1  19 December 2006 Version: Date: 
 Peter Matzen Reviewer: 
Reviewer's report: 
General 
1.A met aanalysis of recent randomised controlled trials of good standard. ------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
2. It should be demonstrated in the discussion that the positive result of the metaanalysis by Andriulli (20) 
from 2000 as to effect of Gabexate depend on only one study by Cavalini (4) as the two other studies are very small, and only on post-ERCP pain. 3. The main results of the sensitivity analyses should be compared in a table to those of the main analysis. 
4. The last sentence in the second last paragrap of the discussion is unclear to me, and should be either 
omited or referenced. 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
4. The last paragraph of the discussion should be omitted (or referenced) ------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
None 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of importance in its field Level of interest: 
 Not suitable for publication unless extensively edited Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
None
Review for 10.1186/1471-230X-7-4 (2007)

Reviewer's report 
 Duodenal Metastases from Renal Cell Carcinoma Presenting as Gastrointestinal Bleeding: Two Case Title: 
Reports and a Review of the Literature 
 1  11 November 2006 Version: Date: 
 Hans Herfarth Reviewer: 
Reviewer's report: 
General 
The authors describe two interesting clinical cases of upper GI-bleeding occurring due to duodenal renal cell carcinoma metastases. The cases are well described. The discussion is structured and reports the current literature. I would recommend to accept the paper for publication. 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore) 
 Accept without revision What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests
Review for 10.1186/1471-230X-7-4 (2007)

Reviewer's report 
 Duodenal Metastases from Renal Cell Carcinoma Presenting as Gastrointestinal Bleeding: Two Case Title: 
Reports and a Review of the Literature 
 1  15 November 2006 Version: Date: 
 Myriam Delhaye Reviewer: 
Reviewer's report: 
General 
The authors report two observations of uncommon presentation of metastatic renal cell carcinoma as upper 
gastrointestinal haemorrhage. 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 1. The authors should be careful in considering the duodenum as the site of metastases rather than the 
more likely pancreatic metastases invading the duodenal wall and causing bleeding. 
Indeed, Figure 1 is inadequate to show a normal head of the pancreas, Figure 2A is showing numerous pancreatic metastases and Figure 3 (case 2) is demonstrating a large mass in the area of the pancreatic head protruding into the duodenum suggesting the diagnosis of pancreatic metastasis. 
Maybe the title should be changed accordingly. 
2. With regard to case 2, the authors should emphasize that surgical resection of pancreatic/duodenal 
metastasis (by duodenopancreatectomy) should be considered when possible (see their reference 17). Indeed, when metastases are limited to the pancreas, surgery can provide 31% 5-year survival rate as 
compared to 9% for metastatic RCC (Faure et al, J Urol 2001; 165: 20-22; Maldazy JD et al, J Urol 1986; 
136: 376-379). ------------------------------------------------------------------------------- Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
1. Introduction, p. 4, l. 2: one or more references could be added at the end of the sentence related to metastasis to the small intestine in RCC, causing gastrointestinal bleeding. 2. Case 1 (p. 5): CLO should be written in full as campylobacter-like organisms the first time it appears in 
the text. 
3. Discussion, p. 11, first sentence: reference 17 reported a case of bleeding due to a pancreatic metastasis 
invading the duodenum and not a duodenal metastasis. 
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Discretionary Revisions (which the author can choose to ignore) 
1. Four upper gastrointestinal endoscopies were necessary during a period of 3 months to achieve the correct diagnosis in case 1 despite the presence of blood in the duodenum. Maybe endoscopy using a lateral viewing duodenoscope would have been useful in such cases when there is suspicion of bleeding 
originating from the periampullary region. 
2. Endoscopic and pathologic (with immunohistochemical staining) pictures could be interesting. 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests.
Review for 10.1186/1471-230X-7-4 (2007)

Reviewer's report 
 Metastases from Renal Cell Carcinoma Presenting as Gastrointestinal Bleeding: Two Case Reports Title: 
and a Review of the Literature 
 2  14 December 2006 Version: Date: 
 Myriam Delhaye Reviewer: 
Reviewer's report: 
General 
I thank you for sending me the revised version of the above manuscript. I think that the authors have correctly answered to the original comments. However, they should correct 2 minor mistakes: 
- references 25 and 33 are the same; 
- the title of the reference 24 is lacking ------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore)
Review for 10.1186/1471-230X-7-5 (2007)

Reviewer's report 
 Prevalence and Associated Factors of Viral Hepatitis and Transferrin Elevations in 5036 Patients Title: 
Admitted to the Emergency Room of a Swiss University Hospital: cross-sectional study 
 1  27 December 2006 Version: Date: 
 Hans Ludger L Tillmann Reviewer: 
Reviewer's report: 
No further comments 
General 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore) 
 Accept without revision What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-7-5 (2007)

Reviewer's report 
 Prevalence and Associated Factors of Viral Hepatitis and Transferrin Elevations in 5036 Patients Title: 
Admitted to the Emergency Room of a Swiss University Hospital: cross-sectional study 
 1  8 January 2007 Version: Date: 
 Mary Jo J Trepka Reviewer: 
Reviewer's report: 
General 
The authors have adequately responded to the concerns that I had. 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) None ------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) None. ------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept without revision What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests.
Review for 10.1186/1471-230X-7-3 (2007)

Reviewer's report 
 Gastroparesis secondary to a demyelinating disease: A Case Series Title: 
 1  10 November 2006 Version: Date: 
 Mauro Bortolotti Reviewer: 
Reviewer's report: 
General 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
- How were the characteristics of the vomiting? Was it neurological? 
- Did the patients have signs of endocranic hypertension at the time of the vomiting start? - No details on the gastric emptying test were given. Was it done with a 
scintigraphic method? The values of the GE parameters before and after 
treatment should be given. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
This is an interesting paper that gives the occasion for a deeper 
investigation on the brain-gut relationships in man. If the Authors would state precisely with the aid of a neuroradiologist and a neurophysiologist the topographic areas of the cervico medullary junction involved by the 
lesions, they should be able to single out the areas of vagal nuclei that 
control gastric motility and that are distinct from the areas of the vomiting center. The present case together with a similar report previously published in J Gastrointest Mot 1989;1:99 could contribute to a deeper 
knowledge of the central control of gastric motility.
Review for 10.1186/1471-230X-7-3 (2007)

Reviewer's report 
 Gastroparesis secondary to a demyelinating disease: A Case Series Title: 
 1  23 November 2006 Version: Date: 
 Oliver Goetze Reviewer: 
Reviewer's report: 
Reddymasu et al. report in a case series of two patients an association of early brain demyelinations in the 
medullary region with delayed gastric emptying (GE) and show an improvement of gastric emptying as well 
as of gastrointestinal and neurological symptoms after treatment with glucocorticoids. The topic is of clinical, pathophysiological and therapeutical interest. To my knowledge only five cases have been published up to now. 
However, the authors should include more clinical data and differential pathophysiological and therapeutical
considerations and highlight how their findings relate to the published case reports and literature. 
Major comments: 
Abstract 
1.The authors should conclude that the improvement of gastrointestinal and neurological symptoms and 
gastroparesis by corticosteroids might only be achieved in early stages of the disease. Discussion: 
2.The authors should highlight how their case series relate to the published literature (Rhagav et al., multiple 
sclerosis 2006; Read et al., Lancet 1995; Atkinson et al., Digestive Diseases and Sciences 1998). 
3.Possible differential pathophysiological mechanisms should be provided e.g. lesions in the vestibular system could also be an explanation for generation of nausea and delayed GE. (Faas et al., Am J Phsiol 
Gastrointest Liver Physiol, 2001) 
4. The effect of other published therapeutical approaches (cisapride) and the effects of glucocorticoids in established multiple sclerosis should be discussed. 
Minor comments: 
Case presentation: 5.The neurological physical exam should be presented more precisely (e.g. cranial nerve function, kind of nystagmus, nystagmus on gaze, reflexes, Babinski signs etc.) 
6.Which technique for measurement of gastric emptying test was used (scintigraphy, MRI etc.) ? What was 
the caloric content of the test-meal ? Was gastric emptying measured until complete stomach emptying ? Was gastric half emptying time determined ? Normal values for GE should be provided in this section. 7.Were also autonomic (abdomino-vagal) function tests performed ? 
8.Which dose of methylprednisolone was administered ? 
Discussion: 9.The statement that corticosteroids can be used for treatment of nausea and vomiting, but not for treatment of gastroparesis should better be referenced. 
10. Table 1 should be deleted, since it repeats information already given in the text. 
11. More informative than the table could be an MRI image slice indicating the lesions in the medulla. 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests.
Review for 10.1186/1471-230X-7-3 (2007)

Reviewer's report 
 Gastroparesis secondary to a demyelinating disease: A Case Series Title: 
 2  21 December 2006 Version: Date: 
 Oliver Goetze Reviewer: 
Reviewer's report: 
The revised manuscript of Reddymasu and colleagues is now adequate in 
presentation of the cases and well described, the findings are now clearly presented and the discussion is 
conclusive. 
 Accept without revision What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests
Review for 10.1186/1471-230X-7-2 (2007)

Reviewer's report 
 Invasive Pulmonary Aspergillosis in Patients with decompensated cirrhosis : case series Title: 
 1  13 June 2006 Version: Date: 
 koenraad H vandewoude Reviewer: 
Reviewer's report: 
General 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
1. In all the three cases described, an exposure to corticosteroid therapy is described. Steroid exposure is 
an important risk factor for the development of invasive aspergillosis. In the discussion, it should be stressed that steroid exposure could have played an role in the development of invasive pulmonary 
aspergillosis. It can be speculated that in critically ill patients, the threshold dose for developing this infection 
is lower than in other patients; even stress doses as now routinely used in septic shock may represent a risk 
factor 1 2. Hence, it may be unclear if liver failure, or the combination of liver failure and steroid exposure, 
may have contributed to the infection. 
2. Since all patients died, it would be of interest to know if the clinical suspicion of aspergillosis was 
confirmed by necropsy. We agree that it is difficult to use the EORTC/MSGT criteria for invasive fungal 
infections in patients without malignancy. The authors have made the diagnosis of invasive pulmonary aspergillosis, based on microbiological data and atypical radiological findings. Hence, it should be stressed 
that this diagnosis is not proven in all three cases. However, we agree that the findings are clinically 
relevant and that an adapted clinical algorithm should be used for diagnostic and therapeutic decision making in this type of patients3. 
3.It would be appropriate to describe the patient characteristics more in depth, with APACHE or SAPS 
score, and severity of organ derangements. It seems that these 3 patients were severely ill and that the expected mortality was very high. 
Conclusion: 
Rewriting of the case histories is mandatory, since the diagnosis of proven aspergillosis is not evident (no 
tissue biopsy, no culture of normally sterile site). Discussion should be adapted, highlighting the 
combination of risk factors present in these patients (steroid exposure, liver failure, previous lung disease 
and lung structural damage due to pneumonia and ARDS). 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests
Review for 10.1186/1471-230X-7-2 (2007)

Reviewer's report 
 Invasive Pulmonary Aspergillosis in Patients with decompensated cirrhosis : case series Title: 
 1  7 August 2006 Version: Date: 
 saad nseir Reviewer: 
Reviewer's report: 
Discretionary Revisions (which the author can choose to ignore) 
Dr. Provanovic and colleagues report a case series of three patients with cirrhosis hospitalized in the ICU for ARDS, sepsis, and multiorgan dysfunction. Invasive pulmonary aspergillosis was diagnosed based on positive Aspergillus antigenemia in two patients, and positive Aspergillus selology in the third one. 
Bronchoalveolar lavage fluid grew Aspergillus fumigatus in all patients. Outcome was fatal in all patients. 
General comments: 
This is a well described case series of invasive pulmonary aspergillosis in patients with moderate 
immunosuppression. In fact, invasive pulmonary aspergillosis is an emerging infectious disease in these 
patients. Therefore, diagnosis should rapidly be raised, and prompt antifungal treatment should be given to these patients. In general, this case series is interesting and well written. However, some clarifications are needed. 
Specific comments: 
1. To my knowledge, according to EORTC criteria the three cases would be classified as probable invasive pulmonary aspergillosis. The authors sated that the first two cases would be classified as proven invasive 
pulmonary aspergillosis (Discussion section, page 6, line 12). However, no histopathologic examination 
from biopsy specimen was performed. 
2. Hemoptysis and bronchospasm are important clinical signs of invasive pulmonary aspergillosis. Were 
these clinical signs present in the studied patients? 
3. The authors stated that prompt empirical antifungal treatment should probably be considered in patients 
with severe cirrhosis and suspected invasive pulmonary aspergillosis. It would be of interest to add a 
comment on combined antifungal treatment in these patients. 
4. Corticosteroid treatment is an important risk factor for invasive pulmonary aspergillosis. Should this 
treatment be stopped in patients with invasive pulmonary aspergillosis? 
5. The three cases of invasive pulmonary aspergillosis were hospital-acquired. Were these cases 
diagnosed during the same period of time? 
6. Minor comment: 
-page 5, case 3, line 4: â€œthis complication occurredâ€¦â€  the sentence is incomplete. 
-page 6, Discussion, line 4: â€œhalo sign, considered of high diagnostic value in cancer patients was 
present or notâ€  should be replaced by â€œhalo sign, considered of high diagnostic value in cancer 
patients, was present or notâ€ 
Dr. Saad NSEIR 
 Accept after minor essential revisions What next?: 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests
Review for 10.1186/1471-230X-7-2 (2007)

Reviewer's report 
 Invasive Pulmonary Aspergillosis in Patients with decompensated cirrhosis : case series Title: 
 2  13 October 2006 Version: Date: 
 saad nseir Reviewer: 
Reviewer's report: 
The authors have convincingly adressed all of my comments. 
 Accept without revision What next?: 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests' below.
Review for 10.1186/1471-230X-7-2 (2007)

Reviewer's report 
 Invasive Pulmonary Aspergillosis in Patients with decompensated cirrhosis : case series Title: 
 2  23 October 2006 Version: Date: 
 Jorge Garbino Reviewer: 
Reviewer's report: 
General 
I really appreciate the way in which the authors considered all the reviewers'comments and made a real 
effort to change and improve their manuscript, which has now become a good one. ------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept without revision What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-7-1 (2007)

Reviewer's report 
 Urodilatin Increases Natriuresis in Cirrhosis Patients with Sodium Retention. Title: 
 1  22 August 2006 Version: Date: 
 Yasuhiko Sugawara Reviewer: 
Reviewer's report: 
General comment 
The manuscript entitled “Urodilatin increases natriuresis in cirrhotic patients with sodium retention” by 
Carstens et al. presents important data on the diuretic effects of synthetic urodilatin intravenous administration in patients with decompressed cirrhosis. Considering the small sample size and the data presented in this study, the title ” Urodilatin increases natriuresis” might be too affirmative and should be 
changed. The study design is well prepared and the finding has potential help for the management of 
decompressed cirrhotic patients. 
Specific comments 
1. The table which summarizes patients’ basal characteristics including ranal and liver exams, urinary 
analysis, and endogenous urodilatin and other hormones (such as renin, angiotensin, aldosterone..)level should be prepared. 2. The transition of the total amount of Na excretion should also be analyzed and presented in figure. 
3. page7, first paragraph. “By the end of infusions there was no difference between Uro and placebo” might 
be incorrect. From the Fig.2 the difference seemed disappear at the end of the study. 
4. The transition of serum urodilation level under URO and placebo had better to be presented in figure, if available. 
5. Is serum urodilatin level of decompressed cirrhotic patients usually elevated or not when compared to 
normal population? ANP, one of the family of natriuretic peptide, usually up-regulated in advanced cirrhosis 
and the decreased response to ANP has been advocated to be one of the reasons of the unresponsiveness 
to ANP infusion in such patients. Is this the case with urodilatin? 
6. The clinical application and limitation of urodilatin for cirrhotic patients should be discussed in association 
with other diseases such as chronic heart failure in which the clinical value of urodilation has been reported. 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review:
Review for 10.1186/1471-230X-7-1 (2007)

Reviewer's report 
 Urodilatin Increases Natriuresis in Cirrhosis Patients with Sodium Retention. Title: 
 2  20 October 2006 Version: Date: 
 Yasuhiko Sugawara Reviewer: 
Reviewer's report: 
General comment 
The manuscript re-entitled “Effects of urodilatin on natriuresis in cirrhotic patients with sodium retention” by 
Carstens et al. has been properly revised according to our suggestion. On the whole this manuscript is acceptable for publication in BMC. I recognized that there are still some minor points which should be revised before publication. 
Minor comments. 
1. page 11, second paragraph. Both “URO was found to have no beneficial effect…” and “In a recent study on decompensated chronic heart failure…” need references. 
2. Third paragraph in page 11 starting with “On the other hand…” might be unnecessary and can be 
omitted. 3. Table 1. The title “summarizes the basal characteristics…” should be changed to “Summaries of the basal characteristics…”. 
4. Table 1. PP and MELD need explanations (spelling out) in the Table. 
 Accept after discretionary revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests.
Review for 10.1186/1471-230X-7-1 (2007)

Reviewer's report 
 Urodilatin Increases Natriuresis in Cirrhosis Patients with Sodium Retention. Title: 
 2  27 October 2006 Version: Date: 
 giorgio della rocca Reviewer: 
Reviewer's report: 
General 
NO------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
NO------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
NO------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
NO 
 Accept without revision What next?: 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interest