JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/1471-230X-11-120 (2011)

Reviewer's report
Title:Surgery for fistula in ano in a specialist colorectal unit: a critical appraisal
Version: 1Date:29 August 2011
Reviewer: Roland Scherer
Reviewer's report:
Minor essential revisions
1.The part Results is almost not readible. There must be more figures to show
the several subgroups of your patients and their results.
2 The figures must show the subgroups (kryptoglandular, Rectovaginal
fistulas,IBD etc), their treatment , the results , follow up and complications)
3.Loose seton was the only treatment in 40,7% of the patients. Please show their
success rates, mean follow up etc, because this was your most common
treatment.
4.If your success rate with only loose seton and removel of the seton is quite
high,why and when did you use advanced flaps.
5.How was the outcome of the nine patients with rectovaginal fistulas?
6.How many surgeons operated on these patients?
7.In the 6 patients with fecal incontinence, which procedutre was done?
8.All patients had incontinence scores before surgery. DO you have the scores
after surgery?If so, please show them.
9.When did you use further diagnostics (ultrasound, MRI etc.)
10. How was the outcome of the "cutting seton patients", esp. regarding pain and
incontinence rates?
4.How many surgeons operated on your patients?
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-11-119 (2011)

Reviewer's report
Title:Bio-physical characteristics of gastrointestinal mucosa of celiac patients:
comparison with control subjects and effect of gluten free diet
Version: 4Date:31 August 2011
Reviewer: Evan Newnham
Reviewer's report:
This is a much improved version. A few suggestions are below.
Minor Essential Revisions
Could the authors please clarify the data '29+/- 1 month' in the results for length
of time on a GFD? if 1 month is to represent the 95% confidence interval, this
cannot be correct based on the values for the range in parentheses.
I would suggest describing each figure underneath the figure itself (as has been
done for table 1 (for example, in figure 1, without referring to the text the reader is
not informed as to which patient group these values are describing).
Can the data in figure 1 be combined onto the one graph? In addition the y axis
needs to be consistent for all figures.
Sentence 2 of the discussion (beginning "This bio-physical..." does not make
sense and needs to be reworded.
Regards
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-11-118 (2011)

Reviewer's report
Title:Delay to celiac disease diagnosis and its implications for health-related
quality of life
Version: 2Date:6 September 2011
Reviewer: Harald Vogelsang
Reviewer's report:
!. Major: it should be tested if the delays are normally distributed or not.
I think not, because there is such a big gap between mean and median. Then
median should be mainly used in the abstract.
2.Minor: the celiac questionnaire would be interesting and an English translation
of the Swedish text preferred.
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-11-118 (2011)

Reviewer's report
Title:Delay to celiac disease diagnosis and its implications for health-related
quality of life
Version: 2Date:6 October 2011
Reviewer: Jeremy Woodward
Reviewer's report:
This is a large study that identified a significant delay in time from the onset of
symptoms in coeliac disease to the diagnosis of the condition. By demonstrating
an improvement in health-related quality of life after diagnosis and institution of
treatment, a preventable burden of ill health has been identified. The study is well
designed and executed with the authors aware of the major limitations of the
work. Potential sources of bias include the difficulty in recall of symptoms prior to
diagnosis - in some cases very many years prior to the study questionnaire being
sent. Whilst the authors suggest that recall bias is likely to underestimate the
symptoms, the opposite may in fact be the case given the likelihood of positive
reinforcement by health professionals encouraging dietary compliance, and
membership of a patient group. There is an unfortunate but unavoidable
response bias as well that probably explains the high rate of dietary compliance
(96%) of the 66% that did respond. This data does not support the idea of mass
screening for coeliac disease, but is further support for a low threshold in testing
for the condition in the presence of symptoms. In this regard a potential
opportunity has been missed by the investigators in determining which type of
symptoms were predominantly experienced by patients and whether this had any
impact on the delay in diagnosis. I would find figure 1 easier to understand with
the addition of the words 'prior to diagnosis' after 'duration of symptoms' on the
abscissa label.
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-11-116 (2011)

Reviewer's report
Title:Gynecomastia during imatinib mesylate treatment for gastrointestinal
tumor: a rare adverse event
Version: 1Date:22 June 2011
Reviewer: Giovanni Caocci
Reviewer's report:
This is an interesting report of patients experiencing gynecomastia during
imatinib treatment for gastrointestinal tumor. Only two reports have previously
decrypted such cases.
In order to judge the case for its impact on future therapy, the Authors will need
to add some data which, unfortunately, are missing.
Major compulsory revisions:
1. Full spectrum of steroid hormones and stimulating hormones (as published by
Gambacorti et al.) before and after tamoxifene treatment should be provided: in
particular, if possible, 17-OHP levels
2. The potential impact of first and second generation TKI on gynecomastia
should be discussed (not only imatinib)
Furthermore, I have the following minor essential revisions:
1. Abstract: In the results section it is not clear to which patients the authors are
referring when they speak about serum free testosterone levels (those with or
without gynecomastia?)
2. Introduction: please also consider the reported relationship between Dasatinib
and gynecomastia
3. Please provide schedule and duration of tamoxifene treatment.
4. Also provide any additional medication with the potential to influence hormonal
levels by interacting with imatinib (e.g., spironolactone)
5. Alternative treatments of gynecomastia should be discussed, e.g. radiation,
considering the interaction of tamoxifen with imatinib.
6. The English language needs to be “polished”. Throughout the paper some
verbs need to be corrected. The paper needs to be corrected by an English
mother tongue assistant.
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-11-116 (2011)

Reviewer's report
Title:Gynecomastia during imatinib mesylate treatment for gastrointestinal
tumor: a rare adverse event
Version: 1Date:6 July 2011
Reviewer: Philippe Cassier
Reviewer's report:
Major compulsory revisions: None
Minor essential revisions:
Overall the article is clearly resented and the level of english is acceptable
although authors should consider rephrasing some sentences. For example p4,
in the result section “Blood samples taken randomly from six patients who do not
have gynecomastia…” should be rephrased as “Blood samples taken from six
randomly selected patients who did not have gynecomastia…”
The author state in their introduction that gynecomastia is a rare event in patients
treated with imatinib mesylate which is in line with the reviewer’s personal
experience, although as it is rarely symptomatic it may be underreported.
However, in the material and methods and result section it appears that 6 of 57
(10%!!!) had such an event therefore making it a very frequent side effect,
especially considering that all patients apparently complained about their
gynecomastia being painful. Please discuss hypotheses possibly explaining this
difference between expected and observed frequency.
As the authors underline in their discussion, other medications are known to
cause gynecomastia, it is therefore esential that the authors a list of concurrent
medications taken by their patients.
Discretionary revisions: None
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have received honoraria from Novartis
Review for 10.1186/1471-230X-11-116 (2011)

Reviewer's report
Title:Gynecomastia during imatinib mesylate treatment for gastrointestinal
tumor: a rare adverse event
Version: 1Date:9 July 2011
Reviewer: Vincenzo Pitini
Reviewer's report:
Dear Dr Timothy Shipley PhD,
In this paper Heli Liu et al. present six patients who developed gynecomastia
during treatment with imatinib.
Interestingly, three patients had increased serum estradiol levels which
suggested that the imbalance of sex hormone may be the cause of gynecomastia
during treatment with imatinib.
This paper has important implications for clinical management and given the
presented data the conclusions are right.
1. The question posed by the authors is well defined
2. The methods are appropriate and well described
3. The data are sound
4. The manuscript adhere to the relevant standards for reporting and data
deposition
5. The discussion and conclusions are well balanced and adequately supported
by the data
6. The title and abstract accurately convey what has been found
7. The writing is acceptable
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
Reviewer declares that he has no conflicts of interest.
With best wishes,
Prof. Vincenzo Pitini
Review for 10.1186/1471-230X-11-116 (2011)

Reviewer's report
Title:Gynecomastia during imatinib mesylate treatment for gastrointestinal
tumor: a rare adverse event
Version: 2Date:24 September 2011
Reviewer: Giovanni Caocci
Reviewer's report:
The paper is now suitable for publication in BMB Gastroenterology
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.
Giovanni Caocci
Review for 10.1186/1471-230X-11-117 (2011)

Reviewer's report
Title:Multidisciplinary Approaches Vary as to the Role of Endoscopic Ultrasound
(EUS) - Guided Fine Needle Aspiration: Controversial Indications
Version: 2Date:29 May 2011
Reviewer: Jose Celso Ardengh
Reviewer's report:
Comments on the paper entitled "Approaches Vary Among the Disciplines
Relevant to the Role of Endoscopic Ultrasound (EUS) - Guided Fine Needle
Aspiration: Controversial Indications. " Lachter et al.
1. Is the question posed by the authors well defined?
Yes but the introduction is long and confusing. I suggest the authors to decrease
the text, making it more objective and convincing to the readers. Goals should be
better addressed.
2. Are the methods appropriate and well described?
This section is clear but I think the proposal specified as doubtful cases shall be
described in this section and not in the results section. The results should show
only the results and not the description of each of the cases under discussion.
3. Are the data sound?
Yes.
4. Does the manuscript adhere to the relevant standards for reporting and data
deposition?
This manuscript is interesting and demonstrates exactly the controversial clinical
situations regarding the indication or not of EUS-FNA of our daily clinical
practice.
5. Are the discussion and conclusions well balanced and adequately supported
by the data?
The discussion and conclusion are long and should be rewritten because at
various points they generate confusion. At certain points the work is confusing
and the writing is long, but this can be fixed easily.
6. Are limitations of the work clearly stated?
Yes.
7. Do the authors clearly acknowledge any work upon which they are building,
both published and unpublished?
Yes
8. Do the title and abstract accurately convey what has been found?
The title is appropriate for the paper. The abstract is well formatted and
expressed specifically what the paper show.
9. Is the writing acceptable?
I think the work should be published because the methodology of applied
research is satisfactory.
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.
Review for 10.1186/1471-230X-11-117 (2011)

Reviewer's report
Title:Multidisciplinary Approaches Vary as to the Role of Endoscopic Ultrasound
(EUS) - Guided Fine Needle Aspiration: Controversial Indications
Version: 4Date:29 July 2011
Reviewer: Silvia Carrara
Reviewer's report:
The manuscript is now more objective and more attractive for the readers.
One only comment: again, the discussion explains the results of the
questionnaire but doesn’t refer to previous international guidelines, and doesn’t
support the results with data, in particular for the management of cystic lesions
(see my previous comment, date 18 May 2011, point 5). The text refers to
controversies between ASGE and ACG, but without any explanations and any
references, please, make it more understandable and add references.
Add references supporting the role of fluid markers analysis for cystic lesions.
The Authors should extend the references and use other published studies to
support their hypothesis in the discussion and in the conclusions.
The conclusions are too long: part of them should be added to the discussion,
and the conclusions re-written.
Review for 10.1186/1471-230X-11-115 (2011)

Reviewer's report
Title:Early liver biopsy, intraparenchymal cholestasis, and prognosis in patients
with alcoholic steatohepatitis
Version: 1Date:27 July 2011
Reviewer: Kaushal Madan
Reviewer's report:
Major revisions:
1. The authors have not described, how was the presence of infection defined?
What parameters of sepsis were considered in order to exclude the patients?
2. What were the features to define the presence of intraparenchymal
cholestasis?
3. The authors should have correlated the response to steroids, in patients with
and without intrahepatic cholestasis. This would have made this study clinically
more relevant.
4. Why did the authors not try to correlate the biochemical markers of
cholestasis, such as alkaline phosphatase and GGT or even AST, or ALT with
survival and with presence or absence of intraparenchymal cholestasis?
5. Was tests for hepatitis A done in all patients and if not why?
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-11-115 (2011)

Reviewer's report
Title:Early liver biopsy, intraparenchymal cholestasis, and prognosis in patients
with alcoholic steatohepatitis
Version: 1Date:3 August 2011
Reviewer: Jerome Dumortier
Reviewer's report:
Alcoholic steatohepatitis (ASH) is a frequent acute liver disease associated with
a poor outcome. Therefore, prognostic factors and scores are needed to select
patients eligible for specific therapy. By now, patients with a severe form of ASH,
as defined by a Maddrey’s score >32 or a MELD score > 18, should be treated
with corticosteroids in order to decrease short-term mortality.
Spahr and coll. explored the prognostic value of several histological features
observed on initial liver biopsy in a large number of patients with documented
ASH, and no associated sepsis. The authors identified that marked
intraparenchymal cholestasis among the full spectrum of histological alterations
as an independent predictor of poor short term outcome together with age, INR
and serum creatinine. They proposed that this particular histological feature
could be combined with existing prognostic models.
I have some comments on the manuscript:
1. Methods
I believe that some biological tests are lacking. A specific focus is needed on the
diagnosis of current infection. The authors must clearly describe how current
infection was searched for (from ascitis, urine, lungs, …). In addition, pertinent
data such as WBC count, neutrophils count, C-reactive protein must be reported.
The authors included in analysis CP, Maddrey and MELD scores. Why did they
not include Lille-model or Glasgow score ?
2. Results
Again, my major comment is about infection. The authors described a cohort of
patients with ASH and no associated sepsis, but 11 patients died from … sepsis.
This must be discussed. Again WBC and neutrophils counts, CRP are lacking. I
do not understand why scores (CP, MELD, Maddrey, Lille, Glasgow) were not
included in univariate and multivariate analyses. I did not find the results of
univariate analysis (except on histological features).
Concerning the diagnosis of ASH, I am surprised by the high number of patients
without steatosis and/or neutrophils on liver biopsy. This must be discussed.
3. Discussion
The discussion must be modified according to my comments on Methods and
Results, especially the possible drawback concerning infection. In addition, a
discussion on all the other available prognostic scores is mandatory.
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-11-115 (2011)

Reviewer's report
Title:Early liver biopsy, intraparenchymal cholestasis, and prognosis in patients
with alcoholic steatohepatitis
Version: 2Date:26 September 2011
Reviewer: Jerome Dumortier
Reviewer's report:
No 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-11-115 (2011)

Reviewer's report
Title:Early liver biopsy, intraparenchymal cholestasis, and prognosis in patients
with alcoholic steatohepatitis
Version: 2Date:2 October 2011
Reviewer: Kaushal Madan
Reviewer's report:
1. accepted
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-11-114 (2011)

Reviewer's report
Title:Mucosal atrophy in collagenous colitis: A case report
Version: 1Date:18 January 2011
Reviewer: Junji Umeno
Reviewer's report:
Comments to the Author
Majores et al. presented a patient with collagenous colitis (CC) for more than 10
years who developed segmental mucosal atrophy in the ascending and
transverse colon. This case report is very interesting, however, it is hard to
recognize mucosal atrophy of the proximal colon as a complication of long
standing CC due to lack of adequate evidence.
Major Compulsory Revisions
1. The time course of the development of mucosal atrophy is unclear. The
authors should present the endoscopic images of the cecum and histological
images of the biopsy specimen in 1998 and 2003.
2. The authors reported that the pattern of mucosal atrophy is inversely related to
the pattern of subepithelial collagen deposition and speculated the influence of
additional luminal factors on the development of mucosal atrophy. As the authors
discussed, mucosal atrophy is deemed to develop by chance. The authors
should show the evidence of relation between mucosal atrophy and CC; for
example, association between the site of mucosal atrophy and histological grade
of inflammation infiltrate.
Minor Essential Revisions
1. Figure 1B shows only subepithelial part of the specimen and also does not
look like a vertically-cut specimen. The authors should present a low-magnified
image showing total mucosal layer.
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-11-114 (2011)

Reviewer's report
Title:Mucosal atrophy in collagenous colitis: A case report
Version: 1Date:30 January 2011
Reviewer: Magnus Ström
Reviewer's report:
This report calls attention to an interesting suspicion of possible development of
atrophy with time in collagenous colitis.
There are however some major objections:
a) An accepted definition of atrophy of the colonic mucosa (preferably
international) should be referred to and used.
b) The histological examination of the specimens should be blindly re-analysed
(six different biopsies from three colonoscopies makes at least 18 slides). Not
only the collagen band thickening should be tabulated but also other variables
indicating grade of inflammation and possible atrophy according to an accepted
definition of atrophy.
Minor point of view:
In the report of Otegbayo et al 2001 the word atrophy is mentioned in the text
without further description and their figure does not seem to support the choice of
that word. If, according to a+b above, this report can show a development of
atrophy in the mucosa I think that the authors can assert they are the first to
report this.
The authors claim they have excluded Crohn´s disease. It would be nice with
further details how this was done including a paragraph in the discussion on the
possibility of any relationship (see Geboes K. Gastroenterol Clin Biol
2008;32:689-94).
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' below
Review for 10.1186/1471-230X-11-114 (2011)

Reviewer's report
Title:Mucosal atrophy in collagenous colitis: A case report
Version: 2Date:11 May 2011
Reviewer: Junji Umeno
Reviewer's report:
Major Compulsory Revisions
1. I think that the authors do not have responded appropriately to Major Essential
Revision Comment #1. The authors described that mucosal atrophy might be
developed from 1998 to 2003 in the revised manuscript without adequate
evidence. The author should show the endoscopic picture of normal appearance
of the cecum in 1998.
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-11-114 (2011)

Reviewer's report
Title:Mucosal atrophy in collagenous colitis: A case report
Version: 2Date:24 May 2011
Reviewer: Magnus Ström
Reviewer's report:
I think the revision is adequate the way things are without access to the original
biopsies from 1998 which is a major shortcoming. However the observation and
the discussion are of interest to those with closely related research.
Minor essential revision: Check the figure number
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-11-114 (2011)

Reviewer's report
Title:Mucosal atrophy in collagenous colitis: A case report
Version: 3Date:4 July 2011
Reviewer: Junji Umeno
Reviewer's report:
Major Compulsory Revisions
The authors showed the endoscopic picture of the cecum in 1998 in the
re-revised manuscript. However, I do not agree with you that this picture shows
normal appearance of the cecum because of its fuzziness.
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-11-113 (2011)

Reviewer's report
Title:A pilot study of transrectal endoscopic ultrasound elastography in
inflammatory bowel disease
Version: 1Date:29 June 2011
Reviewer: M J Solomon
Reviewer's report:
This is an interesting and novel concept to determine UC versus Crohn's utilising
endoscopic ultrasound characteristics. I have some major points that need
clarifying. The use of the terms "elastic" and "strain" require some jsutification as
it really is only based on width dimesnions and these terms imply a dynamic
phsical testing which no matter your references and explanations still does not
clarify these measures. The use of endoscopic ultrasound versus transrectal
ultrasound are very different modalities and are used in the mansucript almost
synonymously which is incorrect. The use of a linear probe for transrectal
ultraousnd assessment went out of vogue in the early 1990's and most utilise at
the cutting edge #D TRUS with 10-16 mHz rotating radial probes. It concerns me
if your tchnology is so out of date and your terminology confusing that the
methods are not reproducible nor validated?
An initial article in 1995 has already discussed anorectal wall thinckness in
Crohn's disease and normal as well as pouches post UC resection and needs
referencing as the concept is not novel (Anal wall thickness under normal and
inflammtory conditions of the anorectum as determine by endorectal
ultrasonography. Am J Gastro 1995:90;574-8. There have been several
therapeutic studies since then in the colorectal literature using TRUS measures
of anal wall thickness to assess medial and surgical repsonse in Crohn's using
these measures as well as acitvity of Crohn's?
Minor points
Not sure these are real words "therapeutical" page 1 "Pathohistologic" (intro)
The assessment of new diagnsotic technology requires systematic assessment
of accuracy (compared to a validated gold standard), reliability and validity. This
paper is quite clumsy scientifically and does not follow any epidemiological
methodology that is reproducible although of some interest clinically.
Review for 10.1186/1471-230X-11-113 (2011)

Reviewer's report
Title:A pilot study of transrectal endoscopic ultrasound elastography in
inflammatory bowel disease
Version: 3Date:12 September 2011
Reviewer: Julio Iglesias-Garcia
Reviewer's report:
Authors have answered my points sufficiently well to allow their manuscript to be
published.
- Discretionary Revisions
Authors have take into account all my discretionary revisions
- Minor Essential Revisions
No complaint regarding minor revision
- Major Compulsory Revisions
Also, no complaint regarding this issue
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-11-112 (2011)

Reviewer's report
Title:DPO multiplex PCR as an alternative to culture and susceptibility testing to
detect Helicobacter pylori and its resistance to clarithromycin.
Version: 1Date:22 August 2011
Reviewer: Michael Selgrad
Reviewer's report:
The authors describe that the Seeplex method can be used in laboratories that
are not able to perform real time pcr.
I wonder about the costs of the new method. Is it really an afforadble tool?
Furthermore I would like to raise one point. Clarihtromycin resistance is of course
the most important factor for failure of H. pylori treatment. However, antibiotic
resistance of the other used antibiotics is also rising. According to international
recommendations, H. pylori suscepitibilty testing should performed after the
failure of second line treatment. Thus, it is mandatory to get to know the
susceptibilty of the other antibiotics, which might be used as salvage therapy.
This test method only detects clarithromycin resistance which in my opinion
lowers the practical application of the test method.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Review for 10.1186/1471-230X-11-112 (2011)

Reviewer's report
Title:DPO multiplex PCR as an alternative to culture and susceptibility testing to
detect Helicobacter pylori and its resistance to clarithromycin.
Version: 1Date:19 September 2011
Reviewer: Manfred Kist
Reviewer's report:
The authors have evaluated the performance of a “ready-to-use” molecular
diagnostic kit for detection of H. pylori and its susceptibility to clarithromycin in
gastric specimens, in comparison with culture as the “gold standard”, and an “in
house” real-time PCR technique. For this purpose they applied a retrospective
study design, based on frozen gastric specimens held on a stock of diagnostic
specimens. They used a recently described modified PCR technology “dual
priming oligonucleotide-PCR(DPO-PCR)with the potential to markedly reduce
unspecificity. This technique has been evaluated before by a Korean group (cited
and discussed by the authors) using basically a comparable design but applying
“disk diffusion”, which is not a generally accepted technique for testing
antimicrobial susceptibility.
The authors found the method nearly adequate to the in-house real-time PCR,
nearly as accurate as culture and phenotypical susceptibility testing, but of better
sensitivity. A problem of the new methodology, discussed by the authors, is the
possibility of false negative results as a consequence of the particular structure of
the primers used.
- Major Compulsory Revisions
No major compulsory revisions demanded
- Minor Essential Revisions
No minor essential revisions demanded
- Discretionary Revisions
Results,
p. 7, 2nd paragraph, lines 3 – 4: are their possible reasons for missing 16
biopsies by culture? What about histology in these cases? This result might be
discussed.
Discussion,
p. 11, 1st paragraph:
1. The authors conclude the Seeplex ClaR-H.pylori an “excellent alternative to
culture”. I would like to suggest that the authors should have in mind that
whenever possible culture should be done, and only in cases when classical
microbiology fails, the use of molecular methods are really indicated. The
rationale behind is that not only clarithromycin resistance is of interest but also
other antimicrobials are, like tetracyclin, quinolones, rifamicins, and
metronidazole. The authors might include these aspects in the discussion.
2. The discussion as a total appears a bit long and might be shortened
appropriately.
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-11-111 (2011)

Reviewer's report
Title:Risk factors associated with symptomatic cholelithiasis in Taiwan: a
population-based study
Version: 1Date:16 June 2011
Reviewer: Claudio Tiribelli
Reviewer's report:
Major Compulsory Revisions
This is an interesting paper analyzing the risk factors of gallstones in a large
series of the Taiwanese population. The methodology is solid and the results are
consistent and in line with previous reports in Western countries. The novelty of
these results is that they originate from the South east Asia. The risk factors
found were essentially the same found in Western series with chronic liver
diseases (both chronic hepatitis and cirrhosis) being the most important. The
relative small role on DMT2 is somehow surprising and needs to be better
stressed in the discussion. Another limitation is that the study did not allow to
have hints on the gallstone composition which is more frequently related to
calcium bilirubinate in Asia. Was the population checked for signs of
hyperhemolysis (lower Hb content) in gallstone series’ This needs to be al least
mentioned.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
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-11-111 (2011)

Reviewer's report
Title:Risk factors associated with symptomatic cholelithiasis in Taiwan: a
population-based study
Version: 1Date:24 June 2011
Reviewer: Gerardo Nava
Reviewer's report:
Summary:
Manuscript entitled: "Risk factors associated with symptomatic cholelithiasis in
Taiwan: a population-based study" examines disease factors associated to
symptomatic cholelithiasis based on a population-based and case-control study.
The relative risk was estimated by adjusted odds ratio (OR) using multivariate
logistic regression analysis. Authors concluded that the risk factors for
cholelithiasis in this population were obesity, hyperlipidemia, hepatitis B infection,
hepatitis C infection, and cirrhosis.
Critique:
This is a well written and nice study. However, there are a few issues that need
to be clarified by the authors.
Major Compulsory Revisions
1. Abstract
It is not clear how risk factors differed between Asian (this study) and West
populations.
2. Introduction
- Authors need to comment on possible biases or limitations of the methods used
for this study.
- This phrase is confusing and need clarification: "Cholelithiasis is known to affect
60-70% of America Indians and a proportionately smaller number individuals of
mixed Hispanic/American Indian background" Comments: authors need to
specify the ethnicity of this groups.
3. Methods
- Numerous studies (see example below) have shown that in outcomes that have
10% or more prevalence, the adjusted odds ratio derived from the logistic
regression do not approximate the risk ratio. In the present study some diseases
have an incidence >10%. Is it possible to correct the ORs or approximate to a
risk ratio from the adjusted odds ratios?
Zhang J, Yu KF. What's the relative risk? A method of correcting the odds ratio in
cohort studies of common outcomes. JAMA. 1998 Nov 18;280(19):1690-1.
- As presented, it is evident that all selected diseases in the present study
(obesity, hyperlipidemia, hepatitis B infection, hepatitis C infection, cirrhosis and
menopause) represent a risk factor (based on OR values) for symptomatic
cholelithiasis. Is it possible to perform additional analysis to rank the contribution
of each of these diseases? Is it possible to perform a multivariate analysis (PCoA
or NMDS, factor analysis, etc.) to establish the contribution of two or more
diseases?
4. Discussion
- The discussion is verbose and descriptive. Specifically, authors need to discuss
which factors contribute to the pigment stones found in the majority of gallstones
found in Asian populations. Also, they need to correlate and discuss their findings
using reports obtained from studies in different ethnic groups.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-11-110 (2011)

Reviewer's report
Title:Feasibility and cost-effectiveness of internet-based exposure treatment for
irritable bowel syndrome in a clinical sample: a randomized controlled trial
Version: 3Date:21 July 2011
Reviewer: Rona Moss-Morris
Reviewer's report:
The authors have done a thorough job of addressing the reviewers’ comments. I
just have two comments to make.
1. … ‘at the end of treatment’ or ‘at 10 weeks’ should be added to the following
hypothesis.
Hypothesis 1:
Our primary hypothesis was that, compared to a waiting list, ICBT would lead to
greater reductions in IBS-symptoms.
2. The authors have misinterpreted my point about ITT. I wasn’t suggesting using
last observation forward as I agree; modeling has now replaced this method.
However, if you have data for at least one follow-up, a mixed model will keep
these people in the model. Therefore a better way to assess if gains were
maintained at 12 months without losing such a large percentage of cases is to
include all 3 time points for the treatment group in the model. I realise this would
be difficult for the post treatment comparison between groups as there is only
one follow-up point, so perhaps in this context, what the authors have done with
the last observation forward is one way to test what happens if all people are
considered.
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-11-110 (2011)

Reviewer's report
Title:Acceptability, effectiveness, and cost-effectiveness of internet-based
exposure treatment for irritable bowel syndrome in a clinical sample: a
randomized controlled trial
Version: 4Date:14 September 2011
Reviewer: Yanda van Rood
Reviewer's report:
The authors have answered my points sufficiently well and I do have no further
commends or suggestions for improvement.
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-11-108 (2011)

Reviewer's report
Title:Expression, localization and polymorphisms of the nuclear receptor PXR in
Barrett's esophagus and esophageal adenocarcinoma
Version: 8Date:16 August 2010
Reviewer: Katerina Dvorak
Reviewer's report:
Expression, localization and polymorphism of the nuclear receptor PXR in
Barrett’s esophagus and esophageal adenocarcinoma
Anouk Van de Winkel, et al.
In this paper, the authors evaluated PXR expression, localization and
polymorphism in normal squamous esophageal mucosa, Barrett’s esophagus
and esophageal adenocarcinoma. This is a well-written paper introducing novel
bile-acid activated pathway that involves PXR receptor. Although this paper is
very interesting, there are some issues that need to be explained more
thoroughly. The quality of the images is very good, however two figures were not
correctly converted to pdf file and it is not possible to evaluate the data.
Major Revision:
1. Figure 1 is not labeled. I think that there were problems with conversion to pdf
file.
2. The authors need to justify why lithocholic acid and taurolithocholic acid were
used in in vitro experiments. This bile acid is not common in the refluxate of BE
patients and the concentrations used are not physiological. In addition, this bile
acid is not very soluble. What is the effect of more common bile acids? Is the
effect of LCA similar in OE33 cells and HET1A cells (translocation to nucleus)?
3. Lithocholic acid is one of the most cytotoxic bile acids. At the concentration of
100uM for 24 hours, what was the effect of LCA and TLCA on cell survival in
both cell lines? Furthermore, the authors should justify why 24 hours treatment
was used, since reflux episodes are usually in terms of minutes.
4. The magnifications in Figure 3B are not same, it needs to be corrected. The
images suggest that after stimulation with LCA overall PXR expression increases
and possibly PXR is translocated to nucleus. Western blot data would answer
this question more definitely. The figure legend also should indicate
magnification.
5. Table 3 shows allele frequencies at SNPs locus at 7635 and 8055. While
healthy controls are compared with reflux esophagitis or BE, there is no
comparison between BE and reflux esophagitis. Are the allele frequencies also
significantly different between BE and RE? If not than the conclusion is not
correct. Also, it would be interesting in future studies to evaluate if there is any
difference in SNPs between different grades of BE dysplasia.
6. Figure 4 was not converted to pdf file.
Minor Revision:
1. Spelling page 6 “a specific“
2. Spelling: page 5 “taurolithocholic acid”
Discretionary Revisions:
1. The authors should speculate why immunohistochemical studies show low
protein expression in BE but high in adenocarcinoma, but PXR mRNA levels are
not different in BE and adenocarcinoma tissue.
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-11-108 (2011)

Reviewer's report
Title:Expression, localization and polymorphisms of the nuclear receptor PXR in
Barrett's esophagus and esophageal adenocarcinoma
Version: 10Date:13 April 2011
Reviewer: Katerina Dvorak
Reviewer's report:
The authors nicely answered majority of comments, however there few points
that needs to be clarified.
Point 2. LCA and TLCA bind with strong affinity to PXR, however these two bile
acids are present in negligible concentrations in the refluxate. It is not valid
justification for use of these bile acids in the study, even if the PXR expression is
increased in BE and esophageal adenocarcinoma. It should be better explained.
As a justification for not using other bile acids the authors state that other bile
acids as well as a mix of bile acids did not affect PXR mRNA levels. This
argument is not valid, since the data show no effect of TLCA on mRNA levels in
OE19 (Figure3).
Point 4. I do not agree with the statement that western blot analysis would
provide data only on the overall PXR expression. It is possible to separate
subcellular fractions and determine the amount of PXR in cytoplasm or nucleus.
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-11-108 (2011)

Reviewer's report
Title:Expression, localization and polymorphisms of the nuclear receptor PXR in
Barrett's esophagus and esophageal adenocarcinoma
Version: 12Date:4 July 2011
Reviewer: Barry Forman
Reviewer's report:
See previous review
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-11-107 (2011)

Reviewer's report
Title:Assessment of the transhepatic clearance of lipopolysaccarides in cirrhosis
before and after transjugular intrahepatic portosystemic stenting (TIPS).
Version: 1Date:6 July 2011
Reviewer: FUat Saner
Reviewer's report:
These are recommendations for improvement which the author can choose to
ignore. For example clarifications, data that would be useful but not essential.
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-11-107 (2011)

Reviewer's report
Title:Assessment of the transhepatic clearance of lipopolysaccarides in cirrhosis
before and after transjugular intrahepatic portosystemic stenting (TIPS).
Version: 1Date:12 July 2011
Reviewer: Daniel Douek
Reviewer's report:
This is an excellent, interesting and well-written study. Many in the field have
discussed performing such analyses and it is nice to see that this has finally been
done with important results as a consequence.
I have a few essential revisions for the authors which I think should be made:
1. The authors never explicitly state their definition of the transhepatic LPS
gradient and how it was calculated. Logically I presume it is the endotoxin
concentration in the portal vein minus the endotoxin concentration in the hepatic
vein.
2. The authors should mention that LBP is synthesized by the liver and how that
may affect the results.
3. L-arginine is also a substrate for arginase in “alternatively activated
macrophages,” leading to collagen production. It should be discussed.
4. The authors should label the y-axis in Figure 1B and 1C.
5. The authors should cite and discuss a recent paper in Gastroenterology on
microbial translocation in cirrhosis which is pertinent to their findings: "Sandler et
al., Host Response to Translocated Microbial Products Predicts Outcomes of
Patients with HBV or HCV infection. Gastroenterology, Online 2 July 2011"
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-11-107 (2011)

Reviewer's report
Title:The transhepatic endotoxin gradient is present despite liver cirrhosis and is
attenuated after transjugular portotsystemic shunt (TIPS)
Version: 2Date:1 September 2011
Reviewer: Daniel Douek
Reviewer's report:
I thank the authors for their attention to my suggestions. They have answered all
of my concerns and, I believe, those of the other reviewer. This is an excellent
manuscript.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-11-107 (2011)

Reviewer's report
Title:The transhepatic endotoxin gradient is present despite liver cirrhosis and is
attenuated after transjugular portotsystemic shunt (TIPS)
Version: 2Date:21 September 2011
Reviewer: FUat Saner
Reviewer's report:
The authors made a great job. The revised manuscript met all the reviewers
comments and should be published soon.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.