Reviewer's report
Title:A capillary blood ammonia bedside test following glutamine load to improve
the diagnosis of hepatic encephalopathy in cirrhosis
Version: 1Date:2 August 2011
Reviewer: Giovanni Tarantino
Reviewer's report:
Minor Essential Revisions
AA are kindly requested to re-phrase the sentence in Introduction ...Neurologic
alterations observed....in response to liver insufficiency and portosystemic
collaterals... because my research (the 7th reference) has hardly evidenced a
correlation between NH4 and porto-systemic encephalopaty (PSE)..... in the
text......Ammonia levels did not predict severity of PSE measured as W-H grades,
i.e., coefficient = 5.04, beta = 0.088, p = 0.28. Furthermore, AA should
emphasize that high venous concentrations of NH4 are a marker of collaterals
presence and not of PSE presence or severity, according to the previously
quoted sudy.
Results
AA have declared to have studied the NH4 changes over time by ANOVA, so
they are kindly requested to show pertinent data, also in a reduced or partial
population.
They have evidenced only the incidence of further episodes of hepatic
encephalopathy (HE) in their follow-up.
Discussion
AA are kindly requested to add among additional parameters that may influence
the minimal HE also the viral factor ..see and quote...Citro V, Milan G, Tripodi FS,
Gennari A, Sorrentino P, Gallotta G, Postiglione A, Tarantino G.
Mental status impairment in patients with West Haven grade zero hepatic
encephalopathy: the role of HCV infection. J Gastroenterol. 2007
Jan;42(1):79-82.
AA are strongly advised to be more direct in lessening the importance of NH4
determinations as valid tool to diagnose HE
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'
Reviewer's report
Title:A capillary blood ammonia bedside test following glutamine load to improve
the diagnosis of hepatic encephalopathy in cirrhosis
Version: 1Date:2 August 2011
Reviewer: Giovanni Tarantino
Reviewer's report:
Minor Essential Revisions
AA are kindly requested to re-phrase the sentence in Introduction ...Neurologic
alterations observed....in response to liver insufficiency and portosystemic
collaterals... because my research (the 7th reference) has hardly evidenced a
correlation between NH4 and porto-systemic encephalopaty (PSE)..... in the
text......Ammonia levels did not predict severity of PSE measured as W-H grades,
i.e., coefficient = 5.04, beta = 0.088, p = 0.28. Furthermore, AA should
emphasize that high venous concentrations of NH4 are a marker of collaterals
presence and not of PSE presence or severity, according to the previously
quoted sudy.
Results
AA have declared to have studied the NH4 changes over time by ANOVA, so
they are kindly requested to show pertinent data, also in a reduced or partial
population.
They have evidenced only the incidence of further episodes of hepatic
encephalopathy (HE) in their follow-up.
Discussion
AA are kindly requested to add among additional parameters that may influence
the minimal HE also the viral factor ..see and quote...Citro V, Milan G, Tripodi FS,
Gennari A, Sorrentino P, Gallotta G, Postiglione A, Tarantino G.
Mental status impairment in patients with West Haven grade zero hepatic
encephalopathy: the role of HCV infection. J Gastroenterol. 2007
Jan;42(1):79-82.
AA are strongly advised to be more direct in lessening the importance of NH4
determinations as valid tool to diagnose HE
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'
Please review this paper.
user
Reviewer's report
Title:A capillary blood ammonia bedside test following glutamine load to improve
the diagnosis of hepatic encephalopathy in cirrhosis
Version: 1Date:2 August 2011
Reviewer: Giovanni Tarantino
Reviewer's report:
Minor Essential Revisions
AA are kindly requested to re-phrase the sentence in Introduction ...Neurologic
alterations observed....in response to liver insufficiency and portosystemic
collaterals... because my research (the 7th reference) has hardly evidenced a
correlation between NH4 and porto-systemic encephalopaty (PSE)..... in the
text......Ammonia levels did not predict severity of PSE measured as W-H grades,
i.e., coefficient = 5.04, beta = 0.088, p = 0.28. Furthermore, AA should
emphasize that high venous concentrations of NH4 are a marker of collaterals
presence and not of PSE presence or severity, according to the previously
quoted sudy.
Results
AA have declared to have studied the NH4 changes over time by ANOVA, so
they are kindly requested to show pertinent data, also in a reduced or partial
population.
They have evidenced only the incidence of further episodes of hepatic
encephalopathy (HE) in their follow-up.
Discussion
AA are kindly requested to add among additional parameters that may influence
the minimal HE also the viral factor ..see and quote...Citro V, Milan G, Tripodi FS,
Gennari A, Sorrentino P, Gallotta G, Postiglione A, Tarantino G.
Mental status impairment in patients with West Haven grade zero hepatic
encephalopathy: the role of HCV infection. J Gastroenterol. 2007
Jan;42(1):79-82.
AA are strongly advised to be more direct in lessening the importance of NH4
determinations as valid tool to diagnose HE
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'
assistant