Title: Factors influencing the cure of pseudolithiasis: A retrospective study of 264 patients
Version: 2 Date: 24 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The introduction primarily focuses on research conducted in specific populations, emphasizing
children and the elderly. Including a brief mention of how pseudolithiasis is managed across
different geographical regions or healthcare settings could enhance the generalizability of the
findings and highlight the global relevance of the issue.
-While the introduction establishes the need for the study, the primary objective could be
stated more clearly upfront. It would benefit the reader to know early on that the study
aims to identify independent predictors of complete resolution in pseudolithiasis and evaluate
therapeutic strategies. This would make the focus of the survey immediately apparent.
-The CT imaging criteria could be described in more detail, particularly regarding how "new-
onset pseudolithiasis" is distinguished from other types of biliary abnormalities (e.g., biliary
sludge or other gallbladder precipitates). While it’s mentioned that CT scans were used to
confirm the diagnosis, a more explicit definition of the imaging characteristics would enhance
the reproducibility of the study.
-While a comprehensive list of laboratory parameters is provided, it would be helpful to explain
why specific markers were chosen and how they are expected to correlate with pseudolithiasis
resolution. For instance, how do AST/ALT ratios, white blood cell counts, or CRP levels tie into
the pathophysiology of pseudolithiasis? A brief rationale for each marker’s inclusion would add
clarity and strengthen the reader’s understanding of the data analysis.
-The significance of the gender difference (P = 0.03) and the higher average age in the complete
resolution group (P = 0.03) is noted, but a more nuanced discussion of how these factors may
relate to pseudolithiasis progression could be helpful. For example, the reasons behind the higher
prevalence of cholecystitis in the complete resolution group could be explored further, as it may
suggest an interplay of inflammatory processes and resolution.
-In the section describing differences in conditions such as viral hepatitis, decompensated liver
cirrhosis, and laboratory markers (e.g., fasting glucose), it would be helpful to discuss why
some variables showed no significant differences (e.g., P > 0.05). Understanding the lack of
association between these factors and pseudolithiasis could provide valuable insight into the
disease's pathophysiology.
-Although the study does not show a significant association between ceftriaxone use and
pseudolithiasis resolution, a brief exploration of why this might be (e.g., shorter treatment
duration or lower cumulative dose) could be beneficial. This might help explain the lack of
association with the typical risk factor for pseudolithiasis.
Title: Factors influencing the cure of pseudolithiasis: A retrospective study of 264 patients
Version: 2 Date: 24 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The introduction primarily focuses on research conducted in specific populations, emphasizing
children and the elderly. Including a brief mention of how pseudolithiasis is managed across
different geographical regions or healthcare settings could enhance the generalizability of the
findings and highlight the global relevance of the issue.
-While the introduction establishes the need for the study, the primary objective could be
stated more clearly upfront. It would benefit the reader to know early on that the study
aims to identify independent predictors of complete resolution in pseudolithiasis and evaluate
therapeutic strategies. This would make the focus of the survey immediately apparent.
-The CT imaging criteria could be described in more detail, particularly regarding how "new-
onset pseudolithiasis" is distinguished from other types of biliary abnormalities (e.g., biliary
sludge or other gallbladder precipitates). While it’s mentioned that CT scans were used to
confirm the diagnosis, a more explicit definition of the imaging characteristics would enhance
the reproducibility of the study.
-While a comprehensive list of laboratory parameters is provided, it would be helpful to explain
why specific markers were chosen and how they are expected to correlate with pseudolithiasis
resolution. For instance, how do AST/ALT ratios, white blood cell counts, or CRP levels tie into
the pathophysiology of pseudolithiasis? A brief rationale for each marker’s inclusion would add
clarity and strengthen the reader’s understanding of the data analysis.
-The significance of the gender difference (P = 0.03) and the higher average age in the complete
resolution group (P = 0.03) is noted, but a more nuanced discussion of how these factors may
relate to pseudolithiasis progression could be helpful. For example, the reasons behind the higher
prevalence of cholecystitis in the complete resolution group could be explored further, as it may
suggest an interplay of inflammatory processes and resolution.
-In the section describing differences in conditions such as viral hepatitis, decompensated liver
cirrhosis, and laboratory markers (e.g., fasting glucose), it would be helpful to discuss why
some variables showed no significant differences (e.g., P > 0.05). Understanding the lack of
association between these factors and pseudolithiasis could provide valuable insight into the
disease's pathophysiology.
-Although the study does not show a significant association between ceftriaxone use and
pseudolithiasis resolution, a brief exploration of why this might be (e.g., shorter treatment
duration or lower cumulative dose) could be beneficial. This might help explain the lack of
association with the typical risk factor for pseudolithiasis.
Please review this paper.
user
Title: Factors influencing the cure of pseudolithiasis: A retrospective study of 264 patients
Version: 2 Date: 24 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The introduction primarily focuses on research conducted in specific populations, emphasizing
children and the elderly. Including a brief mention of how pseudolithiasis is managed across
different geographical regions or healthcare settings could enhance the generalizability of the
findings and highlight the global relevance of the issue.
-While the introduction establishes the need for the study, the primary objective could be
stated more clearly upfront. It would benefit the reader to know early on that the study
aims to identify independent predictors of complete resolution in pseudolithiasis and evaluate
therapeutic strategies. This would make the focus of the survey immediately apparent.
-The CT imaging criteria could be described in more detail, particularly regarding how "new-
onset pseudolithiasis" is distinguished from other types of biliary abnormalities (e.g., biliary
sludge or other gallbladder precipitates). While it’s mentioned that CT scans were used to
confirm the diagnosis, a more explicit definition of the imaging characteristics would enhance
the reproducibility of the study.
-While a comprehensive list of laboratory parameters is provided, it would be helpful to explain
why specific markers were chosen and how they are expected to correlate with pseudolithiasis
resolution. For instance, how do AST/ALT ratios, white blood cell counts, or CRP levels tie into
the pathophysiology of pseudolithiasis? A brief rationale for each marker’s inclusion would add
clarity and strengthen the reader’s understanding of the data analysis.
-The significance of the gender difference (P = 0.03) and the higher average age in the complete
resolution group (P = 0.03) is noted, but a more nuanced discussion of how these factors may
relate to pseudolithiasis progression could be helpful. For example, the reasons behind the higher
prevalence of cholecystitis in the complete resolution group could be explored further, as it may
suggest an interplay of inflammatory processes and resolution.
-In the section describing differences in conditions such as viral hepatitis, decompensated liver
cirrhosis, and laboratory markers (e.g., fasting glucose), it would be helpful to discuss why
some variables showed no significant differences (e.g., P > 0.05). Understanding the lack of
association between these factors and pseudolithiasis could provide valuable insight into the
disease's pathophysiology.
-Although the study does not show a significant association between ceftriaxone use and
pseudolithiasis resolution, a brief exploration of why this might be (e.g., shorter treatment
duration or lower cumulative dose) could be beneficial. This might help explain the lack of
association with the typical risk factor for pseudolithiasis.
assistant