Submited on: 23 Aug 2012 04:41:46 PM GMT
Published on: 24 Aug 2012 02:32:56 PM GMT
 
Review on H.Pylori In Children
Posted by Dr. Sameeh S Ghazal on 29 Aug 2012 06:03:09 AM GMT

  • What are the main claims of the paper and how important are they?

    NA


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    NA


  • Are the claims properly placed in the context of the previous literature?

    NA


  • Do the results support the claims? If not, what other evidence is required?

    NA


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    NA


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    NA


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    NA


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    NA


  • Other Comments:

    It is nice review anyhow, but I could notice the followings:

    1. Author should observe the ward (children) in his title and do his best to describe the disease in children mainly, we could observe that this has been forgotten in describing the prevalence of the disease and disease complications like cancer which is mainly adult issue.
    2. Author did not mention the relation between helicobacter, cytokines associated antigen, high or low production of acids, getting higher incidence of cancer or ulcer.
    3. Author did not mention clearly mode of transmission and its reference
    4. Author did not clarify if there is one or more than one pathogenesis in relation to cancer or ulcer complications?
    5. Author did not mentioned in the diagnosis section the indications of testing for H pylori as recommended by the recent guidelines from North European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and North American Society for Paediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) for H pylori infection in children
    6. Author did not mention a list for the Differential Diagnoses?

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    NA

  • How to cite:  Ghazal S S.Review on H.Pylori In Children[Review of the article 'Helicobacter Pylori Infection in Children ' by Shahid S].WebmedCentral 2012;3(8):WMCRW002208
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Dear Dr. Sameeh Ghazal, Thank u so much for your valuable suggestions. They have been noted and will be incorporated in the revision of the ms TQ Best rgds Dr. Shahid
Responded by Dr. Sukhbir Shahid on 30 Aug 2012 05:41:52 AM
H Pylori Infection is Not Necessarily Bad News
Posted by Dr. Jacob Puliyel on 27 Aug 2012 12:23:12 AM GMT

  • What are the main claims of the paper and how important are they?

    This is a narrative review with 127 references. No claims are made except as a review of published literature.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    As a review article the claims need not be novel.


  • Are the claims properly placed in the context of the previous literature?

    Yes mostly. However the risk of gastric cancer must be reported in terms of absolute risk. The article says that colonization increased the lifetime risk of gastric cancer by 1-2%. What is the risk without colonization? The lifetime risk of developing gastric cancer in UK in women is 1 in 120. What does a 1-2% increase in risk mean in the UK? Similarly the case of India can be taken. Given that 80% of the population are colonized what is the absolute risk reduction if the organism is eradicated.

    This is crucial to understand and clarify. 80% of the population in developing countries are colonized with H pylori. The Abstract claims that H Pylori is a 'potent carcinogen'. It cannot be a potent carcinogen if it increases gastric cancers by a mere 2%

    Later in the paragraph on transmission and pathogenesis the author states risk of gastric cancer is elevated 10 times. What does this mean in the context of what was said above? The authors quote another reference here. In a review article it is hoped the author would try and reconcile these differences or say why the findings are different of different authors.


  • Do the results support the claims? If not, what other evidence is required?

    See below


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Not applicable


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Not applicable


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    See below


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    NA


  • Other Comments:

    1.  Blaser, M. J. (2006). EMBO Reports 7 (10): 956–60 suggests that the organism may have a helpful role to play as it has co-existed in the gastric mucosa for centuries. Reference has been made in passing to this but it needs elaboration.
    2. Reference has been made to the beneficial effect in asthma. However it is implied that the harm results from use of antibiotics. Mice studies are quoted. It is difficult to imagine that mice have been abusing antibiotics. Studies in humans show the H pylori reduce gastro-esophageal reflux and the benefit in asthma may be through this.
    3. Reference is made to usefulness of probiotics but it is not specified how it will benefit.
    4. What is the mechanism of action of PPI. It may reduce symptoms of acidity but how does it help eradicate disease. After all H Pylori requires neutral pH for growth and an antacid will make the environment more conducive to its growth.
    5. It needs to be emphasized that evidence of infection is not indication for treatment. Treatment is indicated only in symptomatic patients or those with a hereditary susceptibility to gastric cancers.
    6. The last sentence in Introduction is a bit wobbly. Suggest the sentence be broken into 2 sentences.
    7. The first line in history: H.pylori is found in sterile gastric mucosa of the majority of the world’s population. This is a contradiction in terms. If H pylori are found it cannot be sterile gastric mucosa.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Pediatrics

  • How to cite:  Puliyel J .H Pylori Infection is Not Necessarily Bad News[Review of the article 'Helicobacter Pylori Infection in Children ' by Shahid S].WebmedCentral 2012;3(8):WMCRW002199
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Dear Dr. J Puliyel, Thank you so much for your suggestions to improve my article. The points have been noted and will be incorporated in my revised ms. TQ Best rgds Dr. Shahid SK
Responded by Dr. Sukhbir Shahid on 27 Aug 2012 04:55:58 PM
Of Mice and Men (& Children)
Posted by Dr. Israel Kochin on 24 Aug 2012 03:15:58 PM GMT

  • What are the main claims of the paper and how important are they?

    It's a review of the literature-  mostly on-target.  The article list me when it spoke too much of mice in the clinical features section. "Recent studies in mice have shown that H.pylori infection can protect against asthma. Overuse of antibiotics has abolished this ancestral, native microflora leading to immune upset and asthma [80]."  The fact that the second sentence is talking only in mice should be more clear.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Mostly not


  • Are the claims properly placed in the context of the previous literature?

    NA


  • Do the results support the claims? If not, what other evidence is required?

    NA


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    NA


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    NA


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    NA


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    NA


  • Other Comments:

    No

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    I trained and am board certified in pediatric gastroenterology by the American Board of Pediatrics

  • How to cite:  Kochin I .Of Mice and Men (& Children)[Review of the article 'Helicobacter Pylori Infection in Children ' by Shahid S].WebmedCentral 2012;3(8):WMCRW002193
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Dear Dr. Israel Kochin, Thanks for your comments. Will look into the suggested points while revising my script TQ Best rgds Dr. Shahid
Responded by Dr. Sukhbir Shahid on 26 Aug 2012 05:17:40 AM