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Research article | DOI: https://doi.org/10.31579/2690-8794/265
1 Rowan-Virtua School of Osteopathic Medicine
2 Nelson Biological Laboratories, 604 Allison Road, Piscataway, New Jersey 08855.
*Corresponding Author: Merrill, G.F, Department of Cell Biology and Neuroscience, Division of Life Sciences, School of Arts and Sciences, Rutgers University, New Brunswick/Piscataway, New Jersey 08855.
Citation: Shah S., Patel S., Merrill G.F, (2025), Acetaminophen and Skeletal Muscle Function in young adult University Students, Clinical Medical Reviews and Reports, 7(7); DOI:10.31579/2690-8794/265
Copyright: © 2025, Merrill, G.F. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 06 June 2025 | Accepted: 24 July 2025 | Published: 01 October 2025
Keywords: acetaminophen; grip strength; fatigue resistance; skeletal muscle; neuromuscular function; analgesics; sex differences; myoprotection
Globally, acetaminophen (paracetamol) is one of the most widely used and affordable analgesics available, primarily known for its efficacy in relieving pain and reducing fever. Despite its widespread use, acetaminophen’s effects on skeletal muscle function, particularly strength, fatigue resistance, and soreness, remain poorly understood. The aim of this study was to investigate the acute effects of acetaminophen on skeletal muscle performance in young adults, specifically assessing grip strength and fatigue resistance. By doing so, we sought to clarify whether acetaminophen has a measurable impact on muscle function and whether this impact varies by sex. A randomized, placebo-controlled crossover design was used. Participants visited the laboratory on two separate occasions and completed a series of grip strength assessments four hours after orally ingesting either 1000 mg of acetaminophen or a placebo in identical capsules. The testing protocol included three tasks: a maximal grip strength test using a manual dynamometer to measure peak force; an intermittent grip test using an electronic dynamometer to assess periodic strength; and a sustained grip endurance test, during which participants maintained their grip for as long as possible to determine time to fatigue. The null hypothesis (H0) stated that there will be no statistically significant difference in skeletal muscle function between placebo and acetaminophen treatments, while the alternative hypothesis (HA) proposed a statistically significant difference. Results revealed sex-specific effects of acetaminophen on muscle function. In young men, acetaminophen significantly increased both the maximum and minimum sustained grip force compared to placebo (P<0.05), suggesting an enhancement in muscular endurance and force maintenance. Young women showed no significant changes in grip strength, yet exhibited a significant increase in time to fatigue (P<0.05), indicating improved resistance to muscular exhaustion. We conclude that acetaminophen can enhance specific aspects of skeletal muscle performance in young adults, with distinct sex-based differences. These findings suggest a potential influence of acetaminophen on neuromuscular function; however, further investigation is needed to elucidate the underlying mechanisms and determine whether these effects extend to other physiological systems or populations.
Intense physical demands on peak performance of both professional and nonprofessional athletes have prompted increased research on chemicals and conditions that play roles in skeletal muscle function and recovery from fatigue. Among numerous compounds, acetaminophen, an inexpensive and widely-used pain reliever, has raised questions regarding its potential for alleviating muscle pain and fatigue. Its mechanisms of action, however, remain unknown. One prevailing theory suggests that acetaminophen blocks prostaglandin formation via inhibition of cyclo-oxygenase (COX) enzymes [1, 2]. There are likely other mechanisms as well (e.g., antioxidant activity).
In our research laboratory at Rutgers University, New Brunswick, we have been engaged in animal research with acetaminophen for the past twenty plus years. In large and small animals, we have found acetaminophen to be both cardioprotective [3-15] and cerebroprotective [16]. In frog gastrocnemius muscle we have more recently shown acetaminophen to be myoprotective [17]. Naturally, such observations have caused us to wonder about the translation of these effects to humans, particularly in clinical arenas.
The above are not unreasonable thoughts because: 1.) acetaminophen has a long-standing history of successful use in Western medicine (e.g. treating fever and pain), 2.) acetaminophen is efficacious and safe when used as directed (e.g. equal to or less than 4000 mg doses per a 24-hour period, see labels on products such as Tylenol and Paracetamol), 3.) relative to other generally-used as well as clinically-safe analgesics/antipyretics, acetaminophen is inexpensive, and 4.) it is broadly available to the public without prescription [18].
Acetaminophen’s only known negative side effect is hepatotoxicity and that occurs, mostly, in persons using the analgesic for intended, harmful purposes (e.g., suicide attempts), and/or who double up on consumption of alcohol and acetaminophen. Moreover, in the experiments we have reported, circulating plasma concentrations of acetaminophen have not exceeded about 50 µg/ml. For the analgesic to be hepatotoxic, circulating plasma concentrations must exceed 300 µg/ml, which are far above those achieved after clinical dosing [19].
Finally, acetaminophen, a monophenol, belongs to a class of compounds known for their antioxidant properties. Phenols can neutralize free radicals, particularly in muscles during heavy exercise or injury [20]. Oxidative stress is a key contributor to muscle fatigue and delayed recovery. Accordingly, acetaminophen might help maintain muscle integrity and improve endurance during sustained exertion of any type. Here we report, for the first time, that acetaminophen has beneficial properties in human subjects undergoing exercise activities to exhaustion.
Experimental Subjects: The experimental subjects were eleven students enrolled in the Spring 2025 Advanced Physiology course at Rutgers University - New Brunswick (RU). Participants represented a diverse range of cultural and ethnic backgrounds, with an average age of approximately 21 years. Each student visited the Merrill Laboratory on two separate occasions. They were instructed not to fast and to maintain consistent lifestyle habits for both visits. All subjects self-reported good health and adhered to the study guidelines. While the primary analysis focused on these current-semester students, some additional analytics were incorporated including aggregated data from similar experiments conducted over the past three semesters (n=42), all of which followed the same experimental protocol.
Experimental Protocol: Hand grip strength and fatigue were selected as measures of muscle performance due to their ease of assessment and relevance to the study’s objectives. Forearm and hand muscles are predominantly composed of type II, fast-twitch muscle fibers. They are more susceptible to fatigue compared to type I, slow-twitch myocytes which are designed for endurance [21]. Given their susceptibility to rapid exhaustion under prolonged exertion, these muscle groups are well-suited for investigating the effects of acetaminophen on muscular activity.
One week prior to experimentation, participants attended a briefing that outlined the study protocol. During this session, each participant received both placebo and acetaminophen capsules, color-coded by a third party to maintain blinding. Participants were instructed to ingest one capsule before arriving at the laboratory for each trial. Upon arriving at the laboratory, subjects were weighed (kg) and their heights (m2) were determined (Health-O-Meter, Continental Scale Corporation, Bridgeview, IL, certified by New Jersey Weights and Measures). From this information Body Mass Index (BMI) was calculated as: weight (kg) / height (m2) = BMI. This was used to normalize raw data, and to account for inter-individual differences in body/muscle mass. Subjects were then introduced to the hand-held dynamometers—both manual and electronic—used for quantifying muscle function. No standardized questionnaire was used to assess subjective parameters such as fatigue or perceived exertion, as the focus of the study was on objective physiological measurements.
For the first activity, maximum strength of grip was estimated using a manual grip force transducer. This also served as a calibration reference for the electronic transducer used in subsequent tasks. In the second task, participants used an MLT004ST electronic grip transducer to perform intermittent maximal grips. Over a 120-second period, they gripped maximally and released once per second for 15 seconds, followed by a 5-second rest. This cycle was repeated six times. The transducer was connected to a data acquisition system and LabChart software (v8.1.30, 2024) on a desktop PC. To avoid bias, subjects were seated facing away from the monitor. Data were recorded for later comparison between placebo and acetaminophen conditions. The final test, performed following five minutes of rest post-intermittent gripping, was used to estimate time-to-fatigue. Upon the verbal command, “3-2-1-Go”, students were told to grip the dynamometer as forcefully and continuously as possible for no less than 120 seconds, but no more than 180 seconds. They were given audible queues every fifteen seconds during the activity. This exercise was similarly monitored by the data acquisition system and computer. All tests were conducted in a controlled environment, with room temperature maintained between 22°C and 24°C.
Acetaminophen vs Placebo: Both participants and investigators were blinded to the treatment condition; neither party knew whether placebo or acetaminophen had been administered. Each participant completed the protocol on two separate occasions, reporting to the Merrill Laboratory after self-administering either a 1000 mg oral dose of placebo or acetaminophen. The dose and timing were based on pilot data previously collected from Rutgers University students. When normalized to a 70 kg body weight (historically-published average adult human weight) the acetaminophen dose corresponds to approximately 14 mg/kg, which is comparable to doses previously used in canine models of myocardial infarction [8].
Statistics: The experimental protocol was designed a priori. All data are reported as means plus or minus one standard error of the mean (s.e.m.). Students t-test for paired data was used to identify significant differences between means, and Analysis of Variance (ANOVA) was used to identify differences in variability. A probability of P<0>
Although multiple potential confounding factors existed (e.g., sleep, diet, hydration, circadian rhythm), efforts were made to minimize their influence. Participants were instructed to follow their typical daily routine on each test day, and the study design was counterbalanced and blinded to reduce bias. Based on previous research and pilot data, we anticipated that the physiological effects of acetaminophen would be robust enough to outweigh minor uncontrolled variables.
An example of a typical response in one male subject during intermittent forearm exercise is shown in Figure 1.
Figure 1: Sample of periodic (intermittent) handgrip exercise in a young adult male in the absence and presence of acetaminophen (1000 mg oral). Image at left represents the first of six sets of fifteen maximal grips and releases. At right is shown the sixth set of data.
Data after consumption of placebo are shown at the left, while those post-acetaminophens are presented at the right. At the beginning of this activity muscle strength increased from about 45kg (placebo) to 53 kg with acetaminophen. At the end of the test corresponding numbers were about 15 vs 20 kg. In the presence of placebo this young man was able to endure for about 55 seconds, while that number increased to nearly 95 seconds with acetaminophen. This subject was an unconditioned, non-athlete.
When the data were pooled for the four young men in the experiment, acetaminophen was shown to significantly improve force of contraction at the beginning and ending of sustained handgrip exercise (Figure 2).
Figure 2: Group data for young men only in the current experiment. Note the significant difference (P<0>
For example, maximum and minimum forces in the presence of placebo were 1.36 ± 0.4 and 0.70 ± 0.14 kg/BMI. Corresponding numbers with acetaminophen were 1.72 ± 0.3 (P<0>
An example of results from a conditioned, competitive female gymnast (Division I, Big Ten Conference) during both intermittent and sustained activities is presented in Figure 3. After administration of placebo her maximum forces of contraction were about 20 (termination) and 45 kg (initiation) for sustained and periodic force, respectively. Corresponding numbers increased to 30 and 55 kg in the presence of acetaminophen.
Figure 3: Sample of both periodic and sustained handgrip exercise in a conditioned, competitive young female gymnast. Note the improvement in muscle function in the presence of acetaminophen.
During sustained handgrip exercise, females (n = 8) were able to endure for a longer period with acetaminophen (14.8 ± 5.0) than with placebo (7.1 ± 1.7) (P<0>
Figure 4: Group data for young women only. In the presence of acetaminophen (1000 mg), young women were able to sustain a maximum grip significantly longer (P<0>
Our main objective was to establish a proof-of-principle: does acetaminophen in human striated skeletal muscle behave like it does in mammalian striated cardiac muscle, i.e is it myoprotective. In heart acetaminophen preserves/protects function during ischemia, reperfusion, hypoxia, reoxygenation, myocardial infarction, and pro- arrhythmic insults. We sought to determine whether the analgesic can improve/sustain endurance, fatigue, and/or strength in challenged skeletal muscle.
Before initiating human trials, we previously collected pilot data in isolated, stressed frog gastrocnemius muscle [17]. Gastrocnemius myocytes are mostly fast twitch, easily-fatigued skeletal muscle. In frogs, acetaminophen consistently and significantly improved contractile force at both the initiation and termination of electrical stimulation (simulated moderate to heavy exercise). It also reduced the rates of fatigue in our frog muscle preparation. These findings provided preliminary evidence supporting a possible myoprotective effect of acetaminophen in skeletal muscle.
In humans, grip strength is primarily governed by the flexor digitorum profundus, flexor pollicis longus, and other forearm muscles. These muscles, along with associated ligaments, nerves, and tendons, facilitate movement and fine motor control of the wrist and fingers. These tissues were the focus of our current study [22]. To our knowledge, this is the first study to examine the impact of acetaminophen on skeletal muscle performance in young adults. Across multiple trials using both manual and electronic dynamometers, young men consistently produced greater grip force than young women—a difference that remained significant even after normalizing for body mass (kg) and body mass index (BMI, kg/m²). This sex-based disparity was evident under both placebo and acetaminophen conditions and aligns with previous findings in older adults [23].
Data were collected across three academic semesters (Spring 2024, Fall 2024, and Spring 2025) from a total sample of 42 university students. During the intermittent grip task—consisting of six 15-second bouts of maximal effort with 5-second rest intervals over a 120-second period—both male and female participants demonstrated a significant increase in grip strength at both the start and end of the activity when under the influence of acetaminophen (n = 19; see Figure 2).
In the current experiment young women were able to sustain a maximum grip for a longer period of time in the presence of acetaminophen. The opposite trend was seen in young men and suggests that the way acetaminophen influences exercise performance could be influenced by gender. Speculatively, young women might have increased resilience to sustained effort, but this requires further investigation.
Acetaminophen is known to alter perception of pain and fatigue during physical activity. In a recent study comparing detection and reporting of pain, women detected pain at lower temperatures and across all levels of pain compared to men [26]. This suggests a higher tolerance to pain and discomfort in women. It also suggests that women might be more willing and able to endure pain and discomfort for longer periods of time than men [21]. This notion also requires further examination in both conditioned athletes and in the general population.
Women are more prone to lower body injuries such as sprained ankles, torn ACLs (anterior cruciate ligaments), and plantar fasciitis [27]. This has been attributed to biomechanical, hormonal, and structural differences in female and male athletes [27]. For example, wider hips, greater reliance on quadriceps over hamstrings, greater ligament laxity, mineral and vitamin deficiencies (e.g iron, calcium, and vitamin D), and hormonal fluctuations, are just some of the challenges female competitors must contend with [25, 28]. Therefore, further exploration into how acetaminophen interacts with sex-specific traits, pain perception, and muscle fatigue is not only scientifically valuable but may have practical implications for both recreational and elite athletes.
Limitations
The hand-held electronic dynamometer used to measure grip strength may have caused mild discomfort for some participants, which could have influenced their effort, potentially introducing bias or performance variability across testing sessions. Additionally, the study exclusively evaluated forearm and hand muscles in a seated, non-weight-bearing position. While this allowed for controlled testing of small muscle groups, it limits the generalization of the findings to larger or postural muscles involved in whole-body movements or athletic activities. The effects of acetaminophen on lower-limb, core, or full-body muscular performance remain unknown and should be the focus of future studies.
In summary, this study provides preliminary yet compelling evidence that acetaminophen may positively influence skeletal muscle performance under conditions of fatigue and repeated exertion, particularly in young adults. Both subjective and objective measurements showed trends suggesting improved endurance and sustained force output. While limitations related to study design, scope, and sample size must be acknowledged, the data suggest a previously underappreciated potential for acetaminophen to modulate muscular fatigue and functional performance.
Given acetaminophen’s widespread use and its known effects on pain perception and central fatigue, further studies should be performed, particularly across diverse muscle groups, postural conditions, and demographic populations. Future research should also explore the underlying mechanisms by which acetaminophen may exert myoprotective or fatigue-mitigating effects and whether these effects are sex-dependent.
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To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
