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Review Article | DOI: https://doi.org/10.31579/2690-4861/967
Klinik Donaustadt and Science Center Donaustadt, 2nd Medical Dept., Vienna, Austria.
*Corresponding Author: Denis Senoner, Klinik Donaustadt and Science Center Donaustadt, 2nd Medical Dept., Vienna, Austria.
Citation: Denis Senoner and Christian Sebesta, (2025), Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Current Stage of Knowledge and Research – Facts and Assumptions, International Journal of Clinical Case Reports and Reviews, 30(4); DOI:10.31579/2690-4861/967
Copyright: © 2025, Denis Senoner. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 04 September 2025 | Accepted: 19 September 2025 | Published: 01 October 2025
Keywords: myalgic encephalomyelitis; chronic fatigue syndrome; me/cfs; infection triggers (epstein-barr virus; sars-cov-2); post-exertional malaise (pem); diagnosis by exclusion; canadian consensus criteria; symptom management
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic multisystem disorder characterized by persistent, debilitating fatigue lasting at least over six months and affecting multiple organ systems. Despite its classification by the WHO as a neurological disease since 1969, the precise pathogenesis remains unclear, and no definitive biomarkers exist. ME/CFS primarily affects adults aged 30–50, predominantly women, often triggered by infections such as Epstein–Barr virus or SARS-CoV-2, with a rising incidence following the COVID-19 pandemic.
Diagnosis is complex and based on exclusion of other conditions, relying heavily on clinical criteria, particularly the hallmark symptom of post-exertional malaise (PEM), a delayed, severe worsening of symptoms following exertion. The Canadian Consensus Criteria are commonly used in Europe, requiring at least five major and two of three minor criteria, including neurological, autonomic, and immunological disturbances.
Currently no causal, evidence-based cure exists. Treatment focuses on symptom management and patient education. The basic principle is the control of physical and mental activities and a careful energy management to avoid PEM, alongside supportive measures such as sleep hygiene, pain management, and psychosocial care. Pharmacological interventions address specific symptoms, with limited evidence for efficacy. Severe cases pose significant care challenges.
ME/CFS represents a substantial burden on patients and families, compounded by delayed diagnosis, lack of specialized care, and societal under-recognition. The current research aims to clarify pathophysiological mechanisms and identify biomarkers to enable targeted therapies. Until then, multidisciplinary, evidence-based management and improved awareness are essential to mitigate the disease’s profound impact.
History, possible causes, epidemiology, prevalence and pathogenesis
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic multisystem disease [1] [2]. It is defined as a condition persisting for more than six months in adults and affecting multiple organs or organ systems. As of September 2025, the full pathogenesis of the disease remains unresolved, and no specific biomarker detectable in routine clinical practice has yet been identified.
Since 1969, ME/CFS has been classified by the World Health Organization (WHO) as a neurological disorder and is currently coded as G93.3 in the ICD-10. Approximately two- thirds of ME/CFS patients are women, with a peak incidence between the ages of 30 and 50, thus affecting the life stage of highest productivity. In most cases (approximately 80%), the onset is preceded by an infection. Other precipitating events include prior surgical interventions, resuscitations, or trauma to the head and neck region. In the majority of patients no plausible trigger can be identified [1] [2] [3].
Potential infectious agents associated with the disease include Epstein–Barr virus (EBV), COVID-19 (with approximately 20% of Long COVID cases manifesting as ME/CFS), herpes simplex virus type 1 (HSV-1), human herpesvirus 6 (HHV-6), enteroviruses, influenza viruses, dengue virus, chikungunya virus, as well as bacterial pathogens such as Borrelia, Mycoplasma, Bartonella, Brucella, Chlamydia, and Legionella, in addition to rarer infections with fungi and protozoa such as Coxiella and amoebae [3].
Prevalence and incidence figures remain unreliable due to the complexity of the condition, the absence of biomarkers, and the challenging and time-consuming diagnostic process, all of which contribute to a high number of undiagnosed cases as well as considerable rates of misdiagnosis. Notably, since the onset of the SARS-CoV-2 pandemic, there has been a marked increase in new ME/CFS diagnoses.
Current medical knowledge about the pathogenesis suggests dysfunction of both the central and autonomic nervous systems, potentially resulting from nerve fiber damage and neuroinflammation, as well as immune system impairment leading to increased susceptibility to infections and reactivation of latent viruses. Additionally, there are indications of impacts to the cardiovascular system (including endothelial cell dysfunction with capillary rarefication and impaired organ perfusion), muscle tissue damage with potential necrosis upon exertion and cerebral hypoperfusion (demonstrable via tilt-table testing and imaging), mitochondrial dysfunction across multiple cell systems (affecting energy production) and the gut microbiome [1] [3].
Ian James Martins discusses the importance of Sirtuin 1 (Sirt1) as a key diagnostic biomarker for chronic diseases, including NAFLD, diabetes, and neurodegenerative disorders, due to its role in regulating mitochondrial function, metabolism, and protein interactions. Sirt1’s activation, particularly through diet, can enhance drug efficacy and manage disease progression by influencing amyloid beta metabolism and insulin resistance. Martins study highlights the need for precise proteomic diagnostics, focusing on Sirt1, to improve therapeutic interventions and avoid errors in drug metabolism and disease management [4].
It should be noted that a future laboratory diagnosis, revealing a mosaic of various changes, is likely to emerge (this is being intensively investigated in ongoing studies). Exemplary in this regard are the research findings particularly related to cerebrospinal fluid analyses by Iwasaki et al. (2025), which provide new insights into distinct immunological subtypes in ME/CFS. The differences identified by Iwasaki et al. (2025) can certainly be characterized as a significant contribution to understanding the pathogenesis of the disease and serve as a starting point for developing more targeted therapeutic strategies. The authors specifically highlight that the detailed characterization of disease subgroups is considered a promising approach [5].
It must be pointed out, however, that all these assumptions currently represent a certain degree of probability, but scientifically conclusive confirmation is still pending. Definitive evidence at the cellular or molecular level, however, remains outstanding. This can only be remedied by basic research in parallel to clinical trials, defining the disease more precisely and unmistakably in order to provide practicing physicians with useful guidance and to clearly visualize the dimension of the problem, moving away from estimated figures to a statistically accurate representation of prevalence and incidence, mortality and lethality. Such a development would also benefit the lack of public awareness and acceptance of the disease itself, which is often complained about by patients and their caregivers, as well as the allocation of funds, not only for further research, but also for securing the usually long- term care of the sick.
As for the current status, it appears that a diagnostic proof for ME/CFS will likely be integrated into diagnostics, as well as the differentiation of disease stages and potential therapies, in the near future. From daily clinical experience it can be confirmed, that the perception and acceptance of the illness as an independent somatic disease entity, possibly as a consequence of a previous infectious disease, is of great importance of those affected.
This must be seen in the light of the fact, that regardless of the specific proposed mechanisms of damage, the common endpoint is physical and cognitive impairment, ranging from mild limitations to complete bedbound status [1].
While significant improvement or recovery in adults is rare, disease severity can becategorized as follows: [2].
Up to 60% of patients are unable to work. Only those with mild disease may be partially able to maintain employment, while approximately 25% are confined to their homes. Family members of patients may also experience considerable physical and psychological strain, often providing care without formal support. Life expectancy and quality of life may be reduced within the group of severe and very severe ill patients by deaths including heart failure, cancers (particularly lymphomas), and suicide [1].
The diagnostic process first consists in obtaining a complete medical history and, where available, analyzing symptom diaries, followed by a physical examination, which may reveal cold, clammy extremities, Raynaud’s phenomenon, mottled skin, elevated resting heart rate, reddened eyes, facial swelling, lymphadenopathy, and throat pain [1] [3].
A useful screening laboratory panel to exclude other, more readily identifiable diseases includes a complete blood count with differential, C-reactive protein (CRP), ferritin, HbA1c, lipid profile, protein C, lipoprotein(a), homocysteine, creatinine, creatine kinase (CK), liver enzymes, lactate dehydrogenase (LDH), bilirubin, electrolytes including phosphate, thyroid peroxidase antibodies (TPO-Ab), thyroid-stimulating hormone (TSH) with free T3 and free T4, immunoglobulin subclasses, antinuclear antibodies (ANA, and if positive extractable nuclear antigens [ENA]), antineutrophil cytoplasmic antibodies (ANCA), anticardiolipin antibodies, prothrombin, angiotensin-converting enzyme 2 (ACE-2), celiac antibodies, and N-terminal pro–B-type natriuretic peptide (NT-pro-BNP). This work-up can reveal deficiencies or abnormalities that may justify further targeted diagnostics (e.g., endocrine axis testing). However, in many cases, no relevant abnormalities are found - apart from, for example, autoantibodies against various receptors, which currently have no therapeutic relevance - so the primary function of this diagnostic panel is to exclude other disease entities [1] [3].
ME/CFS is therefore a classic diagnosis of exclusion. Before the diagnosis can be made, a range of neurological, psychiatric, endocrinological, and metabolic disorders must be thoroughly ruled out if they could plausibly explain the patient’s symptoms. In the absence of a validated biomarker, diagnosis relies on scoring systems and established international criteria.
Diagnostic criteria must always include the cardinal symptom of post-exertional malaise (PEM). PEM is defined as a disproportionately severe deterioration in overall condition and pre-existing symptoms, without physiological recovery, triggered by exertion - often perceived as minor - whether physical, cognitive, emotional, orthostatic, or sensory. PEM may occur immediately after exertion, but more commonly develops 12 to 72 hours later and can be accompanied by so-called “crashes” (onset of new symptoms). By definition, PEM lasts at least 14–24 hours; however, the worsening can persist much longer and carries the risk of permanent deterioration. PEM helps distinguish ME/CFS from depression and burnout: in the latter, reduced drive is typical and physical activity does not cause deterioration, whereas in ME/CFS it does. Moreover, ME/CFS patients are often motivated and show little reduction in drive [1] [2] [3].
PEM must also be differentiated from fatigue of other etiologies, particularly following internal medical illnesses. Important differential diagnoses for fatigue include diseases further outlined in table 1. Fibromyalgia, irritable bowel syndrome, endometriosis, and Hashimoto’s thyroiditis are frequent comorbidities in ME/CFS [1] [3].
| Rheumatology | Polymyalgia rheumatica (PMR), collagenoses, systemic lupus erythematosus (SLE), Sjögren’s syndrome, sarcoidosis, ankylosing spondylitis, and psoriatic arthritis. |
| Endocrinology | Diabetes mellitus, hypothyroidism, Addison’s disease, hypercalcemia. |
| Infectious diseases/Immunology | Post-infectious states, neuroborreliosis, AIDS, chronic sinusitis, chronic hepatitis, mast cell activation syndrome, immunodeficiencies such as common variable immunodeficiency (CVID). |
| Hemato-Oncology | Anemia, iron deficiency, malignant diseases and their treatments |
| Gastroenterology | Inflammatory bowel disease(IBD), celiac disease, primary biliary cholangitis (PBC),and primary sclerosing cholangitis (PSC). |
| Neurology and Psychiatry | Depression, somatic symptom disorder, multiple sclerosis (MS), myasthenia gravis, hypermobile Ehlers–Danlos syndrome (hEDS), Parkinson’s disease, Alzheimer’s disease, sleep disorders (particularly obstructive sleep apnea syndrome [OSAS]), cervical spinal stenosis/whiplash injury, attention-deficit/hyperactivity disorder (ADHD), and autism. |
| Others | Fatigue secondary to heart failure, renal failure, medication side effects, and mitochondrial myopathy. |
Table 1: Differential Diagnoses for Fatigue.
(Own version 2025, based on Hoffmann et al. 2024 & Renz-Polster/Scheibenbogen 2022)
Whereas the underlying mechanisms of PEM, which is not exclusively a symptom of ME/CFS, are not fully understood, the literature agrees, that it cannot be considered a potential cause of death and that PEM is naturally depending on the subjective assessment of the patient, but is anyway part of the assessing CCC and IOM criteria [6].
In Europe, the Canadian Consensus Criteria (CCC) are most frequently applied for diagnosis in adults, as they are more specific than the Institute of Medicine (IOM) clinical criteria, which are more commonly used in the United States. [1] The five major criteria and the three minor criteria are outlined in table 2 [1-3,7].
| Major criteria | Pathological fatigue | Disproportionate exhaustion that does not improve adequately with sleep or rest (with careful consideration of differential diagnoses as described in Table 1 above). |
| PEM | Assessed, for example, by repeated handgrip strength measurements with a dynamometer; such tests are typically limited to research contexts (e.g., measurement of inappropriate blood lactate accumulation). Exercise testing should be avoided, as it may worsen the disease. | |
| Sleep disturbances/unrefreshing sleep | May be supplemented by overnight pulseoximetry or polysomnography if OSAS is suspected. | |
| Pain (head, muscle, joint, bone, neuropathic) | Important differentials includemigraine, cervical spine disorders, peripheral neuropathy, neuroborreliosis, and orthopedic causes. If small fiber neuropathy is suspected, skin biopsy may be indicated; if there are signs for hypermobile Ehlers–Danlos syndrome,the Beighton score should be assessed. | |
| Neurological/cognitive impairments | Memory and concentration deficits, confusion, attention difficulties. Imaging studies investigating cerebral hypoperfusion in ME/CFS are ongoing in multiple trials. | |
| Minor criteria | Autonomic nervous system disturbances | Orthostatic intolerance in postural orthostatic tachycardia syndrome (POTS) and orthostatic hypotension (diagnostically and differentially useful tests include the Schellong test, 10- minute standing test, tilt table testing, 24-hour blood pressure, and ECG monitoring), marked pallor, dizziness, gastrointestinal or urinary disturbances, pupillomotor abnormalities, and palpitations. |
| Neuroendocrine disturbances | Dysregulated body temperature, cold/heat intolerance, febrile sensations, cold extremities, weight changes, abnormal appetite, and impaired stress response. Abnormal findings warrant evaluation of TSH, growth hormone (GH), the gonadotropic axis, the adrenocortical axis, and insulin resistance. | |
| Immunological disturbances | Lymphadenopathy, sore throat, allergic tendencies, persistent flu-like malaise, reactivation of latent viruses, hypersensitivities/intolerances, mast cell |
Table 2: Canadian Consensus Criteria
(Own version 2025, based on Hoffmann et al. 2024; Renz-Polster/Scheibenbogen 2022; Carruthers et al. 2003; Hainzl et al. 2024)
In adults, a minimum illness duration of six months is required to distinguish ME/CFS from the (not uncommon) post-infectious fatigue state. All five major criteria and at least two of the three minor criteria must be met to establish a diagnosis of ME/CFS [7]. For ease of diagnosis, supportive questionnaires and scoring tools exist for each criterion.
After clarifying the diagnosis in the prescribed way, additional tools can be used to assess disease severity (e.g., the Bell score, with repeated
assessments being useful for monitoring), symptom frequency (e.g., the Munich–Berlin Symptom Questionnaire [MBSQ]), and functional capacity (e.g., FUNCAP55) [1]
Without accurate diagnosis and appropriate treatment, the patient’s condition may deteriorate. On average, it takes around five years for a diagnosis of ME/CFS to be established [1]. This delay may be due to the often-non-specific nature of symptoms, particularly in the early stages, as well as to the fact that the disease and its diagnostic process are insufficiently known among the medical profession and are often not recognized as a distinct disease entity. There is a lack of continuing education on ME/CFS, and the condition is addressed only peripherally in university curricula. Consequently, patients often feel misunderstood by physicians, which can severely strain the therapeutic relationship.
As of September 2025, Austria has no specialized ME/CFS facilities. As a result, even after diagnosis, appropriate treatment is often unavailable. By contrast, Germany, though not yet with comprehensive nationwide coverage, offers the Immunodeficiency Outpatient Clinic at Charité Berlin (no age restrictions) and the Chronic Fatigue Centre for Young People at the Technical University of Munich (for patients up to 20 years of age).
Diagnostic work-up is further complicated by the lack of suitable centers and the shortage of specialists, leading to uncoordinated evaluations. Moreover, patients’ mobility and ability to plan daily activities may be severely limited by the disease (e.g., geographically distant facilities may be inaccessible or impossible to attend) [2].
Currently, there is no therapeutic cure for ME/CFS. The focus is primarily on education, self- management, symptomatic treatment, and empathetic psychosocial support [1].
a) Non-pharmacological Intervention
The most important tool in non-pharmacological therapy is "Pacing." Pacing involves individual energy management throughout the day to avoid post-exertional malaise (PEM). The goal is to prevent exceeding
personal limits [1]. This requires attentiveness to both physical and psychological boundaries, with breaks taken before and after exertion [2]. Support can be provided through tools such as diaries and wearables (e.g., smartwatches) [1].
In the future, AI could play a significant role in supporting pacing and general ME/CFS management.
It is important to emphasize that the goal of pacing is not to increase exertion limits, but to stabilize the patient’s overall condition, enabling the feasibility of other therapies. Therefore, the principle of "Pacing first" applies, alongside the best possible symptom-oriented treatment and therapy for comorbidities. However, once the condition reaches a severe stage, pacing can become almost impossible, as basic activities (e.g., eating, drinking, speaking) can trigger PEM [1-3,8].
Other strategies include sleep hygiene, relaxation techniques (such as autogenic training, meditation, breathing exercises), stress reduction, coping mechanisms, physiotherapy (for pain management and circulatory activation, tailored to individual needs), cautious manual therapy, massage, occupational therapy, and dietetics (for intolerances, dietary adjustments, nutritional deficiencies, later evaluation of swallowing difficulties, pureed food, meal replacements, parenteral nutrition, preventing weight loss). For therapists, home visits, teletherapy, or practices with minimal sensory stimuli are recommended (e.g., seating/lying options, minimal waiting times, dimmable lighting, barrier-free access, air filters, masks) [1,2,3].
Supportive tools for sensory shielding can include noise-canceling headphones, acoustic filters, dark sunglasses, room darkening, screen filters, and sleep masks. Adequate hydration (especially before getting up), electrolyte solutions, increased salt intake, compression stockings, and abdominal binders can alleviate symptoms of orthostatic dysfunction. Regarding nutrition, a protein-rich diet of 1g/kg body weight with sufficient unsaturated fatty acids is recommended. If deficiencies are detected, supplementation with iron, folic acid, vitamin B12, and vitamin D should be considered. Psyllium husks may help with irritable bowel symptoms [3].
Patients often take supplements to correct deficiencies and improve energy metabolism. However, there are few clinical studies showing clear benefits in this area. ME/CFS patients likely experience disturbances in mitochondrial energy production, as well as deficits in amino acids, vitamins, and lipids, meaning temporary supplementation with ribose, vitamin B1, B2, B12, NADH, Coenzyme Q10, and carnitine could be helpful, potentially improving symptoms. It is typically recommended to try supplementation for 4 weeks, monitor tolerance, and then reevaluate the individual’s condition [9].
While ME/CFS is not a psychiatric disorder, psychological comorbidities (such as depression and anxiety) may occur, often due to the severity of the illness, stigma, potential social isolation, and/or financial difficulties. These should be addressed and treated adequately (e.g., pharmacologically with antidepressants or SSRIs, if necessary). Psychotherapy should primarily assist with coping with the illness and does not have a curative approach [1]. Additionally, support groups and online forums can help patients process their illness [3].
In the workplace, more flexible models are needed, tailored to each individual’s situation, such as flexible working hours, sufficient breaks, single-person offices, home-office options, quiet spaces, and the possibility to work while lying down. This approach allows certain patients to remain in the workplace or regain workability after periods of limited mobility [10].
Financial and social security is also crucial for patients, as many are partially or fully unable to work. Depending on the individual case, disability pensions, nursing allowances, medical devices (e.g., walkers, electric wheelchairs), and additional support services may be necessary. However, these services are often complicated by bureaucracy and the lack of societal recognition of the illness, adding further burden to patients [1].
Severely affected patients are bedridden and highly sensitive to external stimuli, presenting significant therapeutic challenges. Additionally, there is limited research data on those severely affected by the disease. These patients rely heavily on appropriate caregiving staff and adequate spatial arrangements, particularly in regard to nutrition (e.g., feeding tubes), personal hygiene, and sensory shielding [8].
b) Pharmacological Interventions
Many medications used for ME/CFS are prescribed "off-label," requiring specific informed consent. Additionally, this patient group tends to experience more side effects from therapies, so a critical risk-benefit analysis should be performed beforehand, with regular reevaluations of the treatment. Lactose-free medications and gluten-free diets should only be used when there is verified lactose intolerance or clinically confirmed celiac disease. Over the course of the illness, however, other intolerances may emerge [1].
At the beginning of pharmacological therapy, it is generally recommended to start with a low dose (e.g., using compounded prescriptions) and gradually increase it. Depending on the response and side effects, dose reductions or discontinuation trials can be conducted [2].
Across all therapeutic trials, it can be observed that very few causal approaches are available among a variety of symptomatic treatments: [1,2,3].
or in accordance with antibiogram data. The use of immunoglobulins remains a topic of discussion and is certainly effective in cases of IgG deficiency or immune defects, but such cases may be distinct from ME/CFS.
There are also reports of low-dose Aripiprazole (0.2-2 mg/day) being effective in improving fatigue and cognitive deficits in ME/CFS. One hypothesis is that the neuroinflammation believed to occur in ME/CFS may be mediated by dopamine D2 receptor agonists, which is where the action of Aripiprazole is thought to intervene [11].
There is less evidence for hyperbaric oxygen therapy, anticoagulants, and rheological agents such as Vericiguat and Sulodexide. These treatments aim to prevent or treat microcirculation disturbances caused by microthrombi [1].
In particularly severe cases, experimental treatments such as immunoadsorption or B-cell depletion with Rituximab and Cyclophosphamide are under investigation. These highly invasive therapies are subject to strict indications [3].
In the event of an acute flare-up caused by overexertion or infection, diagnostic evaluation should be initiated, and adequate fluid intake should be provided. Sensory shielding should also be prioritized in this situation. Benzodiazepines (e.g., Alprazolam) may be given short- term, but long-term use requires consideration of the risk of addiction [8].
Recommended guidelines with more detailed information on the pharmacological and non- pharmacological treatment of ME/CFS for patients and healthcare providers can be found on the websites and publications of Charité University Medicine Berlin [12], the German and Austrian ME/CFS societies [1], the National Institute for Health and Care Excellence (NICE) in the UK [13], and the Centers for Disease Control and Prevention (CDC) in the USA [14].
Additionally, the German Society of Neurology (DGN) advocates for a balanced, interdisciplinary, and scientifically grounded approach that considers not only immunological but also psychosomatic and functional aspects. In light of the absence of approved causal therapies, transparent patient education is essential, alongside the development of appropriate care structures and psychiatric support, in order to adequately address the significant psychological burden many patients face [15], However, the recognition of the syndrome as an organic neurological disease should be acknowledged, according to the WHO and newly revisited for the ICD-11 classification beyond dispute [16].
ME/CFS is a multisystem disorder that presents significant challenges for both patients and their treating physicians due to its severe impact on those affected, the absence of biomarkers, the lack of widespread specialized care, and the limited number of reliably effective therapies. The suffering of patients and their families, as well as their entire social environment, can be considered substantial, and the existing deficit in the recognition of the illness exacerbates these issues.
This inevitably gives rise to the justified demand for continuing education, training, and, above all, evidence-based, certified case management for individuals with ME/CFS within the public health and social systems of developed nations. These systems should have sufficient resources for both the research into the underlying causes of the illness and the development of therapy and care options. Current research is underway and must necessarily focus on identifying the triggers of the disease and understanding its pathophysiology in order to develop targeted therapies for ME/CFS patients.
It can be stated that there is sufficient evidence that, according to the WHO definition, ME/CFS is unequivocally a somatic condition that meets all criteria of a chronic illness, although distinguishing it from psychosomatic disorders can sometimes be difficult on a case-by-case basis. The authors of the guidelines believe that while psychological comorbidities often and understandably occur, they are concomitant as a consequence of the underlying condition and not its cause.
Regarding the issue of recognition of the disease by authorities and healthcare institutions, it can be outlined that the challenges mainly stem from its diverse manifestations, the lack of visible presence of affected individuals in public life (which is a characteristic of the illness), and the continued absence of a singular biomarker or pathognomonic imaging.
In summary, the condition represents a complex, chronically debilitating illness with poorly understood and difficult-to-define symptoms that is increasingly coming into the focus of both political and medical attention. Despite intensive research efforts, no reliable biological markers or effective therapies have been identified to date. The neurological community remains critical of the term “encephalomyelitis,” as inflammatory processes in the central nervous system are generally not detectable in ME/CFS. The clinical presentation overlaps with numerous medical and psychiatric conditions, which further complicates diagnosis. Many studies on ME/CFS suffer from methodological limitations, making interpretation difficult and contributing to the lack of evidence-based treatment options.
The authors would like to thank all colleagues who supported the development of this work through discussion and critical feedback. No external funding or institutional support was received.
The authors declare no conflicts of interest. There were no financial, professional, or personal relationships that could have influenced the content or outcomes of this work.
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We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
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 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.
Dear Grace Pierce, Editorial Coordinator of the journal IJCCR, I had a very positive experience with Auctores - Journal throughout the publication process. The Editorial Team was highly responsive, professional, and supportive at every stage. I would like to extend my sincere thanks to the Editor: Grace Pierce, for her guidance and assistance. The peer-review process was smooth and constructive, helping improve the quality of my work. I would gladly recommend Auctores Journal to fellow researchers and authors. Dr. SABITA SINHA, Medical Oncologist, MD (Electro Homeopathy).
Dear Maria Emerson, Editorial Coordinator of - Journal of Clinical Research and Reports. ''I am pleased to provide this testimonial following the publication of our recent case report in this journal. The peer review process was rigorous, constructive, thorough, and conducted in a timely manner. The reviewers’ comments were thoughtful, detailed, and highly constructive, contributing substantially to the refinement, clarity, and scientific robustness of our manuscript. The process was conducted with professionalism and academic integrity throughout. The support provided by the editorial office was exemplary. Communication was consistently prompt, clear, and courteous at all stages of the submission and publication process. The editorial team demonstrated a high level of organization and responsiveness, ensuring that all queries were addressed efficiently and that the process remained transparent and well-coordinated. The overall quality of the journal is reflected in its strong editorial standards, commitment to scientific excellence, and dedication to publishing clinically meaningful research. It has been a privilege to publish our work in this journal, and we would welcome the opportunity to contribute further in the future.'' Best wishes from, Dr. Efstratios Trogkanis, Cardiologist.
Dear Reader: We have published several articles in the Auctores Publishing, LLC, journal, Clinical Medical Reviews and Reports in recent years (CMRR). This is an ‘open access’ journal and the following are our observations. From the initial invitation to submit an article, to the final edits of galley proofs, we have found CMRR personnel to be professional, responsive, rapid and thorough. This entire process begins with Catherine Mitchell, Editorial Coordinator. She is simply outstanding, and, I believe, unparalleled in her capacity. I cannot imagine a more responsive and dedicated Editorial Coordinator. As I read the dates and timing of her correspondence with us, it seems that she never sleeps. I hope Auctores Publishing, LLC, appreciates her efforts as much as these authors do. Thank you to Auctores Publishing, LLC, to the Editorial Staff/Board, and to Catherine Mitchell from a grateful author(s).
