AUCTORES
Globalize your Research
Chat with us
Case Report | DOI: https://doi.org/10.31579/2694-0248/008
*Corresponding Author: Elvis Rafael Ávila Santana, 1First Degree Specialist in Orthopedics and Traumatology. Instructor teacher. William Soler Pediatric Hospital. Havana, Cuba 2020.
Citation: E R Á Santana, E A Santana, L F Barranco, N C Carbalido.(2020). Congenital luxation of the knee: with regard to a case. Clinical Orthopaedics and Trauma Care. 2(1); DOI:10.31579/2694-0248/008
Copyright: ©2020 Elvis Rafael Ávila Santana, 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: 07 July 2020 | Accepted: 16 October 2020 | Published: 21 October 2020
Keywords: complex loss of substance; trauma of the large fingers; amputation; fingertip injury; neurovascular flaps
Introduction: the traumatic injuries of the hand are in the top of the list of industrial working accidents. The treatment of these injuries has as goal to restore the function of the fingertip, improving the life quality of the patients.
Objective: to evaluate results of the application of neurovascular homodigital flaps on the cutaneous defects of the digital fingertip of the large fingers of the hand.
Method: it was perform an observational and descriptive type investigation, in a case chain of 33 patients on the Hermanos Ameijeiras Hospital in the period of October 2013 up to January 2015, were it was apply neurovascular homodigital flaps with direct circulation (17 patients) or indirect circulation (16 patients).
Results: male sex was more affected, with a higher frequency between 36 and 41 years old and also over 41 years old. There was confirmed 4 complications representing the 12%. It was obtained a 72.7% of good and excellent results with the application of these surgical techniques getting an appropriate protector sensibility and a satisfactory cutaneous covering. The patients were satisfied in a 93.9% of the cases with the application of these procedures.
Conclusions: it was demonstrated the efficiency of the application of neurovascular homodigital flaps on the cutaneous defects of the digital fingertip of the large fingers of the hand.
The frequency of hand injuries in industrialized countries represents a third of all accidents. Hand injuries are often treated by inexperienced surgeons, which explains a large part of the aftermath after the accident.
There are multiple surgical procedures to treat losses of complex substance from the digital pulp: targeted healing, free skin graft, Kutler and Atasoy flaps, and neurovascularized homodigital flaps. In the center in question, the homo-digitized neurovascularized island flaps are used because the transferred tissue satisfies the requirements of the reconstruction of the pulp, both from the mechanical and the sensitive point of view, providing a satisfactory protective sensitivity to the receptor area without affecting the main sensitivity of the donor finger, which motivated us to evaluate the results of its application taking into account age, sex, type of amputation, production mechanism, occupation and time of evolution and incorporation to work. The main complications of surgical treatment were also determined.
The objective of our research is not to compare methods but to present the results of our experience since the procedures that we apply, in addition to providing adequate skin coverage, provide a satisfactory protective sensitivity to the receiving digital pad.
Material and Methods
The universe of the study was made up of patients with complex loss of substance from the digital pad of the long fingers of the hand from consultations at the “Hermanos Ameijeiras” Clinical-Surgical Hospital. The sample consisted of 33 patients with complex loss of substance from the long fingers of the hand with surgical criteria of monopedicular neurovascularized homodigital flaps on an island, applying direct circulation flaps to 17 patients (Fig. 1) or indirect circulation to 16 patients (Fig. 2).
Inclusion criteria.
1. Patients over 18 years of age.
2. Patients with lesion of the digital pulp with loss of complex substance from the long fingers of the hand (2nd to 5th fingers), zone 2 and 3 of Merle and Dautel.
3. 6-month postoperative follow-up.
4. Acceptance by the patient of the surgical treatment.
Exclusion criteria.
1. Patients with thumb injuries.
2. Patients who refuse surgical treatment.
3. Patients who do not attend scheduled consultations.
4. Patients who voluntarily wish to leave the study.
Criteria for interruption or exit.
1. Patients who abandon outpatient follow-up.
2. Patients who do not comply with medical indications.
Variables
Age, sex, production mechanism, occupation, type of amputation (Obliquity of the cut), interval between injury-operation, surgical technique, incorporation to work and complications.
The evaluation of the results was carried out according to the Excellent, Good, Fair and Bad scales, taking into account: necrosis of the flap, protective sensitivity, discrepancy of two static points (S2PD), discrepancy of two dynamic points (M2 PD), hypertrophic scar in the borders of the donor area, pain, retractable surgical wound scar, total active flexion (total active motion) of the interphalangeal joints (TAM), flexion or extension contracture of the proximal metacarpophalangeal and interphalangeal joints, stiffness and patient satisfaction.
Procedures
General
Patient in supine position on the operating table, the arm is placed on the hand table, asepsis and antisepsis of the hand is performed, field cloths are placed, regional or local anesthesia is applied (2% lidocaine diluted to 1%) and a tourniquet is placed tire for ischemia.
Specific
Direct circulation monopediculate neurovascularized island flap homodigital.
The island is drawn at the distal end of the affected finger to be used to cover the skin defect, a mid-lateral incision is made on the radial side if the affected one is the 2nd or 3rd finger, and the ulnar side if it is the 4th or 3rd finger. 5th. The island flap is released from the flexor sheath. When sectioning the medial side of the flap, it is advisable to carefully haemostasis the arterial vascular arch of the pulp. The perivascular fatty environment of the pedicle must be preserved. The pedicle dissection can be carried proximally up to the level of the commissure. The two anastomotic arches of Edwards must be located and electrocoagulated in the vicinity of the distal metaphysis of the first and second phalanges. The advancement obtained is the product of pedicle dissection and flexion placement of the interphalangeal joints. A flap is placed in the receptor site, fixing it with a percutaneous needle, it will be removed when the flap is sutured with simple stitches, as well as the rest of the surgical wound. The donor site is grafted using intermediate thickness skin, taken from the hypothenar eminence.
Indirect circulation monopediculate neurovascularized island flap homodigital.
The island is drawn at the proximal end of the affected finger (palmar aspect of the first phalanx) that is to be used to cover the skin defect, medial-lateral incision is made on the radial side if the affected finger is the 2nd or 3rd finger and ulnar side if it is the 4th or 5th. After determining the necessary length of the collateral nerve for the flap defect, it is sectioned in the palm, leaving a stump of the nerve surrounded by palmar adipose tissue. The palmar collateral artery is in turn divided between two ligatures on the proximal edge of the island flap. Dissection continues from proximal to distal, individualizing the pedicle, away from the pedicle elements. The dissection is stopped before reaching the neck of the second phalanx, so as not to damage the anastomotic arch that will feed the flap with reverse circulation. The flap is rotated to cover the skin defect. Microsurgical suture is made between the distal end of the healthy contralateral digital nerve and the flap nerve. The flap is sutured with simple stitches at the level of the loss of substance and then the donor site in the first phalanx is grafted using a total skin graft.
Statistical Analysis
In the statistical analysis, summary measures were used for qualitative variables such as percentages and for quantitative variables the mean and standard deviation.
Due to the small sample sizes, the non-parametric Kruskal-Wallis test was used to compare the means of age according to the surgery result, with a significance level of 0.05.
Results
The most affected age group was between 36-41 years, 10 patients (30.3%) followed by those> 41 years, nine patients (27.3%). Average age was 37.3 10.3 years
According to the production mechanism, the project showed that the most frequent mechanism was crushing, represented by 23 patients constituting 69.7%. (Table 1)
Regarding the occupation of the patients, the most affected were manual workers, 23 patients (69.7%). (Figure 1).
In the series studied, the transverse lesion of the soft foot prevailed, represented by 21 patients (63.6%). (Table 2)
Regarding the time elapsed between the injury and the surgery, the patients operated after 72 hours predominated, 27 patients (81.8%). (Table 3).
Regarding the final results of the investigation, 24 patients (72.7%) obtained Excellent and Good results. The two patients (6.1%) with poor results presented: 1-) total necrosis of the lame, it was a diabetic patient with more than 30 years of evolution, hypertensive and smoker of more than one box of daily cigarettes 2-) rigidity in flexion of the proximal interphalangeal joint due to lack of physical therapy and poor patient cooperation (Table 5)
There were 4 complications (12%). The first complication was total necrosis of the flap in a 55-year-old patient, a diabetic with more than 30 years of evolution, hypertensive, and a smoker of more than one box of cigarettes a day. To solve it, we had to perform necrectomy and targeted healing, but the patient lost the possibility of a more adequate skin coverage and a satisfactory protective sensitivity, so he was also unsatisfied as described above. The second complication was a stiffness in flexion of the proximal interphalangeal joint due to lack of physiotherapy and poor patient cooperation, which was resolved with a second surgical procedure where we sectioned the retinacular ligaments on both sides of the proximal interphalangeal joint and also the lateral recesses of the the plate fly. The third complication was partial necrosis of the flap in another 57-year-old patient, a 13-year-old diabetic and alcoholic. Surgical debridement and targeted healing were also performed, but as the necrosis was partial, the rest of the flap showed adequate coverage with satisfactory protective sensitivity without affecting patient satisfaction. The fourth complication was a parrot-beak deformity in a 30-year-old male patient, a baker, who despite the deformity was satisfied because his main objective was to resolve the skin defect with satisfactory protective sensitivity. (Table 6)
According to the literature consulted, these age groups are more likely to present these injuries because in these stages people are more active at work. ([1,2,6] In the fourth decade of life there is a work experience that brings greater confidence when handling work instruments, which causes non-compliance with protection measures. They also decrease the individual's physical aptitudes, such as: visual deficit, incoordination of fine manual movements and a decrease in the ability to react to dangers.
Digital pulp lesions were more frequent in males, represented by 27 patients (81.8%). Coinciding with the series by Adani et al. [7, 11, 20] It is based on the fact that men perform manual activities of greater risk compared to women.
Due to the great industrial development and the incorporation of multiple complex heavy machinery, crush trauma and blunt avulsive wound are more frequent than incised wounds and bites. Frank Fang et al. [9, 10, 13] and Carlos E. [8, 13] agree with our report.
With the increase in industry and the mechanization of work tools, the manual worker, by the nature of his trade, traumatizes his hands. Hands top the list for industrial workplace accidents and are responsible for much of the compensation costs. [1, 3, 15] French annual statistics report 360,000 hand accidents (32% of work accidents). [17, 18, 19, 21]
Frequently, the production mechanisms that cause these injuries contribute to great contamination of the wounds that also occasionally become well established around 72 hours. Godina [4] recorded an incidence of infection of 1.5% using a protocol of excision of the lesion and skin coverage by microsurgery in 72 hours and an incidence of infection of 17.5% with the closure of the wound in less than 72 hours. Lister and Schoker [4] presented satisfactory results using skin coverage through the use of flaps in the 24 hours following the injury. Brenner et al. They did not observe significant differences in infection rates when they compared emergency primary transfer of free and / or vascularized tissue versus delayed primary or secondary transfer. Delayed treatment allows the injury to be evaluated a second time, verifying the viability of the limb in order to plan the intervention more precisely. However, in our series, no infection was found before or after 72 hours. [4, 12, 16]
Bunelli F. [14, 15, 22] demonstrated in her research that the described incorporation fluctuated between 5-6 postoperative weeks, while the cases incorporated in the two series after eight weeks were those that presented complications. Incorporation before four weeks is difficult when more complex surgical techniques are applied since healing and rehabilitation require at least one month of evolution to obtain a satisfactory result.
The different studies reviewed coincide with our investigation and the results obtained in the present investigation. S. Rojas Sabapathy and Godina [4] demonstrated excellent results with the use of homodigital neurovascularized flaps in covering the loss of complex substance from the pulp.
According to Merle [3, 5] the most frequent complications are: total and partial necrosis of the flap and stiffness of the metacarpophalangeal, proximal and / or distal interphalangeal joints, coinciding with what has been reported by several authors. The study yielded similar results to those obtained in the literature.
Conclusions
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
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
