AUCTORES
Globalize your Research
Case Report
*Corresponding Author: Iqbal Akhtar Khan, MBBS DTM FACTM PhD, Independent Scholar, Lahore-54792, Pakistan.
Citation: Iqbal Akhtar Khan and Hamza Iltaf Malik (2021) COPD, Depression and COVID-19 Pandemic: A Harrowing, Demoralizing and Deleterious Triad. Clinical Medical Reviews and Reports. 3(8); DOI: 10.31579/2690-8794/095
Copyright: © 2021, Iqbal Akhtar Khan, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 01 July 2021 | Accepted: 10 September 2021 | Published: 23 September 2021
Keywords: COPD, depression, COVID19 pandemic, social distancing, shielding, duicidal ideation
COPD is a highly incapacitating global public health problem, with pulmonary and extra-pulmonary manifestations and usually associated with significant concomitant chronic diseases. With enhanced understanding, it has extensively been reported as a complex, heterogeneous and dynamic disease affecting patients’ health beyond pulmones.
Depression, with prevalence of 322 million people, is a major contributor to the overall global burden of disease. In various epidemiological and clinical studies, its prevalence among patients with COPD varies from 18% to 80%. This deadly duo leads to excessive health care utilization rates and costs including increased rates of exacerbation, sub-optimal adherence to prescribed medications, increased hospital admissions, longer hospital stays and increased hospital readmissions. Moreover, there is increased risk of suicidal ideation, suicidal attempts, and suicidal drug overdose. It is a pity that, in significant cases, the co-morbidity remains under-recognized and under-treated.
The impact of prevailing COVID 19 pandemic, on the dual burden of COPD and depression, and possible remedial measures including “The 6 ways to boost one’s well-being-by Mental Heath UK, “The Living with the Times” toolkit--by WHO” and innovative add-ons like Dance Movement Therapy and Musical Engagement Therapy have been discussed.
Dr. William Briscoe, the then Head of the Pulmonary Division New York Hospital-Cornell Medical Center, was the first person to use the term “Chronic obstructive pulmonary disease (COPD), as an umbrella term for chronic bronchitis, emphysema, and chronic asthmatic bronchitis, at the 9th Aspen Emphysema Conference, in 1965. With enhanced understanding, COPD has extensively been reported as a complex [1], heterogeneous [2] and dynamic [3] disease affecting patients’ health beyond pulmones.
Houben-Wilke et al argue that COPD stands for “Complex obstructive pulmonary disease” [4]. Where as a variety of intra- and extra-pulmonary components and considerable variability between individuals have been reported, the present study deals with depression co-existing with COPD. The consequences of social isolation and shielding on such patients, in the prevailing COVID-19 pandemic, are also being discussed.
“In our society that sets high standards of perfection to be ok and wins, the depressed is commonly considered as an outsider, a marginalized person unable to be in line with standards and rhythms fast and competitive of the time we live”.
Romina Tavormina & Maurilio Tavormina [5].
Depression is a leading cause of ill health and disability worldwide and is a major contributor to the overall global burden of disease. According to the latest estimates from WHO, 322 million people are now living with depression [6]. Despite its enormous clinical and public health impact, depressive illness is often under-diagnosed and under-scored, particularly when it co-exists with physical ailment. This often causes great distress for patients who have mistakenly assumed that symptoms, such as weakness or fatigue, are due to an underlying medical condition [7].
Depression and COPD: Dual Burden
“Depression is the largest cause of mental ill health worldwide, described as a “global burden” or a “global crisis” -----World Federation for Mental Health (WFMH, 2012)
Whereas depression is a common emotional disturbance, its association with chronic diseases has been well documented in literature. The mechanisms responsible for depression in patients with COPD are likely to be multifactorial [8]. “Reactive’’ depression associated with declining health status is more common [9]. In various epidemiological and clinical studies, its prevalence among patients with COPD varies from 18% to 80% (10]. In United States alone, the population with COPD has the highest prevalence of depression amongst the three chronic conditions that affect 60 million people (diabetes, heart disease, and COPD) [11].
In a randomized case control Dutch study, it was found that the prevalence of depression in COPD patients, with severe airways obstruction (FEV1 <50>
In a Polish study, it was found that the incidence of depression was high in patients who had recently experienced an exacerbation (AECOPD) [16].In a US retrospective cohort on COPD patients of 40 years and above , it was found that COPD patients with comorbid depression were 77% more likely to have a COPD-related hospitalization, 48% more likely to have an ER visit, and 60% more likely to have a hospitalization/ ER visit compared to the COPD-Only cohort [17].
Of note, depression is a strong predictor for mortality in patients with COPD, among hospitalized [18] and community patients [19]. In a Dutch study, on hospitalized stable patients with COPD, the depressive symptoms were associated with mortality independent of other factors including male sex, older age and lower peak workload (Wpeak) [20]. Atlantis et al showed that the dual burden increased the risk of mortality by 83% compared to the COPD patients without comorbid depression [21].
Studies, at various settings, suggest that depression in COPD leads to excessive health care utilization rates and costs including increased risk of AECOPD [ 22], non-compliance with medical treatment [[23], increased hospital admission, [24], longer hospital stay, [18] and increased hospital readmission. [25]. In a Romanian exploratory analysis, derived from an ongoing cross-sectional study, carried out to evaluate levels of fatigue and impact on health-related quality of life/health status in patients with COPD, fatigue was the most common detected ‘general’ symptom and also one of the most under-recognised and under-treated manifestation of this malady [26].
Suicidal Ideation, Suicidal Attempts and Suicidal Drug Overdose
“A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end”.
Elizabeth Lee Wurtzel (1967-2020)--‘Prozac Nation’ Author
Depression is a well-established risk factor for suicide. In a large case–control study in Family Practices in England, the relative risk of suicide was significantly elevated among patients with COPD compared with those without major chronic illnesses (3.1% versus 1.9%, respectively) [27]. In The DEPREPOC (Depression in COPD), an observational, cross-sectional, multi-center Spanish study designed to analyze the prevalence of depression in COPD patients and to identify factors associated with depression, moderate to severe depression was associated with suicidal ideation [28].
While analyzing suicidal risk, in an epidemiological study in adults ages 18 and older in the United States, it was found that 27.2% of COPD patients had suicidal ideation as compared to 19.6% of subjects without COPD. The history of suicide attempt was significant (15.0% for COPD patients, 6.6% for subjects without COPD [29]. A mixed-methods US study, to examine the prevalence and correlates of suicidal ideation in patients with stable moderate to very severe COPD, revealed that this was common in COPD, may occur disproportionately in women, can persist despite mental health treatment, and had complex relationships with both health and life events. [30]. COPD patients with depression had 13.6- and 10.0-fold higher risks of suicidal attempts and suicidal drug overdose, respectively, than did controls, in a Taiwanese study. The risk was more pronounced in patients aged less than 50 years [31]
In a Korean study, based on data from the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV & V), suicidal ideation was reported by 16.0% of patients in stages I and II, by 23.8% of those in stages III and IV and by 15.7% of controls. The suicidal attempts were reported by 0.6% of patients in stages I and II, by 2.6% of those in stages III and IV and by 1.0% of controls [32]. It should be a matter of serious concern that an association between history of hospitalization and increased suicidal risk has been reported. In a Nested case–control study, based on data from five Danish national, medical, and administrative registries/databases, it was found that patients with a history of hospitalization with COPD were at a significantly increased risk of suicide compared with individuals without such a history. The association was more pronounced in women than in men and in individuals aged 61–95 years than the younger group and in persons with no history of psychiatric illness [33].
The epidemiological and clinical studies reveal that inadequately treated malady is associated with worse outcomes. The deleterious effects include sub-optimal adherence to pharmacotherapy, repeated episodes of AECOPD, increased hospitalization, prolonged length of stay, re-admissions and subsequently increased burden to healthcare system, more pronounced in resource limited countries where the budget is already over-run. Moreover, despite significantly higher toll of depressive disorders in patients with COPD than controls, the low percentage of such patients seeking psychiatric consultation suggests that there is an unmet need in the psychiatric care of COPD patients [34]. While the background information that the psychological status plays an intrinsic role in the overall well- being is ignored, such patients are regularly overlooked, often remain undiagnosed and rarely get access to adequate treatment [35]. In view of the severity of the problem, early detection and prompt intervention is crucial. Of imp, the UK NICE Guidelines for COPD advise that patients should be offered psychological therapies before they are prescribed anti-depressants [36]. Interestingly, “Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) Study” found a 30
In the context of the COVID-19 pandemic, it appears likely that there will be substantial increases in depression associated COPD equilateral is dire need to search for an effective interventional strategy. Following are the suggestions:
(a)—The Psychological First Aid Guidance
Mental Health UK has described the “The 6 Ways to Boost One’s Well-being While Staying Indoors” [52] which are easily doable and really well-rewarding.
(b)—WHO’s Unique Contribution: The “Living with the Times” toolkit containing illustrated posters with key messages for older adults on how to maintain their well-being during the COVID-19 pandemic, is a unique potentially beneficial approach [53].
(c)—Novel Add-ons: Dance Movements Therapy (DMT) and Musical Engagement Therapy have emerged as promising effective Add-ons in the management of COPD and depression and are worth trial in the prevailing situation. [54, 55].
DMT has aesthetic expression, attractive to both genders irrespective of age, tempting to those with disabilities, and a fruitful tool in developing self-confidence. [54]. Certain Organizations of National and International Disability, provide ample opportunities for disabled and would be of special interest to COPD patients, with disabilities, planning to avail the benefits of DMT. Solo dancing, while restricted to home, is a highly accessible, doable, feasible, sustainable and beneficial alternative. Online group-sessions for dance are available for those, willing to join.Interestingly, The Bezmialem Vakif University Istanbul Turkey has championed to initiate “The First Interventional (Clinical Trial) Study to Apply Dance-based Exercise Training in COPD” - with the goal to “to investigate the effect of creative dance-based exercise training on respiratory, balance and cognitive functions, respiratory and peripheral muscle strength and functional capacity in COPD patients”.
Music therapy (singing and listening), an inexpensive and readily accessible resource, has emerged as promising interventional strategy, with acceptance on wider scale, because of its unique link to the emotions and powerful soothing effect [55]. In a systematic review and meta-analysis of 26 studies, a statistically significant reduction in depression levels was found over time in the experimental (music intervention) group compared to a control / comparison group. In particular, elderly participants showed impressive improvements when they listened to music or participated in music therapy projects [56]. Of imp, in the Clinical Trials. gov entitled “Active and Passive Music Therapy Interventions”, sponsored by University of North Carolina Chapel Hill United States, it has been argued that: “Music therapy (MT) interventions are a cost-effective, accessible, and holistic treatment option with social, rhythmic, creative, sensorimotor, and respiratory components, giving them the potential to improve the quality of life for a diverse array of disorders”.
“COPD is an individual disease, I have yet to meet any two people with COPD would have the exact same symptoms and have reacted exactly the same to this horrible disease”.
Mary Clara Ultes (1946-2018)-- "Same Devil - Different Levels, Same Level - Different Devils"
Prevalence studies show that patients who have COPD are four times as likely to develop depression compared to those without COPD. Regrettably, this dual burden is under-recognized and under-treated. Pumar et al have argued that, in daily practice, the presence of psychological manifestations in patients with COPD is often regarded as a complication caused by the physical ailments [57]. Whereas it is known that pulmonary rehabilitation (PR) alleviates depression in patients with COPD and a reduction of depressive symptoms makes PR more effective, and patient are more motivated to cooperate actively with the therapist in the rehabilitation process [11],they are still under- referred, by the health care providers. A tailored, cognitive behavioral approach (CBA) intervention has been developed for patients with COPD and co- morbid anxiety and/or depression. This has been named TANDEM (Tailored intervention for Anxiety and Depression Management in COPD): Protocol for a Randomized Controlled Trial), and has been sponsored by Queen Mary, University of London. This trial would, most hopefully, optimize the unrealized synergy between a psychological intervention and PR. [58]. The fittest closing sentence is from"COPD Makes Things Harder, But Life is Fun"--
“Don’t despair. Life is not over. It is just more challenging”.
The authors are highly grateful to Prof. Nicolino Ambrosino Respirologist (Italy) and Prof. Amin Muhammad Gadit Clinical Professor of Psychiatry (Canada) for their scholarly advice to improve the manuscript.
The authors express great appreciation to Dr. Murad Ahmad Khan (Vancouver, BC) for his insightful suggestions and stimulating discussions, throughout the conduct of this study.
The authors declare that they have no direct and indirect financial, commercial, personal/career affiliation with the article, counting any individually held viewpoint that are relevant to their work, to disclose.
The authors received no financial support, from any quarter, for the research, authorship, and/or publication of this article.
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
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.
