AUCTORES
Globalize your Research
Research Article
*Corresponding Author: Vasily Vlasyuk, Department of forensic medicine of the S. M. Kirov Military Medical Academy, Saint-Petersburg, Russia.
Citation: Vasily Vlasyuk. (2019) Differences between a birth trauma and compression hypoxia. J Neuroscience and Neurological Surgery. 4(4);Doi: 10.31579/2578-8868/081
Copyright: © 2019 Vasily Vlasyuk. 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: 23 July 2019 | Accepted: 27 August 2019 | Published: 17 September 2019
Keywords: intrapartum hypoxia; compression of the head; configuration of the head (molding); compression hypoxia; birth
For a long time there is a problem of separation of hypoxia (asphyxia) and birth trauma. To resolve it, it is necessary to recognize this type of lesion as “compression hypoxia” and share it with a birth trauma. Morphological signs of differences between compression hypoxia and birth trauma, two forms of lesions caused by head compression, are given. The causes of death in birth trauma of the skull and the causes of intrapartum hypoxia are described. It has been shown that in many intranatally deceased children and newborns, intradural hemorrhages in the cerebellum are known, indicating head compression during labor.
It has long been a discussion among pathologists and clinicians about the differences between birth trauma and hypoxia (asphyxia). What damages in newborns to carry to birth trauma, and what - hypoxia? The outstanding American pediatric pathologist, E. Potter, pointed out the importance of separating hypoxic and traumatic lesions [1], but to date these issues have not been resolved. Аt the present time, the diagnosis of "hypoxic-ischemic encephalopathy" (HIE) is widespread. At the same time, “cranial-brain compression ischemic encephalopathy” [2, 3] is distinguished, which includes brain damage caused by compression of the skull during labor (with a head configuration, using obstetric forceps, a vacuum extractor and other causes). There is the concept of "fetal head compression syndrome" [4], where it considered predominantly gross traumatic damages to the skull and brain. There is an idea that birth trauma can be mechanical and hypoxic [5]. М.Gutner [6] considered the leading hypoxia of the fetus to be “circulatory hypoxia”, to which he attributed brain damage caused by impaired blood circulation associated with compression of the head of the fetus during childbirth. All this indicates the existence of the problem of differential diagnosis of hypoxic and traumatic lesions. The question arises whether all the damage caused by compression of the skull (mechanical forces) should be attributed to birth trauma? Can compression lead to hypoxia of the fetus and its brain? Both in the domestic and foreign literature recognize the existence of brain damage to the fetus and newborn, caused by the configuration of the head, compression of the skull, hypoxia, caused by venous congestion of the blood in еxpressed configuration of the head. Can this condition be attributed to birth trauma, since it is caused by the action of mechanical forces in the process of labor? Is it correct to attribute this condition to hypoxia, since the child has no gross mechanical damage to the skull and brain? To answer the questions it is necessary to identify the differences between birth trauma and hypoxia.
Material and method
The study was conducted on non-selective material of 344 intranatally dead fetuses and newborns. A pathologic-anatomical study with a detailed study of the cerebellar tentorium, brain and spinal cord was performed. The study was conducted in accordance with its own method of opening the skull and extracting the brain [7]. For the purpose of differential diagnosis of hypoxic-ischemic lesions caused by circulatory hypoxia and birth trauma, detailed morphological studies of the skull, head tissues, bone displacement, changes in the sinuses, dura mater, and brain were carried out.
Results and Discussian
Birth trauma as the main disease with various ruptures and subdural hemorrhages was detected in 49 children (14.2%). In 7 cases (2%), small ruptures of the cerebellar structure were found without subdural hemorrhage. In these cases, the existing birth injury is a concomitant or underlying disease. In 35 children (10.2%) hemorrhages in the cerebellum were discovered, caused by its overstretching during labor. Thus, 24.4% of children experienced compression (physical) effects on the skull during childbirth, half of which were diagnosed with birth injury. In 13 children with intradural hemorrhages, aspiration of amniotic fluid was detected (37.1%), confirming the development of intranatal hypoxia in them, and in 11 premature infants (31.4%) there was RDS-syndrome (pneumopathy). Consequently, more than half of the children (68.5%) with intradural hemorrhages in the cerebellar model died from pulmonary pathology.
Intranatal hypoxia as a cause of death was detected in 45 children (13%). Its causes were violations of the uteroplacental circulation (11 cases), especially premature placental abruption, weakness of labor activity (3 cases), pathology of the umbilical cord (3 cases), cardiac arrest of the mother (1 case), dystocia, etc. In 14 cases the cause of intranatal hypoxia, even after careful study of the after birth, was unclear (31.1%). In the study of the brain, subarachnoid and subpial hemorrhages were found in 9 children, hemorrhages in the cerebellum in 4, subependymal and intraventricular hemorrhages in 3, and in 6 children intradural hemorrhages in the cerebellum were found. These data indicate that in some children with intranatal hypoxia, there was compression of the brain with the development of hemorrhages in the tentoria, subarachnoidal, subpial, and other hemorrhages. It was possible to assume that intranatal hypoxia in unclear cases could be caused by compression of the skull.
The results of the study of causes of death indicate the existence of birth trauma (1), hypoxia (2) caused by impaired uteroplacental circulation, pathology of the umbilical cord and diseases of the mother, as well as conditions (3) in which children have slight signs of mechanical (compression) damage in childbirth, which are combined with signs of pronounced hypoxic lesions of brain neurons. This condition can be related to "compression hypoxia" (CH). Traumatic injuries (4) that occur during childbirth, which are concomitant or background lesions, should also be highlighted.
Since both birth trauma and circulatory hypoxia are caused by the action of mechanical forces, these damages should be distinguished. In order to clearly distinguish between birth trauma and hypoxia, it is necessary to distinguish such a type of hypoxia as CH [8], and to clearly know the damage characteristic of a given brain lesion. In view of the material it is possible to carry out differentiation lineages arising from damage caused by compression of the skull, as follows.
The following major mechanical damages are attributable to birth trauma (BT) of the skull [7]:
1) ruptures of the tentorium cerebelli, falx, bridging veins, tributaries of the vein of Galen,
2) subdural and epidural hemorrhages,
3) subarachnoid hematomas,
4) large focal intracerebral and intracerebral hemorrhages,
5) compression portions on the surface of the brain,
6) cephalohematomas
7) fractures of the skull.
Mechanical damages related to CH of the skull and brain are:
1) intradural hemorrhages in the tentorium cerebelli and falx cerebry,
2) area of periosteal stagnation of blood of the skull,
3) spotty and pinpoint epidural hemorrhages,
4) spotted subpial hemorrhages on the tops of the convolutions, caused by the rupture of small vessels and capillaries between the pia mater and the molecular layer of the cortex,
5) subarachnoid hemorrhage in areas of outflow of the bridging veins caused by rupture of the tributaries of the bridging veins,
6) small focal intracerebral hemorrhages in areas of pressure on the brain of the bones of the skull,
7) intraventricular hemorrhages due to rupture of the capillaries of the vascular plexuses of the lateral ventricles of the brain overflowed with blood,
8) hemorrhages in the quadrangular lobules of the cerebellum, caused by the pressure of the edges of the tentorium on the cerebellum during dislocation of the brain and some others.
In deceased children, as a result of compression of the skull, 4 types of conditions develop: 1) CH, 2) BT, 3) CH + BT, 4) BT + CH. In type 1, the fetus develops CH, accompanied by hypoxia of the brain and its injuries, which leads to the development of complications, death or recovery. In type 2, the fetal head is subjected to severe compression (for example, in pelvic presentation), ruptures occur, massive hemorrhages, leading to death. With type 3, a fetus experiencing CH in labor increases compression, which leads to the addition of signs of birth trauma. With type 4, the head of the fetus in the absence of CH immediately begins to experience severe compression (for example, when applying obstetric forceps), which leads to BT, severe hemorrhages, increasing intracranial pressure and leading to impaired cerebral circulation and hypoxia of the brain. With 3 and 4 types of lesions diagnosed with BT.
It should be noted that CН and ВT are not only often combined, but also often occur on the background of violations of the general hemodynamics of the fetus and general hypoxia. An increase in intrauterine pressure is accompanied not only by the configuration of the head of the fetus, but also by impairment of the uteroplacental circulation and hypoxia of the fetus. For example, severe contractions are accompanied by pronounced contractions of the uterus and can lead to impaired uteroplacental circulation and gas exchange in the placenta. Fast delivery, accompanied by strong and frequent contractions, often a decrease in mother's blood saturation with oxygen, circulatory disorders in the vessels of the placenta, lead to periods of general hypoxia of the fetus and contribute to hypoxic brain damage. Consequently, the degree of configuration of the head reflects the general condition of the fetus, the degree of impaired systemic blood circulation in the fetus, and not only in the brain. Therefore, CН is often combined with general hypoxia of the fetus, aspiration of amniotic fluid.
With each contraction of the uterus (pain), the intrauterine pressure rises, the fetus's heart rate compensatory decreases and the blood pressure rises. This provides improved blood flow through the placenta and fetal organs, prevents the development of hypoxia. With the end of the pain in the normal everything is restored. Continuing bradycardia between contractions of the uterus indicates that normal circulation has not been restored. An increase in the degree of configuration of the head requires an ever increasing in blood pressure in the fetus in order to restore impaired blood circulation in the brain (as a result of compression of the vessels and sinuses), in the placenta and umbilical cord. This increases the physiological load on the heart. Develop circulatory and hypoxic brain damage. The development of cardiac decompensation and death of the fetus is possible. Similar changes occur during prolonged labor and weak labor.
Thus, fetal hypoxia during labor is caused not only by impairment of the uteroplacental and umbilical cord blood circulation, but also by compression of the head during labor. This type of hypoxia is called CH and is associated with impaired blood circulation in the pathology of the skull configuration and compression of the head. A child may die in childbirth, after birth, or remain alive. The process of childbirth is accompanied by a configuration of the head, in which the brain moves, changes shape, the veins of the bridge are stretched, the sinuses are compressed, the outflow of venous blood changes, etc. There are 3 degrees of the configuration of the head, and also distinguish the physiological and pathological configurations [7].
In the case of a pathological configuration, hypoxia and acidosis occurs in the brain tissue, there are damages of both hypoxic-ischemic and traumatic nature. How to distinguish between these damages? For ВТ of the skull are characterized by ruptures of the tentorium cerebelli, falx, bridging veins, subdural and large-focal subarachnoid hemorrhages, intracerebral hemorrhages and other signs. For HIE due to the СН, which is characteristic intradural hemorrhage in the tentorium cerebelli and falx, subarachnoid hemorrhages in the places of origin of the bridge veins, subpial hemorrhages on the apex of the cerebral hemispheres of the brain, subependymal hemorrhages and other. In the case of two nosological forms, other types of hypoxic-ischemic brain lesions may be present: periventricular leucomalacia, selective neuronal necrosis, intraventricular hemorrhages, and other lesions. Thus, fetal hypoxia leads to HIE, and one of its types - compression hypoxia - leads to hypoxic-ischemic compression encephalopathy.
Conclusion
In the process of labor under the action of mechanical forces and compression of the skull, two types of lesions (conditions, diseases) can occur: birth trauma and compression hypoxia. They differ in the nature of the resulting damage to the skull and brain. In BT, gross mechanical damage dominates in the form of tears, subdural hemorrhages, etc. During CH, hypoxic brain damage caused by impaired blood circulation, venous congestion, increased intracranial pressure, compression of cerebral vessels, etc., dominates. It is necessary to differentiate between two different nosological forms of brain damage in children – BT and CH brain in children. There are characteristic pathological changes in these pathologies. Clinicians may try to diagnose these changes in living children, pathologists determine morphological changes in the dead. In order to prevent CH and birth trauma, it is necessary to diagnose the degree of configuration of the head during labor, to make sure that the physiological configuration does not become pathological.
Funding source - Missing.
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.
