AUCTORES
Globalize your Research
Review ariticle
*Corresponding Author: Joanna Pietras, Department of Perinatology, Gynecological Obstetric Clinical Hospital of Poznan University of Medical Sciences, Polna 33, 60-535, Poznan, Poland.
Citation: Joanna Pietras, Anna Markowska, Stefan Sajdak, (2024), Overview of Uterine Fibroid Treatment Procedures; Review Article, International Journal of Clinical Case Reports and Reviews, 19(3); DOI:10.31579/2690-4861/549
Copyright: © 2024, Joanna Pietras. 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: 20 September 2024 | Accepted: 04 October 2024 | Published: 22 October 2024
Keywords: uterine fibroids; pharmacological treatment; interventional radiological techniques; surgical treatment
Myomas are benign uterine tumours found in 40-70% of women of reproductive age. About 30% of them cause various ailments (bleeding, pain, infertility) that reduce the quality of women’s life.
Uterine fibromas are the cause of 40-60% of hysterectomies.
Different treatment methods are used depending on the size, number, location of myomas and the patient's preferences. Conservative treatment includes nonsteroidal anti-inflammatory drugs, hormonal therapies as contraceptives, GnRH agonists or antagonists, selective progesterone receptor modulators and levonorgestrel.
Radiologic intervention types include are UAE (uterine artery embolization), high-intensity focused ultrasound (HIFU), magnetic resonance (MRgFUS), and radiofrequency ablation (RFA).
There are also more radical methods, namely surgical treatments, such as myomectomy (hysteroscopic, laparoscopic, robotic or abdominal) and hysterectomy. The oldest of methods is abdominal hysterectomy, while in some women, vaginal hysterectomy can be applied. Recently, laparoscopic or robotic hysterectomy (using the da Vinci robot) has been used. The latter procedures are associated with a better quality of life following treatment.
Uterine fibroids are benign tumors composed of involuntary muscle and fibroblasts, occurring in 40-70% of women of reproductive age. Their wide incidence range depends on the studied population and diagnostic methods used. Most women do not report any symptoms; in about 30%, uterine fibroids affect the quality of life, causing: abnormal uterine bleeding, heavy menstruation, pelvic pain and pressure, and infertility [1,2,3,4,5]. Lockwood showed that aberrant angiogenesis underlines abnormal bleeding associated with myomas and endometrial polyps. As it turns out, vascular flow disorders the influence of the etiopathogenesis of uterine fibroids and many other uterine pathologies. [6,7] The term "fibroids" was first introduced in the 1860s. Hippocrates, a Greek physician (460-375 BC), termed them "uterine stones" (womb stones), and Galen (2nd century) described them as "scleromas" [5,8]. Numerous factors have been identified as playing a role in the pathogenesis and epidemiology of fibroids. Stewart et al. [9], based on 60 publications, showed that 12 factors are involved in the development of fibroids, the dominant one being African American women. The critical role of ovarian steroid hormones - estrogens and progesterone has been established in epidemiological, clinical and experimental studies. Progesterone is essential for developing and proliferating fibroid cells, while estrogens are required for sensitising fibroid cells to progesterone [10,11,12]. It has been shown that chromosomal aberrations are found in 40-50% of patients with uterine fibroids [13,14]. In their review, Yang et al. [5] described four types of molecular mutations: in MED12, overexpression in HMGA2, deficiency in fumarate hydratase (FH), and deletions in COL4A5/COL4A6. Mutations in MED12 are the dominant type and occur more frequently in African women. They are associated with smaller fibroid sizes and subserosal locations. Studies have also shown that stem cells participate in developing fibroids using the Wnt/ßcatenin signaling pathway. Increased expression of VEGF-A has been found in the uterine fibroids of young women, which may be a sign of increased angiogenesis and intensive tumor growth. According to literature data, a close relationship has also been demonstrated between impaired VEGF gene expression and the development of ovarian tumors. [15,16] The involvement of cytokines and chemokines with pro-inflammatory and profibrinolytic features has also been suggested in developing fibroids. Vitamin D deficiency has been studied to play a role in the growth of myomas [5,17]. It turns out that vaginal dysbiosis plays a crucial role in the development of uterine fibroids and many other diseases of the uterus, including endometrial cancer [18,19] Fibroid treatment includes numerous methods, from conservative pharmacological treatment to various types of surgical procedures. The choice depends on various factors, such as the size, number, location of fibroids, symptoms, the patient's age, health condition, and individual expectations, e.g., maintaining fertility [5,20,21,22]. Conservative treatment involves regular monitoring of small asymptomatic fibroids.
The purpose of this article is to provide a comprehensive summary of the various pharmacological and surgical options available for uterine fibroid treatment, highlighting their benefits, risks, and potential outcomes.
Pharmacological treatment
It is a group of analgesic and anti-inflammatory drugs that inhibit cyclooxygenase, thereby reducing the synthesis of prostaglandins at the endometrial level. This mechanism leads to a reduction in heavy menstrual bleeding and painful menstruation [20,23,24]. Tranexamic acid reduces menstrual blood loss by inhibiting fibrinolysis via reversible plasminogen blockade. It is often used in laparoscopic or abdominal myomectomy to reduce blood loss [20,22].
Recent studies indicate the beneficial role of vitamin D and epigallocatechin gallate (Epicatechin-3-gallate-EGCG) - catechin belonging to polyphenols contained in green tea (Camellia sinensis) [24,25,26]. Vitamin D regulates cell proliferation and differentiation, inhibits angiogenesis and stimulates apoptosis [27]. EGCG inhibits the proliferation of myoma cells and induces apoptosis by inhibiting the COMT enzyme (catechol-O-methyl transferase) associated with the pathogenesis of myomas [28]. Both of these compounds can be used together or separately. Currently, a prospective randomized FRIEND study (from 2022-2025) is ongoing, involving 200 patients with uterine fibroids and a history of infertility, assessing the efficacy of EGCG in reducing the volume of fibroids and their impact on infertility [29].
Contraceptives are commonly used to treat abnormal uterine bleeding and heavy periods. Studies have shown a reduction in menstrual blood loss after six months of use by up to 72% [20]. In some cases, combined pills containing estrogen and progesterone can help with menstrual pain [12]. The role of hormonal contraception in the development of fibroids is minimal [30]. However, some studies show it is a protective factor against developing fibroids [31].
LNG-IUS is a contraceptive method that is also effective in treating heavy menstrual bleeding. It affects the endometrium locally, reducing the duration and intensity of menstruation. It has also been noted that it does not impact the size of pre-existing fibroids. However, it is not recommended for women with submucous fibroids due to the possibility of expulsion of the device [20,30].
SPRMs reduce fibroid cell proliferation by inducing apoptosis and reducing collagen synthesis and extracellular matrix. This results in a 20–57% reduction in fibroid volume [20,26,30]. In 2012, the European Medicines Agency (EMA) approved ulipristal acetate (Esmya) for the treatment of moderate to severe symptoms associated with fibroids in women of reproductive age [26]. Studies have shown that UPA (ulipristal acetate) causes significant changes in the expression of four genes in uterine fibroids. UPA treatment significantly reduced the expression of the integrin subunit beta 4, tenascin C and surviving gene. In those who did not respond to UPA treatment, the expression of delta-two catenin increased [32]. Although UPA significantly reduced bleeding, the size of fibroids and the size of the uterus and was used by over 765,000 women, this drug caused severe liver damage in 5 women, of which four required transplantation [33]. As of 2020, the EMA Risk Assessment Committee indicates that UPA may only be used for intermittent treatment in premenopausal women, especially in cases where surgical interventions, including embolization, are unsuitable or ineffective [20,26,33].
The use of GnRH analogs (Leuproid, Goserelin) is a well-known method of treating uterine fibroids. By inhibiting the pulsatile secretion of GnRH, they reduce the production of LH and FSH, which leads to hypoestrogenism. It has also been found that GnRH analogs disrupt the production of matrix metalloproteinases and induce apoptosis. This mechanism leads to a reduction in the size of fibroids during the first months of medication use, but in some cases, a regrowth of fibroids is observed after discontinuation of the therapy. The use of GnRH analogs leading to the inhibition of ovarian hormone secretion causes undesirable menopausal symptoms. GnRH analogues should only be used for large fibroids in the short term - especially before procedures - e.g., myomectomy, which beneficially reduces blood loss during surgery [20,26,30,34]. GnRH antagonists are considered drugs for long-term use. Blocking the GnRH receptor leads to hypoestrogenism with the risk of menopause. Add-back therapy (ABT) has been used together with the use of antagonists. It involves adding estrogen-progestogen or progestogen-only therapy to GnRH antagonist treatment to alleviate menopausal symptoms without reducing the effectiveness of the treatment. So far, three drugs for symptoms associated with fibroids have been registered: Relugolix, Elagolix and Linzagolix. The first of the medications, apart from relugolix (40 mg), also contains estradiol (1 mg) and norethisterone acetate (0.5 mg). The trade name of the medication is Ryeqo. Elagolix - 300 mg contains the same amounts of estradiol and norethisterone acetate. Its trade name is Oriahnn. Linzagolix contains only linzagolix in doses of 100mg or 200mg. Its brand name is Yselty. In May 2020, the FDA approved using Elagolix in clinical practice and then, in 2021, the use of Relugolix. The European Medicines Agency (EMA) approved Relugolix (Ryeqo) for use in 2021. Linzagolix received approval from the EMA in 2022 [35].
Interventional radiological techniques
This is a non-invasive procedure used for the treatment of fibroids. UAE was first introduced in France in the 1990s as an alternative method of treating fibroids for women who wish to avoid traditional surgical methods or are not suitable for them [36]. UAE involves blocking the blood flow to the myomas by using various embolization agents (e.g., hydrophilic microspheres or polyvinyl alcohol (PVA)). Contraindications to UAE include pedunculated submucosal or subserosal fibroids [12,20,37].
Quality of life studies in 6 randomized clinical trials did not show any differences with other minimally invasive procedures used to treat fibroids (e.g. myomectomy) [38,39]. Conflicting data exists regarding the frequency of re-intervention after UAE. According to the aforementioned randomized studies, UAE is associated with increased re-intervention rates, while in another study of 152 women who underwent this procedure, the recurrence rate was even lower than in patients after myomectomy (14.3% vs 31.6%, respectively) [40].
It is a non-invasive method of treating fibroids that has been used for 20 years. This method uses a precisely directed high-energy ultrasound beam within the fibroid. The procedure can be performed under MRI or ultrasound guidance [20, 30, 41, 42]. It causes an increase in temperature in the myoma and its necrosis. Patel et al. [41], based on the analysis of 14 studies, concluded that HIFU is an equivalent therapy to surgery, allowing for the preservation of fertility. The reduction of the myoma size was 68-75
In recent years, methods for treating uterine fibroids have developed. This applies to pharmacological treatment, interventional radiological techniques, and minimally invasive surgical procedures. This progress is associated with improving the quality of life of treated women and possibly preserving fertility. Nevertheless, there is still a lack of an ideal method that minimizes risk, has no side effects, and is highly effective.
Author 1: Joanna Pietras led the conceptualization of the review, conducted the literature search, and drafted the initial manuscript.
Author 2: Anna Markowska contributed to the selection and analysis of key articles, organized the structure of the review, and critically revised the manuscript.
Author 3: Stefan Sajdak provided expertise in the subject matter, reviewed the content for accuracy, and oversaw the final editing and approval of the manuscript.
The authors declare no conflict of interests.
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
