AUCTORES
Globalize your Research
Research
*Corresponding Author: Lázaro Martín Martínez Estupiñan, Specialist in Orthopedics and traumatology. Full Professor at the UCM-VC. General University Hospital Mártires del 9 de Abril. Villa Clara. Cuba.
Citation: Leonardo M. Aparicio, Martínez Estupiñan LM, Roberto M. Piñeiro, Gerardo C. Oliva, Sergio M. Piñeiro, (2024), Proposals for Modifications to The Mipo Surgical Technique in Diaphyseal Fractures of the Tibia, J. Clinical Orthopedics and Trauma Care, 6(1); DOI:10.31579/2694-0248/080
Copyright: © 2024, Lázaro Martín Martínez Estupiñan. 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: 08 January 2024 | Accepted: 16 January 2024 | Published: 24 January 2024
Keywords: minimal blade osteosynthesis; MIPO
There are multiple techniques for the treatment of tibia fractures, sometimes these techniques require a group of special accessories and instruments that allow the surgeon to carry out the procedure quickly and easily. Professionals make proposals for modifications, especially on instruments. After prioritizing in the group, seven modifications to the technique were proposed. Modifications to the MIPO technique may be another alternative in the therapeutic arsenal
There are multiple techniques for the treatment of tibia fractures, sometimes these techniques require a group of special accessories and instruments that allow the surgeon to carry out the procedure quickly and easily. Generally these accessories are expensive and the services do not have them. Fractures of the tibia have an incidence of 16.9/100,000 per year and between four and 23% are open injuries. Depending on the pattern of the fracture and the involvement of the soft tissues, they can be treated conservatively or surgically; However, there is no consensus for determining the optimal surgical technique. Since the introduction of dynamic compression plates (DCP) for osteosynthesis, their popularity has increased in the invasive treatment of these fractures. In the latest research, study dynamics have been created regarding concepts such as biological osteosynthesis, minimally invasive osteosynthesis, relative stability and absolute stability [1]. It was Christian Krettec and Harald Tscherne who in 1997 introduced the concept of minimally invasive osteosynthesis. [2]
The concept of biological osteosynthesis refers to the preservation of bone vascularity during surgical intervention to ensure the vitality of the individual fragments and achieve fracture healing with a minimum of damage to the soft tissues and a relative stability that favors the materials. [3]
Conventional osteosynthesis techniques applied for multifragmentary fractures can lead to a variety of complications: delayed union, infections, implant failure and nonunion. This happens because to achieve anatomical reduction, extensive surgical exposure is necessary and, sometimes, the fracture fragments are stripped of the soft tissues that provide vascularity [4-5] The first attempts in the use of biological osteosynthesis They appear in the 80s of the last century; The development of indirect reduction techniques and the use of new osteosynthesis materials caused a basic change in the treatment of fractures.
Every fracture evolves towards consolidation, with pain, inflammation and immobility and reflects what is known as fracture disease, which, if not adequately treated, produces muscle atrophy and generates adhesions that, taken to an extreme, cannot be reversed. and determine sequelae that limit functionality. [6] An adequate quality of life is guaranteed by free and painless movement, this is the philosophy that motivates selecting a fracture fixation technique that allows achieving total mobilization and favors rapid recovery. revascularization of bone and soft tissues.
Minimally invasive osteosynthesis is a method in which the percutaneous use of laminae to remotely fixate the fracture site through minimal exposure is an alternative procedure for the treatment of tibia fractures. [7] We intend to present a series of modifications to the MIPO surgical technique.
A prospective longitudinal study was carried out where the mixed research paradigm was assumed, while quantitative and qualitative data were analyzed in the same study to respond to the research problem.
Theoretical and empirical scientific research techniques were used. With a multi-stage study.
- Stage 1 Explore. Identify and describe the current situation, selection of investigative techniques and the sample for the study.
- Stage 2 Elaborate, where creation, preparation, design of modifications to the MIPO technique are carried out
- Stage 3 Validate the results. Where the evaluation by the group of the modifications is defined.
A semi-structured interview is carried out with specialist doctors linked to trauma care:
After agreement with each professional, a semi-structured interview was carried out in which the level of information and mastery of theoretical and practical aspects associated with traumatology and osteosynthesis was explored.
Semi-structured interview with physicians involved in the care of patients with limb trauma.
General objective: Obtain information about the opinions and assessments of specialist doctors who participate in the process of medical care for patients with trauma of the limbs and spine.
Interviewer-interviewee relationship:
Achieve social interaction, through a process of mutual understanding and trust.
Interview situation:
Carry out in a climate that respects the natural interaction of people characterized by naturalness and free expression.
Guide or guidelines for the development of the interview:
- Exploration of the knowledge that specialist doctors have about the process of medical care for patients with trauma of the limbs and spine.
- Possibilities of proposals for the modification to MIPO osteosynthesis in our context.
- Search for needs and contributions.
Evaluation of the judgment of specialists on the possibility of modifications to the MIPO technique
With the purpose of knowing the opinion of specialists with experience in the subject, regarding osteosynthesis and modifications to the MIPO technique, a questionnaire was applied to evaluate the judgment of specialists.
Description of the sample. The sample was made up of __23__ specialist medical professionals, selected from intentional non-probabilistic sampling. For its selection, the following inclusion criteria were established:
- Willingness and interest to collaborate with the research, expressed through informed consent.
- Theoretical and/or practical knowledge of the topics.
- Possess more than ten years of professional experience.
Focus group: This technique allowed the generation of ideas through the identification of the critical variables of medical care for adult patients with a diagnosis of tibia fracture and the establishment of priorities. An environment was fostered that stimulated interventions to identify the issues. of group consensus. A guide to the topics to be discussed was previously prepared.
Topic guide for Focus Groups.
General objective: Explore the criteria of medical specialists, through individual and group reflection, on the variations in the concepts of osteosynthesis in the new century, the insufficiencies that osteosynthesis with the standard open technique of the fracture focus may present, and the proposals for modifications to the surgical technique.
Selection of participants: ______________________
Selection of the moderator and rapporteur: Moderator: _______________________.
Rapporteur: ___________________________.
Description of the place where it takes place: ______________________________.
Date: _________________.
Hour: _____________.
Steps of the focus group technique:
1. Explanation of the objectives of the technique and the rules of its development.
2. Presentation of the questions.
3. Reflection and individual recording of ideas.
4. Presentation and debate of all ideas.
5. Assessment of common ideas.
At the end of the systematic review on osteosynthesis and surgical treatment with MIPO for tibial diaphyseal fractures, a group technique was carried out with a group of high-category orthopedic professionals, whether scientific, teaching and research, all members of the Cuban Society of Orthopedics and Traumatology, who provided opinions on what modifications to the technique can be made in our current context, with our limitations to offer the population a surgical treatment option that is in accordance with modern principles of osteosynthesis, provides satisfaction and minimizes risks. of the conventional open technique.
Table 1 shows the participation of professionals and the number of interventions and their proposals made.
Proposals
| Participants with proposals for modifications to the MIPO technique | Total participating specialists | |
| Yeah | not | ||
| About instrumental | 14 | 9 | 23 |
| About boarding | 12 | 11 | 23 |
| About tracking | 8 | 13 | 23 |
| About the indications | - | 23 | 23 |
Each of the proposals made was addressed individually and prioritized by the group, who evaluated them to ultimately decide which ones could be proposed for implementation in our service. Table 2.
It can be seen that everyone agrees on the relevance of implementing modifications to the MIPO technique in our context, preparation of professionals for the implementation of the modifications to the technique, the relevance of its implementation, the coherence of the research phases, the rigor scientific of the proposed modifications and compliance with bioethical principles.
# specialist
| Proposals to specialists
| Very suitable
| Suitable | Slightly suitable | Not suitable |
| 23 | Need to design new instruments | 20 | 2 | ||
| 23 | Relevance of implementing modifications to the MIPO technique in our context | 23 | |||
| 23 | Preparation of professionals for the implementation of modifications to the technique | 23 | |||
| 23 | Relevance of its implementation | 23 | |||
| 23 | Coherence of research phases | 23 | |||
| 23 | Quality of the proposed objectives | 22 | 1 | ||
| 23 | Value of the proposed objectives | 19 | 2 | 1 | |
| 23 | Scientific rigor of the proposed modifications | 23 | |||
| 23 | Compliance with bioethical principles | 23 |
Table 2. Prioritization of proposals on the MIPO technique by our specialists
Thanks to the study of a focus group of professionals, a series of proposals are provided to make modifications to the MIPO technique in tibial diaphyseal fractures. These were prioritized by a nominal group of specialists with experience in traumatology for more than 20 years and provided opinion. positive to present them to a group of experts. Based on the impossibility of having a minimally invasive surgery set to perform osteosynthesis in tibia fractures, the same happens with the impossibility of
acquiring minimal contact sheets and with all this providing patients with a treatment option in accordance with the principles modern 2004 osteosynthesis association and combine them with less surgical aggression and the possibility of minimizing risks and avoiding complications.
These professionals led by the project manager presented a series of modifications that, after being prioritized in the group, were as follows, table 3.
| Number | Modifications to the MIPO technique |
| 1 | Use of your own periosteal device, with extra long characteristics. Creation and use of own periosteal system. Figure 1. |
| 2 | Use of AO, narrow DCP sheets, instead of minimum contact sheets. |
| 3 | Creation and use of our own sheet holder, designed by our service team. Figure 2. |
| 4 | Marking of holes by radiological control method and not by templates. |
| 5 | Divergent placement of screws. |
| 6 | At the end of the intervention, use an elastic bandage to cover the surgical area, from the completion of the intervention until two weeks after surgery. |
| 7 | No use of an external tutor before or during surgery |
Table 3. Proposals for modifications to the MIPO technique
Minimally invasive osteosynthesis is a suitable treatment method for tibial fractures and provides a high union rate and a good functional result. It can be an alternative treatment if its indications are taken into account; This technique can be reproducible with AO plates, without the need for special instrumentation (Figure 3) and, as it is a biological osteosynthesis that preserves vascularization and fracture hematoma, it has less risk of complications.
Figure 1. Extra long periosteal. Designed and built in our service.
Figure 2. Own sheet holder, designed by our service team.
Figure 3. Use of the blade holder in tibia fracture surgery.
The modification to the MIPO technique in our context is a necessity since we do not have the specific instruments to perform the technique as described by its authors, however, it complies with the general guidelines of the Arbeitsgemeinschaft für Osteosynthesefragen (AO). This Swiss foundation, created in 1958, defines the principles of osteosynthesis worldwide. The development of AO surgical techniques for the treatment of fractures constituted a major advance in medicine. [8]
The principles of fracture treatment enunciated by the AO are currently reevaluated and redefined. The reformulation of these principles can be interpreted as follows:
Adequate functional reduction: one should always try to achieve the best possible anatomical restoration and the conservation of the longitudinal axis of the bone, a very important factor to allow correct mobilization of the joints neighboring the fracture site.
It is considered a primary or direct bone union in which osteosynthesis is carried out by opposition of the ends, anatomical reduction and interfragmentary compression; Minimally invasive osteosynthesis does not emphasize absolute stability, but rather the preservation of vascularity and soft tissues,[9] this term was developed by the AO/ASIF within the framework of a new conception of bone consolidation in the fractures of the diaphysis and contributes to achieving minimal disturbance of the biology in the fractured area.[10]
The different forms of stability are explained from the histo-morphological point of view the principle of compression is understood, which gave absolute stability, evidenced from the clinical point of view in early, painless movement without the formation of bone callus. to X-rays (consolidation per primam or without callus) -. The biomechanical principle in osteosynthesis is the way in which the implants and the bone in which they are applied function or interact for the surgical treatment of fractures.
At this point, some concepts have changed in recent times:[11] indirect bone union is in which a non-anatomical reduction is achieved, preserving the axis and structural conformation of the bone through a tutor-like system in which a secondary consolidation, with the presence of bone callus and the preservation of the biological environment is prioritized; When a closed or minimally invasive bone reduction is added to this, it is known as biological osteosynthesis. Until very recently this procedure was not considered; the aim was always to faithfully reduce the fragments and place firm materials, by exposing the fracture focus; In light of the updated principles of osteosynthesis, the changes are evaluated.
Stable fixation: it is the most important factor if a satisfactory bone repair is to be achieved because excessive instability of the fragments induces osteolysis, delays the repair and induces a hypertrophic bone callus, even if the repair process fails.
The function of an osteosynthesis material is to achieve relative stability while the fracture site, with its periosteal blood supply, is left virtually untouched. [12] As a consequence, the movement between the fragments causes the fracture to consolidate secondarily with callus formation; Indirect fracture reduction to achieve axial and rotational alignment is a challenging process. The amount of interfragmentary movement is influenced by the stability achieved, which is resolved by the rigidity of the material used, the width of the opening depends on the reduction achieved.
Adequate surgical technique: the surgical technique must be as atraumatic as possible and avoid exaggerated manipulation of the tissues and it is necessary to be very careful with the irrigation of the fragments and the affected bone, all under the best possible conditions. [13] Biology is essential in the preservation of vascularization, with minimal access and minimally invasive osteosynthesis with plates, always guided by images, a precept with which our modifications to the technique comply.
Significant soft tissue injuries contribute to delayed healing, in part due to loss of vascular supply to the bone; The intramedullary vascular supply is normally provided by nutrient vessels that irrigate the medullary contents and part of the cortex. Only the outer third of the cortical bone receives its blood supply from the tissues that cover it (periosteum). The most important factor in the management of the fracture is the care of the soft tissues and maintaining the blood supply to the bone fragments, without damage to the fracture hematoma. [14]
In many displaced fractures of long bones, the spinal vascularization is altered and the vascular supply will depend only on the soft tissues adhered to the periosteum. The involvement of the remaining vascularization by surgical intervention in a displaced fracture has been clearly related to the lack of consolidation, due to the effects of periosteal detachment and soft tissue dissection. As consolidation occurs, the spinal system resumes and a normal vascularization pattern may be reestablished.
- Early mobilization: whenever osteosynthesis allows it, early mobilization of the affected limb should be initiated because it is an important stimulus for osteogenesis; The rapid return to activity significantly reduces the negative effects caused by fracture disease and minimizes muscle atrophy, adhesions and ankylosis.
The author considers that although they are not frequently indicated, these techniques provide the specialist with an alternative method for bone stabilization in complex fractures of the tibia. The final objective, in any case, is to minimize the surgical aggression without reducing the effectiveness of the technique performed because it includes the preservation of the fracture hematoma, less surgical trauma to the soft tissues, the reduction of surgical time and, consequently, the reduction in the risk of infection and, finally, the indirect healing process with abundant callus.
The performance of these techniques must be carried out by specialists experienced in traditional osteosynthesis. We must not forget that, during the learning curve, a mini-invasive procedure may require an open reduction of the focus, so in-depth knowledge of the anatomy of the musculoskeletal system and traditional surgical approaches is essential.
Babst and Khong [15] summarized the indications for minimally invasive osteosynthesis:
- Epi-/metaphyseal fracture
- Inappropriate soft tissue condition
- Intramedullary nailing is not feasible, there is no image intensifier or they are not available.
In fractures of the tibia, these types of implants are indicated in injuries that occur in any area of the bone that ranges from the proximal end, diaphysis and distal end. The indications are the same as for traditional osteosynthesis with open reduction and wide approaches; However, one of the important differences is that minimally invasive plate osteosynthesis does not have as its primary objective anatomical or exact reduction, but only the correct alignment of the fragments in the longitudinal axis. [16] Care should be taken to avoid errors. rotational defects towards medial or lateral and, finally, in multi-fragmented fractures it is important to avoid shortening.
Osteosynthesis planning is essential to determine the length of the implant. It is important to mention that there is no publication, clinical research or textbook that mentions how long the implant should be. Some suggest that the ends of the fracture, proximal and distal, be located and from there measure at least two centimeters to place the screws most proximal to the fracture; It should be taken into account that there must be at least three screws at each end of the implant. [17]
Various reduction methods can be used, from manual to the use of pointed forceps for percutaneous reduction. If the anatomical conditions of the bone and the fracture allow it, it is very important to perform a balanced osteosynthesis; That is, from the center of the fracture towards the ends the same implant distance must be measured. After sliding the plate, radiological control should be performed to ensure that the bone drilling and screw placement are adequate. Finally, the wounds are sutured with conventional technique, without leaving drainage, and the leg is covered with gauze to protect the wounds.
Postoperative management is the same as that used in traditional osteosynthesis. In the case of stable fractures with possibilities of bone support, weight unloading can begin from the beginning with partial weight bearing, which gradually increases until reaching full unloading in a period of six weeks. If there is no bone support (multi-fragmentation), you should wait until you see radiological signs of consolidation before starting weight bearing.
Osteosynthesis evolves theoretically and practically throughout its use, trends in the use of large dissections for more rigid methods of fixation are moving towards minimally invasive osteosynthesis, but universal clinical adoption will depend on the clinical results observed, therefore that the evaluation of works on the subject are necessary to prove its effectiveness. [18-19] These minimally invasive treatments provide adequate union rates, with few complications, as well as fairly good functional results. [20]
Indirect reduction techniques were developed to avoid further soft tissue injury at the fracture site and thus improve fracture healing rates. In relation to the weeks of consolidation, Bingol and collaborators [21] published a study with 30 patients treated using a minimally invasive technique in which a consolidation of 19.2 weeks was obtained, in the study carried out by Zhang [22] the consolidation occurred around of 16.7 weeks and developed by Andalib and collaborators, similar results were obtained and analyzes of the effectiveness of the method were carried out. [23]
Despite the size of the sample in the consulted works and its retrospective design, the results of this research support that the treatment of tibia fracture using the minimally invasive technique has a group of advantages: surgical time is less, with less damage to the soft tissues, the surgical incisions are smaller, less painful and more aesthetic, the hospital stay, blood loss and infection rate are reduced, in general recovery is faster and postoperative pain is reduced.
The largest number of proposals on modifications to the MIPO technique for tibial diaphyseal fractures were made on the instruments, although the proposals are multiple; after prioritizing in the group, seven modifications to the technique remained as proposals. Modifications to the MIPO technique may be another alternative in the therapeutic arsenal, mainly in fracture injuries of the tibia with multiple fragments, although its limitations must be considered if the principles of osteosynthesis are not taken into account. Case studies with a larger number of samples and longer periods of evolution are necessary.
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.
