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Review Article | DOI: https://doi.org/10.31579/2690-8808/299
Orthopaedic and Trauma Surgery Viale Regina Margherita, 70022, Altamura (Bari), Italy.
*Corresponding Author: Bernardino, Orthopaedic and Trauma Surgery Viale Regina Margherita, 70022, Altamura (Bari), Italy.
Citation: Bernardino, (2026), Rotator Cuff Disease Adhesive Capsulitis and Osteoarthritis.A review of literature, J, Clinical Case Reports and Studies, 7(2); DOI:10.31579/2690-8808/299
Copyright: ©, 2026, Bernardino. 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: 12 December 2025 | Accepted: 05 January 2026 | Published: 26 January 2026
Keywords: shoulder; pain; inflammation;pathologies; conservative treatment
Shoulder pain may occur as a secondary symptom to a wide range of conditions, including rotator cuff disorders, glenohumeral osteoarthritis, or adhesive capsulitis. One common factor linking these diseases is inflammation. Understanding the role of inflammation in shoulder disorders can help physicians to manage and treat these common problems. Here, I document a perspective of a review of literature on these pathologies of shoulder.
Shoulder pain is a common orthopedic problem accounting for more than six million out-patient visits to orthopedic surgeons each year. Multiple pathologies exist that can be the inciting factor, including degenerative and inflammatory arthritis, rotator cuff pathology (ranging from impingement and bursitis to cuff tear arthropathy), and adhesive capsulitis. One common factor linking these diseases is inflammation.
The physiologic process of inflammation is a necessity for an appropriate healing and immune response in the human body. However, the etiology of many pathological processes in the body such as coronary artery disease (CAD), certain types of cancer, and Alzheimer’s disease (AD) is a direct result of inflammation. Understanding the role of inflammation in shoulder disorders can help physicians to manage and treat these common problems.
Pathophysiology
The human shoulder has a unique design that depends on the enveloping soft tissues for motion and stability.
The tendons of the rotator cuff pass are inferior to the relatively rigid coracoacromial arch, which is composed of the acromion, acromioclavicular (AC) joint, and the coracoacromial ligament. Normally, the subacromial bursae promotes smooth gliding between the two surfaces. Disruption of this mechanism, in the form of bursitis, tendonitis, and tendon tear, is extremely common and can lead to shoulder pain and disability.[1–5]
The estimated incidence of rotator cuff tear is greater than 56% within the population.[5–7] Recently, the link between rotator cuff disease and glenohumeral joint pathology has been investigated.
Aside from the fact that impingement and rotator cuff disease are traditionally considered extra-articular diseases, investigators have identified inflammatory mediators in both the glenohumeral joint and the subacromial space, which have been implicated in the etiology of cytokine-induced tendonitis.[10–14]
Glenohumeral joint arthropathy associated with rotator cuff disease may represent a continuum of intraarticular pathology that occurs in association with rotator cuff disease. Bursal interleukin (IL)-1, tumor necrosis factor (TNF)-á, transforming growth factor (TGF)-â, and basic fibroblast growth factor (bFGF) have been identified in the subacromial space of patients with rotator cuff disease when compared with patients with instability.[18] The expression of IL-1 and IL-8, both pro-inflammatory cytokines, have been found to correlate with symptomatic impingement.[19,20] Glenohumeral arthritis is a well documented clinical problem, with total shoulder replacement being the third most frequent joint replacement procedure performed in the US. Inflammatory arthritis and degenerative arthritis both comprise this subset of pathologic shoulder pain. Chronic inflammation is the hallmark of all inflammatory arthritides. The presentation of cartilage auto-antigen (types II, IX, and XI collagen, aggrecan, and link protein), in conjunction with a major histocompatibility class II receptor by the antigen-presenting cell, is believed to initiate the inflammatory cascade. This is followed by a complex interplay of multiple inflammatory cells that lead to synovial hypertrophy and the destruction of articular cartilage. The most important cytokines identified in the etiology of inflammatory arthritis have been TNF-á and IL-1. Animal models have demonstrated that the inhibition of these cytokines abolishes the process of erosive arthritis that occurs with their presence.[8–9]
Non-inflammatory arthritis has a distinctly different pathology and is less well understood. There is a cascade of cellular and biochemical events that occurs leading to the breakdown of articular cartilage, which is followed by insufficient cartilage repair. The biochemical events associated with osteoarthritis include a loss of collagen matrix, resulting in an increase in water content, alterations in proteoglycan composition, and an increase in proteolytic enzymes and cytokines (IL and TNF). The increase in cartilage degradation and repair processes results in an increase in cartilage breakdown products, as well as an increase in the synthesis of cartilage proteoglycans.[8–9] Adhesive capsulitis (or frozen shoulder) has an uncertain etiology characterized by the restriction of active and passive motion, usually accompanied by severe pain. Both primary and secondary adhesive capsulitis exist, with the onset of the former often being slow and insidious after minimal or no trauma. Secondary frozen shoulder has been linked to disorders, such as impingement, but can also be associated with systemic disease such as thyroid disease or diabetes.
There is disagreement in the literature as to whether the underlying pathologic process is inflammatory in nature or a fibrotic condition.[10,15–17] A comparison of tissue biopsies of shoulder capsule and synovium in patients with adhesive capsulitis compared with those with synovitis demonstrated an increased expression of TGF-â, platelet-derived growth factor (PDGF), and hepatocyte growth factor. Staining for the growth factors and the receptor isolated preferentially to the synovial tissue rather than the capsule. A predominance of fibroblasts and synovial cells were identified. The elevated presence of the inflammatory mediators suggest that adhesive capsulitis is likely to be a continuum of synovial inflammation that precedes the capsular fibrosis.[10]
Non-pharmacologic Treatment
Options for the Painful Shoulder
Physical therapy is generally considered to be the first step when treating patients with persistent shoulder pain. The specific approach to therapy is dictated by the diagnosis at presentation.
Impingement and Rotator Cuff Disorders
Physical therapy is the initial treatment of the patient with impingement and rotator cuff disorders.
Investigation has led to a greater understanding of the specific muscle groups involved and has brought attention to the entire arm as a kinetic chain,21 which has subsequently led to more targeted therapy on scapular stabilizers.[22] Both supervised physiotherapy and self guided training programs have shown to significantly improve range of motion and decrease pain.[23] The goals of physical therapy are to recover and maintain a passive range of motion and to strengthen the rotator cuff once acute symptoms have abated.[24] The first step in physical therapy is to strengthen the cuff in a non-impingement range of motion, below the horizontal plane. An individualized stretching program should be carried out several times a day. Passive arcs in all positions should reach at least 80% that of normal, prior to initiation of strengthening exercises that place the arm in a provocative position for impingement. Once pain-free range of motion is achieved, strength should be restored through a rotator cuff and scapular stabilization program.[25]
Multiple studies have demonstrated the benefits of physical therapy for impingement and rotator cuff disorders. Results from these studies have shown that initial management with a program of continuous passive motion significantly improved the range of motion.[26,27] Findings from a 12-month study of 90 consecutive patients with rotator cuff disease and a positive impingement sign also indicated that exercises aimed at strengthening the stabilizers and decompressors of the shoulder are effective in improving mean constant scores over one year of follow-up.[28] The American Academy of Orthopedic Surgery (AAOS) guidelines indicate that a majority of patients presenting with rotator cuff disorders will respond favorably to an effectively designed physical therapy program within several weeks. If a favorable response does not occur, the diagnosis should be revisited and the possibility of structural damage requiring alternative therapy should be considered.[24]
Osteoarthritis of the Glenohumeral Joint
Physical therapy to maintain motion and strength (although not so aggressive as to aggravate the patient’s condition) is recommended for patients with glenohumeral osteoarthritis.[24] Unlike patients with adhesive capsulitis, they should not be encouraged to ‘push’ through the pain as structural changes associated with arthritis often cause a mechanical block to motion. Pre-operative physical therapy for patients with glenohumeral arthritis should be focused on increasing range of motion within these mechanical limits and improving rotator cuff and scapulothoracic muscle strength.[29]
Adhesive Capsulitis
Physical therapy is also recommended for patients with adhesive capsulitis. The treatment program for these
patients should initially focus on regaining range of motion and, once this is achieved, improving strength.[24]
Multiple controlled clinical trials have documented the effectiveness of physical therapy for patients with adhesive capsulitis in improving range of motion.[30–32] Vigorous exercises are contraindicated in the patient with adhesive capsulitis because of the pain associated with rupture of adhesions. In addition, more aggressive and painful rehabilitation regimens have been associated with poor patient compliance.[33]
Oral Pharmacotherapy
Non-steroidal Anti - inflammatory
Drugs and Cyclo-oxygenase-2
Oral non-steroidal anti-inflammatory drugs (NSAIDs) are considered to be first-line systemic pharmacotherapy for patients with shoulder pain.[24,34] Both conventional NSAIDs and more recently developed cyclo-oxygenase-2 (COX-2) selective inhibitors have demonstrated efficacy in patients with shoulder pain in a small number of controlled clinical trials.[35–37] Unfortunately, there is concern about the use of these agents due to the high risk of gastrointestinal (GI) side effects (conventional NSAIDs) and the potential for increased cardiovascular (CV) risk (conventional NSAIDs and COX-2).[38–41] NSAIDs also have renal, hematological, dermatological, and neurological side effects that may limit their use.43 Elderly patients may beat a particular risk; NSAIDs should therefore be used with caution.[43] NSAIDs may blunt the effects of diuretics, â-blockers, angiotensin converting enzyme (ACE) inhibitors, and angiotensin type-2 receptor antagonists, which can lead to loss of blood pressure control in patients with hypertension. NSAIDs can also interfere with digoxin levels, potentiate anticoagulants, and interact with platelet inhibitors, thus leading to a higher bleeding risk in patients taking these drugs.[42,44] A short course of NSAID therapy is generally recommended for patients with shoulder pain.[45] The increased CV effects of NSAIDs and COX-2 inhibitors have been shown only with long-term therapy (more than two to three months).To decrease adverse GI side effects associated with conventional NSAID therapy, a proton pump inhibitor can be co-administered. This pump has been shown to heal ulcers and decrease the risk of recurrence in clinical trials.[46,47]
Acetaminophen
Acetaminophen can be considered a reasonable alternative to NSAIDs for pain relief, but it can also increase the risk of CV disease (CVD). Results from two prospective cohort studies among older women (51 to 77 years of age) from the Nurses’ Health Study I and younger women (34 to 53 years of age) indicate that both older and younger women who took a dose of more than 500mg/day of acetaminophen were at significantly greater risk from the development of hypertension compared with controls.[48] The benefit of acetaminophen is decreased GI risk when compared with traditional NSAIDs.
Opioids
Opioid analgesics may be used for the treatment of patients with shoulder pain. Opioids are often delivered in fixed-dose combinations with either an NSAID or acetaminophen. These combinations are generally recommended for the treatment of patients with moderate to severe pain.[49] Safety concerns for opioid analgesics vary somewhat from one product to another, but these drugs are generally contraindicated in patients with significant respiratory depression. Opioids also have significant liability for abuse.
Local Therapy Corticosteroid Injection
Corticosteroid injections are commonly used for the treatment of shoulder pain. Current AAOS guidelines recommend subacromial injection with a mixture of a local anesthetic and a short-acting corticosteroid in patients with rotator cuff disorders that do not respond to physical therapy and oral anti-inflammatory medications.
However, current guidelines do not specifically recommend such injections for patients with either adhesive capsulitis or glenohumeral osteoarthritis.24 Nevertheless, corticosteroid injections are used widely in clinical practice for patients with shoulder pain of all etiologies and are occasionally employed in conjunction with physical therapy as an initial treatment for patients with shoulder pain. The response to injection is generally rapid and pain relief may enhance the benefits achieved with physical therapy.[33]
Results indicate that injection of a corticosteroid is significantly superior to a local injectable anesthetic in providing long-term pain relief and improving range of motion in patients with subacromial impingement.[50,51]
In contrast, Alvarez et al. found no significant benefit of a subacromial injection in patients with tendonosis or a partial rotator cuff tear with symptoms for longer than six months who had failed physical therapy and atrial of NSAIDs.[52] Two studies have demonstrated the efficacy of corticosteroid injection alone or in combination with physical therapy in the treatment of adhesive capsulitis.[53,54]
There is still considerable variability in the results of subacromial corticosteroid injection. It is hypothesized that this may be due to the degree of inflammation involved in the patient’s acute pathology. Steroid injections may be most beneficial in patients with inflammatory disease and less effective in those with long-term pain, such as osteoarthritis. Other variables affecting the outcome may be needle placement, anatomical site of inflammation, frequency and dose of injection, and type of corticosteroid delivered.[55]
Hyaluronate Injection
There is a growing body of evidence supporting the use of intra-articular injections of sodium hyaluronate preparations in patients with shoulder pain. Hyaluronans are large polysaccharide molecules found naturally in the synovial fluid, which help to create a viscous environment cushioning joints and preserving normal function.[56]
Hyaluronans are used extensively in the management of osteoarthritis of the knee and clinical trial results have documented their effectiveness for this indication.[57 3] Results also suggest that the highest molecular-weight hyaluronic acid may be more effective than lower molecular-weight hyaluronic acid in treating osteoarthritis.[58]Hyaluronic acid injections have also been evaluated in small-scale studies of patients with rotator cuff tears,[59] extra-articular arthritis of the shoulder,[60,61] adhesive capsulitis,[62] and shoulder osteoarthritis.[63] Results from all these studies indicate the significant benefits of active treatment over placebo in relieving pain, improving range of motion, and decreasing the use of oral analgesics. The first large-scale randomized controlled study evaluating sodium hyaluronate injections in patients with shoulder pain provided support for the efficacy of this therapy. This trial included 602 patients with diagnoses such as osteoarthritis, rotator cuff tear, and/or adhesive capsulitis. All patients enrolled in the study had a limited range of motion and had failed conventional non-operative modalities. Patients without arthritis experienced no benefit compared with a placebo injection, while patients with osteoarthritis who received the series of injections experienced statistically significant pain relief.[64] While the range of patients that may benefit from non-surgical intervention with sodium hyaluronate injection therapy is not yet clear, it is reasonable to suggest that these injections may be most effective in individuals with persistent pain compared with those experiencing acute inflammation.
The relative lack of side effects and concern over CV risk and other systemic adverse effects may make this an attractive option for treatment.
Shoulder pain may occur as a secondary symptom to a wide range of conditions, including rotator cuff disorders, glenohumeral osteoarthritis, or adhesive capsulitis.[34] Despite the variable etiology, a similar stepwise approach to care appears to be appropriate for most patients who do not exhibit evidence of structural damage that would mandate immediate surgical intervention. The first step in treatment is physical therapy focused on improving range of motion and strength. Oral medications to decrease pain and inflammation are often administered to patients with shoulder pain, although the risk of potential side effects must be examined for each patient. Injection therapy with corticosteroids has demonstrated benefits for patients with rotator cuff disorders, adhesive capsulitis, and inflammatory disease. Recently, several studies have suggested that the injection of sodium hyaluronate is also effective for the treatment of shoulder pain, particularly those with glenohumeral osteoarthritis. Additional well-controlled trials are needed to better define which treatment modalities are likely to be the most effective in different subsets of patients with shoulder pain.
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"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
