Oral health in adolescent smokers at the Armando de la Rosa Polytechnic Institute of Informatics

Research Article | DOI: https://doi.org/10.31579/2690-8794/264

Oral health in adolescent smokers at the Armando de la Rosa Polytechnic Institute of Informatics

Ivis Eliany Gómez Hernández ¹
Ileana María Yero Mier ^2*
Marisel García Rodríguez3 ³
Dayanis Marín Herrera ⁴
Delsa Elena Morgado Marrero ⁵

1Provincial Stomatological Clinic of Sancti Spíritus, Sancti Spíritus

2 Faustino Pérez Faculty of Medical Sciences. Sancti Spíritus

*Corresponding Author: Ileana María Yero Mier, Faustino Pérez Faculty of Medical Sciences. Sancti Spíritus.

Citation: Ileana María Yero Mier, (2025), Research Article: Oral health in adolescent smokers at the Armando de la Rosa Polytechnic Institute of Informatics., Clinical Medical Reviews and Reports; 7(3): DOI: 10.31579/2690-8794/264

Copyright: © 2025 Ileana María Yero Mier, 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: 24 May 2025 | Accepted: 12 June 2025 | Published: 30 June 2025

Keywords: adolescent; smoking; oral health

Abstract

Introduction. Tobacco uses in children and adolescents is already a major health problem and negatively impacts oral health. The oral cavity is one of the areas where the harmful effects of tobacco are most easily recognized. Objective: To describe the oral health of adolescent smokers at the Armando de la Rosa Polytechnic Institute of Informatics. Materials and methods. A cross-sectional, descriptive, observational study was conducted from September 2023 to October 2024. Theoretical, empirical, and mathematical statistical methods were used. The variables used were: age, sex, duration of smoking, oral diseases according to duration of smoking, risk perception of smoking, and knowledge about the effects of smoking on the oral cavity. Results. Fifty-eight percent of adolescents were female, and 58.5% were between 17 and 18 years of age. Smoking duration was more than one year (46.3%). Periodontal disease affected 92.7% of adolescents. Knowledge about the effects of smoking on the oral cavity was insufficient in 75.6%, and risk perception regarding smoking was inadequate in 61.0%. Conclusions. Females and the 17-18 age group predominated, as did adolescent smokers for more than one year, with periodontal disease and dental caries predominating. Insufficient knowledge about smoking in the oral cavity and inadequate risk perception regarding smoking prevailed.

Introduction

The World Health Organization (WHO) defines adolescence as the period of human growth and development that occurs after childhood and before adulthood, between the ages of 10 and 19. (1)

Adolescents are an age group of great importance, the impact that can be had on their behaviors will influence the development of their way of life and lifestyles, currently adolescents are surrounded by a world that invites them to technology to socialize, learn and entertain themselves. Therefore, it is the faculty of the personnel involved in health education to take advantage of the various strategies offered by the environment, in order to promote healthy lifestyles. (2)

Smoking is considered a universal epidemic and is a burden on the individual, the family and society. It is classified as a chronic systemic disease, belonging to the group of addictions. It is one of the main risk factors for multiple diseases. (3)

They consider it one of the epidemics of the twentieth and twenty-first centuries; another important factor to take into account is that the habitual consumption of tobacco is the cause of deaths, but without a doubt they can be avoided, even if it pretends to be an elegant habit. The World Health Organization (WHO) indicates that there are more than 1300 million smokers worldwide, representing approximately one third of the population over 15 years of age (4)

90% of smokers start the habit before the age of 19 and problems of behavioural disorders such as shyness and aggressiveness have been detected in children and adolescents who smoke, which is interpreted as a risk for the subsequent consumption of other substances or drugs such as marijuana, cocaine, cocaine, cocaine, stimulants and sedatives (5)

The oral cavity is the part of the body that has the first contact with tobacco with its compounds and emissions, which is why it is more frequent to suffer various types of pathologies and carcinogenic effects, microbial and immunological alterations. The main pathologies present due to tobacco consumption are: stains on teeth due to the effects of nicotine and tar combustion, increased caries due to low salivary flow production, periodontal disease, halitosis and leukoplakia. (6)

Smoking is a widespread drug addiction throughout the world that reaches a global prevalence of 47% in the population. (5)

24% of young people consume tobacco daily worldwide and the prevalence increases by more than ten points in university students, which is explained by factors such as academic stress and the influence of the group, which favor the initiation and/or consolidation of this habit at this stage of life. In addition, the time to develop a physical and psychological dependence on nicotine is two years, from the time young people try tobacco. As a result, during their time at university, 30% of young people will develop addiction to tobacco and will have difficulty quitting.(7)

In Cuba, of the top ten causes of death, eight are related to this addiction. Among the countries of the Americas, the aforementioned country ranks fifth in prevalence of smoking, with 23.7%; There are more than 2 million smokers, four out of 10 men smoke (41.4%) and two out of 10 women (23%). (8)

The perceived severity associated with smoking is related to the smoker's perception of the serious damage that tobacco or cigarette consumption causes him or her and, at the same time, being aware of the loss of health due to this addiction. It is vitally important that the smoker achieves a greater perception and in this way proposes to take actions in order to recover the health lost due to smoking. (9)

The Cuban Anti-Smoking Program arose with the purpose of promoting and protecting the oral cavity and the body in general. Despite the disclosure of the consequences and complications for oral health, there are still people who are unaware of the damage it causes, or do not achieve positive changes in their attitudes towards the habit. (10)

From the analysis of the health situation of the Provincial Teaching Stomatological Clinic of the northern area of Sancti Spíritus, it has been found that smoking is a latent risk factor in adolescents, who do not have sufficient knowledge in oral health issues and their attitudes towards health are not the most favorable. It is important to know the behavior of oral health in high school students who practice smoking, due to the prevalence of this addiction in adolescence, a stage in which they are usually subjected to greater stress loads due to the high teaching demand, as well as the knowledge and perception about tobacco addiction and the oral diseases associated with the habit, which will allow us to carry out educational activities aimed at this group populational

Taking into account the above and the insufficient research approach to the problem in the territory, it was proposed: to describe the oral health of adolescent smokers at the Armando de la Rosa Polytechnic Institute of Informatics.

Methods

A cross-sectional descriptive observational study was carried out in the period from September 2023 to October 2024. The population consisted of all adolescent smokers who belong to the Armando de la Rosa Polytechnic Institute of Information Technology (133), the sample was made up of 41 adolescents based on simple random probabilistic sampling, who met the inclusion criteria and gave their consent to participate in the study. The variables used were: age, sex, time of smoking addiction, oral diseases according to the time of smoking addiction, perception of risk of smoking, knowledge about smoking and the oral cavity. The research was developed in a stage of: diagnosis.

Diagnostic stage: the topic under study was communicated to the management and scientific council of the health institution. Patients included in the study were provided with detailed information and a request for informed consent. The oral examination was performed and the History was made Clínica Individual para recoger la información de los adolescentes relativo a sus datos sociodemográficos.

The knowledge survey on smoking and oral cavity was applied.(11)

A questionnaire (12) was used to explore the perception of risk about smoking. It consists of 15 items to which the answer is made using a Likert-type scale, where one represents total disagreement and five is always or totally agree.

The study was carried out with prior consultation, review and approval by the ethics committee of the institution and the management of the Armando de la Rosa Polytechnic Institute of Informatics, municipality of Sancti Spíritus, and then obtained the consent of the students to participate in the research, taking into account the ethical principles established in the Declaration of Helsinki.

Results

In the population studied, the highest percentage of adolescent smokers corresponded to the female sex with 58.5%, the most representative age group was 17-18 years (58.5%). (Table 1)

Age group	Female		Male		Total
Age group	No	%	No	%	No	%
15-16	9	21,9	8	19,6	17	41,5
17-18	15	36,6	9	21,9	24	58,5
Total	24	58,5	17	41,5	41	100

Table 1. Adolescents according to age and sex.

Table 2 shows the time of smoking addiction in adolescents, where the habit prevailed in more than one year (46.3%), and only 19.1% practiced it less than a year ago.

Time of addiction smoking	Female		Male		Total
Time of addiction smoking	No	%	No	%	No	%
Less than a year	5	12,2	3	7,3	8	19,1
One year	9	22,0	5	12,2	14	34,1
More than a year	10	24,4	9	21,9	19	46,3
Total	24	58,5	17	41,5	41	100

Table 2. Adolescents according to smoking addiction time

When evaluating oral conditions, a predominance of periodontal disease was evidenced in 92.7%; affecting more those who had been practicing for more than a year (46.3%), followed by dental caries with 63.4%. Lesions were found in the oral mucosa of an adolescent, representing 2.4% of smokers who have been practicing this habit for more than a year. (Table 3)

Smoking Addiction Time	Caries dental		Periodontal disease		Lesions of the oral mucosa
Smoking Addiction Time	No	%	No	%	No	%
Less than a year	3	7,3	5	12,2	_	_
One year	10	24,4	14	34,1	_	_
More than a year	16	39,0	19	46,3	1	2,4
Total	29	63,4	38	92.7	1	2,4

Table 3. Oral conditions of adolescent smokers according to the time of consumption

75.6% of the adolescents who participated in this study have insufficient knowledge about the harmful effects of smoking on the oral cavity. Despite the promotional actions carried out in primary care, only 24.4% reached a sufficient level of information (Table 4)

Sex	Enough		Insufficient
Sex	No	%	No	%
Female	7	17,1	17	41,5
Male	3	7,3	14	34,1
Total	10	24,4	31	75,6

Table 4. Knowledge about smoking and the oral cavity by sex in adolescents

The perception of risk of smoking was inadequate, 61.0

Discussion

In the present research, the age group between 17 and 18 years and the female sex predominated, truly alarming results if we take into account the multiple preventive campaigns that are carried out in the country against this harmful habit, coinciding with the results obtained by Lorenzo-Felipe D, et al. (13) Galbe Sánchez-Ventura J, et al. (14), and Bouza Vera M, et al. (15) However, it differs from Valdés Sardiñas SA et al. (5) where smoking was manifested in 64.6% of all those studied, with a predominance of males.

The results of the study differ from those found by Espinoza Aguirre A, et al. (16) where they refer that tobacco consumption is a practice highly conditioned by gender, where there is an association between the male sex and the prevalence of current tobacco consumption.

The authors report that smoking is part of the culture and customs of the Cuban population, in which the health team plays a great role in carrying out educational prevention activities to avoid the habit, in addition to offering treatment to people interested in quitting smoking and rehabilitation to ex-smokers.

Smoking in the adolescents studied dates back more than a year and more frequently in females.

Similar to the results Martín Suárez M de los Á, et al. (17) where they found that the majority of adolescents started the habit after the age of 15, 31 young people, representing 60.8%, followed by those who started between the ages of 12 and 14 years, 16 smokers (31.4%)

Smoking causes dissimilar damage to the body. The oral cavity is one of the areas where the harmful effects of tobacco are most easily recognized. (5)

A high percentage of adolescents with periodontal disease was found to be related to the time of cigarette consumption. Similar results were found by Valdés Sardiñas S.A., et al (5). También se coincide con los resultados Bouza Vera M, et al (15), Gutiérrez Solano MP, et al (18)

The authors state that smoking influences periodontal disease by releasing epinephrine that causes vasoconstriction and relative anoxia of the capillaries of the gum, by a transient decrease in the potential for oxidation and reduction; as well as the deterioration it can have on leukocyte function.

The indicators obtained in this study, dental caries was another of the oral conditions that predominated in adolescent smokers. These results are similar to those reported in other studies that have described in detail the adverse effects of smoking on the maintenance of oral health as a determining element for the prevention of dental caries, related to risk factors and lifestyles of the population. (15, 19, 20)

In the opinion of the researchers, as the time of smoking addiction in adolescents increases, dental caries and periodontal disease increase their prevalence, which causes the presence of stains on the tooth surfaces, allowing the accumulation of dental plaque, a risk factor for dental caries and periodontal disease.

The adolescents who participated in this study have insufficient knowledge about the harmful effects of smoking on the oral cavity, results similar to Renda Valera L, et (11), Leyva, E. H. P, et al. (21), Martell Martínez M et al (22)

In the opinion of the authors, adolescents know that when smoking, they can die from heart or lung involvement, but they are unaware of the effects on oral health. In addition, it is considered that the country has potential to develop health promotion strategies where health professionals involve teachers, since when they teach they do it naturally, with professionalism, they are believed and they try to imitate them or do what they indicate, and in the school itself the results found in adolescents can be modified

The perception of the risk of smoking was inadequate, similar to the study by Pérez Martínez D et al (9) who before the intervention had a predominance of low perceived severity, manifested in 62.2 % of the cases and after the intervention developed, 95.6 % of the people presented a high perceived severity. Similar also with the research Herrera-Santí P, et al (23)

The results of the study differ from those found by Fernández-Castillo E, et al. (12) where it has been shown that women have higher levels of risk perception regarding tobacco consumption.

The authors consider it necessary to adapt the perception of risk with respect to tobacco consumption in adolescents, it should not only focus on the informative aspects, although their importance is recognized, but this dimension should be transcended, and favor the incorporation of this knowledge into the personal functioning of each student, in addition it is necessary to apply educational intervention strategies, that emphasis be placed on el efecto del tabaco con respecto a la salud bucal y elevar la percepción del riesgo del hábito de fumar para la salud bucal.

Las principales limitaciones de esta investigación se relacionan con la no valoración de los factores de riesgo de los adolescentes con hábitos de fumar.

Conclusion

The study was dominated by females and the 17-18 age group; as well as adolescent smokers over one year of age, with periodontal disease and dental caries predominating. Insufficient knowledge about smoking and its effects on the oral cavity and inadequate risk perception of smoking prevailed.

Conflict of interest.

The authors declare that there is no conflict of interest

Contribution of the authors.

All authors participated in the conceptualization, formal analysis, project management, writing – original draft, writing – review, editing and approval of the final manuscript.

References

Alcaina Lorente A, Saura López V, Pérez Pardo A, Guzmán Pina S, Cortés Lillo O. Oral health: influence of lifestyles in adolescents. Rev Pediatr Aten Primaria [Internet]. 2020 Sep [cited 2024 Mar 13] ; 22( 87 ): 251-261.
View at Publisher | View at Google Scholar
Estévez Arbolay M, Pérez García LM, Morgado Marrero DE, Jiménez Marín O, Carmona Pérez SM. The education of adolescents in oral hygiene mediated by Information and Communication Technologies. Gac méd espirit [Internet]. 2021 [cited 2024 Mar 22]; 23(3).
View at Publisher | View at Google Scholar
Oconor-Riverón R, Canut-Gómez L. Periodontal disease associated with smoking and poor oral hygiene. Trusted Clinic. Las Mangas. Bayamo. 2019. MULTIMED [online journal]. 2020 [cited 2024 Mar 22]; 24 (3)
View at Publisher | View at Google Scholar
Fernández-González E, Figueroa-Oliva D. Smoking and its relationship with cardiovascular diseases. Habanera Journal of Medical Sciences [Internet]. 2018 [cited 2024 Mar 22]; 17 (2): [approx. 10 p.].
View at Publisher | View at Google Scholar
Valdés Sardiñas S A, Hernández Gutiérrez D, Broche Pombo A, Suárez Morales X, Francisco Tejera A, Marcial López G. Smoking and its association with adolescent oral health. Acta méd centro [Internet]. 2020 Mar [cited 2024 Mar 22]; 14( 1 ): 44-52.
View at Publisher | View at Google Scholar
Aguiló Juanola MC. Smoking: novel aspects for its approach and updated review of concepts. Pharm Care Esp [Internet]. 2020 [cited 2024 Mar 22]; 22(5):353-66.
View at Publisher | View at Google Scholar
Pardavila Belio M, Lizarbe-Chocarro M, Canga-Armayor N. Attitudes, self-efficacy and intention towards smoking cessation in Spanish university students. An. Sist. Health. Navar [Internet]. 2019 [cited 2024 Mar 22]; 42(1):41-47.
View at Publisher | View at Google Scholar
Valera LR, Borjas YC, Maden DP, Garcell KC. Level of knowledge about smoking and its relationship with the oral cavity. Cuban Journal of Military Medicine. [Internet]. 2020 [cited 2024 Mar 22]; 49(1):41-56.
View at Publisher | View at Google Scholar
Pérez-Martínez D, Saborit-Corría E, Jiménez-Sánchez L. Educational intervention to increase the perceived severity of smoking in smoking patients. Revista de Ciencias Médicas de Pinar del Río [online journal]. 2019 [cited 2024 Mar 22]; 23(1):[approx. 15 p.].
View at Publisher | View at Google Scholar
Ministry of Public Health. Program for the Prevention and Control of Smoking in Cuba. Havana: MINSAP. [cited 2024 Mar 22].
View at Publisher | View at Google Scholar
Renda-Valera L, Cruz-Borjas Y, Parejo-Maden D, Cuenca-Garcel K, Gumila-Jardines M. Evaluation of an educational intervention on smoking and its relationship with the oral cavity. Cuban Journal of Military Medicine [Internet]. 2020 [cited 2024 Mar 22]; 49 (4)
View at Publisher | View at Google Scholar
Fernández-Castillo E, Molerio-Pérez O, Cruz-Peña A, López-Torres L, Grau R. Risk perception regarding tobacco consumption in young Cuban university students. Cuban Journal of Integral General Medicine [Internet]. 2016 [cited 2024 Mar 22]; 32 (2)
View at Publisher | View at Google Scholar
Lorenzo-Felipe D, Vinardell-Lorenzo J, Garrido-Tapia E, Gabriel-Aguilera E, Torres-Guerra A. Axiological analysis of the perception of risk in health. Medical Scientific Mail [Internet]. 2020 [cited 2024 Mar 22]; 24 (2)
View at Publisher | View at Google Scholar
Galbe Sánchez Ventura J, Rando Diego Á, San Miguel Muñoz Mª J, Colomer Revuelta J, Cortés Rico O, Esparza Olcina Mª J et al. Prevention of tobacco use in adolescence. Rev Pediatr Aten Primaria [Internet]. 2020 [cited 2024 Mar 27] ; 22( 88 ): 411-422.
View at Publisher | View at Google Scholar
Bouza Vera M, Vera Ramírez D, Rodríguez Motta C, Gou Godoy M A, Ibáñez Piedra S L, Barrios Rodríguez T. Smoking habits and oral health in adolescents. Israel Moliné Rendón Polytechnic, Limonar, 2015. Rev.Med.Electron. [Internet]. 2017 Dec [cited 2024 Mar 22]; 39(6): 1248-1258.
View at Publisher | View at Google Scholar
Espinoza Aguirre A, Fantin R, Barboza Solís C, Salinas Miranda A. Sociodemographic characteristics associated with the prevalence of tobacco use in Costa Rica. Rev Panam Salud Pública [Internet]. 2020 [cited 2024 Mar 22]; 44: E17.
View at Publisher | View at Google Scholar
Martín Suárez M de los Á, Echevarría García E, Sánchez Fernández Cl M, Hernández Aise M I, Triana Pérez M, Hernández Ruiz O A. Smoking behavior in adolescents from the Fructuoso Rodríguez District, Cárdenas. Rev.Med.Electron. [Internet]. 2015 Dec [citado 2024 Abr 01]; 37(6): 579-588.
View at Publisher | View at Google Scholar
Gutiérrez Solano MP, Centeno Dávila M del C. Association between periodontal disease and cardiovascular disease. Odontol. Act. [Internet]. 2023 [cited 2024 Mar 22]; 8(1):43-56.
View at Publisher | View at Google Scholar
Mosquera Campaign L, Rodríguez Fonseca JX. Effects of smoking on the periodontium of smoking students at the Faculty of Dentistry of the Universidad Santo Tomás [thesis]. Bucaramanga: Universidad Santo Tomás; 2017 [cited 2024 Mar 22].
View at Publisher | View at Google Scholar
Oliveira del Río JA, Balladares Araujo GA, Andrade Vera FM. Adolescence and parodontopathies. Pol with [Internet]. 2018 Jan [cited 2024 Mar 22]; 3 (1):3-12.
View at Publisher | View at Google Scholar
Pérez Leyva EH, Frómeta Báez M, Martínez Pérez JR, Bermudez Cordoví LL. Educational intervention on smoking in students of the
View at Publisher | View at Google Scholar
Martell-Martínez M, Betancourt-Sánchez N, Lozada-Bazain R, Echemendía-Reyes E, Suárez-Ramos L, Reyes-Hernández B. Educational intervention on the consequences of smoking in adolescents in Nuevitas. Medisur [online journal]. 2021 [cited 2024 Mar 22]; 19(2): [approx. 7 p.].
View at Publisher | View at Google Scholar
Herrera-Santí P, Martínez-García N, Navarrete-Ribalta C. Community intervention to improve the quality of life of the elderly. Cuban Journal of Integral General Medicine [Internet]. 2015 [cited 2024 Mar 22]; 31 (4)
View at Publisher | View at Google Scholar

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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.

S Munshi

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.

Tania Munoz

“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”.

George Varvatsoulias

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.

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.

Khurram Arshad

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.

Gomez Barriga Maria Dolores

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.

Lin Shaw Chin

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.

Maria Dolores Gomez Barriga

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.

Dr Maria Dolores Gomez Barriga

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¨.

Dr Maria Regina Penchyna Nieto

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.

Dr Marcelo Flavio Gomes Jardim Filho

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!”

Zsuzsanna Bene

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

Dr 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.

Lin-Show Chin

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.

Sonila Qirko

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.

Luiz Sellmann

I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.

Zhao Jia

Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."

Thomas Urban

I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.

Cristina Berriozabal

To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.

Dr Tewodros Kassahun Tarekegn

"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".

Dr Shweta Tiwari

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.

Dr Farooq Wandroo

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.

Dr Anyuta Ivanova

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.

Dr David Vinyes

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.

Gertraud Teuchert-Noodt

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

Dr 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.

Dr Oleg Golyanovski

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.

Dr Susan Anne Smith

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.

Dr 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.

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.

Dr Susan Anne Smith

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 Eric S Nussbaum

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.

Hala Al Shaikh

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.

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.

Dr 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.

Dr Jelle 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