Annals of Medicine (ANN MED)

Publisher: Suomalainen lääkäriseura Duodecim, Informa Healthcare

Journal description

Annals of Medicine is an international, peer-reviewed review journal bridging molecular medicine and clinical practice. It provides current opinions on a wide range of medical specialties focusing on internal medicine. This unique resource enables readers to keep up-to-date with the latest advances in the understanding of the pathogenesis of diseases and how molecular medicine can impact on daily clinical practice. The series on Trends in Clinical Practice and Trends in Molecular Medicine are published regularly. Special Sections feature commissioned, peer-reviewed papers on different aspects of a theme, which in 2001 will include tumorigenesis, obesity, angiogenesis and depression. A new series on the very latest advances in molecular medicine will start with molecular cardiology and molecular endocrinology. Annals of Medicine has an impact factor of 2.566 and is ranked 12/110 in the world in the category of Medicine, General and Internal. This journal is published for The Finnish Medical Society Duodecim.

Current impact factor: 4.73

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 4.733
2012 Impact Factor 5.094
2011 Impact Factor 3.516
2010 Impact Factor 4.323
2009 Impact Factor 4.246
2008 Impact Factor 5.435
2007 Impact Factor 5.779
2006 Impact Factor 4.594
2005 Impact Factor 3.848
2004 Impact Factor 3.617
2003 Impact Factor 3.614
2002 Impact Factor 3.422
2001 Impact Factor 2.818
2000 Impact Factor 2.794
1999 Impact Factor 2.566
1998 Impact Factor 1.9
1997 Impact Factor 2.104
1996 Impact Factor 1.716
1995 Impact Factor 1.84
1994 Impact Factor 1.129
1993 Impact Factor 1.401
1992 Impact Factor 1

Impact factor over time

Impact factor

Additional details

5-year impact 4.64
Cited half-life 7.20
Immediacy index 0.76
Eigenfactor 0.01
Article influence 1.64
Website Annals of Medicine website
Other titles Annals of medicine (Helsinki, Finland), Annals of medicine, Ann med
ISSN 0785-3890
OCLC 19550892
Material type Periodical, Internet resource
Document type Journal / Magazine / Newspaper, Internet Resource

Publisher details

Informa Healthcare

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • On author's personal website or institution website
    • Publisher copyright and source must be acknowledged
    • On a non-profit server
    • Must link to publisher version
    • Publisher's version/PDF cannot be used
    • NIH funded authors may post articles to PubMed Central for release 12 months after publication
    • Wellcome Trust authors may deposit in Europe PMC after 6 months
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: A close relationship between cancer and thrombosis does exist, documented by the fact that an overall 7-fold increased risk of venous thromboembolism (VTE) has been reported in patients with malignancy compared to non-malignancy. The potential impact of antithrombotic agents in cancer-associated VTE has long been recognized, and, in particular, several clinical trials in the last 20 years have reported the safety and efficacy of low-molecular-weight heparins (LMWHs) for treatment and prophylaxis of VTE in patients with various types of cancer. More recently, a number of preclinical and clinical studies have suggested that LMWHs may improve survival in cancer patients with mechanisms that are different from its antithrombotic effect but are linked to the ability of influencing directly the tumor biology. This paper reviews the evidence around the potential survival benefits of LMWHs by analyzing the suggested mechanisms and the available clinical data.
    Annals of Medicine 03/2015; 47(2):1-6. DOI:10.3109/07853890.2015.1004361
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    ABSTRACT: There is increasing knowledge that patients can be predisposed to a certain disease by genetic variations in their DNA. Extensive genetic variation has been described in molecules involved in short- and long-term complications after lung transplantation (LTx), such as primary graft dysfunction (PGD), acute rejection, respiratory infection, chronic lung allograft dysfunction (CLAD), and mortality. Several of these studies could not be confirmed or were not reproduced in other cohorts. However, large multicenter prospective studies need to be performed to define the real clinical consequence and significance of genotyping the donor and receptor of a LTx. The current review presents an overview of genetic polymorphisms (SNP) investigating an association with different complications after LTx. Finally, the major drawbacks, clinical relevance, and future perspectives will be discussed.
    Annals of Medicine 03/2015; 47(2):1-10. DOI:10.3109/07853890.2015.1004359
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    ABSTRACT: Background. Short-term weight loss is often successful, but the obtained results are difficult to maintain. Therefore, a study focusing on obese people who successfully lost weight, with special emphasis upon methods applied and background factors, is of major importance. Methods/subjects. This study was based upon a web-based questionnaire, which the participants filled in after registration. Altogether 316 people were recruited through articles in newspapers all over Finland, and of them 184 met the inclusion criteria: age 18-60 years, body mass index (BMI) ≥ 30 kg/m(2) before weight loss, a weight loss of at least 10%, and maintaining it for a minimum of 2 years. Results. A total of 158 participants (100 women and 58 men) were included in the final analyses. The mean age was 44.5 years, average BMI before weight loss 35.9 kg/m(2) and after weight loss 26.1 kg/m(2), average weight loss was 26.5% or 32.4 kg. Compared with the general Finnish population the participants smoked less (P = 0.009), used less alcohol (P ≤ 0.001), and were physically more active (P ≤ 0.001). Conclusions. People who were successful in long-term weight loss have a much healthier lifestyle than the general Finnish population. Increased physical activity seems to be a major determinant of successful long-term results.
    Annals of Medicine 03/2015; 47(2):1-6. DOI:10.3109/07853890.2015.1004358
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    ABSTRACT: Objective. To evaluate the effect of body weight (BW) on safety and efficacy of direct oral anticoagulants (DOACs). Methods. We performed a meta-analysis of randomized controlled trials (RCTs) comparing DOACs with vitamin K antagonists (VKA) in patients with venous thromboembolism (VTE). Efficacy (prevention of recurrent VTE or VTE-related death) and safety (occurrence of major or clinically relevant non-major bleeding) outcomes were stratified according to patients' BW (low, normal, and high). Results. Six RCTs with a total of 27,023 patients were included. DOACs showed a similar efficacy to VKA in patients with high BW, normal BW, and low BW (RR 0.98, 95% CI 0.72, 1.35; RR 0.91, 95% CI 0.75, 1.09; and RR 0.84, 95% CI 0.57, 1.24, respectively). Safety was comparable among DOACs and VKA in patients with high BW and low BW (RR 0.93, 95% CI 0.65, 1.32; and RR 0.80, 95% CI 0.54, 1.20), whereas DOACs were marginally safer than VKA in normal-BW subjects (RR 0.82, 95% CI 0.67, 1.00). However, the difference among DOACs and VKA in the rate of bleeding episodes appeared similar in the three BW groups. Conclusions. Results of our meta-analysis suggested that DOACs might be a safe and effective therapeutic option for the treatment of acute VTE even in the patients with extreme body weights. However, other studies with larger study populations are warranted to confirm our findings.
    Annals of Medicine 02/2015; 47(1):1-8. DOI:10.3109/07853890.2014.982064
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    ABSTRACT: Objective. To investigate the predictive value of T-wave inversion (TWI) on routine electrocardiogram (ECG) for mortality in the general population with various risk groups in a prospective population-based follow-up study. Subjects. ECGs of a random population-based sample of 1814 men aged 42-60 years without coronary heart disease (CHD) at baseline. Results. During an average follow-up of 21 years, 685 deaths occurred. Of these deaths 174 were due to CHD and 278 to cardiovascular disease (CVD). There were 57 subjects with TWI. After adjusting for age, TWI was associated with an increased CHD mortality (relative risk (RR) 4.10, 95% CI 2.26-7.41), CVD mortality (RR 3.47, 95% CI 2.09-5.78), and all-cause mortality (RR 2.07, 95% CI 1.37-3.12). After further adjustment for conventional risk factors, TWI remained statistically significant, predicting CHD mortality (RR 2.62, 95% CI 1.57-4.36), CVD mortality (RR 2.18, 95% CI 1.40-3.38), and all-cause mortality (RR 1.41, 95% CI 1.00-2.01), respectively. Conclusion. TWI is a strong predictor for CHD, CVD, and all-cause mortality in the general population. The respective risks of CHD and CVD among men with TWI were also increased among men with high blood pressure, LDL cholesterol, and obesity.
    Annals of Medicine 01/2015; 47(1):1-5. DOI:10.3109/07853890.2014.985703
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    ABSTRACT: Adult-onset Still's disease (AOSD), a systemic inflammatory disorder, is often considered a part of the spectrum of the better-known systemic-onset juvenile idiopathic arthritis, with later age onset. The diagnosis is primarily clinical and necessitates the exclusion of a wide range of mimicking disorders. AOSD is a heterogeneous entity, usually presenting with high fever, arthralgia, skin rash, lymphadenopathy, and hepatosplenomegaly accompanied by systemic manifestations. The diagnosis is clinical and empirical, where patients are required to meet inclusion and exclusion criteria with negative immunoserological results. There are no clear-cut diagnostic radiological or laboratory signs. Complications of AOSD include transient pulmonary hypertension, macrophage activation syndrome, diffuse alveolar hemorrhage, thrombotic thrombocytopenic purpura and amyloidosis. Common laboratory abnormalities include neutrophilic leukocytosis, abnormal liver function tests, and elevated acute-phase reactants (ESR, CRP, ferritin). Treatment consists of anti-inflammatory medications. Non-steroidal anti-inflammatory drugs have limited efficacy, and corticosteroid therapy and disease-modifying anti-rheumatic drugs are usually required. Recent advances have revealed a pivotal role of proinflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin (IL)-1, IL-6, IL-8, and IL-18 in disease pathogenesis, giving rise to the development of novel targeted therapies aiming at optimal disease control. The review aims to summarize recent advances in pathophysiology and potential therapeutic strategies in AOSD.
    Annals of Medicine 01/2015; 47(1):1-9. DOI:10.3109/07853890.2014.971052
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    ABSTRACT: Idiopathic pulmonary fibrosis (IPF) is a severe, progressive fibrotic disease of the lung of unknown etiology that affects approximately 150,000 patients in the United States. It carries a median survival of two to three years, but clinical course can vary markedly from patient to patient. There has been no established treatment for IPF, but recent advances in coordinated clinical trials through groups such as IPFnet and academia–industry partnerships have allowed this relatively rare disease to be studied in much greater depth. Historically, the default therapy for IPF was a combination of prednisone, N-acetylcysteine, and azathioprine, but recent trials have shown that this regimen actually increases mortality. An enormous body of work in recent years, spanning the bench to the bedside, has radically altered our understanding of the molecular mechanisms underlying IPF. Newer modalities, particularly those involving monoclonal antibodies targeted at specific pathways known to contribute to the fibrotic process, have generated a great deal of excitement in the field, and recent clinical trials on therapies such as pirfenidone and nintedanib herald a new era in targeted IPF therapies.
    Annals of Medicine 01/2015; 47(2). DOI:10.3109/07853890.2014.991751
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    ABSTRACT: Aims. We examined the prognostic impact of eight different intraventricular conduction delays (IVCD) in the standard electrocardiogram (ECG) in a community cohort. Methods and results. Data were collected from 6299 Finnish individuals. During a mean 8.2 years (interquartile range 8.1 to 8.3) of follow-up 640 subjects died (10.2%); 277 (4.4%) were cardiovascular deaths. For both sexes, all-cause and cardiovascular mortality was higher in subjects with IVCD than in those without. In Cox regression analysis after adjustment for age and gender, the hazard ratio for cardiovascular mortality for non-specific IVCD was 4.25 (95% confidence interval [CI] 1.95–9.26, P < 0.0001) and for left bundle branch block (LBBB) 2.11 (95% CI 1.31–3.41, P = 0.002). Right bundle branch block (RBBB) was not related to additional mortality, while incomplete RBBB (IRBBB) presented a hazard ratio of 2.24 (95% CI 1.064–4.77, P = 0.036). Conclusions. In the general population, non-specific IVCD, LBBB, and IRBBB were associated with increased relative risk for all-cause and cardiovascular mortality. RBBB did not have an impact on cardiovascular mortality either in subjects with or without previous heart disease.
    Annals of Medicine 01/2015; 47(1). DOI:10.3109/07853890.2014.985704
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    ABSTRACT: Aims. The aim was to carry out a systematic screening of interactions between the traditional risk factors and to evaluate which interactions are truly relevant for estimation of cardiovascular disease (CVD) risk. Methods. Cox regression was used in a meta-analysis of five independent, population-based health examination surveys (the National FINRISK Study). End-points were 10-year incidence of coronary heart disease (CHD), ischemic stroke (IS), and CVD in a population free of cardiovascular disease (n = 35,460). Results. In addition to expected age interactions, systolic blood pressure was found to be a markedly stronger risk factor for CVD (and for CHD) among subjects with normal BMI (BMI < 25: HR 1.42 [1.30–1.55] for one SD increase in systolic blood pressure) when compared to obese subjects (BMI > 30: HR 1.10 [1.01–1.19]) (P < 0.001 for interaction) and among subjects with highest high-density lipoprotein (HDL) (33% tertile: HR 1.43 [1.29–1.58]) when compared to subjects with low HDL (lowest 33% tertile: HR 1.20 [1.13–1.28]) (P < 0.001 for interaction). Interactions improved risk prediction of CVD (cross-validated continuous net reclassification improvement [NRI] 49.4% with 95% CI 44.7%–54.1%, P < 0.0001 and clinical NRI 4.7%, with 95% CI 2.8%–6.5%, P < 0.0001). The C-statistic improved from 0.8438 to 0.8455 (P = 0.010). No significant interaction was associated with the risk of IS. Conclusions. There are significant effect modifications between major risk factors, and accounting for them leads to significantly more accurate estimation of cardiovascular risk.
    Annals of Medicine 11/2014; 47(1). DOI:10.3109/07853890.2014.970570
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    ABSTRACT: The GRADE method (Grading of Recommendations, Assessment, Development, and Evaluation) provides a tool for rating the quality of evidence for systematic reviews and clinical guidelines. This article aims to analyse conceptually how well grounded the GRADE method is, and to suggest improvements. The eight criteria for rating the quality of evidence as proposed by GRADE are here analysed in terms of each criterion's potential to provide valid information for grading evidence. Secondly, the GRADE method of allocating weights and summarizing the values of the criteria is considered. It is concluded that three GRADE criteria have an appropriate conceptual basis to be used as indicators of confidence in research evidence in systematic reviews: internal validity of a study, consistency of the findings, and publication bias. In network meta-analyses, the indirectness of evidence may also be considered. It is here proposed that the grade for the internal validity of a study could in some instances justifiably decrease the overall grade by three grades (e.g. from high to very low) instead of the up to two grade decrease, as suggested by the GRADE method.
    Annals of Medicine 10/2014; 47(1). DOI:10.3109/07853890.2014.969766
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    ABSTRACT: Aim. To evaluate the effects of canrenone compared to placebo on blood pressure control, some non-conventional biomarkers in cardiovascular stratification, and on metalloproteinases in patients affected by metabolic syndrome. Methods. A total of 156 Caucasian patients were treated with placebo or canrenone, 50 mg once a day, for 3 months and then 50 mg twice a day, till the end of the study. We evaluated: systolic (SBP) and diastolic blood pressure (DBP), body weight, body mass index (BMI), fasting plasma glucose (FPG), lipid profile, plasma aldosterone, creatinine, potassium, brain natriuretic peptide (BNP), metalloproteinases 2 and 9 (MMP-2 and -9), lipoprotein (a) (Lp(a)), and serum myeloperoxidase (MPO). Results. We observed a significant decrease of SBP and DBP in the canrenone group compared to baseline. Canrenone gave a significant decrease of MMP-2 and -9, Lp(a), and MPO compared to baseline, not observed with placebo. Plasma aldosterone, but not BNP, decreased with canrenone, both compared to baseline and to placebo. Conclusion. Canrenone seems to be effective in reducing blood pressure in patients with metabolic syndrome. Moreover, canrenone seems also to improve MPO, Lp(a), and metalloproteinases in these patients.
    Annals of Medicine 10/2014; 47(1):1-6. DOI:10.3109/07853890.2014.969303
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    ABSTRACT: Cardiac biomarker troponin can be elevated in patients without a primary cardiac diagnosis and may have prognostic value. We conducted a systematic review to estimate the prevalence and prognostic significance of elevated troponin levels in patients admitted to hospital without a primary cardiac diagnosis. Literature search was done using MEDLINE (1946 to November 2012), EMBASE (1974 to Week 45, 2012), and Cochrane Central Register of Controlled Trials (November 2012). Two independent investigators reviewed full-text studies for final inclusion. We included studies of patients admitted without a primary cardiac diagnosis. Eligible studies compared adverse outcomes in patients with normal versus elevated troponin levels. Twenty-seven studies were included in the meta-analysis. Elevated troponin was associated with increased in-hospital and 30-day mortality (25 studies, 7255 patients, OR 3.88, 95% CI 2.90–5.19, P < 0.0001). Elevated troponin was also associated with increased risk of long-term mortality at 6 months (9 studies, 5368 patients, OR 4.21, 95% CI 1.84–9.64, P < 0.00001). Troponin is an independent predictor of short-term mortality with a pooled adjusted OR of 2.36, 95% CI 1.47–3.76, P < 0.0003. In conclusion, elevated troponin in non-cardiac patients is independently associated with increased mortality.
    Annals of Medicine 10/2014; 46(8). DOI:10.3109/07853890.2014.959558
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    ABSTRACT: The primary unseptated heart tube undergoes extensive remodeling including septation at the atrial, atrioventricular, ventricular, and ventriculo-arterial level. Alignment and fusion of the septal components is required to ensure full septation of the heart. Deficiencies lead to septal defects at various levels. Addition of myocardium and mesenchymal tissues from the second heart field (SHF) to the primary heart tube, as well as a population of neural crest cells, provides the necessary cellular players. Surprisingly, the study of the molecular background of these defects does not show a great diversity of responsible transcription factors and downstream gene pathways. Epigenetic modulation and mutations high up in several transcription factor pathways (e.g. NODAL and GATA4) may lead to defects at all levels. Disturbance of modulating pathways, involving primarily the SHF-derived cell populations and the genes expressed therein, results at the arterial pole (e.g. TBX1) in a spectrum of ventricular septal defects located at the level of the outflow tract. At the venous pole (e.g. TBX5), it can explain a variety of atrial septal defects. The various defects can occur as isolated anomalies or within families. In this review developmental, morphological, genetic, as well as epigenetic aspects of septal defects are discussed.
    Annals of Medicine 10/2014; 46(8):1-13. DOI:10.3109/07853890.2014.959557
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    ABSTRACT: Several studies reported on the association between antiphospholipid syndrome (APS) and venous thrombosis. In contrast, little is known about cardiovascular (CV) risk in APS. We performed a meta-analysis on the impact of APS on major markers of CV risk. Studies on the relationship between APS and common carotid artery intima-media thickness (CCA-IMT), internal carotid artery IMT (ICA-IMT), carotid bifurcation IMT (BIF-IMT), prevalence of carotid plaques, flow-mediated dilation (FMD), nitrate-mediated dilation (NMD), and ankle-brachial index (ABI) were systematically searched in PubMed, Web of Science, Scopus, and EMBASE databases. Twenty case-control studies (668 cases, 678 controls) were included. Compared to controls, APS patients showed a higher CCA-IMT (mean difference [MD] 0.11 mm; 95% CI 0.07, 0.14), ICA-IMT (MD 0.08 mm; 95% CI 0.05, 0.11), BIF-IMT (MD 0.09 mm; 95% CI 0.06, 0.12) and a higher frequency of carotid plaques (OR 3.87; 95% CI 1.61, 9.31). Moreover, a lower FMD was found in APS subjects than in controls (MD –4.49%; 95% CI –6.20, –2.78), with no differences in NMD (MD –1.80%; 95% CI –4.01, 0.42). Finally, an increased prevalence of pathological ABI was found in APS patients compared to controls (OR 7.26; 95% CI 1.77, 29.71). Despite heterogeneity among studies, APS appears significantly associated with markers of subclinical atherosclerosis and CV risk. These findings can be useful to plan adequate prevention strategies and therapeutic approaches.
    Annals of Medicine 10/2014; 46(8). DOI:10.3109/07853890.2014.959559