The outcomes of considering goals of care in medication reviews for older adults: a systematic review.

Introduction: This is a systematic review of prescribing, clinical, patient-reported, and health utilization outcomes of goal-directed medication reviews in older adults.

Methods: A systematic review was conducted using MEDLINE, EMBASE, SCOPUS and CINAHL databases to identify studies examining outcomes of goal-directed medication reviews in humans, with mean/median age ≥ 60 years and in English.

Results: Seventeen out of 743 articles identified were included.

Effect of garlic (Allium sativum) oil on exercise tolerance in patients with coronary artery disease.

The effect of six weeks garlic oil administration was observed on cardiac performance and exercise tolerance in 30 patients of coronary artery disease. After initial treadmill stress test, they were administered garlic oil in the dose of four capsules twice a day for 6 weeks and treadmill stress test was repeated. Garlic significantly (P<0.

Protective effect of ginger, Zingiber officinale Rosc on experimental atherosclerosis in rabbits.

The effects of air dried ginger powder (0.1g/kg body weight, po, for 75 days) were studied on experimentally induced atherosclerosis in rabbits by cholesterol feeding (0.3g/kg body weight, po).

Ginger, fat and fibrinolysis.

Administration of 50 gm of fat to 30 healthy adult volunteers decreased fibrinolytic activity from a mean of 64.20 +/- 5.31 to 52.

Antioxidant property of Saffron in man.

50 mg of Saffron dissolved in 100 ml of milk was administered twice a day to 20 human subjects. Lipoprotein oxidation susceptibility (LOS) was estimated initially and after 3 and 6 weeks. There was a constant decrease in LOS during this period.

Effect of garlic (Allium sativum) on blood lipids, blood sugar, fibrinogen and fibrinolytic activity in patients with coronary artery disease.

Thirty patients with coronary artery disease (CAD) were administered garlic (study group) while another 30 patients received the placebo (control group). Various risk parameters were determined at 1.5 and 3 months of garlic administration.

Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease.

In a placebo-controlled study the effect of ginger and fenugreek was examined on blood lipids, blood sugar, platelet aggregation, fibrinogen and fibrinolytic activity. The subjects included in this study were healthy individuals, patients with coronary artery disease (CAD), and patients with non-insulin-dependent diabetes mellitus (NIDDM) who either had CAD or were without CAD. In patients with CAD powdered ginger administered in a dose of 4 g daily for 3 months did not affect ADP- and epinephrine-induced platelet aggregation.

Effect of garlic on platelet aggregation in humans: a study in healthy subjects and patients with coronary artery disease.

Garlic's value in preventing cardiovascular disease has been reported by several research groups. Garlic and its components are known to possess antiplatelet activity which has been demonstrated mostly in vitro. It was found that garlic oil administration to healthy subjects and patients with coronary artery disease (CAD) inhibited platelet aggregation ex vivo.

Radio-protective effect of garlic Allium sativum Linn. in albino rats.

S-allyl cysteine sulphoxide (SACS), a sulphur containing aminoacid of garlic is the precursor of allicin and garlic oil, and has been found to show significant radio protective effect in albino rats which were whole body irradiated with 400 rads of irradiation by Cobalt 60 source. It markedly reduced the radiation induced mortality and showed significant protection against the tissue damaging effects of irradiation in histopathological sections of liver and lung.

Curcumin, a major component of food spice turmeric (Curcuma longa) inhibits aggregation and alters eicosanoid metabolism in human blood platelets.

In traditional medicine, Ayurveda, several spices and herbs are held to possess medicinal properties. Earlier we have reported that extracts from several spices, including turmeric, inhibit platelet aggregation and modulate eicosanoid biosynthesis. Due to their eicosanoid-modulating property, it was suggested that the spices may serve to provide clues to drugs directed to arachidonic acid (AA) pathway enzymes as pharmacological targets.

The hypoglycemic effect of chloroquine.

Ten persons were studied to observe the effect of intravenous administration of chloroquine on serum glucose level. Ten healthy individuals were given 800 mg of chloroquine in three hours infusion. There was a significant (p = 0.

Effect of ginger on platelet aggregation in man.

Dietary supplementation of 100 g butter in 20 healthy male volunteers for 7 days was found to enhance platelet aggregation to a significant extent (P < 0.001). Addition of 5 g of dry ginger in two divided doses with fatty meal (in 10 individuals) significantly (P < 0.

Effect of intravenous infusion of verapamil in patients of severe hypertension.

Thirty patients with diastolic blood pressure of 120 mm Hg or more were administered a bolus dose of verapamil (0.15 mg/kg) followed immediately by an intravenous infusion at a rate of 0.005 mg/kg/min for one hour.

Ear-lobe crease and ear-canal hair as predictors of coronary artery disease in Indian population.

215 patients of different communities were selected randomly to predict the correlation between the ear-lobe crease, ear-canal hair and coronary artery disease. On analysis, it was found that prevalence of the ear-lobe crease increases with advancing age, and the incidence was much more higher in Sindhis in whom the overall incidence of CAD is also significantly high. Bilateral diagonal ear-lobe crease was found to be significantly (P less than 0.

Effect of vitamin C on platelet adhesiveness and platelet aggregation in coronary artery disease patients.

The effect of oral administration of vitamin C on platelet adhesive index (PAI), platelet aggregate ratio (PAg R) and serum ascorbic acid levels was studied. Feeding 75 g of butter to healthy males (group I, n = 10 cases), enhanced the tendency of platelet adhesiveness (PAd) and platelet aggregation (PAg) to a significant level at the end of 4 h. This was distinctly prevented when 1 g of vitamin C was added to the fatty meal.

Effect of garlic on blood lipids in patients with coronary heart disease.

The study was conducted on two groups of individuals. Group A consisted of 20 healthy volunteers who were fed garlic for 6 months and then followed for another 2 months without garlic. Garlic administration significantly lowered the serum cholesterol and triglycerides while raising the high-density lipoproteins.

The effect of fried versus raw garlic on fibrinolytic activity in man.

The effect of fried and raw garlic on blood fibrinolytic activity has been compared in 20 patients with ischaemic heart disease. Three blood samples were collected on the first day of the study and similarly on the 2nd and 7th days after garlic administration, either in raw or fried form. Fibrinolytic activity increased by 72% and 63% within 6 h of administration of raw or fried garlic, respectively.