Browsing by Subject "efficacy"
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Item Open Access Emerging treatment options to improve cardiovascular outcomes in patients with acute coronary syndrome: focus on losmapimod.(Drug Des Devel Ther, 2015) Kragholm, Kristian; Newby, Laura Kristin; Melloni, ChiaraEach year, despite optimal use of recommended acute and secondary prevention therapies, 4%-5% of patients with acute coronary syndrome (ACS) experience relapse of ACS or other cardiovascular events including stroke, heart failure, or sudden cardiac death after the index ACS. The sudden atherosclerotic plaque rupture leading to an ACS event is often accompanied by inflammation, which is thought to be a key pathogenic pathway to these excess cardiovascular events. Losmapimod is a novel, oral p38 mitogen-activated protein kinase (MAPK) inhibitor that targets MAPKs activated in macrophages, myocardium, and endothelial cells that occur as a part of global coronary vascular inflammation following plaque rupture. This review aims to 1) discuss the pathophysiological pathways through which p38 MAPKs may play key roles in initiation and progression of inflammatory disease and how losmapimod is thought to counteract these p38 MAPKs, and 2) to describe the efficacy and safety data for losmapimod obtained from preclinical studies and randomized controlled trials that support the hypothesis that it has promise as a treatment for patients with ACS.Item Open Access Reworking Efficacy: The Social Life of Medicine in Northern Togo(2013-04-23) Middleton, AlexandraWhen considering the local, indigenous, “traditional” healing practices of non-Western societies, Euro-Americans often ask whether or not they are efficacious – “do they work?” Posed from a biomedical paradigm, the concept of work adheres to a narrow definition. This thesis seeks to expand constrained prevailing views of medical efficacy, challenging conception of the “work” medical systems perform. Rooted in ethnographic fieldwork conducted in the village of Kuwdé, Northern Togo, I apply the question of work to the Kabre local medical system. I consider how the purposeful distribution of remedies among houses in Kuwdé orients the individual body to community, clan, and history through health and disease. I draw upon theories of embodiment, relationality, and power to show that a medical system does social, relational, and political work as well as physiological work. In doing so, I aim to move from a conception of health solely as biological-pathway-to-biological-impact, to situating health in its social and relational dimensions. I then engage with the field of global health, arguing that an expanded notion of efficacy and work may, in turn, improve the delivery of biomedical care. It is my hope that this project cultivates awareness of how definitions of efficacy frame the lived experience and practice of medicine.