Now showing items 21-40 of 10568

    • Cyril C.H. Feng Papers Finding Aid

      Wink, Tara (2019-05)
      Most of the materials in the Cyril C.H. Feng Papers come from Feng’s time as director of the University of Maryland at Baltimore Health Sciences Library from 1977 to 1990. They provide a glimpse into the business of the Health Sciences Library during a time of growth and reorganization and medical library administration generally. Feng was especially interested in integrated library systems.
    • Barnett-Potter-Goldsborough Family Correspondence Finding Aid

      Wink, Tara (2018-05)
      This collection includes letters and correspondence from the Barnett, Potter, and Goldsborough Family. The letters are to or from Drs. Nathaniel Potter and John Barnett, who married the Goldsborough Sisters, Sally and Catherine. The letters include medical advice as well as happenings in Talbot and Caroline Counties as well as Baltimore, Maryland. Other topics include family news and advice on John Henry Bartnett’s medical education. Finally, the collection includes genealogical research on the families conducted by Dolores L. DuPont, great great granddaughter of Dr. John Barnett.
    • HS/HSL Connective Issues 2019-2020

      University of Maryland, Baltimore. Health Sciences and Human Services Library, 2020
    • Dr. Harold H. Burns Lecture Notes Finding Aid

      Wink, Tara (2019-05)
      This collection contains the medical lecture notes of Dr. Harold H. Burns, University of Maryland School of Medicine class of 1936. The notes date from September 1933 to February 1935 corresponding to Dr. Burns’ first and second years of medical school. The first two years of study at that time were devoted entirely to the study of the structures and functions of the body; later years were devoted to clinical study. The notes in this collection reflect the medical research and teachings of the time.
    • Women's Auxiliary Board of the University Hospital Records Finding Aid

      Wink, Tara (2018)
      The Women’s Auxiliary Board of the University Hospital Records contains materials relating to the operations and history of the organization which served the University of Maryland, Baltimore University Hospital and School of Medicine from 1887 to 1999. The Women’s Auxiliary Board of the University Hospital served as a fundraising and service arm of the University Hospital from its inception in 1887 until it was dissolved in 1999. This collection provides insight into the women who volunteered their time, money, and expertise to support the University Hospital and its patients. The records document an impactful organization in the history of the University of Maryland, Baltimore and its hospital.
    • Micro-RNAs as biomarkers and therapeutic targets for autoimmune arthritis

      Dudics, Steven Rudolph; Moudgil, Kamal (2019)
      Rheumatoid arthritis (RA) is a chronic, debilitating autoimmune disease that affects 0.3-1% of the world’s population. Approximately 30-40% of RA patients fail to respond well to presently used drugs, and the prolonged use of these drugs may result in serious adverse effects. Additionally, there are inherent limitations in the current biomarkers for RA with regard to their utility in the diagnosis and monitoring of therapeutic response. Therefore, there is an urgent need for novel therapeutic agents and new biomarkers for better management of RA. We proposed that specific micro-RNAs (miRNAs) can serve both these needs. MiRNAs are 19-22 nucleotides in length, transcribed mostly from the non-coding regions of the genome, and increasingly being recognized as master regulators of gene expression. Using the rat adjuvant-induced arthritis (AA) model of RA, we examined the miRNA expression profile of arthritic rats and determined how this profile is modulated following anti-arthritis therapy. We used celastrol, a bioactive triterpenoid derived from a plant extract (celastrus), as a potential therapeutic. Following statistical and bioinformatical analyses, 8 miRNAs that were found to be increased after arthritis development were selected for further study. The expression of 6 of these miRNAs was significantly modulated by celastrol treatment, and the expression profile of the draining lymphoid cells was different from that of serum. We then identified the genes targeted by specific miRNAs, e.g., miR-96. Using transfection of RAW cells (macrophages) and HUVECs (endothelial cells) with miRNA mimics, we identified the target genes whose products play an important role in osteoclastogenesis and angiogenesis, respectively. Network analysis and functional assays further revealed the effects of select miRNAs on these two arthritis-related processes. Interestingly, the levels of expression of some of these miRNA-regulated genes were altered by celastrol, suggesting their involvement in its anti-arthritic effect. We suggest that the above miRNAs may serve as novel biomarkers of disease activity and therapeutic response in arthritis. A subset of these miRNAs could also be targeted for arthritis therapy.
    • Protein organization and NMDA receptor activation at individual hippocampal synapses.

      Metzbower, Sarah Wein Ransom; Blanpied, Thomas A. (2019)
      Protein organization and receptor activation coordinate to maintain synaptic efficacy at individual synapses. Therefore, it is important to explore both mechanisms that impact how proteins are arranged and factors that influence receptor activation. Transsynaptic cleft proteins are important for synaptogenesis and synapse function but little is known about how they are organized within the cleft. One such transsynaptic protein is Synaptic Cell Adhesion Molecule 1 (SynCAM 1), which has been shown to be important for synaptogenesis and synapse maintenance but its subsynaptic organization had not been explored. Using a combination of high-resolution imaging approaches, including cryoelectron tomography and super-resolution imaging, it was determined that not only does SynCAM 1 form peri-synaptic puncta, but also that the presence of SynCAM 1 is required for normal protein density distribution within the synaptic cleft. Thus supporting the idea that the synapse is organized into nano-compartments and that SynCAM 1 may be important for this subsynaptic organization. Additionally, NMDA receptor (NMDAR) activation is critical for maintenance and modification of synapse strength. Specifically, NMDAR activation by spontaneous glutamate release has been shown to mediate some forms of synaptic plasticity, as well as synaptic development. Interestingly, there is evidence that within individual synapses each release mode may be segregated such that postsynaptically there are distinct pools of responsive receptors. In order to examine potential regulators of NMDAR activation due to spontaneous glutamate release in cultured hippocampal neurons, I utilized GCaMP6f imaging at single synapses in concert with confocal and super-resolution imaging. Using these single-spine approaches, I found that Ca2+ entry activated by spontaneous release tends to be carried by GluN2B-NMDARs. The amount of NMDAR activation varies greatly both between synapses and within synapses, and is unrelated to spine and synapse size, but does correlate loosely with synapse distance from the soma. Despite the critical role of spontaneous activation of NMDARs in maintaining synaptic function, their activation seems to be controlled by factors other than synapse size or synapse distance from the soma. It is most likely that NMDAR activation by spontaneous release influenced variability in subsynaptic receptor position, release site position, vesicle content, and channel properties.
    • Effect of Physiologic Bilirubin Concentrations on Apoptosis

      Njonkou Tchoquessi, Rosy Linda; Bearer, Cynthia F. (2019)
      Background: The mechanisms of bilirubin neurotoxicity are poorly understood. We hypothesize that free bilirubin at concentrations found in preterm infants increases neuronal apoptosis. To test this hypothesis, we measured the expression of pro-apoptotic proteins in primary cultures of cerebellar granule neurons exposed to bilirubin using quantitative immunoblotting techniques. Methods: Cerebellar granule neurons were plated on poly-L-Lysine overnight, then treated with human serum albumin combined with bilirubin to produce physiologic concentrations of free bilirubin. Staurosporine was added to some cultures as a positive control. Cell lysates were prepared, and cleaved caspase 3 expression was determined using quantitative immunoblotting techniques. Results: Addition of physiologic concentrations of free bilirubin to cerebellar granule neurons increased the expression of cleaved caspase 3 in a dose dependent manner at 24 hours. Conclusions: Physiologic concentrations of free bilirubin induces apoptosis in cultured rat cerebellar granule neurons.
    • Prescription Medication Adherence among Socioeconomically Diverse Black Men

      DeVance-Wilson, Crystal Lynn; Storr, Carla L. (2019)
      Abstract Background: Non-adherence to prescription medications may at least partially explain high rates of morbidity and mortality from chronic illness among Black men. Black men from lower socioeconomic backgrounds have previously been identified as low adherers but little is known about Black men with adequate incomes and access to healthcare resources. The Ecological Model is used as a framework to examine barriers and facilitators of medication adherence among Black men. Purpose: The purpose of this study is to estimate the prevalence and identify barriers and facilitators to medication adherence among a socioeconomically diverse group of Black men with a range of chronic illnesses. Methods: A cross-sectional study using a 105 item anonymous survey questionnaire was conducted. A convenience sample of 276 Black men (age 35-75 years) was recruited from 15 churches in Baltimore City, and Baltimore, Montgomery and Prince George’s counties. Mann-Whitney U, Kruskall-Wallis and Chi-square analysis were used to examine group differences and multinomial logistic regression provided odds ratio estimates of the association between various factors and low (reference), medium and high medication adherence. Results: Half the sample (49%) were low adherers. Socioeconomic differences in medication adherence were identified by homeownership (X2 = 6.327, p = .042). No statistically significant differences were found for education, employment, income and health insurance coverage. Personal and interpersonal factors found to be associated with medium adherence were coping (AOR=.91, 95% CI=.84-.99), self-efficacy (AOR=6.74, 95% CI=2.79-16.27), income – (low - AOR=10.94, 95% CI=2.42-49.51, middle –AOR=3.34, 95% CI=1.38-8.10), marriage or having a significant other (AOR=5.40, 95% CI=1.83-15.92) and homeownership (AOR=3.37, 95% CI=1.04-10.92). Personal and interpersonal factors found to be associated with high adherence were self-efficacy (AOR=6.63, 95% CI=1.89-23.27), homeownership (AOR=9.32, 95% CI=1.41-61.60), income (low - AOR=8.55, 95% CI=1.31-55.68) and not sharing information with others (AOR=2.89, 95% CI=1.17-7.13). No associations were identified for community, organizational or government/policy level factors. Conclusions: Higher self-efficacy, homeownership and marital status were facilitators and higher coping, higher income and some forms of social support were barriers to medication adherence. This study illuminates opportunities for improving prescription medication education and implementing practice innovations to increase rates of adherence among Black men across the socioeconomic spectrum.
    • Participation and Effectiveness of Worksite Health Promotion Program

      Han, Myeunghee; Doran, Kelly; Storr, Carla L. (2019)
      Background: Worksite Health Promotion Programs (WHPPs) are limited by low participation and engagement. However, little is known about what factors influence participation and the relationship between participation and changes in body weight and composition. Mobile health technology (mHealth) may facilitate participation and engagement in WHPPs as mhealth is not limited by time or location, which are known barriers to participation and engagement. Yet, few studies have examined the use and effectiveness of WHPPs using mHealth interventions that aimed to change body weight and composition. Purpose: To explore the features and effectiveness of WHPPs in previous studies that used mHealth interventions. To identify factors influencing participation and engagement in a WHPP and the relationship between participation and changes in body weight and composition. Methods: A systematic literature review was conducted to explore features of WHPPs using mHealth that aimed to change body weight and composition. A secondary data analysis was conducted using data obtained from participants in the intervention group of a WHPP to identify: 1) factors that influence participation and engagement and 2) the relationship between participation and body weight and composition changes. Results: From the systematic review, 10 out of 12 WHPP studies using mHealth significantly improved body weight and composition. The most commonly used mHealth interventions were providing information, goal setting, and data entry. Based on the secondary data analysis, low levels of stress, anxiety, or high job satisfaction were significantly related to high participation in a WHPP. Significant relationships between participation and body weight and composition changes were not found due to a small sample size. However, this study found that those who reduced five pounds of body weight at six months among overweight or obese participants showed high participation in physical activity and/or diet components of a WHPP. Conclusions: WHPPs using mHealth can significantly improve body weight and composition. Employees’ psychological factors should be considered to increase participation in WHPPs. Further studies with larger sample size are needed to identify the relationship between participation and changes in body weight or body composition.
    • Mothers Engaging in Street-Level Prostitution: A Lived Experience

      Bailey-Kloch, Marie; Shdaimah, Corey S. (2019)
      Abstract Title of Dissertation: Mothers Engaging in Street-Level Prostitution: A Lived Experience Marie G. Bailey-Kloch, Doctor of Philosophy, 2019 Dissertation Directed by Corey Shdaimah, PhD, Professor, School of Social Work This dissertation is a qualitative study with mothers who engage in street-level prostitution. Using a phenomenological approach, this study explored how respondents understand their roles as mothers who engage in street-level prostitution and how these two identities co-exist. The aim of the study was an examination of the way motherhood is understood and explained by the women themselves. The purpose was to understand the way women who engage prostitution construct and define motherhood and how they feel about themselves by eliciting their stories through a phenomenological lens. Six mothers engaging in street-level prostitution were interviewed; a second in-depth semi-structured interview was conducted with five of these. After an analysis employing an interpretive phenomenological approach (IPA), three themes emerged from the data: addiction, perseverance and motherhood. All the respondents met the criteria for the DSM 5 diagnosis of severe substance use disorder. They had the resilience to survive in spite of a lack of resources and enduring trauma. They all believed they had qualities of being a “good mother” even if that meant not living with their children. These findings may help to structure programs that may help influence whether they will seek services to improve the quality of their own lives and the lives of their children. Current programs delivering services to mothers engaged in street-level prostitution, such as substance abuse treatment and diversion programs, do not always recognize the significance to their women participants of being identified as a mother. The insights and perspectives of study respondents regarding their lived experience provides guidance to improve policy and programs that deliver services to mothers who engage in street-level prostitution.
    • Rolando fracture

      Windsor, T.A.; Blosser, K.M.; Richardson, A.C. (Wiley-Blackwell Publishing Ltd, 2019)
      Rolando fractures are associated with poor prognosis and when they occur on the dominant hand potential for disability is even greater. Timely imaging, placement into a thumb spica splint, and orthopedic surgery evaluation are integral to ensuring the best possible outcome for the patient. Copyright 2019 The Authors.
    • Impact of Global Budget Revenue Policy on Emergency Department Efficiency in the State of Maryland

      Ren, A.; Hirshon, J.M.; Pimentel, L. (University if California, 2019)
      INTRODUCTION: On January 1, 2014, the State of Maryland implemented the Global Budget Revenue (GBR) program. We investigate the impact of GBR on length of stay (LOS) for inpatients in emergency departments (ED) in Maryland. METHODS: We used the Hospital Compare data reports from the Centers for Medicare and Medicaid Services (CMS) and CMS Cost Reports Hospital Form 2552-10 from January 1, 2012-March 31, 2016, with GBR hospitals from Maryland and hospitals from West Virginia (WV), Delaware (DE), and Rhode Island (RI). We implemented difference-in-differences analysis and investigated the impact of GBR implementation on the LOS or ED1b scores of Maryland hospitals using a mixed-effects model with a state-level fixed effect, a hospital-level random effect, and state-level heterogeneity. RESULTS: The GBR impact estimator was 9.47 (95% confidence interval [CI], 7.06 to 11.87, p-value<0.001) for Maryland GBR hospitals, which implies, on average, that GBR implementation added 9.47 minutes per year to the time that hospital inpatients spent in the ED in the first two years after GBR implementation. The effect of the total number of hospital beds was 0.21 (95% CI, 0.089 to 0.330, p-value = 0 .001), which suggests that the bigger the hospital, the longer the ED1b score. The state-level fixed effects for WV were -106.96 (95% CI, -175.06 to -38.86, p-value = 0.002), for DE it was 6.51 (95% CI, -8.80 to 21.82, p-value=0.405), and for RI it was -54.48 (95% CI, -82.85 to -26.10, p-value<0.001). CONCLUSION: Our results indicate that GBR implementation has had a statistically significant negative impact on the efficiency measure ED1b of Maryland hospital EDs from January 2014 to April 2016. We also found that the significant state-level fixed effect implies that the same inpatient might experience different ED processing times in each of the four states that we studied.
    • Evaluating the Effects of Acupuncture Using a Dental Pain Model in Healthy Subjects - A Randomized, Cross-Over Trial

      de Matos, N.M.P.; Pach, D.; Witt, C.M. (Churchill Livingstone Inc., 2019)
      Acupuncture is a complementary and nonpharmacological intervention that can be effective for the management of chronic pain in addition to or instead of medication. Various animal models for neuropathic pain, inflammatory pain, cancer-related pain, and visceral pain already exist in acupuncture research. We used a newly validated human pain model and examined whether acupuncture can influence experimentally induced dental pain. For this study, we compared the impact of manual acupuncture (real acupuncture), manual stimulation of a needle inserted at nonacupuncture points (sham acupuncture) and no acupuncture on experimentally induced dental pain in 35 healthy men who were randomized to different sequences of all 3 interventions in a within-subject design. BORG CR10 pain ratings and autonomic responses (electrodermal activity and heart rate variability) were investigated. An initial mixed model with repeated measures included preintervention pain ratings and the trial sequence as covariates. The results showed that acupuncture was effective in reducing pain intensity when compared to no acupuncture (? = ?.708, P =.002), corresponding to a medium Cohen's d effect size of.56. The comparison to the sham acupuncture revealed no statistically significant difference. No differences in autonomic responses between real and sham acupuncture were found during the intervention procedures. Perspective: This study established a dental pain model for acupuncture research and provided evidence that experimentally induced dental pain can be influenced by either real acupuncture or manual stimulation of needles at nonacupuncture points. The data do not support that acupoint specificity is a significant factor in reducing experimental pain. Copyright 2019 The Authors
    • Is substance use disorder more prevalent in patients with hidradenitis suppurativa?

      Aldana, P.C.; Driscoll, M.S. (Elsevier Inc, 2019)
      Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that disproportionately affects women and is associated with significant physical and psychosocial impact. Recent studies have reported an increased prevalence of substance abuse among patients with HS, including increased alcohol, opioid, and cannabis use. Whether substance use disorder is more prevalent among patients with HS is controversial because these data come from small studies and a major confounder is that patients with HS are often prescribed opioids for HS-associated pain. This review summarizes the current literature on substance use in HS to investigate whether substance use disorder is more likely in this patient population. We also highlight possible cofounders and areas of unmet need in HS that are potential causes of abuse, such as adequate pain control and impaired quality of life, and suggest opportunities for provider intervention. Evidence suggests that there is an increased prevalence of substance use disorder in patients with HS, but the full extent is still difficult to determine. However, with early screening and appropriate referrals to specialists, dermatologic providers may properly intervene and prevent substance use disorder in patients with HS.
    • Histoplasmosis of the gallbladder

      Claassen, C.; Grove, C.; Saleeb, P. (Elsevier Ltd, 2019)
      Histoplasmosis of the gallbladder is an extremely rare condition. We present the case of cholecystitis due to progressive, disseminated histoplasmosis in an immunocompetent woman. Copyright 2019 The Authors
    • A reduced-graphene oxide-modified microelectrode for a repeatable detection of antipsychotic clozapine using microliters-volumes of whole blood

      Shukla, R.P.; Cazelles, R.; Kelly, D.L. (Elsevier B.V., 2019)
      Antipsychotic clozapine is the most effective medication currently available for schizophrenia. However, clozapine is dramatically underutilized due to its harsh side effects that are not effectively monitored. By continuously monitoring clozapine blood levels, such as use of an implantable glucometer, which has transformed diabetes management, the treatment can be optimized and side effects will be minimized. Currently, none of the methods for clozapine detection show the ability to repeatedly measure clozapine in whole blood without pretreatment steps. Here we propose using a microelectrode modified with reduced graphene oxide—a material that was used for repeatable measurements in implantable electrochemical devices. We present the successful direct electrodeposition of reduced-graphene oxide coating onto microelectrodes. Systematic characterization of the electrodeposition technique parameters (i.e., the technique scan rate and the number of cycles) revealed their effect on the electrochemical activity and the structural properties (the film thickness and roughness) of the films. The developed reduced–graphene oxide-modified microelectrode exhibited the feasibility to detect clozapine in microliters–volume-samples of whole blood with a limit-of-detection and a sensitivity of 0.64 ± 0.04 μM and 19.6 ± 1.3 μA/cm2μM, respectively. Moreover, the reduced graphene oxide-modified microelectrodes exhibited high repeatability (retaining 94.6% of the electrochemical signal after 10 repeats), reproducibility (3.6% relative standard deviation), and storage stability (retaining 89% of the electrochemical signal after 4 weeks). Finally, relative recovery studies of 0.5, 1, and 2 μM clozapine concentrations resulted in 108 ± 4.0%, 112 ± 3.5%, and 103 ± 2.2%, respectively. Future studies should investigate the microelectrode fouling mechanisms in whole blood and explore methods to overcome fouling. Copyright 2019 The Authors
    • Molecular mechanisms in chaperonopathies: clues to understanding the histopathological abnormalities and developing novel therapies

      Macario, A.J.L.; de Macario, E.C. (John Wiley and Sons Ltd, 2019)
      Molecular chaperones, many of which are heat shock proteins (Hsps), are components of the chaperoning system and when defective can cause disease, the chaperonopathies. Chaperone-gene variants cause genetic chaperonopathies, whereas in the acquired chaperonopathies the genes are normal, but their protein products are not, due to aberrant post-transcriptional mechanisms, e.g. post-translational modifications (PTMs). Since the chaperoning system is widespread in the body, chaperonopathies affect various tissues and organs, making these diseases of interest to a wide range of medical specialties. Genetic chaperonopathies are uncommon but the acquired ones are frequent, encompassing various types of cancer, and inflammatory and autoimmune disorders. The clinical picture of chaperonopathies is known. Much less is known on the impact that pathogenic mutations and PTMs have on the properties and functions of chaperone molecules. Elucidation of these molecular alterations is necessary for understanding the mechanisms underpinning the tissue and organ abnormalities occurring in patients. To illustrate this issue, we discuss structural-functional alterations caused by mutation in the chaperones CCT5 and HSPA9, and PTM effects on Hsp60. The data provide insights into what may happen when CCT5 and HSPA9 malfunction in patients, e.g. accumulation of cytotoxic protein aggregates with tissue destruction; or for Hsp60 with aberrant PTM, degradation and/or secretion of the chaperonin with mitochondrial damage. These and other possibilities are now open for investigation.
    • Homozygous variant in ARL3 causes autosomal recessive cone rod dystrophy

      Sheikh, S.A.; Usmani, M.A.; Riazuddin, S.; Ahmed, Z.M. (Association for Research in Vision and Ophthalmology Inc., 2019)
      Purpose: Cone rod dystrophy (CRD) is a group of inherited retinopathies characterized by the loss of cone and rod photoreceptor cells, which results in poor vision. This study aims to clinically and genetically characterize the segregating CRD phenotype in two large, consanguineous Pakistani families. Methods: Funduscopy, optical coherence tomography (OCT), electroretinography (ERG), color vision, and visual acuity assessments were performed to evaluate the retinal structure and function of the affected individuals. Exome sequencing was performed to identify the genetic cause of CRD. Furthermore, the mutation's effect was evaluated using purified, bacterially expressed ADP-ribosylation factor-like protein 3 (ARL3) and mammalian cells. Results: Fundus photography and OCT imaging demonstrated features that were consistent with CRD, including bull's eye macular lesions, macular atrophy, and central photoreceptor thinning. ERG analysis demonstrated moderate to severe reduction primarily of photopic responses in all affected individuals, and scotopic responses show reduction in two affected individuals. The exome sequencing revealed a novel homozygous variant (c.296G>T) in ARL3, which is predicted to substitute an evolutionarily conserved arginine with isoleucine within the encoded protein GTP-binding domain (R99I). The functional studies on the bacterial and heterologous mammalian cells revealed that the arginine at position 99 is essential for the stability of ARL3. Conclusions: Our study uncovers an additional CRD gene and assigns the CRD phenotype to a variant of ARL3. The results imply that cargo transportation in photoreceptors as mediated by the ARL3 pathway is essential for cone and rod cell survival and vision in humans. Copyright 2019 The Authors
    • Lipid-Lowering Efficacy of Ezetimibe in Patients with Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analyses

      Shaya, F.T.; Sing, K.; Milam, R. (Adis, 2019)
      Introduction: Patients with atherosclerotic cardiovascular disease (ASCVD), especially those with recent (< 1 year) acute coronary syndrome (ACS), are at high risk for recurrent cardiovascular events. This risk can be reduced by lowering low-density lipoprotein cholesterol (LDL-C) levels. A comprehensive meta-analysis on the LDL-C-lowering efficacy of ezetimibe is lacking. This study attempts to address this gap. Methods: A systematic literature review of randomized controlled trials evaluating the LDL-C-lowering efficacy of ezetimibe in the ASCVD population was conducted. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for publications from database inception to August 2018 and for conference abstracts from 2015 to August 2018. Meta-analyses were conducted to evaluate the LDL-C-lowering efficacy of ezetimibe in the ASCVD population and the recent ACS subgroup. Results: In total, 12 studies were eligible for the meta-analyses. Treatment with combination ezetimibe plus statin therapy showed greater absolute LDL-C reduction than statin monotherapy (mean difference − 21.86 mg/dL; 95% confidence interval [CI] − 26.56 to − 17.17; p < 0.0001) after 6 months of treatment (or at a timepoint closest to 6 months). Similarly, in patients with recent ACS, combination ezetimibe plus statin therapy was favorable compared with statin monotherapy (mean treatment difference − 19.19 mg/dL; 95% CI − 25.22 to − 13.16; p < 0.0001). Conclusions: Ezetimibe, when added to statin therapy, provided a modest additional reduction in LDL-C compared with statin monotherapy. However, this may not be sufficient for some patients with ASCVD who have especially high LDL-C levels despite optimal statin therapy. Copyright 2019, The Author(s).