16 results on '"MacKenzie, Lauren J."'
Search Results
2. Post-exposure prophylaxis or pre-emptive therapy for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): study protocol for a pragmatic randomized-controlled trial
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Lother, Sylvain A., Abassi, Mahsa, Agostinis, Alyssa, Bangdiwala, Ananta S., Cheng, Matthew P., Drobot, Glen, Engen, Nicole, Hullsiek, Kathy H., Kelly, Lauren E., Lee, Todd C., Lofgren, Sarah M., MacKenzie, Lauren J., Marten, Nicole, McDonald, Emily G., Okafor, Elizabeth C., Pastick, Katelyn A., Pullen, Matthew F., Rajasingham, Radha, Schwartz, Ilan, Skipper, Caleb P., Turgeon, Alexis F., Zarychanski, Ryan, and Boulware, David R.
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- 2020
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3. Hydroxychloroquine as Pre-exposure Prophylaxis for Coronavirus Disease 2019 (COVID-19) in Healthcare Workers: A Randomized Trial
- Author
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Rajasingham, Radha, Bangdiwala, Ananta S, Nicol, Melanie R, Skipper, Caleb P, Pastick, Katelyn A, Axelrod, Margaret L, Pullen, Matthew F, Nascene, Alanna A, Williams, Darlisha A, Engen, Nicole W, Okafor, Elizabeth C, Rini, Brian I, Mayer, Ingrid A, McDonald, Emily G, Lee, Todd C, Li, Peter, MacKenzie, Lauren J, Balko, Justin M, Dunlop, Stephen J, Hullsiek, Katherine H, Boulware, David R, Lofgren, Sarah M, Abassi, Mahsa, Balster, Andrew, Collins, Lindsey B, Drobot, Glen, Krakower, Douglas S, Lother, Sylvain A, MacKay, Dylan S, Meyer-Mueller, Cameron, Selinsky, Stephen, Solvason, Dayna, Zarychanski, Ryan, and Zash, Rebecca
- Subjects
0301 basic medicine ,Microbiology (medical) ,Canada ,medicine.medical_specialty ,Health Personnel ,Placebo ,Loading dose ,law.invention ,03 medical and health sciences ,Pre-exposure prophylaxis ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Intensive care ,medicine ,Clinical endpoint ,Humans ,030212 general & internal medicine ,Online Only Articles ,SARS-CoV-2 ,business.industry ,Hydroxychloroquine ,COVID-19 Drug Treatment ,Clinical trial ,030104 developmental biology ,Infectious Diseases ,Pre-Exposure Prophylaxis ,business ,medicine.drug - Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a rapidly emerging virus causing the ongoing coronavirus disease 2019 (COVID-19) pandemic with no known effective prophylaxis. We investigated whether hydroxychloroquine could prevent SARS-CoV-2 in healthcare workers at high risk of exposure. Methods We conducted a randomized, double-blind, placebo-controlled clinical trial of healthcare workers with ongoing exposure to persons with SARS-CoV-2, including those working in emergency departments, intensive care units, COVID-19 hospital wards, and first responders. Participants across the United States and in the Canadian province of Manitoba were randomized to hydroxychloroquine loading dose then 400 mg once or twice weekly for 12 weeks. The primary endpoint was confirmed or probable COVID-19–compatible illness. We measured hydroxychloroquine whole-blood concentrations. Results We enrolled 1483 healthcare workers, of whom 79% reported performing aerosol-generating procedures. The incidence of COVID-19 (laboratory-confirmed or symptomatic compatible illness) was 0.27 events/person-year with once-weekly and 0.28 events/person-year with twice-weekly hydroxychloroquine compared with 0.38 events/person-year with placebo. For once-weekly hydroxychloroquine prophylaxis, the hazard ratio was .72 (95% CI, .44–1.16; P = .18) and for twice-weekly was .74 (95% CI, .46–1.19; P = .22) compared with placebo. Median hydroxychloroquine concentrations in whole blood were 98 ng/mL (IQR, 82–120) with once-weekly and 200 ng/mL (IQR, 159–258) with twice-weekly dosing. Hydroxychloroquine concentrations did not differ between participants who developed COVID-19–compatible illness (154 ng/mL) versus participants without COVID-19 (133 ng/mL; P = .08). Conclusions Pre-exposure prophylaxis with hydroxychloroquine once or twice weekly did not significantly reduce laboratory-confirmed COVID-19 or COVID-19–compatible illness among healthcare workers. Clinical Trials Registration Clinicaltrials.gov NCT04328467.
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- 2020
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- View/download PDF
4. Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19
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Skipper, Caleb P., Pastick, Katelyn A., Engen, Nicole W., Bangdiwala, Ananta S., Abassi, Mahsa, Lofgren, Sarah M., Williams, Darlisha A., Okafor, Elizabeth C., Pullen, Matthew F., Nicol, Melanie R., Nascene, Alanna A., Hullsiek, Kathy H., Cheng, Matthew P., Luke, Darlette, Lother, Sylvain A., MacKenzie, Lauren J., Drobot, Glen, Kelly, Lauren E., Schwartz, Ilan S., Zarychanski, Ryan, McDonald, Emily G., Lee, Todd C., Rajasingham, Radha, and Boulware, David R.
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stomatognathic diseases ,Original Research - Abstract
There is no known effective oral therapy for early COVID-19. This randomized, double-blind, placebo-controlled trial evaluated effects of oral hydroxychloroquine on symptoms and disease severity in adult outpatients with early COVID-19., Background: No effective oral therapy exists for early coronavirus disease 2019 (COVID-19). Objective: To investigate whether hydroxychloroquine could reduce COVID-19 severity in adult outpatients. Design: Randomized, double-blind, placebo-controlled trial conducted from 22 March through 20 May 2020. (ClinicalTrials.gov: NCT04308668) Setting: Internet-based trial across the United States and Canada (40 states and 3 provinces). Participants: Symptomatic, nonhospitalized adults with laboratory-confirmed COVID-19 or probable COVID-19 and high-risk exposure within 4 days of symptom onset. Intervention: Oral hydroxychloroquine (800 mg once, followed by 600 mg in 6 to 8 hours, then 600 mg daily for 4 more days) or masked placebo. Measures: Symptoms and severity at baseline and then at days 3, 5, 10, and 14 using a 10-point visual analogue scale. The primary end point was change in overall symptom severity over 14 days. Results: Of 491 patients randomly assigned to a group, 423 contributed primary end point data. Of these, 341 (81%) had laboratory-confirmed infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or epidemiologically linked exposure to a person with laboratory-confirmed infection; 56% (236 of 423) were enrolled within 1 day of symptoms starting. Change in symptom severity over 14 days did not differ between the hydroxychloroquine and placebo groups (difference in symptom severity: relative, 12%; absolute, −0.27 points [95% CI, −0.61 to 0.07 points]; P = 0.117). At 14 days, 24% (49 of 201) of participants receiving hydroxychloroquine had ongoing symptoms compared with 30% (59 of 194) receiving placebo (P = 0.21). Medication adverse effects occurred in 43% (92 of 212) of participants receiving hydroxychloroquine versus 22% (46 of 211) receiving placebo (P < 0.001). With placebo, 10 hospitalizations occurred (2 non–COVID-19–related), including 1 hospitalized death. With hydroxychloroquine, 4 hospitalizations occurred plus 1 nonhospitalized death (P = 0.29). Limitations: Only 58% of participants received SARS-CoV-2 testing because of severe U.S. testing shortages. Conclusion: Hydroxychloroquine did not substantially reduce symptom severity in outpatients with early, mild COVID-19. Primary Funding Source: Private donors., Visual Abstract. Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19 There is no known effective oral therapy for early COVID-19. This randomized, double-blind, placebo-controlled trial evaluated effects of oral hydroxychloroquine on symptoms and disease severity in adult outpatients with early COVID-19. Visual Abstract. Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19 There is no known effective oral therapy for early COVID-19. This randomized, double-blind, placebo-controlled trial evaluated effects of oral hydroxychloroquine on symptoms and disease severity in adult outpatients with early COVID-19.
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- 2020
5. Safety of Hydroxychloroquine Among Outpatient Clinical Trial Participants for COVID-19
- Author
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Lofgren, Sarah M, primary, Nicol, Melanie R, additional, Bangdiwala, Ananta S, additional, Pastick, Katelyn A, additional, Okafor, Elizabeth C, additional, Skipper, Caleb P, additional, Pullen, Matthew F, additional, Engen, Nicole W, additional, Abassi, Mahsa, additional, Williams, Darlisha A, additional, Nascene, Alanna A, additional, Axelrod, Margaret L, additional, Lother, Sylvain A, additional, MacKenzie, Lauren J, additional, Drobot, Glen, additional, Marten, Nicole, additional, Cheng, Matthew P, additional, Zarychanski, Ryan, additional, Schwartz, Ilan S, additional, Silverman, Michael, additional, Chagla, Zain, additional, Kelly, Lauren E, additional, McDonald, Emily G, additional, Lee, Todd C, additional, Hullsiek, Kathy H, additional, Boulware, David R, additional, and Rajasingham, Radha, additional
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- 2020
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6. Hydroxychloroquine as pre-exposure prophylaxis for COVID-19 in healthcare workers: a randomized trial
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Rajasingham, Radha, primary, Bangdiwala, Ananta S, additional, Nicol, Melanie R, additional, Skipper, Caleb P, additional, Pastick, Katelyn A, additional, Axelrod, Margaret L, additional, Pullen, Matthew F, additional, Nascene, Alanna A, additional, Williams, Darlisha A, additional, Engen, Nicole W, additional, Okafor, Elizabeth C, additional, Rini, Brian I, additional, Mayer, Ingrid A, additional, McDonald, Emily G, additional, Lee, Todd C., additional, Li, Peter, additional, MacKenzie, Lauren J, additional, Balko, Justin M, additional, Dunlop, Stephen J, additional, Hullsiek, Katherine H, additional, Boulware, David R, additional, and Lofgren, Sarah M, additional
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- 2020
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7. An observational cohort study of hydroxychloroquine and azithromycin for COVID-19: (Can’t Get No) Satisfaction
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Lee, Todd C., primary, MacKenzie, Lauren J, additional, McDonald, Emily G., additional, and Tong, Steven Y.C., additional
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- 2020
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8. A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19
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Boulware, David R., primary, Pullen, Matthew F., additional, Bangdiwala, Ananta S., additional, Pastick, Katelyn A., additional, Lofgren, Sarah M., additional, Okafor, Elizabeth C., additional, Skipper, Caleb P., additional, Nascene, Alanna A., additional, Nicol, Melanie R., additional, Abassi, Mahsa, additional, Engen, Nicole W., additional, Cheng, Matthew P., additional, LaBar, Derek, additional, Lother, Sylvain A., additional, MacKenzie, Lauren J., additional, Drobot, Glen, additional, Marten, Nicole, additional, Zarychanski, Ryan, additional, Kelly, Lauren E., additional, Schwartz, Ilan S., additional, McDonald, Emily G., additional, Rajasingham, Radha, additional, Lee, Todd C., additional, and Hullsiek, Kathy H., additional
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- 2020
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- View/download PDF
9. Post-exposure Prophylaxis or Preemptive Therapy for SARS-Coronavirus-2: Study Protocol for a Pragmatic Randomized Controlled Trial
- Author
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Lother, Sylvain A, primary, Abassi, Mahsa, additional, Agostinis, Alyssa, additional, Bangdiwala, Ananta S, additional, Cheng, Matthew P, additional, Drobot, Glen, additional, Engen, Nicole, additional, Hullsiek, Kathy H, additional, Kelly, Lauren E, additional, Lee, Todd C, additional, Lofgren, Sarah M, additional, MacKenzie, Lauren J, additional, Marten, Nicole, additional, McDonald, Emily G, additional, Okafor, Elizabeth C, additional, Pastick, Katelyn A, additional, Pullen, Matthew F, additional, Rajasingham, Radha, additional, Schwartz, Ilan, additional, Skipper, Caleb P, additional, Turgeon, Alexis F, additional, Zarychanski, Ryan, additional, and Boulware, David R, additional
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- 2020
- Full Text
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10. Hydroxychloroquine as Pre-exposure Prophylaxis for Coronavirus Disease 2019 (COVID-19) in Healthcare Workers: A Randomized Trial.
- Author
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Rajasingham, Radha, Bangdiwala, Ananta S, Nicol, Melanie R, Skipper, Caleb P, Pastick, Katelyn A, Axelrod, Margaret L, Pullen, Matthew F, Nascene, Alanna A, Williams, Darlisha A, Engen, Nicole W, Okafor, Elizabeth C, Rini, Brian I, Mayer, Ingrid A, McDonald, Emily G, Lee, Todd C, Li, Peter, MacKenzie, Lauren J, Balko, Justin M, Dunlop, Stephen J, and Hullsiek, Katherine H
- Subjects
INTENSIVE care units ,COVID-19 ,HOSPITAL emergency services ,CONFIDENCE intervals ,TREATMENT effectiveness ,RANDOMIZED controlled trials ,BLIND experiment ,HYDROXYCHLOROQUINE ,PREVENTIVE medicine - Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a rapidly emerging virus causing the ongoing coronavirus disease 2019 (COVID-19) pandemic with no known effective prophylaxis. We investigated whether hydroxychloroquine could prevent SARS-CoV-2 in healthcare workers at high risk of exposure. Methods We conducted a randomized, double-blind, placebo-controlled clinical trial of healthcare workers with ongoing exposure to persons with SARS-CoV-2, including those working in emergency departments, intensive care units, COVID-19 hospital wards, and first responders. Participants across the United States and in the Canadian province of Manitoba were randomized to hydroxychloroquine loading dose then 400 mg once or twice weekly for 12 weeks. The primary endpoint was confirmed or probable COVID-19–compatible illness. We measured hydroxychloroquine whole-blood concentrations. Results We enrolled 1483 healthcare workers, of whom 79% reported performing aerosol-generating procedures. The incidence of COVID-19 (laboratory-confirmed or symptomatic compatible illness) was 0.27 events/person-year with once-weekly and 0.28 events/person-year with twice-weekly hydroxychloroquine compared with 0.38 events/person-year with placebo. For once-weekly hydroxychloroquine prophylaxis, the hazard ratio was.72 (95% CI,.44–1.16; P =.18) and for twice-weekly was.74 (95% CI,.46–1.19; P =.22) compared with placebo. Median hydroxychloroquine concentrations in whole blood were 98 ng/mL (IQR, 82–120) with once-weekly and 200 ng/mL (IQR, 159–258) with twice-weekly dosing. Hydroxychloroquine concentrations did not differ between participants who developed COVID-19–compatible illness (154 ng/mL) versus participants without COVID-19 (133 ng/mL; P =.08). Conclusions Pre-exposure prophylaxis with hydroxychloroquine once or twice weekly did not significantly reduce laboratory-confirmed COVID-19 or COVID-19–compatible illness among healthcare workers. Clinical Trials Registration Clinicaltrials.gov NCT04328467. [ABSTRACT FROM AUTHOR]
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- 2021
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11. Anaplasmosis: An emerging tick-borne disease of importance in Canada
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Uminski, Kelsey, primary, Kadkhoda, Kamran, additional, Houston, Brett L., additional, Lopez, Alison, additional, MacKenzie, Lauren J., additional, Lindsay, Robbin, additional, Walkty, Andrew, additional, Embil, John, additional, and Zarychanski, Ryan, additional
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- 2018
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12. Is there a rural/urban gap in the quality of HIV care for treatment-naïve HIV-positive individuals initiating antiretroviral therapy in British Columbia?
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MacKenzie, Lauren J., primary, Hull, Mark W., additional, Samji, Hasina, additional, Lima, Viviane D., additional, Yip, Benita, additional, Zhang, Wendy, additional, Lourenço, Lillian, additional, Colley, Guillaume, additional, Hogg, Robert S., additional, and Montaner, Julio S. G., additional
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- 2017
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13. The Continuum of HIV Care in Rural Communities in the United States and Canada: What Is Known and Future Research Directions
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Schafer, Katherine R., primary, Albrecht, Helmut, additional, Dillingham, Rebecca, additional, Hogg, Robert S., additional, Jaworsky, Denise, additional, Kasper, Ken, additional, Loutfy, Mona, additional, MacKenzie, Lauren J., additional, McManus, Kathleen A., additional, Oursler, Kris Ann K., additional, Rhodes, Scott D., additional, Samji, Hasina, additional, Skinner, Stuart, additional, Sun, Christina J., additional, Weissman, Sharon, additional, and Ohl, Michael E., additional
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- 2017
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14. Safety of Hydroxychloroquine among Outpatient Clinical Trial Participants for COVID-19.
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Lofgren SM, Nicol MR, Bangdiwala AS, Pastick KA, Okafor EC, Skipper CP, Pullen MF, Engen NW, Abassi M, Williams DA, Nascene AA, Axelrod ML, Lother SA, MacKenzie LJ, Drobot G, Marten N, Cheng MP, Zarychanshi R, Schwartz IS, Silverman M, Chagla Z, Kelly LE, McDonald EG, Lee TC, Hullsiek KH, Boulware DR, and Rajasingham R
- Abstract
Introduction: Use of hydroxychloroquine in hospitalized patients with COVID-19, especially in combination with azithromycin, has raised safety concerns. Here, we report safety data from three outpatient randomized clinical trials., Methods: We conducted three randomized, double-blind, placebo-controlled trials investigating hydroxychloroquine as pre-exposure prophylaxis, post-exposure prophylaxis and early treatment for COVID-19. We excluded individuals with contraindications to hydroxychloroquine. We collected side effects and serious adverse events. We report descriptive analyses of our findings., Results: We enrolled 2,795 participants. The median age of research participants was 40 (IQR 34-49) years, and 59% (1633/2767) reported no chronic medical conditions. Overall 2,324 (84%) participants reported side effect data, and 638 (27%) reported at least one medication side effect. Side effects were reported in 29% with daily, 36% with twice weekly, 31% with once weekly hydroxychloroquine compared to 19% with placebo. The most common side effects were upset stomach or nausea (25% with daily, 18% with twice weekly, 16% with weekly, vs. 10% for placebo), followed by diarrhea, vomiting, or abdominal pain (23% for daily, 16% twice weekly, 12% weekly, vs. 6% for placebo). Two individuals were hospitalized for atrial arrhythmias, one on placebo and one on twice weekly hydroxychloroquine. No sudden deaths occurred., Conclusion: Data from three outpatient COVID-19 trials demonstrated that gastrointestinal side effects were common but mild with the use of hydroxychloroquine, while serious side effects were rare. No deaths occurred related to hydroxychloroquine. Randomized clinical trials can safely investigate whether hydroxychloroquine is efficacious for COVID-19.
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- 2020
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15. Hydroxychloroquine as pre-exposure prophylaxis for COVID-19 in healthcare workers: a randomized trial.
- Author
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Rajasingham R, Bangdiwala AS, Nicol MR, Skipper CP, Pastick KA, Axelrod ML, Pullen MF, Nascene AA, Williams DA, Engen NW, Okafor EC, Rini BI, Mayer IA, McDonald EG, Lee TC, Li P, MacKenzie LJ, Balko JM, Dunlop SJ, Hullsiek KH, Boulware DR, and Lofgren SM
- Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a rapidly emerging virus causing the ongoing Covid-19 pandemic with no known effective prophylaxis. We investigated whether hydroxychloroquine could prevent SARS CoV-2 in healthcare workers at high-risk of exposure., Methods: We conducted a randomized, double-blind, placebo-controlled clinical trial of healthcare workers with ongoing exposure to persons with Covid-19, including those working in emergency departments, intensive care units, Covid-19 hospital wards, and first responders. Participants across the United States and in the Canadian province of Manitoba were randomized to hydroxychloroquine 400mg once weekly or twice weekly for 12 weeks. The primary endpoint was confirmed or probable Covid-19-compatible illness. We measured hydroxychloroquine whole blood concentrations., Results: We enrolled 1483 healthcare workers, of which 79% reported performing aerosol-generating procedures. The incidence of Covid-19 (laboratory-confirmed or symptomatic compatible illness) was 0.27 events per person-year with once-weekly and 0.28 events per person-year with twice-weekly hydroxychloroquine compared with 0.38 events per person-year with placebo. For once weekly hydroxychloroquine prophylaxis, the hazard ratio was 0.72 (95%CI 0.44 to 1.16; P=0.18) and for twice weekly was 0.74 (95%CI 0.46 to 1.19; P=0.22) as compared with placebo. Median hydroxychloroquine concentrations in whole blood were 98 ng/mL (IQR, 82-120) with once-weekly and 200 ng/mL (IQR, 159-258) with twice-weekly dosing. Hydroxychloroquine concentrations did not differ between participants who developed Covid-19 (154 ng/mL) versus participants without Covid-19 (133 ng/mL; P=0.08)., Conclusions: Pre-exposure prophylaxis with hydroxychloroquine once or twice weekly did not significantly reduce laboratory-confirmed Covid-19 or Covid-19-compatible illness among healthcare workers.
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- 2020
- Full Text
- View/download PDF
16. The Continuum of HIV Care in Rural Communities in the United States and Canada: What Is Known and Future Research Directions.
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Schafer KR, Albrecht H, Dillingham R, Hogg RS, Jaworsky D, Kasper K, Loutfy M, MacKenzie LJ, McManus KA, Oursler KA, Rhodes SD, Samji H, Skinner S, Sun CJ, Weissman S, and Ohl ME
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- Canada, Humans, Rural Population, United States, Continuity of Patient Care organization & administration, HIV Infections diagnosis, HIV Infections drug therapy
- Abstract
The nature of the HIV epidemic in the United States and Canada has changed with a shift toward rural areas. Socioeconomic factors, geography, cultural context, and evolving epidemics of injection drug use are coalescing to move the epidemic into locations where populations are dispersed and health care resources are limited. Rural-urban differences along the care continuum demonstrate the implications of this sociogeographic shift. Greater attention is needed to build a more comprehensive understanding of the rural HIV epidemic in the United States and Canada, including research efforts, innovative approaches to care delivery, and greater community engagement in prevention and care.
- Published
- 2017
- Full Text
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