iiinova — where your digital self keeps evolving

Amanda Hempel @amandahempel.bsky.social · 13/11/2025

Finally we have an app with Canadian specific antibiotic guidelines...clinicians can access free and easy-to-use recommendations for common conditions actually targeted towards Canadian setting and resistance patterns. Partnership between AMMI, PHAC and Firstline. firstline.org/canada/

firstline.org

Canadian Antibiotic Treatment Guidance

Localized Clinical Decisions Platform for ID and Antimicrobial Stewardship

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Amanda Hempel @amandahempel.bsky.social · 22/10/2025

Everyone thinks we need to reduce the ridiculous number of hospital cyber security modules, but personally I think we should allowed to delegate them to grandparents who fall for a phishing scheme at least once a month.

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Amanda Hempel @amandahempel.bsky.social · 23/06/2025

Its considered lifelong. Some high risk individuals they recommend q10 years. Its hard to say for sure because it is rare, so hard to study.

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Amanda Hempel @amandahempel.bsky.social · 18/06/2025

Having now seen a couple of cases, I am finding "unpasteurized milk" is now rapidly rising on my list of exposures to ask most ID patients 🫠

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Amanda Hempel @amandahempel.bsky.social · 18/06/2025

Inefficient infrastructure costs lives. It's not as sexy as investing in gene therapy research or new transplant treatments and other groundbreaking medical discoveries that every donor or politician wants their name on, but would have so much greater impact on improving healthcare for everyone.

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Amanda Hempel @amandahempel.bsky.social · 18/06/2025

Instead you have to look up nearby specialists online. *Fax* referral to the first one. Not in their niche scope? No clinic? Not accepting new referrals? Try someone else. Found one! But didn't know that physician 1 km further had half the wait list.

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Amanda Hempel @amandahempel.bsky.social · 18/06/2025

Ontario is a single payer system under 1 regulatory body. We could easily create a universal referral system where you could search for specialists by area, identify their scope, and determine who has the shortest wait times and send/receive referrals, all through one electronic system.

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Amanda Hempel @amandahempel.bsky.social · 18/06/2025

The most frustrating part of healthcare is that while we create incredibly advanced treatments, we never invest in infrastructure to effectively deliver care. We can use lasers, robots and brain implants to treat you, but your family doc needs to use Google, fax and a prayer to refer you there.

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Amanda Hempel @amandahempel.bsky.social · 19/05/2025

If you think your patient has pulmonary edema but are giving them Piptazo "just in case", just remember it's like turning on three faucets in an already overflowing sink.

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Amanda Hempel @amandahempel.bsky.social · 16/05/2025

Yeah exactly! Useful if you know what you're looking for and can spot mistakes/incorrect generalizations or read primary material. (once tried to ask for susceptibility data on specific rare organism and it said it should be susceptible to cefazolin because "cefazolin covers gram positives" 🫠🫠🫠)

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Amanda Hempel @amandahempel.bsky.social · 16/05/2025

I tried open evidence because I do a lot of lit searches for unusual ID consults. And alarmed at how it manages some ID questions unless super specific about what you want. If you don't have the expertise to recognize what it's saying doesnt make sense or references are off, you can be very misled.

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Amanda Hempel @amandahempel.bsky.social · 16/05/2025

My biggest fear is people (including physicians) blindly depending on AI programs without recognizing how small changes in the prompt can make big changes in the answers, and lacking the expertise or will to critically examine what it tells you. #AI #meded

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Amanda Hempel @amandahempel.bsky.social · 16/05/2025

First experience of another physician trying to refute my specialist recommendation based on something they looked up on OpenEvidence...because they didn't realize they didn't give enough context to properly answer the question. AI can be a useful tool but it remains totally dependent on the user

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Amanda Hempel @amandahempel.bsky.social · 09/05/2025

I like to refer to ID detention when you order meropenem "just in case" in the patient you have clearly diagnosed with pulmonary edema.

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Reposted by Amanda Hempel

Ben Collins @bencollins.bsky.social · 04/05/2025

It is a little weird to me countries aren’t more aggressively, formally trying to take advantage of the U.S. science brain drain. Once in a lifetime opportunity to buy low on Non-Dumbass Americans with PhDs who just wanna look into microscopes and quietly cure ass cancer as our country eats shit.

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Amanda Hempel @amandahempel.bsky.social · 02/05/2025

This isn't just politics. It's everywhere. One of the most frustrating things in public health during COVID was seeing "pro-public health/science" people undermining actual public health efforts by insulting/belittling healthcare hesitant people and creating further distrust.

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Amanda Hempel @amandahempel.bsky.social · 02/05/2025

The problem is we default to really ineffective methods that make things worse. OR when people do change, we reject them for past sins. His point here is if you want change, you are either going to have change people's minds AND accept them when they do, or you're going to have to eliminate them.

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Amanda Hempel @amandahempel.bsky.social · 02/05/2025

I think you're missing the point. He isn't saying "let them be bigoted and spread that bigotry around". What he is saying is "let's try find effective ways to change their minds" If you want to create societal change, you need to some people who currently not on your side to become on your side

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Amanda Hempel @amandahempel.bsky.social · 01/05/2025

However this methodology seems absolutely insane. So many assumptions, so many corrections for missing info, so many indirect measurements...I have no doubt the number of people receiving correct treatment is low. But I have very little confidence in these specific numbers.

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Amanda Hempel @amandahempel.bsky.social · 30/04/2025

Mentally preparing to see the fundraising foundation slap this on everything we produce.

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Amanda Hempel @amandahempel.bsky.social · 30/04/2025

Second time I have heard of an unusual leptospirosis infection only diagnosed with genomics. Leptospirosis is rarely cultured. Generally diagnosed on serology or PCR which means they have to had suspicion for it. At least from the story given here, I would not have thought of lepto .

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Amanda Hempel @amandahempel.bsky.social · 30/04/2025

Since when is doxycycline not effective in 20% of patients?? That is not true.

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Amanda Hempel @amandahempel.bsky.social · 29/04/2025

I am also very curious what the distribution would be under a ranked ballot system

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Amanda Hempel @amandahempel.bsky.social · 29/04/2025

This is another one of the sad cases of vote splitting. 57% of votes went to Liberals+NDP. But the split meant the Cons 38% is the plurality. A lot of the flipped conservative seats happened this way. People didn't vote them in so much as failed their attempt to strategically vote them out

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Amanda Hempel @amandahempel.bsky.social · 29/04/2025

Everytime I see Americans proudly talking about people waiting hours in line to vote, i think about the fact I have never waited longer than 5 minutes to vote. I am impressed at their dedication to overcoming voter suppression. But very grateful we don't have that experience.

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Amanda Hempel @amandahempel.bsky.social · 29/04/2025

I sincerely hope not. Poilievre is not good for Canada. Carney was the smart choice and I look forward to seeing what he does. Hopefully the conservatives will drop the populist act now that it has failed them yet again.

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Amanda Hempel @amandahempel.bsky.social · 29/04/2025

This is not the case. The party chooses the leader. And typically in Canadian politics, if you are a major party leader and lose an election, you lose the leadership. Although the cons gained ground, fumbling such a major lead will be seen as Polievre's fault. He was not liked by Canadians

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Amanda Hempel @amandahempel.bsky.social · 29/04/2025

The 2-level left-wing vote split makes every election unpredictable and turns voting into a strategy game 🫠 I think about this everytime I hear Americans say they want to get rid of your 2 party system. Make sure you aren't the only side that splits!

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Amanda Hempel @amandahempel.bsky.social · 25/04/2025

Amongst the most pathetic failures of our time? We had the tools to eliminate, get 90% of the way there and then just...stop using it.

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Amanda Hempel @amandahempel.bsky.social · 25/04/2025

Coffee plantation! It's one of those ID buzzwords...if you see a question about a south or central american Coffee farmer on an exam, the answer is probably paracocci.

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Amanda Hempel @amandahempel.bsky.social · 25/04/2025

Agree! Oral should be default, particularly for longer courses. Only 4 indications for IV 1. No oral options 2. Need for speed 3. Unable to swallow/absorb 4. Social factors that make IV preferable

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Amanda Hempel @amandahempel.bsky.social · 25/04/2025

The most impressive part of this study is that they found enough PCR confirmed Whipple's disease to do a study

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Amanda Hempel @amandahempel.bsky.social · 25/04/2025

The oral only therapy in this study is NOT Bactrim specifically because of risk of developing resistance. They used Doxycycline + HCQ for 12m, and only added Bactrim if cns disease (stopped once csf cleared).

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Reposted by Amanda Hempel

Stanford Antimicrobial Safety & Sustainability Program @stanfordasp.bsky.social · 09/04/2025

🌟 ABX Pearl of the Day: "static" vs "cidal" ABX💊 ❓ Q: I am treating an MSSA abscess with TMP/SMX. This is a “static” antibiotic - should I switch to a “cidal” agent like cephalexin? #IDsky #medsky #meded #pharmsky #skyRX

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Amanda Hempel @amandahempel.bsky.social · 10/04/2025

Cheese is more expensive in canada than the US - the downside of our supply management system. This resulted in market for a literal CHEESE smuggling ring at our border. So yes. If prices are higher or supply lower on one side of a border than the other, it will create a market for smuggled goods.

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Reposted by Amanda Hempel

The Ferrari Lab @theferrarilab.bsky.social · 06/04/2025

A second child, an 8 yo girl, has died of measles in Texas. Some have asked "could this actually be RFK Jr's or Trump's fault? They've barely been in charge. Vaccination has been falling since before". It's a valid question, with a clear answer. Yes. They have ignored the standard of care 1/

nytimes.com

A Second Child Dies of Measles in Texas

It is the second confirmed measles death in the U.S. in a decade. If the outbreak continues at the current pace, the nation may lose its “elimination” status.

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Amanda Hempel @amandahempel.bsky.social · 31/03/2025

"No signs of infection, two weeks keflex given for anti-pruritis" 🫠 You know sometimes it really is the little things that hurt in ID

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Amanda Hempel @amandahempel.bsky.social · 06/03/2025

Who was teaching that the lungs or urinary tract were sterile 😱😱

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Amanda Hempel @amandahempel.bsky.social · 01/03/2025

This is...so dumb? It's not like they are saving themselves money.

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Amanda Hempel @amandahempel.bsky.social · 26/02/2025

These are called zoonotic infections. This isnt new but there are several things increasing risk now. Changes in climate, habitat destruction and human agricultural/market practices are forcing more frequent interaction amongst different species, fostering more chances for these "jumps" to occur

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Amanda Hempel @amandahempel.bsky.social · 26/02/2025

Over time, this forms are special relationship where the microbe and host evolve to co-exist But when a microbe "jumps" to a new species that hasnt had this protective co-evolution, the new host is susceptible to severe illness. That's why infections that suddenly spread to humans are so serious

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Amanda Hempel @amandahempel.bsky.social · 26/02/2025

It's not about a "better" immune system than humans, it's just different. Infectious microbes evolve alongside their host. A healthy host is better for microbes (to keep carrying and spreading the bug). So the microbe evolves to cause minimal harm to host and the host evolves to protect itself.

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Amanda Hempel @amandahempel.bsky.social · 26/02/2025

No one warns you when you agree to work on random case reports in medical school that you will spend the rest of your life declining requests to peer review in a field you no longer have anything to do with.

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Reposted by Amanda Hempel

Anthony Lau, PharmD BCPS @alaurx.bsky.social · 21/02/2025

Still get asked about Paxlovid for covid at times. Most pts don’t need it especially post-vaccination. EPIC-SR trial showed no significant benefit in reducing hospitalizations or deaths. With lower covid morbidity & immunity from vaccines & different strains, Paxlovid offers little to no benefit☹️ 1/

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Reposted by Amanda Hempel

Isaac Bogoch @isaacbogoch.bsky.social · 01/02/2025

To our American friends who may now be struggling to find health information on US websites: Please check out the Public Health Agency of Canada's website for helpful resources, updated dashboards & practical health tips. 🇨🇦🇨🇦🇨🇦 canada.ca/en/public-he...

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Amanda Hempel @amandahempel.bsky.social · 20/02/2025

@idsky.bsky.social How do we boost the profile of ID amongst the public to understand what we really do? Most people I speak to think we just deal with epidemics. What are places doing to put a united face of ID expertise out to the public?

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Amanda Hempel @amandahempel.bsky.social · 19/01/2025

Yes! I think BPaLM for MDR and BPaL for pre-XDR would be the standard. But I believe some increasing resistance to BPaLM already being seen in high burden areas 😔

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