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Amanda Hempel @amandahempel.bsky.social · Jun 23

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 · Jun 18

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 · Jun 18

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 · Jun 18

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 · Jun 18

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 · Jun 18

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 · May 19

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 · May 16

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 · May 16

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 · May 16

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 · May 16

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 · May 9

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

Tim Onion @bencollins.bsky.social · May 4

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 · May 2

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.

Amanda Hempel @amandahempel.bsky.social · May 2

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 · May 2

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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Reposted by Amanda Hempel

Andrew Pavia @andrewpaviamd.bsky.social · May 1

#IDSky You may have seen this declaration by the editors of some of our leading ID journals. It is a strong and important statement of principal. academic.oup.com/cid/advance-...

Scientific Integrity Under Threat: The Role of the IDSA, PIDS, and SHEA Journals in an Evolving Political Landscape

The landscape of scientific publishing, education, and healthcare research is facing unprecedented challenges as political decisions increasingly encroach

academic.oup.com

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Amanda Hempel @amandahempel.bsky.social · May 1

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.

Amanda Hempel @amandahempel.bsky.social · Apr 30

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

Amanda Hempel @amandahempel.bsky.social · Apr 30

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 · Apr 30

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

Amanda Hempel @amandahempel.bsky.social · Apr 29

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

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Amanda Hempel @amandahempel.bsky.social · Apr 29

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 · Apr 29

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 · Apr 29

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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