「can」の検索結果

This skill recommends transsphenoidal selective adenomectomy (TSS) by an experienced pituitary surgeon as the optimal treatment for Cushing's disease in pediatric and adult patients. Use when a patient with ACTH-dependent Cushing syndrome is a surgical candidate; triggers include overt Cushing's syndrome, elevated UFC or late-night salivary cortisol, and pituitary MRI showing an adenoma.

日本語の概要は準備中です。原文の説明を表示しています。

This skill determines whether confirmatory testing can be omitted after a positive aldosterone-to-renin ratio (ARR) in patients with suspected primary aldosteronism. It is applied when a patient exhibits spontaneous hypokalemia, undetectable renin, and a plasma aldosterone concentration ≥20 ng/dL (550 pmol/L).

日本語の概要は準備中です。原文の説明を表示しています。

Identifies young patients with classic primary aldosteronism features who may proceed directly to unilateral adrenalectomy without adrenal venous sampling based on high probability of unilateral disease. Triggered when a clinician sees a patient <35 years with hypokalemia, unilateral adrenal tumor on CT, and high plasma aldosterone concentration and asks whether AVS can be bypassed.

日本語の概要は準備中です。原文の説明を表示しています。

Determines when adrenal venous sampling (AVS) is indicated for functional subtyping of primary aldosteronism (PA) when surgical treatment is feasible and desired by the patient. Triggered when a clinician confirms PA diagnosis and asks 'Do I need AVS for subtyping?' or evaluates surgical candidacy.

日本語の概要は準備中です。原文の説明を表示しています。

Provides a checklist of five evidence-based measures to enhance the technical success of adrenal venous sampling procedures. Triggers include when preparing for AVS and asking 'How can I maximize success rate?' or troubleshooting failed attempts.

日本語の概要は準備中です。原文の説明を表示しています。

Provides guidance on acceptable blood sampling conditions for primary aldosteronism screening when ideal early‑morning supine fasting conditions cannot be met. Triggers include when a clinician says “The patient wasn’t fasting/supine” or questions whether non‑ideal sampling affects screening validity.

日本語の概要は準備中です。原文の説明を表示しています。

In pregnant women with primary adrenal insufficiency (PAI), the guideline suggests using hydrocortisone over cortisone acetate, prednisolone, or prednisone for glucocorticoid replacement. It recommends against dexamethasone due to its lack of placental inactivation, which can expose the fetus to excess glucocorticoid exposure.

日本語の概要は準備中です。原文の説明を表示しています。

Suggests using morning cortisol ≤140 nmol/L (5 µg/dL) in combination with ACTH as a preliminary test suggestive of primary adrenal insufficiency when a corticotropin stimulation test is not feasible. Use when patients present with indicative symptoms such as hypotension, hyponatremia, hyperkalemia, or fatigue and corticotropin stimulation testing cannot be performed.

日本語の概要は準備中です。原文の説明を表示しています。

Determines whether adrenal venous sampling (AVS) is needed in addition to CT for lateralizing primary aldosteronism before surgery. Trigger phrases include "patient with primary aldosteronism considering surgery", "unilateral adrenal adenoma on CT", "surgical candidate", and "age <35 with hypokalemia and >1‑cm adenoma".

日本語の概要は準備中です。原文の説明を表示しています。

Suggests using a low-dose (1 µg) corticotropin stimulation test to diagnose primary adrenal insufficiency when the standard 250 µg corticotropin is unavailable due to drug shortage. Consider this approach when clinicians encounter a corticotropin shortage or when the standard dose cannot be obtained.

日本語の概要は準備中です。原文の説明を表示しています。

Determines whether to perform adrenal venous sampling (AVS) to lateralize aldosterone excess in patients with confirmed primary aldosteronism (PA) who are being evaluated for surgical treatment. Indicated when surgery is feasible and desired by the patient, or when subtype workup is planned for a surgical candidate, especially in those younger than 35 years with spontaneous hypokalemia, marked aldosterone excess, and unilateral adrenal lesions on CT.

日本語の概要は準備中です。原文の説明を表示しています。

Decide whether a kidney from a brain-dead deceased donor (DBD) with diabetes mellitus and/or hypertension is suitable for transplantation, using the ISOT 2025 Delphi consensus and Table 4 eligibility checklist. Trigger when a clinician asks "can I use a kidney from a diabetic deceased donor", "is this DBD with HTN/DM acceptable", "ECD donor with diabetes — accept or decline", "DBD eligibility for hypertensive donor", or shares a deceased donor with diabetes or hypertension and needs an accept/borderline/decline decision.

日本語の概要は準備中です。原文の説明を表示しています。

In patients with normal preoperative adrenal function, suggests an individualized clinical approach for postoperative glucocorticoid administration until HPA axis evaluation can be performed. Triggers include managing postoperative patient with normal preoperative adrenal function needing glucocorticoid management.

日本語の概要は準備中です。原文の説明を表示しています。

Suggests periodic screening for autoimmune diseases known to be more prevalent in PAI patients in whom autoimmune origin of PAI has not been excluded; optimal frequency unknown but can be done annually. Use when determining screening schedule for PAI patient with uncertain autoimmune origin.

日本語の概要は準備中です。原文の説明を表示しています。

Bedside prescribing reference for Bemdec (bempedoic acid / NEXLETOL) — indication check, dose, statin co-prescribing safety caps, monitoring plan, warnings for hyperuricemia and tendon rupture, and special population guidance. Use when a clinician asks "can I start bempedoic acid", "Bemdec indication", "is bempedoic acid safe with my statin", "patient on Nexletol has joint pain or high uric acid", "bempedoic acid in CKD or liver disease or pregnancy", or any prescribing or monitoring question about bempedoic acid.

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Reconcile baseline-versioned files that the `create-baseline upgrade` CLI staged for LLM-assisted semantic merge. Use when the CLI prints "Open Claude Code and run /upgrade-project to reconcile". Reads the stage manifest at `.claude/state/upgrade/<ts>/manifest.json`, reasons through each pending file's three-way delta in main context, writes a reconciled LOCAL, then deletes the stage when every file lands. Supports `--dry-run` (preview the reconciled diff without writing) and a structured "needs-user-input" fallback when the conflict cannot be disambiguated automatically.

日本語の概要は準備中です。原文の説明を表示しています。

Cycle-end retrospective converting recurring judgment failures into durable enforcement. Reviews the cycle's friction — repeated user corrections, guard trips, RCA themes, integrate failures — and turns each recurring one into a landmines.md entry, then proposes graduation candidates up the enforcement funnel (landmine → advisory hook → hard gate). Pairs with standup: standup says what shipped and what's next; retrospective says what kept going wrong and how to stop it structurally. Writes only memory entries and a report — graduation proposals are advisory and require the normal seed.md amendment path to become enforcement. Invoke at the end of a release cycle, an epic, or any stretch of work with repeated friction.

日本語の概要は準備中です。原文の説明を表示しています。

Bootstrap the central system spec at `docs/system/` for a repository that has never had one. Scans the governed surface, proposes a concept map clustered by directory, and materializes elements + shards ONLY after a human confirms that map. Use when adopting the baseline on an existing project, or when the corpus needs re-deriving from scratch. Re-runnable. Requires `memory.architecture_map.enabled` and a declared `governed_surface`.

日本語の概要は準備中です。原文の説明を表示しています。

Use when the user describes a problem, decision or stuck situation but names no method: "how should I approach this?", "help me think this through", "we can't decide", "where do I start?". Picks the best-fit thinking method and runs it. Skip for plain execution tasks or when a method is named.

日本語の概要は準備中です。原文の説明を表示しています。

Take a markdown file of raw material and shape it into an article through a conversational session — drafting candidate openings, growing the piece paragraph by paragraph, arguing about format (lists, tables, callouts, quotes) at each step. Use when the user has a pile of notes, fragments, or a rough draft and wants help turning it into something publishable.

日本語の概要は準備中です。原文の説明を表示しています。

Extract a DDD-style ubiquitous language glossary from the current conversation, flagging ambiguities and proposing canonical terms. Saves to UBIQUITOUS_LANGUAGE.md. Use when user wants to define domain terms, build a glossary, harden terminology, create a ubiquitous language, or mentions "domain model" or "DDD".

日本語の概要は準備中です。原文の説明を表示しています。

Pre-commit review: security scan, quality gates, auto-fix.

日本語の概要は準備中です。原文の説明を表示しています。

Use when facing 2+ independent tasks that can be worked on without shared state or sequential dependencies

日本語の概要は準備中です。原文の説明を表示しています。

Extract text from PDFs/scans (pymupdf, marker-pdf).

日本語の概要は準備中です。原文の説明を表示しています。