「recommend」の検索結果

Recommends real-time CGM with confirmatory bedside POC-BG monitoring for insulin dosing adjustments rather than POC-BG testing alone in adults with insulin-treated diabetes at high risk of hypoglycemia. Consider this approach for patients aged ≥65 years, BMI ≤27 kg/m², total daily insulin dose ≥0.6 units/kg, CKD stage ≥3, or recent hypoglycemia.

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Recommends postpartum endocrine care (diabetes management) in addition to usual obstetric care for individuals with preexisting diabetes (including those with pregnancy loss or termination). Triggered by postpartum care planning for patients with diabetes after delivery.

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Recommends contraception when pregnancy is not desired for individuals with diabetes who could become pregnant. Triggered by discussions about pregnancy planning, contraception needs, or when pregnancy is not desired.

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Recommends using continuous glucose monitoring instead of fingerstick self-monitoring for type 1 diabetes patients on multiple daily injections to reduce hypoglycemia risk. Use when a clinician evaluates glucose monitoring options for T1D on MDIs or manages hypoglycemia-prone T1D patients.

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Recommends against routine addition of metformin to insulin for pregnant individuals with type 2 diabetes already on insulin. Triggered when considering adding metformin to an insulin regimen in pregnancy for patients with type 2 diabetes.

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Recommends discontinuation of GLP-1RA before conception rather than between start of pregnancy and end of first trimester for individuals with type 2 diabetes who are planning pregnancy. Trigger when clinician considers stopping GLP-1RA therapy in a patient with type 2 diabetes who is planning pregnancy or seeking preconception care.

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This skill recommends that all patients with Cushing’s syndrome receive monitoring and adjunctive treatment for cortisol-dependent comorbidities including psychiatric disorders, diabetes, hypertension, hypokalemia, infections, dyslipidemia, osteoporosis, and poor physical fitness. Apply when managing any CS patient to address associated health issues; triggers include confirmed or suspected hypercortisolism, preoperative evaluation, postoperative follow‑up, or persistent hypercortisolism despite treatment.

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This skill recommends obtaining an oncology consultation to direct treatment of the underlying malignancy causing hypercalcemia of malignancy. It is triggered when a clinician diagnoses HCM and seeks guidance on coordinating cancer‑directed therapy.

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Recommends additional treatments for patients with persistent overt hypercortisolism after initial surgical intervention for Cushing's syndrome. Trigger phrases include "post-op CS patient shows ongoing hypercortisolism," "persistent overt hypercortisolism after TSS," and "elevated UFC or midnight salivary cortisol following surgery."

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This skill recommends against initiating treatments aimed at normalizing cortisol or its action when only borderline biochemical abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis are present without specific signs of Cushing's syndrome. Use when encountering borderline urinary free cortisol, late-night salivary cortisol, or dexamethasone suppression test results without classic Cushingoid features; triggers include borderline UFC (1-2× ULN), equivocal late-night salivary cortisol, or nondiagnostic low-dose DST.

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This skill recommends against initiating cortisol-lowering treatment when there is no established diagnosis of Cushing's syndrome. It is triggered when a clinician considers treating suspected CS based only on borderline biochemical abnormalities or nonspecific signs without confirmatory testing; examples include "suspected CS", "borderline UFC", "no confirmed diagnosis", "consider empiric ketoconazole".

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This skill recommends discussing and offering age-appropriate vaccinations (influenza, herpes zoster, pneumococcal) to patients with Cushing’s syndrome due to increased infection risk. Use when reviewing preventive care for a CS patient; triggers include discussing preventive care, vaccination status, or infection risk in a CS patient.

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This skill recommends bilateral adrenalectomy for occult or metastatic ectopic ACTH secretion or as a life-preserving emergency treatment in patients with very severe ACTH‑dependent Cushing’s syndrome who cannot be promptly controlled by medical therapy. It is triggered by life‑threatening complications of uncontrolled hypercortisolism such as infection, pulmonary thromboembolism, cardiovascular catastrophe, or acute psychosis.

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This skill recommends discontinuing glucocorticoid when the response to HPA axis recovery tests (morning cortisol, ACTH stimulation, or insulin-induced hypoglycemia) is normal, indicating adequate adrenal function recovery. Use in postoperative Cushing’s syndrome patients with at least one intact adrenal gland when test results are available.

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This skill recommends educating patients and families about the clinical features of remission in Cushing's syndrome when a patient achieves biochemical remission after treatment. Use when a CS patient has postoperative normal cortisol levels, reports symptom improvement, and requires guidance on long-term expectations and monitoring for recurrence.

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This skill recommends obtaining serum free T4 and prolactin levels within 1–2 weeks after transsphenoidal surgery (TSS) for Cushing's syndrome to screen for overt hypopituitarism. Use in postoperative Cushing's syndrome patients during the early recovery window when evaluating for new pituitary hormone deficiencies.

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This skill recommends glucocorticoid replacement and patient education for hypocortisolemic patients after surgical remission of Cushing's syndrome. Use when a postoperative Cushing's patient exhibits low cortisol (e.g., morning cortisol <5 µg/dL) or symptoms of adrenal insufficiency.

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This skill recommends follow-up morning cortisol and/or ACTH stimulation tests or insulin-induced hypoglycemia to assess HPA axis recovery in postoperative Cushing's syndrome patients with at least one intact adrenal gland. Triggers include postoperative remission (morning cortisol <5 µg/dL or UFC <28–56 nmol/d) and the need to evaluate HPA recovery before glucocorticoid discontinuation.

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This skill recommends measuring late-night salivary or serum cortisol to screen for Cushing's disease recurrence in patients with eucortisolism after transsphenoidal surgery, including cases where eucortisolism was established by medical treatment prior to surgery. Use when postoperative follow-up shows eucortisolism (normal morning cortisol/UFC) but concern for recurrence exists.

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This skill recommends lifelong follow-up tests for cardiac myxoma and associated disease (testicular tumors, acromegaly, thyroid lesions) in patients with Carney complex. Use when managing a Cushing’s syndrome patient with a confirmed or suspected Carney complex diagnosis (e.g., spotty skin lentigines, cardiac myxoma, endocrine tumors).

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This skill recommends localizing and resecting ectopic ACTH-secreting tumors with node dissection when ectopic ACTH secretion is suspected or confirmed. Clinical triggers include unexplained persistent hypercortisolism after pituitary surgery, elevated ACTH with negative pituitary MRI, or identification of occult ectopic ACTH syndrome (EAS) on biochemical testing.

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This skill recommends measuring serum cortisol or urine free cortisol off-medication at 6- to 12-month intervals to assess radiation therapy effect in patients with Cushing's syndrome undergoing or post-radiotherapy. It is also indicated when patients on stable medical therapy develop new adrenal insufficiency symptoms such as fatigue, weight loss, or hypotension.

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This skill recommends that a multidisciplinary team, including an experienced endocrinologist, incorporates patient values and preferences while providing education about treatment options for Cushing’s syndrome. Use when planning treatment for a CS patient requiring coordinated care; triggers include persistent hypercortisolism after transsphenoidal surgery, consideration of bilateral adrenalectomy, radiotherapy, or medical therapy, and need for shared decision‑making.

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This skill recommends obtaining a postoperative pituitary MRI within 1–3 months after successful transsphenoidal surgery (TSS) to establish a new baseline for future recurrence assessment. Use when a Cushing’s syndrome patient has achieved biochemical remission post‑TSS and is entering routine follow‑up.

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。