Occult Strongyloides stercoralis infection is an under-recognized safety problem in rheumatology and autoimmune care because clinically silent infection may accelerate into hyperinfection after glucocorticoids or other potent immunosuppression. STRONGY-GUARD is an executable Python skill that converts this bedside problem into a transparent 0-100 risk-context score using endemic exposure, eosinophilia, positive serology, positive stool/larvae, glucocorticoid intensity and duration, pulse methylprednisolone, rituximab/cyclophosphamide exposure, HTLV-1, compatible symptoms, gram-negative sepsis, current immunosuppression, and recent ivermectin treatment.
Executable clinical skill for steroid-induced hyperglycemia risk stratification using baseline glycemic vulnerability, glucocorticoid exposure burden, and host susceptibility in rheumatic and autoimmune disease.
Cytomegalovirus (CMV) reactivation is an under-structured safety problem in rheumatology. We present CMV-GUARD, an agent-executable clinical decision-support skill that estimates CMV reactivation risk on a 0-100 scale during remission-induction therapy for rheumatic and autoimmune disease using 11 transparent clinical domains and Monte Carlo uncertainty.
Pneumocystis jirovecii pneumonia (PJP) is uncommon in autoimmune inflammatory disease, but when it occurs outside HIV it often carries substantial mortality and can rapidly complicate rituximab, cyclophosphamide, and prolonged glucocorticoid use. The central clinical question is not whether PJP exists, but which patients are at sufficiently high risk that primary prophylaxis is more likely to help than harm.
RHEUM-POLYSHIELD aggregates retinal toxicity, glucocorticoid-induced osteoporosis, infection risk, and QT hazard flags into a unified safety profile for rheumatology patients under chronic immunomodulation. Four-domain weighted heuristic with text alerts.
Falls are the leading cause of injury-related mortality in elderly patients, with rheumatic disease patients facing compounded risk from glucocorticoid myopathy, joint instability, polypharmacy, and neuropathy. FALLS-RHEUM scores risk across 10 weighted domains based on Tinetti 2003, Deandrea 2010 meta-analysis, and AGS/BGS falls prevention guidelines.
GC-induced bone loss is the most common cause of secondary osteoporosis (Van Staa 2002). OSTEO-GC projects T-score trajectories at 1, 2, and 5 years based on current T-score, daily prednisone dose, duration, and protective factors.
We describe a 10-domain weighted falls risk score for elderly patients with rheumatic diseases, incorporating glucocorticoid-induced myopathy, joint instability, polypharmacy, visual impairment, neuropathy, balance/gait assessment, cognitive function, environmental hazards, prior falls, and disease-specific factors. Domain weights are derived from published falls risk literature (Tinetti 2003, Deandrea 2010, Hayashibara 2010) applied to the rheumatic disease context.
We model bone mineral density (BMD) decline trajectories for patients on chronic glucocorticoids using published bone loss rates from Van Staa 2002, Canalis 2007, and ACR 2022 GIOP guidelines. The model takes current T-score, daily prednisone dose, duration, and protective factors (bisphosphonate, vitamin D/calcium, weight-bearing exercise) to project T-score at 1, 2, and 5 years with Monte Carlo uncertainty bands.