Patient Portal Activation and Use in Hospitalized Children at an Academic Medical Center.

OBJECTIVES: Electronic health records are becoming increasingly common tools for storing and sharing patient health information. Many vendors offer patient "portals" as a way for patients and/or proxies to view test results and communicate with their health care teams. Few researchers have looked at patient portals in the inpatient pediatric population. Our objectives were to describe portal activation and use and factors associated with these end points for hospitalized children. METHODS: Retrospective, single-center study of pediatric patients birth through 17 years old who had at least one hospital admission and one or more inpatient diagnostic test performed between January 1, 2018, to December 31, 2018. Portal use was defined as viewing one or more test result. Multivariate logistic regression analyzed the association between patient characteristics and portal account activation and use. RESULTS: A total of 5862 patients with 170 685 diagnostic test results were included. A total of 40.9% of patients had an activated account, and 20.3% viewed one or more test result. Factors associated with an increased odds of portal activation and/or use included English as preferred language, white race, commercial insurance, multiple admissions, previous outpatient testing, and having both laboratory and imaging inpatient studies performed. CONCLUSIONS: In this study, we highlight the underuse of the patient portal in the inpatient pediatric population, especially for patients whose preferred language is not English, self-identify as multiracial and are publicly insured or uninsured. Concerted efforts to eliminate health care disparities in relation to portal activation are needed.

Data on the relationship between acetone, ethylene glycol, isopropanol, methanol, and propylene glycol serum/plasma concentrations and osmolal gaps in patients at an academic medical center.

Ingestion of toxic alcohols other than ethanol (ethylene glycol, methanol, isopropanol, and propylene glycol) can cause life-threatening complications including altered level of consciousness, respiratory depression, and organ damage from metabolites. Many hospitals lack the ability to specifically analyze these compounds using gas chromatography, gas chromatography/mass spectrometry, or by enzymatic assays for ethylene glycol. Consequently, the presence of these compounds in blood is often ascertained indirectly by laboratory testing for acid-base status, osmolal gap, and anion gap. In the related research article, we analyzed 260 samples originating from 158 unique patients that had osmolal gap and specific testing for toxic alcohols performed on serum/plasma at an academic medical center central clinical laboratory. The data in this article provide the patient demographic, osmolal gap (and associated laboratory tests needed for this calculation), ethanol concentration by enzymatic assay, specific testing for toxic alcohols (ethylene glycol, isopropanol, methanol, propylene glycol) and acetone, anion gap, clinical history, antidotal treatment, and estimated timing of ingestion. The analyzed data is provided in the supplementary tables included in this article. Bias plots of osmolal gap estimations are included in a figure. The dataset reported is related to the research article entitled "Correlation of Osmolal Gap with Measured Concentrations of Acetone, Ethylene Glycol, Isopropanol, Methanol, and Propylene Glycol in Patients at an Academic Medical Center" [1].

Correlation of osmolal gap with measured concentrations of acetone, ethylene glycol, isopropanol, methanol, and propylene glycol in patients at an academic medical center.

The ingestion of toxic alcohols including methanol, ethylene glycol, and isopropanol remains a significant public health problem. These compounds can cause central nervous system depression and, for methanol and ethylene glycol, organ damage from toxic metabolites. The presence of these compounds in serum/plasma can often be determined and monitored by measuring the osmolal gap (OG). However, other compounds originating from endogenous or exogenous sources, such as propylene glycol and acetone, can also increase the OG. Conversion factors can be used to estimate specific concentrations of acetone and toxic alcohols from OG. In this retrospective study, data were analyzed for 260 samples originating from 158 unique patients that had determination of both OG and concentrations for toxic alcohols at an academic medical center central laboratory. Specific analysis included gas chromatography (acetone, isopropanol, methanol, ethylene glycol, propylene glycol) and/or enzymatic assay (ethylene glycol). Many samples also contained ethanol. The data was grouped by type of ingestion. The present study analyzed the relationship between the OG calculated from measured plasma/serum osmolality and the OG estimated by applying conversion factors to measured concentrations of the different compounds. The correlations tend to be linear and vary by compound, with methanol and ethylene glycol having the highest R2 values of 0.93 and 0.95, respectively, consistent with other published studies. Higher variability was seen for the data for isopropanol and acetone. For each of the data subsets, the estimated toxic alcohol concentration calculated using conversion factors from OG tends to overestimate the actual concentration of the compound. Overall, the present study demonstrates the generally linear relationship between OG determined by osmolality and the OG estimated using measured concentrations of acetone and toxic alcohols.

Expert Insights on Triple-Negative Breast Cancer: Preparing for the Next Wave of Treatments.

Heather R. Greene, MSN, FNP, AOCNP®, and Lee S. Schwartzberg, MD, FACP, discussed the current and future treatment landscape for triple-negative breast cancer, including recent and emerging data on approved treatments, novel therapeutic options being investigated, and best practices for identifying and monitoring adverse events associated with PARP and immune checkpoint inhibitors at JADPRO Live 2019.

Collaborative Management of Patients With Estrogen Receptor-Positive Breast Cancer.

Cyclin-dependent kinase (CDK) inhibitors represent a new form of cytotoxic chemotherapy. Advanced practitioners can read this article to find out about the science behind CDK inhibition, when CDKs are indicated, how to monitor for and manage side effects, as well as when and how to dose adjust.