Monitoring parameters for patients receiving long-term home parenteral nutrition (HPN) should include assessment of micronutrient status to avoid deficiencies and potential excesses of any micronutrient. This evaluation examined the effectiveness of a standardized micronutrient assessment tool administered semiannually to long-term HPN consumers, for identifying signs/symptoms of a suspected deficiency or excess. All patients assessed were receiving long-term HPN from a single home-infusion provider. Of the 275 micronutrient assessments evaluated, 30 patients were found to have a suspected deficiency. Laboratory tests were ordered for 13 patients: deficiencies were confirmed in 6 patients, no deficiency was found in 4 patients, and 1 patient was not deficient in the suspected micronutrients but was found deficient in others. The micronutrient assessment tool is effective in determining the suspected presence of micronutrient deficiencies. All long-term HPN patients should receive ongoing monitoring by a home care clinician, including an assessment of micronutrient status, to ensure adequacy of the nutrition support regimen.

Although there are many effective medications for topical treatment of skin eruptions, the addition of a new therapeutic agent is welcome. The application of external medications directly and repeatedly to skin lesions is one of the most important measures in treating dermatoses. The efficacy of such ointments or lotions can be evaluated readily by objective critical and comparative observations.'One of the prerequisites of an acceptable topical medicament is that it cause no primary irritation or sensitization. From clinical reports2. we judged Triburon worthy of investigation in a pediatric dermatological practice. One hundred patients were studied by use of covered patch tests, and Triburon was found to be not a primary irritant. In paired-comparison studies on 38 patients it was shown to be effective, clearing widespread impetigo within 5 days3 In studies in which Triburon was used for a wide variety of skin eruptions, results were excellent?, Another aspect to be considered in pediatric practice is the possible ingestion of any topically applied agent. While no human tolerance studies are reported (Triburon is not a systemic drug), in rats and mice oral lethal doses were as high as 375 to 400 mg./kg.; in dogs, lethal doses could not be determined, since a dose of 20 mg./kg. produced emesis! I t can be assumed from these studies that the probability of internal toxicity in children would be slight. The amount of ointment sucked from the affected skin would be inconsequential and, if a large quantity were ingested, emesis would probably result.In the study reported here we used Triburon both with hydrocortisone and plain, in a Carbowax base. The rationale for hydrocortisone is that it is a potent anti-inflammatory and antipruritic agent that produces fast, if temporary, improvement.6 I t has no antibacterial activity. Methods and MaterialsThe group under study comprised 52 patients with dermatological disorders, 39 of whom were children. Twenty-eight suffered with eczematous conditions, some of which were complicated by secondary infection, while the remaining 24 could be characterized roughly as exhibiting primary or secondary pyodermas. The former were treated with Triburon and 0.5 per cent hydrocortisone, while the latter received the Triburon (plain) medication.Group 1 consisted of 13 males and 15 females, whose age ranged from 33.5 months to 77 years. Group 2 consisted of 11 males and 13 females, with an age range of 4 months to 40 years. In the pyodermal group all but 2 patients * Triburon, Hoffmann-La Roche. 141