[Satellite center of human milk: Analysis of cost reduction]. / Centro satélite de donación y recepción de leche materna como alternativa a la creación de un banco de leche independiente. Análisis de reducción de costes.

INTRODUCTION: Donor milk is the second best alternative for a newborn after the mother's own milk, especially when the baby is a premature or a sick child since this milk has the advantage of protecting against necrotizing enterocolitis. There are currently 13 milk banks in Spain, however this is not sufficient to supply all Spanish neonatal units with donor milk. In order to bring donor milk to the babies in Neonatal Unit of the Regional University Hospital of Malaga, a Satellite Centre (CS) was created in 2012, depending on the Milk Bank of Virgen de las Nieves Hospital in Granada. AIM: Assessing the efficiency of a SC compared to an independent milk bank. METHOD: A study of cost minimization is used for the analysis. The cost of the implementation of the SC is calculated and compared to the cost of the implementation of the Milk Bank of Virgen de las Nieves of Granada. Additionally, the maintenance cost per year of the 2 models is compared, taking into account the running phase from June, 2012 through August 2015 in the SC. RESULTS: A SC implies savings of 88,852 Euro in equipment, and 24,572 Euro per year in maintenance compared to an independent milk bank. CONCLUSIONS: The efficiency of the SC is due to a better use of resources. A distribution network model of donor human milk, consisting of milk banks and SC, makes it possible to equally supply human milk to premature infants with a reduced cost.

Diagnóstico 'cronológico' en neonatología / Chronological diagnosis in neonatology

Una parte importante de la morbilidad y mortalidad neonatal ocurre en los recién nacidos prematuros, especialmente en los de muy bajo peso. Los acontecimientos que pueden presentar estos niños suelen tener una secuencia temporal, y el conocimiento de las razones que los provocan permite al neonatólogo 'esperar' el problema antes de que ocurra, detectarlo de forma inmediata y, de esta forma, hacer más eficaz el tratamiento. El objetivo de este artículo es mostrar esta secuencia temporal, las razones que la explican y algunas consideraciones terapéuticas al respecto. Obviamente, no pretendemos ser exhaustivos, pero sí didáctivos (formación de nuevos residentes en neonatología). Además, creemos que comprender esta idea tiene importantes implicaciones clínicas para todos los que asistimos a neonatos

A substantinal part of current routine practice in neonatology is focused on premature infants, especially those having a very low birth weight, the group associated with the highest rates of morbidity and mortality. The problems that these children may develop usually follow a temporal sequence. The knowledge of this common pattern enables the clinician to concentrate his attention on each predictable event as it occurs, aiding him in the diagnosis and the treatment of the patient. The aim of this paper is to describe this temporal pattern, the reasons that explain it and some considerations regarding treatment, for possible use as a tool in the training of residents in neonatology. We feel that the understanding of this issue has important implications for all the professionals involved in the care of newborn infants