Biomonitoring bisphenols, parabens, and benzophenones in breast milk from a human milk bank in Southern Spain.

BACKGROUND: Human breast milk is considered the optimal source of nutrition for infants. Milk from breast milk banks offers an alternative to infant formulas for vulnerable hospitalized neonates most likely to benefit from exclusive human milk feeding. However, breast milk can also be a source of exposure to environmental contaminants, including endocrine-disrupting chemicals (EDCs). AIM: To evaluate concentrations of phenolic EDCs, including bisphenols, parabens (PBs), and benzophenones (BPs), in samples from a human milk bank in Granada, Southern Spain and to explore sociodemographic, reproductive, and lifestyle factors related to their concentrations in the milk. METHODS: Concentrations of three bisphenols [bisphenol A (BPA), bisphenol F (BPF), and bisphenol S (BPS)], four PBs [methyl- (MeP), ethyl- (EtP), propyl- (n-PrP), and butyl-paraben (n-BuP)], and six BPs [BP-1, BP-2, BP-3, BP-6, BP-8, and 4-hydroxy-BP] were determined in milk samples from 83 donors. Information on potential explanatory variables was gathered using the milk bank donor form and an ad hoc questionnaire. Multiple linear and logistic regression models were fitted. RESULTS: Detectable concentrations were found of at least one of the analyzed compounds in all donor breast milk samples and at least five compounds in one-fifth of them. The most frequently detected compounds were MeP (90.5%), BP-3 (75.0%), EtP (51.2%), n-PrP (46.4%), and BPA (41.7%). Median concentrations ranged between <0.10 ng/mL (n-PrP, n-BuP, BP-1) and 0.59 ng/mL (BP-3). No sample contained detectable concentrations of BPF, BPS, or most BPs (BP-2, BP-6, BP-8, and 4- hydroxy-BP). Breast milk phenol concentrations were associated with parity, the utilization of deodorants, mouthwash, skin care products, and cosmetics, and the intake of nutritional supplements. CONCLUSIONS: Results reveal the widespread presence of BPA, PBs, and BP-3 in donor breast milk samples, highlighting the need for preventive measures to enhance the benefits of breast milk from milk banks and from breastfeeding women in general.

[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.

Transfusión de plaquetas en el recién nacido / Platelet transfusion in the newborn

La trombocitopenia (cifra de plaquetas inferior a 150 x 10 Elevado a 9/L) es uno de los problemas hematológicos más frecuente en los recién nacidos, sobre todo en los prematuros enfermos. El objetivo de este trabajo es realizar un revisión de la práctica transfusional y de los tipos de preparados disponibles para la transfusión de plaquetas en el neonato. Existen tres métodos diferentes para obtener concentrados de plaquetas. Hasta 2007 los concentrados de plaquetas se obtenían a partir de plasma rico en plaquetas de sangre total.En la actualidad, se producen a partir de sangre total, mezclando los buffy-coat, o capa leucoplaquetaria, de 4-5 donantes (CPB). El otro método de obtención de concentrados de plaquetas es la plaquetoaféresis (CPA).En cuanto a eficacia, los CPB y CPA contienen una concentración similar de plaquetas (incluso podría ser superior en los CPB). Los estudios comparativos han mostrado una cierta equivalencia terapéutica en los incrementos plaquetarios postransfusionales y efectos hemostáticos. La seguridad infecciosa en medicina transfusional es actualmente altísima. Además, ambos productos están leucorreducidos, y no existen diferencias significativas en cuanto a la capacidad de aloinmunización HLA. Por otra parte, mantener componentes CPA y alícuotas de éstos para asegurar un soporte plaquetario en pediatría, con todos los grupos sanguíneos, implicaría inevitablemente un alto índice de caducidad. Podemos concluir que los concentrados de plaquetas CPB son los más adecuados para nuestros neonatos. Los CPA serían la primera opción tan sólo en los pacientes con trombocitopenia resistente por aloinmunización HLA (AU)

Thrombocytopenia (platelet count lower than 150 x 10 to elevate 9/L) is one of the most frequent hematological issues in the newborn, especially in the premature infant. The aim of this work is to perform a review of transfusion practice and the types of preparations available for the newborn platelet transfusion. There are three different methods to obtain platelets for transfusion. Until the year 2007 they were obtained from platelet rich plasma of whole blood. Nowadays they are produced from whole blood as well, but mixing the buffy coats of four or five donors (APC). The other method used is of the platelets concentrations by platelets can also be apheresis (PCB).In terms of effectiveness, platelet concentrates APC and PCB offer a similar number of platelets, even higher in APC. Comparative studies have shown therapeutical equivalence in terms of post transfusion platelet increase and hemostatic effects. From an infectious point of view, security in transfusion medicine is quite high nowadays. What is more, both products are leukocyte depleted, and there are no significative differences in the capacity to induce HLA alloimmunization. On the other hand, storing enough PCB concentrates for all the blood groups in pediatrics would imply high losses due to short expiration dates. We can conclude that APC platelet concentrates are the most adequate for our neonates. PCB would be the first option only in patients with refractory thrombocytopenia associated with HLA alloimmunization (AU)

[Lactate dehydrogenase isoenzymes in the serum and bronchial aspirate of newborn infants with respiratory difficulty of different etiologies]. / Isoenzimas de lactato deshidrogenasa en el suero y aspirado bronquial de recién nacidos con dificultad respiratoria de etiología diversa.

OBJECTIVE: To study the usefulness of lactate dehydrogenase isoenzymes serum determination as tissue injury markers in newborns with respiratory distress. DESIGN AND METHODS: Ninety four neonates were studied and classified in two groups: 64 suffering various types of respiratory problems, and 30 healthy newborns of a similar birth weight and gestational age. LDH activity and its isoenzymes was determined in the serum of all the infants and in 23 samples of the bronchial aspirate of infants who required ventilation support. The isoenzymes were separated by electrophoresis on agarose gel and their activity was expressed as percentage of the total LDH. RESULTS: LDH1 and LDH2 isoenzymes were decreased, and LDH4 and LDH5 isoenzymes were significantly increased (p > 0.001) in infants serum with respiratory distress, compared with controls. We compared LDH isoenzymes values found in bronchial aspirate with their values found in serum of ventilate infants, and we found a significant levels of LDH2 and LDH3 were lower, and those of LDH5 were higher (p < 0.001) in bronchial aspirate than in serum and a positive correlation (r = 0.47, p < 0.01) between LDH5 values in both samples. CONCLUSIONS: The study shows significantly differences in the LDH isoenzyme profiles of neonates with respiratory distress compared with controls. The increase in serum of LDH4 and particularly of LDH5 isoenzymes could be an effective marker of tissue damage in lung disease in the newborn.