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  1. Article ; Conference proceedings: Multisystem Inflammatory Syndrome in Children” (MIS-C) after COVID-19 infection in the Metropolitan Area Nuremberg-Erlangen with a case of MIS-C like disease following SARS-CoV-2 mRNA vaccination

    Hébert, Steven / Schmidt, Marius / Wallukat, G / Ponader, R / Topf, Georg / Rieger, Daniel / Klinge, Jens / Vermehren, J / Fusch, Christoph / Grillhoesl, C / Schroth, Michael / Krickau, Tobias / Toni, I / Reutter, Heiko / Morhart, Patrick / Hanslik, Gregor / Mulzer, Linda / Woelfle, Joachim / Agaimy, A /
    Hohberger, Bettina / Hoerning, André

    Zeitschrift für Geburtshilfe und Neonatologie

    2023  Volume 227, Issue 03

    Event/congress Abstracts zur 49. Jahrestagung der Gesellschaft für Neonatologie und Pädiatrische Intensivmedizin (GNPI), Hamburg, 2023-06-15
    Language English
    Publishing date 2023-06-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 1226748-x
    ISSN 1439-1651 ; 0948-2393 ; 0300-967X ; 1615-5300
    ISSN (online) 1439-1651
    ISSN 0948-2393 ; 0300-967X ; 1615-5300
    DOI 10.1055/s-0043-1769326
    Database Thieme publisher's database

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  2. Article: "Multisystem Inflammatory Syndrome in Children" (MIS-C) after COVID-19 Infection in the Metropolitan Area of Nuremberg-Erlangen, Germany-Expectations and Results of a Two-Year Period.

    Hébert, Steven / Schmidt, Marius / Topf, Georg / Rieger, Daniel / Klinge, Jens / Vermehren, Jan / Fusch, Christoph / Grillhösl, Christian / Schroth, Michael / Toni, Irmgard / Reutter, Heiko / Morhart, Patrick / Hanslik, Gregor / Mulzer, Linda / Woelfle, Joachim / Hohberger, Bettina / Hoerning, André

    Children (Basel, Switzerland)

    2023  Volume 10, Issue 8

    Abstract: Background: Multisystemic Inflammatory Syndrome in children (MIS-C) is a rare autoimmune disorder ... occurring after a latency period following acute SARS-CoV-2 infection. The therapeutic regime of MIS-C is ... to gain further knowledge about MIS-C. Thus, we aimed to investigate the incidence, symptoms ...

    Abstract Background: Multisystemic Inflammatory Syndrome in children (MIS-C) is a rare autoimmune disorder occurring after a latency period following acute SARS-CoV-2 infection. The therapeutic regime of MIS-C is adapted to the therapy of the Kawasaki disease, as clinical symptoms are similar. Since the Kawasaki disease can potentially result in severe symptoms, which may even affect long-term health, it is essential to gain further knowledge about MIS-C. Thus, we aimed to investigate the incidence, symptoms, therapeutical procedure and outcome of MIS-C patients in the metropolitan area of Nuremberg-Erlangen during the SARS-CoV2 pandemic.
    Material and methods: Retrospective analysis of clinical charts of MIS-C patients was carried out at three children's hospitals covering the medical care of the metropolitan area of Nuremberg-Erlangen in Germany. Demographic characteristics and symptoms at first visit, their clinical course, therapeutic regime and outcome were recorded within the time period January 2021-December 2022.
    Results: Analysis of 10 patients (5 male, 5 female) with MIS-C resulting in an incidence of 2.14/100.000 children. The median time between COVID-19 infection and admission to hospital was 5 weeks. The median age was 7 years. Symptoms comprised fever (100%), rash (70%), bilateral non-purulent conjunctivitis (70%) and urticaria (20%). At the time of presentation, diagnosis-defining inflammation parameters were increased and the range for C-reactive protein was 4.13 mg/dL to 28 mg/dL, with a median of 24.7 mg/dL. Procalcitonin was initially determined in six patients (1.92 ng/mL to 21.5 ng/mL) with a median value of 5.5 pg/mL. Two patients displayed leukocytosis and two displayed leukopenia. None of the patients presented coronary pathologies. Nine of the ten patients received intravenous immunoglobulin (IVIG) therapy. In addition, patients received intravenous steroids (80%) and acetylsalicylic acid (80%).
    Conclusion: SARS-CoV virus may rarely exert multiorgan manifestations due to hyperinflammatory immunological processes. Within two years of the COVID-19 pandemic, we identified ten patients with COVID-induced MIS-C in the metropolitan area Nuremberg-Erlangen. In the description of the patient collective, we can confirm that MIS-C is distinguished from the Kawasaki disease by the lack of coronary manifestations. Interestingly, although having monitored all pediatric facilities in the investigated area, we find lower incidences of MIS-C compared to findings in the literature. In conclusion, an overestimation of incidences in the upcoming MIS-C during the pandemic needs to be considered.
    Language English
    Publishing date 2023-08-09
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2732685-8
    ISSN 2227-9067
    ISSN 2227-9067
    DOI 10.3390/children10081363
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  3. Article ; Online: [Agua, sodio, potasio y cloruro].

    Fusch, Christoph

    World review of nutrition and dietetics

    2022  Volume 122, Page(s) 110–129

    MeSH term(s) Humans ; Potassium ; Water
    Chemical Substances Water (059QF0KO0R) ; Potassium (RWP5GA015D)
    Language Spanish
    Publishing date 2022-09-29
    Publishing country Switzerland
    Document type Journal Article ; Review
    ISSN 1662-3975 ; 0512-3593 ; 0084-2230
    ISSN (online) 1662-3975
    ISSN 0512-3593 ; 0084-2230
    DOI 10.1159/000526501
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  4. Article ; Online: Water, Sodium, Potassium, and Chloride.

    Fusch, Christoph

    World review of nutrition and dietetics

    2021  Volume 122, Page(s) 103–121

    MeSH term(s) Chlorides ; Humans ; Potassium ; Potassium Chloride ; Sodium ; Water
    Chemical Substances Chlorides ; Water (059QF0KO0R) ; Potassium Chloride (660YQ98I10) ; Sodium (9NEZ333N27) ; Potassium (RWP5GA015D)
    Language English
    Publishing date 2021-08-05
    Publishing country Switzerland
    Document type Journal Article ; Review
    ISSN 1662-3975 ; 0512-3593 ; 0084-2230
    ISSN (online) 1662-3975
    ISSN 0512-3593 ; 0084-2230
    DOI 10.1159/000514770
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  5. Article ; Online: Avoiding Postnatal Growth Retardation by Individualized Fortification of Breast Milk: Implications for Somatic and Neurodevelopmental Outcomes.

    Fusch, Christoph

    Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine

    2019  Volume 14, Issue S1, Page(s) S15–S17

    MeSH term(s) Breast Feeding ; Child Development/physiology ; Food, Fortified ; Growth Disorders/etiology ; Growth Disorders/prevention & control ; Humans ; Infant, Newborn ; Infant, Premature/growth & development ; Infant, Premature, Diseases/etiology ; Infant, Premature, Diseases/prevention & control ; Milk, Human/chemistry ; Nutrients/administration & dosage
    Language English
    Publishing date 2019-03-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2234680-6
    ISSN 1556-8342 ; 1556-8253
    ISSN (online) 1556-8342
    ISSN 1556-8253
    DOI 10.1089/bfm.2019.0031
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  6. Article ; Online: Donor Milk Banking - Safety, Efficacy, New Methodologies.

    Fusch, Christoph / Gebauer, Corinna

    Nestle Nutrition Institute workshop series

    2022  Volume 96, Page(s) 57–71

    Abstract: ... but high-pressure pasteurization or ultraviolet C irradiation conserve the unique properties of DM better and ... c) additional supplementation using 0.3-0.5 g protein/100 mL seems to be reasonable, (d) adjusted ...

    Abstract Donor milk (DM) is of increasing interest as primary nutritional source for preterm infants. Safe access requires special infrastructure, trained staff, sophisticated algorithms, and standard operating procedures as well as quality control measures. DM has limitations like low protein content and unpredictable composition of the other macronutrients, despite fortification frequently not meeting recommendations - both of them compromising growth. The first paragraph is devoted to COVID-19 and how it impacts processes of DM banking. The following paragraphs review aspects of "pasteurization," "safety audits/donor screening," and "DM nutrient variability." In summary, (i) Holder pasteurization still is the most suitable procedure for milk banks, but high-pressure pasteurization or ultraviolet C irradiation conserve the unique properties of DM better and deserve more research to make it suitable for clinical routine. (ii) In regard to safety/screening, guidelines are valuable for safe DM bank operation, but they differ between legislations. There is a surprisingly high rate of non-disclosed donor smoking (0.3%, p > 0.05) and of adulteration of delivered DM (up to 2%, p < 0.05) not detected by standard donor screening procedures. Frequencies differ between remunerated and non-remunerated programs. (iii) Neonatal caregivers should be aware of unpredictable composition of DM. They should be trained on how these can be overcome to avoid negative impact on growth and long-term outcomes like (a) measuring and disclosing nutrient contents of delivered DM batches to customers, (b) implementing certain types of donor pooling to reduce the risk of macronutrient depleted DM, (c) additional supplementation using 0.3-0.5 g protein/100 mL seems to be reasonable, (d) adjusted fortification may help to improve growth, but is not efficient in all preterm infants, (e) target fortification seems to improve growth (and probably also neurodevelopmental index) compared to standard fortification, (f) more research and clinical studies are needed.
    MeSH term(s) COVID-19 ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Milk Banks ; Milk, Human/chemistry ; Pasteurization/methods
    Language English
    Publishing date 2022-05-10
    Publishing country Switzerland
    Document type Journal Article ; Review
    ISSN 1664-2155
    ISSN (online) 1664-2155
    DOI 10.1159/000519400
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  7. Article ; Online: Reply - Letter to the Editor -Individualized target fortification of breast milk with protein, carbohydrates, and fat for preterm infants.

    Rochow, Niels / Fusch, Christoph

    Clinical nutrition (Edinburgh, Scotland)

    2021  Volume 40, Issue 4, Page(s) 1463–1466

    MeSH term(s) Carbohydrates ; Female ; Food, Fortified ; Humans ; Infant ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Infant, Premature ; Milk, Human
    Chemical Substances Carbohydrates
    Language English
    Publishing date 2021-02-25
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 604812-2
    ISSN 1532-1983 ; 0261-5614
    ISSN (online) 1532-1983
    ISSN 0261-5614
    DOI 10.1016/j.clnu.2021.02.025
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    In stock of ZB MED Cologne/Königswinter

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  8. Article ; Online: Milk analysis using milk analyzers in a standardized setting (MAMAS) study: A multicentre quality initiative.

    Kwan, Celia / Fusch, Gerhard / Rochow, Niels / Fusch, Christoph

    Clinical nutrition (Edinburgh, Scotland)

    2019  Volume 39, Issue 7, Page(s) 2121–2128

    Abstract: ... used, over 6 months; C) ring trial consisting of 2 samples to be measured monthly. The devices tested ...

    Abstract Background: Human milk analyzers are increasingly used to rapidly measure the macronutrient content in breast milk for individual target fortification, to reduce the risk of postnatal growth restriction. However, many milk analyzers are used without calibration, validation or quality assurance.
    Aims: To investigate measurement quality between different human milk analyzers, to test whether accuracy and precision of devices can be improved by establishing individual calibration curves, and to assess long-term stability of measurements, following good clinical laboratory practice (GCLP).
    Methods: Sets of identical breast milk samples were sent to 13 participating centres in North America and Europe, for a total of 15 devices. The study included 3 sets of samples: A) initial assessment of the device's performance consisting of 10 calibration samples with random replicates; B) long term stability and quality control consisting of 2 batches of samples to be measured every time before the device is used, over 6 months; C) ring trial consisting of 2 samples to be measured monthly. The devices tested were Unity SpectraStar (n = 5) and MIRIS Human Milk Analyzer (n = 10).
    Results: There are significant variations in accuracy and precision between different milk analyzers' fat, protein and lactose measurements. However, the accuracy of measurements can be improved by establishing individual correction algorithms. Repeated measurements are more robust when coming from a larger batch volume. Long term stability also varies between devices.
    Conclusion: The variations in measurements between devices are clinically significant and would impact both daily dietary prescriptions, and the outcomes of clinical studies assessing the effect of targeted adjustment of nutrient intake in preterm babies. This study shows that it is crucial to follow GCLP when using milk analyzers to ensure proper measurement of macronutrients, similar to what is required of other medical devices.
    MeSH term(s) Algorithms ; Breast Feeding ; Breast Milk Expression ; Calibration ; Dietary Fats/analysis ; Equipment Design ; Europe ; Female ; Humans ; Infant ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Lactose/analysis ; Milk Proteins/analysis ; Milk, Human/chemistry ; North America ; Nutritional Status ; Nutritive Value ; Predictive Value of Tests ; Quality Control ; Reference Standards ; Reproducibility of Results ; Spectrophotometry, Infrared/instrumentation ; Spectrophotometry, Infrared/standards
    Chemical Substances Dietary Fats ; Milk Proteins ; Lactose (J2B2A4N98G)
    Language English
    Publishing date 2019-09-03
    Publishing country England
    Document type Comparative Study ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't ; Validation Study
    ZDB-ID 604812-2
    ISSN 1532-1983 ; 0261-5614
    ISSN (online) 1532-1983
    ISSN 0261-5614
    DOI 10.1016/j.clnu.2019.08.028
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  9. Article ; Online: Analysis of noise levels in the neonatal intensive care unit: the impact of clinical microsystems.

    Fusch, Gerhard / Mohamed, Saber / Bakry, Ahmad / Li, Edward W / Dutta, Sourabh / Helou, Salhab El / Fusch, Christoph

    European journal of pediatrics

    2023  Volume 183, Issue 3, Page(s) 1245–1254

    Abstract: Reorganization of neonatal intensive care by introducing clinical microsystems may help to allocate nursing time more appropriately to the needs of patients. However, there is concern that cohorting infants according to acuity may enhance noise levels. ... ...

    Abstract Reorganization of neonatal intensive care by introducing clinical microsystems may help to allocate nursing time more appropriately to the needs of patients. However, there is concern that cohorting infants according to acuity may enhance noise levels. This single-center study investigated the impact of reorganization of neonatal intensive care unit by implementing clinical microsystems in a Level III NICU on environmental noise. This prospective study measured 24-h noise levels over a period of 6 months during pre- and post-implementation of microsystems cohorting infants of similar acuity. Comparative analyses of the mixed acuity (i.e., before) and the cohorting (i.e., after) model were performed by creating daily profiles from continuous noise level measurements and calculating the length of exposure to predefined noise levels. Compared to baseline daytime measurements, noise levels were 3-6 dBA higher during physician handover. Noise levels were 2-3 dBA lower on weekends and 3-4 dBA lower at night, independent of the organizational model. The introduction of clinical microsystems slightly increased average noise levels for high-acuity pods (A and B) but produced a much more substantial decrease for low-acuity pods (E), leading to an overall reduction in unit-wide noise levels.    Conclusion: Our data show that noise levels are more driven by human behavior than by technical devices. Implementation of microsystems may help to reduce noise exposure in the lower acuity pods in a NICU. What is Known: • Excessive noise levels can lead to adverse effects on the health and development of premature infants and other critically ill newborns. • The reorganization of the neonatal intensive care unit following the clinical microsystems principles might improve quality of care but also affect noise exposure of staff and patients. What is New: • The transition from a mixed -acuity to cohorting model is associated with an overall reduction in noise levels, particularly in low-acuity pods requiring less nursing care. • Nevertheless, baseline noise levels in both models exceeded the standard permissible limits.
    MeSH term(s) Infant ; Infant, Newborn ; Humans ; Intensive Care Units, Neonatal ; Prospective Studies ; Noise/adverse effects ; Infant, Premature ; Intensive Care, Neonatal
    Language English
    Publishing date 2023-12-14
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 194196-3
    ISSN 1432-1076 ; 0340-6199 ; 0943-9676
    ISSN (online) 1432-1076
    ISSN 0340-6199 ; 0943-9676
    DOI 10.1007/s00431-023-05335-z
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  10. Article: Postnatale Wachstumsretardierung und die Möglichkeit, das Wachstum durch individuell angepasste Nahrung zu verbessern.

    Fusch, Christoph

    Kinderkrankenschwester : Organ der Sektion Kinderkrankenpflege

    2015  Volume 34, Issue 12, Page(s) 469

    Title translation Postnatal growth retardation and the possible growth improvement by individually adapted nutrition.
    MeSH term(s) Failure to Thrive/nursing ; Growth Disorders/nursing ; Humans ; Infant ; Infant Nutritional Physiological Phenomena/physiology ; Infant, Newborn ; Infant, Premature, Diseases/nursing ; Milk, Human/chemistry ; Milk, Human/physiology ; Nutritional Requirements
    Language German
    Publishing date 2015-12
    Publishing country Germany
    Document type News
    ZDB-ID 586637-6
    ISSN 0723-2276
    ISSN 0723-2276
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