RESUMO
BACKGROUND: Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awareness and effective treatments, to further standardize and strengthen the clinical management and to reduce the mortality of HFMD, the guidelines for diagnosis and treatment have been developed. METHODS: National Health Commission of China assembled an expert committee for a revision of the guidelines. The committee included 33 members who are specialized in diagnosis and treatment of HFMD. RESULTS: Early recognition of severe cases is utmost important in diagnosis and treatment of patients with HFMD. The key to diagnosis and treatment of severe cases lies in the timely and accurate recognition of stages 2 and 3 of HFMD, in order to stop progression to stage 4. Clinicians should particularly pay attention to those EV-A71 cases in children aged less than 3 years, and those with disease duration less than 3 days. The following indicators should alert the clinician of possible deterioration and impending critical disease: (1) persistent hyperthermia; (2) involvement of nervous system; (3) worsening respiratory rate and rhythm; (4) circulatory dysfunction; (5) elevated peripheral WBC count; (6) elevated blood glucose and (7) elevated blood lactic acid. For treatment, most mild cases can be treated as outpatients. Patients should be isolated to avoid cross-infection. Intense treatment modalities should be given for those severe cases. CONCLUSION: The guidelines can provide systematic guidance on the diagnosis and management of HFMD.
Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coxsackievirus/diagnóstico , Doença de Mão, Pé e Boca/diagnóstico , Doença de Mão, Pé e Boca/terapia , Isolamento de Pacientes/métodos , Criança , Pré-Escolar , Terapia Combinada , Infecções por Coxsackievirus/epidemiologia , Infecções por Coxsackievirus/terapia , Feminino , Doença de Mão, Pé e Boca/epidemiologia , Humanos , Incidência , Lactente , Masculino , Guias de Prática Clínica como Assunto , Prognóstico , Medição de Risco , Estações do Ano , Índice de Gravidade de Doença , Taxa de Sobrevida , Resultado do TratamentoRESUMO
ß-O-4 and α-O-4 linkages can be selectively cleaved by Pd-Ni bimetallic nanoparticles in ionic liquids using hydrogen gas as the hydrogen donor under ambient pressure and neutral conditions. No hydrogenation of the benzene ring takes place in the catalytic system. An obvious improvement in activity is found compared with single nickel and palladium catalysts based on the results of experiments and characterization. After the reaction, the catalytic system still remains in the reactor by simple extraction, which can be reused without further treatment.