Effect of On-Demand vs Routine Nebulization of Acetylcysteine With Salbutamol on Ventilator-Free Days in Intensive Care Unit Patients Receiving Invasive Ventilation: A Randomized Clinical Trial.

Importance: It remains uncertain whether nebulization of mucolytics with bronchodilators should be applied for clinical indication or preventively in intensive care unit (ICU) patients receiving invasive ventilation.

Objective: To determine if a strategy that uses nebulization for clinical indication (on-demand) is noninferior to one that uses preventive (routine) nebulization.

Design, Setting, And Participants: Randomized clinical trial enrolling adult patients expected to need invasive ventilation for more than 24 hours at 7 ICUs in the Netherlands.

Microelectrophoresis of Silica Rods Using Confocal Microscopy.

The electrophoretic mobility and the zeta potential (ζ) of fluorescently labeled colloidal silica rods, with an aspect ratio of 3.8 and 6.1, were determined with microelectrophoresis measurements using confocal microscopy.

Preventive nebulization of mucolytic agents and bronchodilating drugs in invasively ventilated intensive care unit patients (NEBULAE): study protocol for a randomized controlled trial.

Background: Preventive nebulization of mucolytic agents and bronchodilating drugs is a strategy aimed at the prevention of sputum plugging, and therefore atelectasis and pneumonia, in intubated and ventilated intensive care unit (ICU) patients. The present trial aims to compare a strategy using the preventive nebulization of acetylcysteine and salbutamol with nebulization on indication in intubated and ventilated ICU patients.

Methods/design: The preventive nebulization of mucolytic agents and bronchodilating drugs in invasively ventilated intensive care unit patients (NEBULAE) trial is a national multicenter open-label, two-armed, randomized controlled non-inferiority trial in the Netherlands.

Gelation versus liquid crystal phase transitions in suspensions of plate-like particles.

Gelation is a common effect in aqueous suspensions of charged colloidal clay platelets at concentrations as low as 1 wt%. However, in systems of charged gibbsite [Al(OH)3] platelets, gelation can be delayed to concentrations as high as 50 wt% depending on the ionic strength. We investigated the phase behaviour of this system approaching the state of gelation in the delicate region between attractive and repulsive states that originate from competition between Coulomb repulsion and van der Waals attraction.

Distribution of costameric proteins in the diaphragm of patients with chronic obstructive pulmonary disease.

Background: Chronic obstructive pulmonary disease (COPD) is associated with an increased load on the diaphragm. Increased (eccentric) loading has been shown to result in disturbances in the cytoskeleton.

Objectives: We hypothesized that due to a continuous overload of the diaphragm in COPD patients, distinct alterations in the membrane-associated cytoskeleton occur, especially in the costameres.

Sedimentation and phase transitions of colloidal gibbsite platelets.

We study the competition between sedimentation, gelation, and liquid crystal formation in suspensions of colloidal gibbsite platelets of five different sizes at three ionic strengths. For large particles (with diameters of 350, 420, and 570 nm) sedimentation is initially the most important factor determining the macroscopic behavior. Only after the main part of the sample has sedimented in an amorphous phase, phase separation takes place.

Metabolic capacity of the diaphragm in patients with COPD.

Chronic obstructive pulmonary disease (COPD) is associated with an increased load on the diaphragm. Chronic loading on skeletal muscles results in metabolic changes and fiber-type shifts. Therefore, we investigated whether the load on the human diaphragm imposed by COPD altered oxidative enzyme activity, glycogenolytic enzyme activity and mitochondrial energy generating capacity and efficiency.

Seeded growth of monodisperse gibbsite platelets to adjustable sizes.

Nanosized hexagonal gibbsite seeds are grown from a mixture of dissolved alumina alkoxides at 85 degrees C. Centrifugation reduces the polydispersity by 30%. The seeds can be grown further by adding them to a fresh alkoxide mixture and heating it.

Synthesis of fluorescent silica-coated gibbsite platelets.

We describe the fluorescent labeling of gibbsite particles. Gibbsite particles are first stabilized with polyvinyl pyrrolidone. Subsequently the particles are covered with a silica layer in which a fluorescent dye is incorporated.

Crystallization in settling mixtures of colloidal spheres and plates.

The behavior of mixtures of silica spheres and smaller silica-coated gibbsite plates is studied by means of confocal microscopy. Addition of plates slows down the crystallization of the settling spheres. Liquidlike microphases of the plates are found in the sediments of the spheres.

Vibrational sum frequency scattering from a submicron suspension.

A novel application of vibrational sum frequency generation (VSFG) is developed to study the molecular properties of the surface of submicron particles in suspension. The Rayleigh-Gans-Debye scattering theory is extended to extract the local molecular response from the macroscopic nonlinearly scattered spectral intensity. These results demonstrate the use of VSFG to investigate quantitatively the surface molecular properties of submicron particles, dispersed in solution.

Preparation of photonic crystals made of air spheres in titania.

Three-dimensional crystals of air spheres in titania (TiO2) with radii between 120 and 1000 nanometers were made by filling the voids in artificial opals by precipitation from a liquid-phase chemical reaction and subsequently removing the original opal material by calcination. These macroporous materials are a new class of photonic band gap crystals for the optical spectrum. Scanning electron microscopy, Raman spectroscopy, and optical microscopy confirm the quality of the samples, and optical reflectivity demonstrates that the crystals are strongly photonic and near that needed to exhibit band gap behavior.

Systolic time intervals in coronary heart disease at rest and during exercise: effect of physical training with and without beta blockade.

Systolic time intervals (STIs) were measured in recumbency at rest and in the sitting position at rest and during exercise, before and after a physical training program, in 28 patients with coronary heart disease. Fifteen patients were treated with a beta-blocking drug and 13 were not. After training, oxygen uptake at peak exercise increased similarly in both groups, by 41% and 37%, respectively, whereas heart rate at rest and during submaximal exercise decreased in both groups.

Experimental stroma herpes simplex keratitis. Influence of treatment with topical bromovinyldeoxyuridine and trifluridine.

Two compounds, bromovinyldeoxyuridine ([E]-5-[2-bromovinyl]-2'-deoxyuridine) and trifluridine (5-trifluoromethyl-2' deoxyuridine) were compared for their efficacy in the topical treatment of experimental stroma herpetic keratitis produced by the injection of live herpes simplex virus, type 1, into the corneal stroma of rabbits. The trifluridine was used as 1% eyedrops, whereas bromovinyldeoxyuridine was used as either 0.1% or 0.