Vasopressin and corticosteroids are often added to support cardiovascular dysfunction in patients who have septic shock that is nonresponsive to fluid resuscitation and norepinephrine infusion. ...However, it is unknown whether vasopressin treatment interacts with corticosteroid treatment.
Post hoc substudy of a multicenter randomized blinded controlled trial of vasopressin vs. norepinephrine in septic shock.
Twenty-seven Intensive Care Units in Canada, Australia, and the United States.
: Seven hundred and seventy-nine patients who had septic shock and were ongoing hypotension requiring at least 5 microg/min of norepinephrine infusion for 6 hours.
Patients were randomized to blinded vasopressin (0.01-0.03 units/min) or norepinephrine (5-15 microg/min) infusion added to open-label vasopressors. Corticosteroids were given according to clinical judgment at any time in the 28-day postrandomization period.
The primary end point was 28-day mortality. We tested for interaction between vasopressin treatment and corticosteroid treatment using logistic regression. Secondary end points were organ dysfunction, use of open-label vasopressors and vasopressin levels.
There was a statistically significant interaction between vasopressin infusion and corticosteroid treatment (p = 0.008). In patients who had septic shock and were also treated with corticosteroids, vasopressin, compared to norepinephrine, was associated with significantly decreased mortality (35.9% vs. 44.7%, respectively, p = 0.03). In contrast, in patients who did not receive corticosteroids, vasopressin was associated with increased mortality compared with norepinephrine (33.7% vs. 21.3%, respectively, p = 0.06). In patients who received vasopressin infusion, use of corticosteroids significantly increased plasma vasopressin levels by 33% at 6 hours (p = 0.006) to 67% at 24 hours (p = 0.025) compared with patients who did not receive corticosteroids.
There is a statistically significant interaction between vasopressin and corticosteroids. The combination of low-dose vasopressin and corticosteroids was associated with decreased mortality and organ dysfunction compared with norepinephrine and corticosteroids.
ABSTRACT For all exoplanet candidates, the reliability of a claimed detection needs to be assessed through a careful study of systematic errors in the data to minimize the false positives rate. We ...present a method to investigate such systematics in microlensing data sets using the microlensing event OGLE-2013-BLG-0446 as a case study. The event was observed from multiple sites around the world and its high magnification (Amax ∼ 3000) allowed us to investigate the effects of terrestrial and annual parallax. Real-time modeling of the event while it was still ongoing suggested the presence of an extremely low-mass companion (∼3M⊕) to the lensing star, leading to substantial follow-up coverage of the light curve. We test and compare different models for the light curve and conclude that the data do not favor the planetary interpretation when systematic errors are taken into account.
Using data from the All Sky Monitor (ASM) on the Rossi X-ray Timing Explorer (RXTE), we have searched for long term periodicities in the X-ray flux of GX 1+4, Sco X-2 (GX 349+2), and GX 339−4. For GX ...1+4, we also used data from BATSE and Galactic Centre scans performed by RXTE. We find no evidence for X-ray modulations at the suggested ∼304
d orbital period of GX 1+4. However, we find tentative evidence for a periodicity at 420–460
d. An upper limit of 15% peak-to-peak is set on any sinusoidal modulation in the 1.5–3.0
keV flux of Sco X-2 for periods in the 30–100
d range. For GX 339−4, we confirm the Low State modulation and report the detection of significant low-frequency modulations in both the High State and Very High State. We fail to detect this modulation in the Off State. We show that if the reported orbital period of GX 339−4 lies in the range 0.5–1.7
d, then it is not present in the RXTE ASM light curve.
Searches for extrasolar planets have uncovered an astonishing diversity of planetary systems, yet the frequency of solar system analogs remains unknown. The gravitational microlensing planet search ...method is potentially sensitive to multiple-planet systems containing analogs of all the solar system planets except Mercury. We report the detection of a multiple-planet system with microlensing. We identify two planets with masses of ~0.71 and ~0.27 times the mass of Jupiter and orbital separations of ~2.3 and ~4.6 astronomical units orbiting a primary star of mass ~0.50 solar masses at a distance of ~1.5 kiloparsecs. This system resembles a scaled version of our solar system in that the mass ratio, separation ratio, and equilibrium temperatures of the planets are similar to those of Jupiter and Saturn. These planets could not have been detected with other techniques; their discovery from only six confirmed microlensing planet detections suggests that solar system analogs may be common.
We combine all available information to constrain the nature of OGLE-2005-BLG-071Lb, the second planet discovered by microlensing and the first in a high-magnification event. These include ...photometric and astrometric measurements from Hubble Space Telescope, as well as constraints from higher-order effects extracted from the ground-based light curve, such as microlens parallax, planetary orbital motion and finite-source effects. Our primary analysis leads to the conclusion that the host of Jovian planet OGLE-2005-BLG-071Lb is a foreground M dwarf, with mass M = 0.46 {+-} 0.04M{sub {circle_dot}}, distance D{sub l} = 3.3 {+-} 0.4 kpc, and thick-disk kinematics {nu}{sub LSR} {approx} 103 km s{sup -1}. From the best-fit model, the planet has mass M{sub p} = 3.5 {+-} 0.3 M{sub Jupiter}, lies at a projected separation r{sub {perpendicular}} = 3.6 {+-} 0.2 AU from its host and has an equilibrium temperature of T {approx} 50 K, i.e., similar to Neptune. A degenerate model less favored by {Delta}{sub {chi}}{sup 2} {approx} 4 gives essentially the same planetary mass M{sub p} = 3.3 {+-} 0.3 M{sub Jupiter} with a smaller projected separation, r{sub {perpendicular}} = 2.1 {+-} 0.1 AU, and higher equilibrium temperature T {approx} 68 K. These results from the primary analysis suggest that OGLE-2005-BLG-071Lb is likely to be the most massive planet yet discovered that is hosted by an M dwarf. However, the formation of such high-mass planetary companions in the outer regions of M-dwarf planetary systems is predicted to be unlikely within the core-accretion scenario. There are a number of caveats to this analysis, but these could mostly be resolved by a single astrometric measurement a few years after the event.
Aims. We present a detailed analysis of OGLE 2004-BLG-482, a relatively high-magnification single-lens microlensing event that exhibits clear extended-source effects. These events are relatively ...rare, but they potentially contain unique information on the stellar atmosphere properties of their source star, as shown in this study. Methods. Our dense photometric coverage of the overall light curve and a proper microlensing modelling allow us to derive measurements of the OGLE 2004-BLG-482source star’s linear limb-darkening coefficients in three bands, including standard Johnson-Cousins I and R, as well as in a broad clear filter. In particular, we discuss in detail the problems of multi-band and multi-site modelling on the expected precision of our results. We also obtained high-resolution UVES spectra as part of a ToO programme at ESO VLT, from which we derive the source star’s precise fundamental parameters. Results. From the high-resolution UVES spectra, we find that OGLE 2004-BLG-482’s source star is a red giant of MK type a bit later than M3, with Teff = 3667 ± 150 K, log g = 2.1 ± 1.0 and an assumed solar metallicity. This is confirmed by an OGLE calibrated colour − magnitude diagram. We then obtain from a detailed microlensing modelling of the light curve linear limb-darkening coefficients that we compare to model-atmosphere predictions available in the literature, and find a very good agreement for the I and R bands. In addition, we perform a similar analysis using an alternative description of limb darkening based on a principal component analysis of ATLAS limb-darkening profiles, and also find a very good agreement between measurements and model predictions.
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