1 giant leap download1/4/2024 ![]() ![]() Self-treating his symptoms with ibuprofen, he explains “no one in the hospital will have seen symptoms of having been in space for a year” ( 3). The author, a retired NASA astronaut who participated in NASA’s Twin Study, describes severe leg swelling, orthostatism, nausea, rash, and pain within days after landing. This point was also illustrated in Scott Kelly’s autobiography Endurance: My Year in Space, A Lifetime of Discovery. The authors of this report highlighted challenges of space medicine, including novel medical conditions with no evidence for decision making, the need in telemedicine, and limited pharmacy. Spontaneous flow was still absent after 90 days of apixaban treatment onboard the ISS but was shown on landing ( 1). Apixaban was administered to the astronaut from 42 days after the diagnosis until four days before return to Earth. Meanwhile, apixaban was delivered to the ISS by a supply aircraft. Due to limited availability of anticoagulants onboard the International Space Station (ISS) the astronaut was initially treated with enoxaparin with dose reduction thirty three days later to allow treatment extension. During a recent study on jugular vein flow and morphology, obstructive thrombosis was detected for the first time in an astronaut in space ( 1, 2). Although astronauts are usually healthy and in good physical shape, they still can become sick, get infected or even develop blood clots.
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