Astronaut treated for blood clot on ISS

In a first, an unnamed astronaut had been treated for a blood clot while on a six-month mission on ISS sometime in the last few years.

Ultrasound examinations of the astronauts’ internal jugular veins were performed at scheduled times in different positions during the mission. Results of the ultrasound performed about two months into the mission revealed a suspected obstructive left internal jugular venous thrombosis (blood clot) in one astronaut. The astronaut, guided in real time and interpreted by two independent radiologists on earth, performed a follow-up ultrasound, which confirmed the suspicion.

Since NASA had not encountered this condition in space before, multiple specialty discussions weighed the unknown risks of the clot traveling and blocking a vessel against anticoagulation therapy in microgravity. The space station pharmacy had 20 vials containing 300 mg of injectable enoxaparin (a heparin-like blood thinner), but no anticoagulation-reversal drug. The injections posed their own challenges – syringes are a limited commodity, and drawing liquids from vials is a significant challenge because of surface-tension effects.

The astronaut began treatment with the enoxaparin, initially at a higher dose that was reduced after 33 days to make it last until an oral anticoagulant (apixaban) could arrive via a supply spacecraft. Anticoagulation-reversing agents were also sent.

Although the size of the clot progressively shrank and blood flow through the affected internal jugular segment could be induced at day 47, spontaneous blood flow was still absent after 90 days of anticoagulation treatment. The astronaut took apixaban until four days before the return to Earth.

On landing, an ultrasound showed the remaining clot flattened to the vessel walls with no need for further anticoagulation. It was present for 24 hours after landing and gone 10 days later. Six months after returning to Earth, the astronaut remained asymptomatic.

What is not known is whether weightlessness caused the clot, or whether it would have occurred regardless. The former seems very possible as the astronaut had no history of such clots, and returned to normal almost immediately upon return to Earth. As noted at the link, more research is necessary, especially in anticipation of long interplanetary flights.

Most biomedical research cannot be replicated

New studies looking at the work of scientists in the biomedical field has found that their research is difficult if not impossible to replicate, partly because much of their raw data is never made available for other researchers to review.

But over the past several years, a growing contingent of scientists has begun to question the accepted veracity of published research—even after it’s cleared the hurdles of peer review and appears in widely respected journals. The problem is a pervasive inability to replicate a large proportion of the results across numerous disciplines.

In 2005, for instance, John Ioannidis, a professor of medicine at Stanford University, used several simulations to show that scientific claims are more likely to be false than true. And this past summer Brian Nosek, a professor of psychology at the University of Virginia, attempted to replicate the findings of 100 psychology studies and found that only 39 percent of the results held up under rigorous re-testing. “There are multiple lines of evidence, both theoretical and empirical, that have begun to bring the reproducibility of a substantial segment of scientific literature into question,” says Ioannidis. “We are getting millions of papers that go nowhere.”

There’s a lot more. Read it all. It appears that much if not all of biomedical research is suspect. Their conclusions might be correct, but their methods are questionable, at best.

$28 billion spent on poor biomedical research?

The uncertainty of science: A new study suggests that $28 billion is spent on biomedical research that no one can reproduce.

I have no doubt that a vast amount of medical research is so poorly done that no one else will ever be able to replicate the results. However, the article notes that the way the researchers came up with the $28 billion figure is quite questionable, reviewing only about two dozen studies and then extrapolating their numbers across the entire research field. This is highly uncertain and should be taken with a grain of salt.