Fran Crippen Death: Likely Heat Stroke or Heart

Photo Courtesy - Getty Images(NEW YORK) -- Doctors may never know precisely what killed open water swimmer Fran Crippen, the 26-year-old who died during a race in Abu Dhabi over the weekend, but they agree that strenuous exercise in hot water could result in fatal heat stroke.

Had a safety boat been near the elite swimmer when he lost consciousness, he might have been cooled down and been saved, they say.

"It's pretty straightforward -- he died of one of two things," said Dr. Mark Morocco, associate professor of emergency medicine at the UCLA School of Medicine.

"He drowned of a cardiac arrhythmia or he died of drowning because he passed out," said Morocco, who has never treated Crippen. "Both were directly related to over-exertion, which is a terrible garbage-can diagnosis and does not speak to what happened."

"In the age of kayaks, jet skis and outboard motors, this sort of thing should never happen to an elite swimmer," he said. "No one was there to help him up out of the water."

USA Swimming said Monday it would commission a full, independent investigation into Crippen's death.

Some earlier reports indicated that the Olympic-bound athlete died of a heart attack. The findings of an autopsy by local authorities have not been released, and even that may not give definitive answers.

Heat stroke, for example, could only be determined if doctors got an internal body temperature right after Crippen died. His body wasn't found until two hours after the race ended -- about 400 meters from the finish line.

The International Swimming Federation (FINA) said doctors ruled the cause of death as severe fatigue.

Crippen's sister Maddy, herself an Olympic swimmer, told ABC News that her brother had been voicing concerns for months about inadequate safety.

Crippen had told Shoulberg just 12 hours before the race that the outside temperature was 100 degrees and that the water was 87 degrees. Several swimmers complained of dehydration and disorientation and three were taken to the hospital.

"l have heard lot people complaining about the water being too warm," said Bill Volckening, a former editor of Swimmer magazine for U.S. Masters swimming. "There are some dangers of hyperthermia that have not really come to light yet and I hope there is some major reform in the sport of open water swimming with regard to safety."

Those who trained with Crippen said he also used GU energy gel, a replenishing liquid that contains high amounts of caffeine. The swimmer reportedly consumed 10 to 15 packs during a typical two-hour swim.

Doctors say, however, that caffeine is generally "pretty safe."

"It's probably not that likely, but certainly a possible factor in the picture," said Morocco. "Caffeine can cause arrhythmias in sensitive individuals."

The more likely cause of death was hyperthermia, which led to heat stroke.

"During physical exertion as the muscles are working, part of the byproducts is heat, like a power plant," said Dr. Ted Benzer, chief of clinical operations in the emergency department and attending physician at Massachusetts General Hospital.

"The challenge is to get rid of the heat and the body doesn't have that many ways to do that," he said. "The human body underwater is not like a fish or a whale. The primary way it releases heat is through evaporative losses like sweating."

Sweat on the surface of the body creates a cooling effect on blood just under the skin. Unlike a dog, humans can't pant to get rid of the heat.

"It is an intriguing concern that [Crippen] had major exertion submersed under very hot water," said Benzer. "But this is very unusual -- I have never seen this in all the years I have worked in emergency medicine."

When the body's temperature reaches 106 to 107 degrees, it starts to cause death of tissue and organ failure.

One of the first warning signs is confusion and delirium as the brain begins to dysfunction. If not treated by cooling the body down, it can cause death.

"It's hard to say what happened," said Benzer. "Who knows who was watching and how closely. Basically, he may have become confused and his actions might have been unpredictable. Maybe he started getting heat stroke, was delirious and then drowned."

However, doctors say there are other conditions that can cause sudden death in a young athlete -- heart valve problems, an electrolyte imbalance, congenital thickening of the heart muscle, cerebral aneurysms and even undetected arrhythmias like long QT syndrome.

UCLA's Morocco agrees that many of those medical events could have been treated had there been more attention paid to safety.

"A lot of the responsibility is on the folks who put the race together," he said. "When you are 500 feet in the water, you are as far away as being in wilderness 20 miles in Yosemite. If you don't have someone in a rescue boat, you are in trouble. Anything can happen."

"The other problem is elite athletes are not very good patients," said Morocco. "They don't want to get out of the race, even if they feel poorly. They are well-trained, but are also pressured to perform. Oftentimes a great athlete cannot advocate for himself. But those running the race should advocate for him."

Copyright 2010 ABC News Radio


Study Finds Sleepiness Might Be Genetic

Photo Courtesy - Getty Images(PHILADELPHIA) -- No matter how little they sleep, some people can keep a skip in their step while others will yawn and struggle through the day.  A new study from the University of Pennsylvania School of Medicine found that the reason could be in our genes.

Researchers found that healthy people with one particular genetic variant were generally sleepier than those without the gene.  About 25 percent of the general public has the genetic variant, called DQB1 *0602, but only a small percentage of them actually suffer from sleep problems.

For the study, researchers compared 37 healthy adults with the gene variant to 92 healthy adults without it to see if they suffered from any other sleep-related problems.

The research, published in the journal Neurology, found people with the gene variant reported feeling sleepier and more fatigued compared to the people without the variant, whether they slept four hours or 10 hours.  People with the gene variant also spent less time in deep sleep, and woke up more times during their sleep compared to the non-gene participants.

Copyright 2010 ABC News Radio


Lose Weight with 'Ice Cube Diet?'

Photo Courtesy - Desert Labs(NEW YORK) -- Many weight loss products promise to melt away pounds, but few of them take this idea to such a literal extreme as the new ice cube diet.  The premise is simple: you simply pop a "Hoodia satiety cube" into the drink of your choice once a day.  The cubes naturally curb appetite so you snack less and ultimately, weigh less.

Desert Labs, the company that markets the cubes, says the magic ingredient is hoodia, an herbal supplement South African bushmen have used for centuries to control hunger pangs while hunting game.  But Jennifer Neily, a registered dietitian and spokesperson for the Dallas Dietetic Association, is skeptical.

"Hoodia is very rare and protected by strict environmental laws," she says.  "So my question is how can all these products that claim to contain it, actually contain it?"

Even assuming the cubes are 97 percent hoodia, as it says on the box, that doesn't guarantee they're a dieter's secret weapon, either.  The few independent studies analyzing the supplement's effect on weight loss have been disappointing or inconclusive.  A private study conducted by the ice cube makers and posted on their website claims that 88 percent of the participants lost a significant amount of weight, but they don't specify any of the details.

Copyright 2010 ABC News Radio


Cows Working Nights to Help Insomniacs

Photo Courtesy - Getty Images(MUNICH) -- German cows are working nights to help insomniacs.

A herd of 1,400 cows is being milked between the hours of 2 a.m. and 4 a.m. under the theory they will produce more sleep-inducing melatonin in their milk at a time when they are usually lying down in the dark.

To further boost the melatonin production, the cows are fed clover and soothed under warm red lights to lower stress levels while being milked. During the day when the weather is good, the pampered animals are turned out in a pen with grass and deep, cozy sand, which the workers call "cow beach."

By giving the cows special treatment, the Milchkristalle company says it's getting special milk with 10 times more of the sleep-regulating hormone melatonin than normal milk. The milk is freeze-dried and turned into a product known as Nightmilk Crystals, which can be mixed with regular milk or with yogurt and consumed before going to bed.

After six years of research, the Munich-based company says its studies show giving cows different care and milking them during the middle of the night changes the level of nocturnal melatonin in their blood and the milk they produce.

Milchkristalle began selling the Nightmilk Crystals in German pharmacies and through its website in March. Recently, the company's had orders from India, Austria and the U.S.

Melatonin, which is widely available without a prescription in the U.S., is under much stricter restrictions in Europe where it's only available at pharmacies. The hormone is naturally produced by the body and used by the brain to regulate the sleep-wake cycle. Doctors often recommend supplements of melatonin for people who have jet lag or work odd shifts.

Copyright 2010 ABC News Radio


FDA Rejects New Weight-Loss Pill

Photo Courtesy - Getty Images(SAN DIEGO) -- The U.S. Food and Drug Administration rejected a New Drug Application from Arena Pharmaceuticals, Inc. and Eisai Inc. for lorcaserin. 

In a letter to the companies, the FDA cited various safety concerns, both clinical and non-clinical, to support their decision not to approve the new drug intended for obese patients living with weight-related comorbid conditions.

The FDA also recommended that lorcaserin be placed in Schedule IV of the Controlled Substance Act after careful review of data submitted in the new drug application.  The companies applying for the approval of lorcaserin were also offered the opportunity to "complete pre-clinical studies that may lead to a different recommendation."

"Eisai is committed to collaborating with Arena to address the FDA's requests.  Obesity is an epidemic in America, and our goal is to bring locaserin to physicians and patients who need additional weight-loss options," said Lonnel Coats, President and CEO of Eisai Inc.

Arena plans to request a meeting with FDA officials to "clarify its requests."  FDA guidelines state that if a meeting is granted, it must take place within 30 days of the request.

Copyright 2010 ABC News Radio


Georgetown Students Arrested for Manufacturing Illegal Drug in Dorm Room

Photo Courtesty - Getty Images(WASHINGTON) -- Police in Washington, D.C. arrested three men at Georgetown University over the weekend and charged them with illegally manufacturing a controlled substance after authorities say they discovered a drug, later determined to be dimethyltryptamine (DMT), was being manufactured in a dorm room.

The men, two students and a guest, were arraigned Monday.  A police spokeswoman said police were directed to a certain room on the ninth floor of Harbin Hall after a student reported a strange odor.  Seven people, including several students, were treated for possible effects from exposure to chemicals, but no one was hospitalized.

In an e-mail, Greg Olson, Georgetown's vice president of student affairs, told parents that the U.S. Drug Enforcement Agency had confirmed that DMT was being made in the dorm room.

According to the Drug Enforcement Agency, DMT is a powerful hallucinogenic drug that is typically smoked, sniffed or injected.  It's found naturally in plants and seeds but can also be manufactured synthetically.  It's also found in very small amounts in the brains of most mammals, including humans.

It acts by increasing the brain's level of serotonin, a neurotransmitter that influences moods.  DMT produces what's called the "businessman's trip" -- a high that lasts for about an hour.

"Serotonin is thought to be the target of a lot of hallucinogens, like LSD, MDMA [ecstasy], PCP and others," said Glen Hanson, professor of pharmacology and toxicology at the University of Utah and former director of the National Institute on Drug Abuse.

DMT is not very addicting, unlike drugs like methamphetamine.  It's also relatively easy to manufacture, according to the DEA.

In addition to the psychedelic high, the drug can have serious physiological consequences, including high blood pressure, agitation, seizures and dizziness, according to the DEA.  In very high doses, it can bring on a coma and respiratory arrest.

Regarding long-term use, experts also said there wasn't much research about how harmful long-term use can be, but Hanson suspected it could take its toll on the brain after a while.

DEA statistics show that between January and June of 2009, law enforcement officials seized 72 items that were later identified as DMT.  In 2008, they seized 94 such items, up from 59 in 2007.

DMT is an illegal substance and is considered a schedule one drug, meaning that it's not approved for medical use.

Copyright 2010 ABC News Radio


Researchers Find Smoking Increases Risk of Dementia

Photo Courtesy - Getty Images(NEW YORK) -- Everyone pretty much agrees smoking can cause cancer and other serious diseases, but new research now suggests smoking could also increase your risk of dementia. 

More than 20,000 people in the U.S. were questioned between 1978 and 1985 about their smoking habits.  In 2008, statistics on dementia diagnosis among that group were gathered. 

Scientists from the University of Finland reviewed the data and found those who reported smoking more than two packs of cigarettes a day at the time of the survey had a 100% greater risk of being diagnosed later in life with a type of dementia like Alzheimer's disease compared to non-smokers.

The research appears in the newest edition of Archives of Internal Medicine.

Copyright 2010 ABC News Radio


Teens Not Truthful About Drug Use, Says New Study

Photo Courtesy - Getty Images(DETROIT) -- A new study may confirm what many already suspect: teens don't always tell the truth about their use of illegal drugs.

Researchers from Wayne State University and the National Institute on Drug Abuse found that when asked about their use of cocaine and opiates, teens often fudged their answers -- even though they knew they were being subjected to hair analysis that would prove they did use those drugs.

"The basic finding is that when teens were asked about their use of cocaine and opiates, they gave socially acceptable answers rather than being completely forthright," said Dr. Virginia Delaney-Black, a study co-author and professor of pediatrics at Wayne State in Detroit.

While other studies have identified similar behavior in adults, few have looked at the phenomenon in teenagers. Adolescent health experts say it has implications for teaching health care providers how to better assess teen drug use. They also say the behavior of the teens in the study is consistent with that of most of their peers.

The researchers surveyed more than 400 teens and parents or caregivers and asked whether they used a variety of drugs, including cocaine, opiates and marijuana. They later did hair analyses on them and compared the results of those tests with their survey answers. Teens and parents did not generally answer questions honestly about teens' drug use, and parents also did not answer truthfully about their own drug use. They were unable to accurately analyze marijuana use because the hair tests were not sensitive enough.

Copyright 2010 ABC News Radio


Hundreds of Doctors Earned Big Money from Drug Companies

Photo Courtesy - Getty Images(NEW YORK) -- Pharmaceutical companies paid out more than $250 million to some 17,000 doctors and nurses across the country in 2009 and 2010, according to a new database compiled and published by ProPublica, a non-profit investigative journalism group.

The data from seven drug makers, who manufacture about 35 percent of the medications sold in America, showed that nearly 400 of those doctors received payments of $100,000 or more to promote drugs, serve as medical consultants and speak at conferences.

Separately, ProPublica found records in 18 states that showed 250 of the doctors had been accused of professional misconduct, disciplined by state medical boards or didn't have the credentials to be considered specialists or researchers.  The list includes some doctors ProPublica found were accused of sexual misconduct and other criminal behavior.

Copyright 2010 ABC News Radio


Pediatricians to Screen for Postpartum Depression

Photo Courtesy - Getty Images(NEW YORK) -- A new American Academy of Pediatrics effort will see pediatricians doing more screening for postpartum depression in mothers of their tiny patients.  Pediatricians already do postnatal screenings but the Academy says more screening is needed as a newborn grows.

Many pediatricians find that inadequate follow-up time, incomplete training in diagnosing the potentially tragic depression, and lack of reimbursement serve as barriers to proper screening.  The authors of a new study say awareness of postpartum depression is essential to healthy child development.

The study suggests pediatricians use an already established list of questions at the 1, 2, 4 and 6 month visits, and offer support strategies and referrals if the mother of one of their patients shows signs of depression. 

Copyright 2010 ABC News Radio

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