Lethal Bentazone Intoxication - A Report of Two Cases.

This study presents two cases of lethal bentazone poisonings, their clinical presentation, the course of the disease and the autopsy findings. The first is a 50-year-old male who had sprayed corn with a solution of bentazone and was admitted to the hospital with sweating, fever, nausea, vomiting of aqueous and hemorrhagic content, and bloody, watery stools. He was treated according to the symptoms including extracorporeal hemodialysis, but eventually suffered from multiorgan failure (acute respiratory failure, acute liver failure, coagulopathy, acute renal failure, metabolic acidosis, and gastrointestinal bleeding) and died 11.35 h after admittance. The cause of death was probable bentazone intoxication. The second case, also a male, aged 49 who committed suicide by ingesting a bentazone solution. He was transferred to the hospital prostrated and cyanotic and died 14.15 h after admittance despite all efforts by the hospital staff. The cause of death was acute bentazone intoxication.

Heart Rate-Corrected QT and JT Intervals in Electrocardiograms in Physically Fit Students and Student Athletes.

In literature, data on the prevalence of prolonged and shortened corrected QT (QTc) have shown considerable variability. The aim of the study was to compare QTc and JTc intervals of competitive student athletes and noncompetitive sport participants to QTc cutoff points used in athletes. A group of 485 physically fit candidates for the study of kinesiology (139 female and 346 male candidates) aged 18-20 participated in the study. Basic anthropometry, field fitness test, cardiovascular, electrocardiograms measurements, and blood sampling for lipid profile were conducted. The prolonged QTc according to European Society of Cardiology criteria was found in 2.9% of female and 4.3% of male students. When the "Seattle criteria" were used, the proportion of prolonged QTc was 1.44% in female and 0.29% in male students. The shortened QTc according to the Seattle cutoff points was presented in 0.7% of female and 2.0% of male students. The JTc over 400 ms was found in 0.72% of female and 0.29% of male students. The JTc shorter than 320 ms was presented in 0.7% of female and 1.1% of male students. No significant differences were found between students involved in competitive sport and those involved in recreational sporting activities. Female students had lower body mass index and blood pressure values, better blood lipid profile, and lower uric acid concentrations. In conclusion, the Seattle criteria markedly decreased the proportion of prolonged QTc in student athletes, particularly in male students. It seems that the JTc interval could be a better parameter than the QTc interval for the estimation of specific repolarization time in physically fit university students.

Which is more important for reducing the odds of metabolic syndrome in men: Cardiorespiratory or muscular fitness?

OBJECTIVE: To examine combined associations of cardiorespiratory fitness (CRF) and muscular fitness (MF) with metabolic syndrome (MetSy) in a sample of young men. METHODS: Participants were 557 men aged 19-47 years. CRF was quantified as peak oxygen uptake measured during an incremental treadmill test by a metabolic cart, while a composite MF score was calculated as the sum of z-scores from a push-ups and sit-ups test. The presence of MetSy was defined according to the updated NCEP-ATP III criteria. RESULTS: We found a graded inverse relationship between CRF and MetSy presence. The most aerobically fit individuals had 90% lower odds of having MetSy compared to their least fit counterparts, independent of MF (odds ratio [OR] = 0.10, 95% CI = 0.04-0.21). Conversely, an increment in MF across the first three quartiles was not associated with lower odds of MetSy; only the most muscularly fit men were 2.5 times less likely to have MetSy (OR = 0.41, 95% CI = 0.21-0.78). Finally, participants with high CRF but low MF exhibited a 50% decrease in odds of having MetSy (OR = 0.49, 95% CI = 0.26-0.91), while no protective effect was found for having high MF but low CRF (OR = 0.95, 95% CI = 0.55-1.62). CONCLUSIONS: CRF exhibited a strong protective effect against having MetSy, while the effect of MF was less pronounced.

Anthropometry in cardio-metabolic risk assessment.

High prevalence of obesity, as a major public health problem, is connected with chronic cardiovascular and metabolic diseases. That is why some simple anthropometric parameters were developed to estimate overweight and obesity, and in the primary screening of risk groups. In this field, body mass index (BMI) is the most frequent parameter, both in epidemiological research and in everyday practice. It is a part of the algorithm used in the early detection of overweight and obese persons. However, BMI does not provide any data on body composition. This is why it is particularly insufficient in estimating body mass in physically active persons and in athletes who are often overweight, with a higher proportion of lean body mass but without any excess fat, as well as in those with normal weight but lower than normal lean body mass and/ or gentle skeleton. Over the last few decades, attention has been especially directed to different body fat distribution in relation to chronic cardio-vascular and metabolic diseases. Waist circumference (WC) is the best anthropometric predictor of cardiovascular risk. It is considered an indirect parameter of visceral fat. WC and waist-to-hip ratio are good parameters showing body fat distribution and cardio-metabolic risk. Waist-to-height ratio is suggested by some authors to be an even better parameter of cardio-vascular risk and metabolic syndrome. Hypertriglyceridemia combined with increased WC is considered a marker of atherogenic metabolic risk. The paper also deals with procedures of body composition analysis. Anthropometric assessment of body composition analysis belongs to a group of simple and inexpensive procedures. Development of generalised equations for body density prediction introduced anthropometric methods in the analysis of body composition in everyday practice.

Smoking habits according to metabolic traits in an island population of the eastern Adriatic Coast.

The study deals with the connection between metabolic syndrome (MS) and smoking habits of 1602 males and 828 females aged 18-97 years from the island of Hvar, Croatia. The age-adjusted prevalence of MS was higher in males (18.1-31.2%) than females (9.7-24.2%) by all five criteria that were defined, except the one by AHA/NHLBI. The overall prevalence of MS reached 12.9% by WHO using body mass index (BMI), 13.1% by EGIR, 14.5% by WHO using waist to hip ratio (WHR), 18.2% by NCEP/ATP III, 18.9% by AHA/NHLBI, and 26.7% by IDF criteria. The prevalence of smoking habits was similar in males (24.7%) and females (23.8%). The frequency of mild, moderate and heavy smoking was higher in males than females, 35.8:26.6%, 31.0:27.0%, and 35.9:7.7%, respectively. Age and sex had significant influence on BMI and WHR, both being highest in male former smokers (28.15 kg/m2 and 0.973, respectively) and in female non-smokers (27.18 kg/m2 and 0.869, respectively). The appearance of arterial hypertension (HTN) differed according to frequency of smoking; males had higher prevalence than females using WHO and EGIR criteria of blood pressure > or = 140/90 mmHg, even after age adjustment. In males and females respectively, systolic HTN in non-smokers was 20.7:15.1%, in former smokers 17.9:15.2% and in current smokers 16.9:13.0%; diastolic HTN in non-smokers was 19.8:12.7%, in former smokers 22.4:10.5%, and in current smokers 11.3:9.1%. By NCEP, AHA, IDF criteria of blood pressure > or = 130/85 mmHg, arterial HTN was also more prevalent in males than females; systolic HTN in non-smokers being 31.4:19.8%, in former smokers 29.9:12.7%, and in current smokers 25.4:11.1%; and diastolic HTN in non-smokers was 20.5:11.5%, in former smokers 24.8:11.3%, and in current smokers 14.7:9.4%. According to AHA/NHLBI and IDF criteria of high plasma glucose as > or = 5.6 mmoL/L, both males and females in all the three categories of smokers had glucose levels above the normal range (5.80-6.31 mmol/L in males and 5.80-5.91 mmol/L in females), except female current smokers (5.51 mmol/L). By WHO, EGIR and NCEP/ATP III criteria of high plasma glucose as > or = 6.1 mmol/L, only male non-smokers (6.31 mmol/L) and former smokers (6.24 mmol/L) had elevated levels. Considering normal HDL-cholesterol as > 1.0 mmol/L in males and > 1.2 mmol/L in females, both males and females in all the three smoker's categories had HDL within normal range; females having higher HDL levels (1.52 mmol/L) than males (1.30 mmol/L). Considering normal value for triglycerides as < 1.7 mmol/L, male former smokers (1.76 mmol/L) and current smokers (1.81 mmol/L) had higher levels; and as a whole group triglycerides were higher in males than females, 1.66:1.37 mmol/L respectively. The prevalence of MS differed between males and females using various MS criteria. Both males and females had the highest prevalence of MS by IDF criteria; male former smokers 60.5%, female non-smokers 51.4%, male non-smokers 53.8%, female former smokers 38.2%, and lowest in both male and female current smokers 39.8 and 33.0% respectively. In males, the lowest prevalence of MS was observed in non-smokers by AHA criteria (30.5%), in former smokers by WHO criteria (35.7%), and in current smokers using EGIR criteria (18.1%). Females in all the three smoker's categories had the lowest prevalence of MS using EGIR and WHO criteria. MS were less prevalent in current smokers than in non-smokers and former smokers.

Dietary patterns in adults from an Adriatic Island of Croatia and their associations with metabolic syndrome and its components.

Adriatic islanders have a high prevalence of metabolic syndrome (MetS) although they have traditionally practiced an active lifestyle and adhered to a Mediterranean diet. We performed a cross-sectional study to identify dietary patterns in a sample of 1442 adults from the island of Hvar, and determined whether MetS and its components: waist-circumference, serum triglycerides, fasting plasma glucose, HDL-cholesterol, and blood pressure, were related to an altered pattern of the traditional Mediterranean diet. Dietary intake was assessed by a food frequency questionnaire. MetS was defined using the International Diabetes Federation criteria. Our study showed that dietary patterns in this population have diversified from the traditional diet. Principal component analysis identified three major patterns. The meat, alcohol, and fish pattern (MAFp), sweets, grains, and fats pattern (SGFp), and an olive-oil, vegetables, and fruits pattern (OVFp) explained 30.6% of total dietary variance. The MAFp associated significantly with MetS (p = 0.027) and high plasma glucose (p = 0.006).

Modeling metabolic syndrome through structural equations of metabolic traits, comorbid diseases, and GWAS variants.

OBJECTIVE: To provide a quantitative map of relationships between metabolic traits, genome-wide association studies (GWAS) variants, metabolic syndrome (MetS), and metabolic diseases through factor analysis and structural equation modeling (SEM). DESIGN AND METHODS: Cross-sectional data were collected on 1,300 individuals from an eastern Adriatic Croatian island, including 14 anthropometric and biochemical traits, and diagnoses of type 2 diabetes, coronary heart disease, gout, kidney disease, and stroke. MetS was defined based on Adult Treatment Panel III criteria. Forty widely replicated GWAS variants were genotyped. Correlated quantitative traits were reduced through factor analysis; relationships between factors, genetic variants, MetS, and metabolic diseases were determined through SEM. RESULTS: MetS was associated with obesity (P < 0.0001), dyslipidemia (P < 0.0001), glycated hemoglobin (HbA1c; P = 0.0013), hypertension (P < 0.0001), and hyperuricemia (P < 0.0001). Of metabolic diseases, MetS was associated with gout (P = 0.024), coronary heart disease was associated with HbA1c (P < 0.0001), and type 2 diabetes was associated with HbA1c (P < 0.0001) and obesity (P = 0.008). Eleven GWAS variants predicted metabolic variables, MetS, and metabolic diseases. Notably, rs7100623 in HHEX/IDE was associated with HbA1c (ß = 0.03; P < 0.0001) and type 2 diabetes (ß = 0.326; P = 0.0002), underscoring substantial impact on glucose control. CONCLUSIONS: Although MetS was associated with obesity, dyslipidemia, glucose control, hypertension, and hyperuricemia, limited ability of MetS to indicate metabolic disease risk is suggested.

Finding missing heritability in less significant Loci and allelic heterogeneity: genetic variation in human height.

Genome-wide association studies (GWAS) have identified many common variants associated with complex traits in human populations. Thus far, most reported variants have relatively small effects and explain only a small proportion of phenotypic variance, leading to the issues of 'missing' heritability and its explanation. Using height as an example, we examined two possible sources of missing heritability: first, variants with smaller effects whose associations with height failed to reach genome-wide significance and second, allelic heterogeneity due to the effects of multiple variants at a single locus. Using a novel analytical approach we examined allelic heterogeneity of height-associated loci selected from SNPs of different significance levels based on the summary data of the GIANT (stage 1) studies. In a sample of 1,304 individuals collected from an island population of the Adriatic coast of Croatia, we assessed the extent of height variance explained by incorporating the effects of less significant height loci and multiple effective SNPs at the same loci. Our results indicate that approximately half of the 118 loci that achieved stringent genome-wide significance (p-value<5×10(-8)) showed evidence of allelic heterogeneity. Additionally, including less significant loci (i.e., p-value<5×10(-4)) and accounting for effects of allelic heterogeneity substantially improved the variance explained in height.

The effect of cigarette smoking history on muscular and cardiorespiratory endurance.

The purpose of this study was to investigate the effect of cigarette smoking history on physical fitness in younger adults. Small, insignificant differences in BMI between non-smokers and smokers were shown regardless of cigarette smoking history duration. Although the differences in muscular endurance increased in the samples with progressing cigarette smoking history duration, a highly significant difference in aerobic endurance was observed between the group of non-smokers and smokers with a history of smoking up to 5 years and persisted at the same level in smokers with a history of smoking for longer than 10 years.

Unexpected sudden death due to recreational swimming and diving in men in Croatia in a 14-year period.

The article deals with 17 sudden deaths which occurred during recreational swimming and diving in men in Croatia in a 14-year period: from January 1, 1998 to December 31, 2011. The sample is taken out from the total number of 61 sudden deaths in men during or immediately after sport or recreational exercise. Included are also sudden deaths of 8 foreigners spending holidays at the Croatian Adriatic Coast. In all of them forensic medicine autopsy was done. Thirteen males from Croatia died during recreational swimming. Three of them were aged 15-29 yrs: one had signs of hypertrophic cardiomyopathy, the second suffered from chronic myopericarditis with left ventricular aneurysm, and the third had cardiomegaly and blood alcohol level of 1.7 per thousand. Five were aged 30-64 yrs: four of them have suffered from coronary atherosclerosis and left ventricular hypertrophy of 15-18-18-22 mm, and one with left ventricular hypertrophy drowned suddenly, probably because of malignant ventricular arrhythmia. The fifth suffered stroke and drowned. Five elderly men, aged 65-85 yrs, have suffered from coronary atherosclerosis, myocardial fibrosis or myocardial scars, and three of them had left ventricular hypertrophy of 19 mm. Four males died during recreational diving. One aged 26yrs drowned, at autopsy he had left ventricular hypertrophy of 17 mm. Three males were middle-aged: two had coronary atherosclerosis, two of them had a severe degree of coronary atherosclerosis and one had coronary atherosclerosis of medium degree but with myocardial fibrosis and left ventricular hypertrophy of 18 mm. Seven male foreigners died, five of them during swimming: two aged 30-64 and two aged 65-85. They all have had coronary atherosclerosis: one of them had an acute myocardial infarction of the posterior wall, and one hypertrophic cardiomyopathy as well. One middle-aged and one elderly man died during diving, and both had an acute myocardial infarction of the posterior wall. One elderly foreign woman died during swimming, she had coronary atherosclerosis and a myocardial scar. In Croatia, death rate during both swimming and diving in men aged 15-29 years amounted to 0.63/1,000.000 (p=1.0000); in those aged 30-64 it reached 0.56/1,000.000 (p=0.3698), and in those aged 65-85 it was 1.41/1,000.000 (p=0.1849). The death rate during swimming in men aged 15-29 amounted to 1.47/1,000.000 (p=0.9864), in men aged 30-64 it reached 0.35/1,000.000 (p=0.2245), and in those aged 65-85 it was 1.41/1,000.000 (the difference is significant, p=0.0472). The death rate during diving in men aged 15-29 was 0.16/1,000.000, and in men aged 30-64 the observed rate was 0.21/1,000.000 (p=1.0000).

Genome-wide association of serum uric acid concentration: replication of sequence variants in an island population of the Adriatic coast of Croatia.

A genome-wide association study of serum uric acid (SUA) laevels was performed in a relatively isolated population of European descent from an island of the Adriatic coast of Croatia. The study sample included 532 unrelated and 768 related individuals from 235 pedigrees. Inflation due to relatedness was controlled by using genomic control. Genetic association was assessed with 2,241,249 single nucleotide polymorphisms (SNPs) in 1300 samples after adjusting for age and gender. Our study replicated four previously reported SUA loci (SLC2A9, ABCG2, RREB1, and SLC22A12). The strongest association was found with a SNP in SLC2A9 (rs13129697, P=2.33×10(-19)), which exhibited significant gender-specific effects, 35.76 µmol/L (P=2.11×10(-19)) in females and 19.58 µmol/L (P=5.40×10(-5)) in males. Within this region of high linkage disequilibrium, we also detected a strong association with a nonsynonymous SNP, rs16890979 (P=2.24×10(-17)), a putative causal variant for SUA variation. In addition, we identified several novel loci suggestive of association with uric acid levels (SEMA5A, TMEM18, SLC28A2, and ODZ2), although the P-values (P<5×10(-6)) did not reach the threshold of genome-wide significance. Together, these findings provide further confirmation of previously reported uric-acid-related genetic variants and highlight suggestive new loci for additional investigation.

[Croatian guidelines for nutrition in the elderly, part I]. / Hrvatske smjernice za prehranu osoba starije dobi, dio I.

Aging produces numerous physical and physiologic changes, which in turn alter nutritional requirements and affect nutritional status. The presence of chronic disease, and/or medications can enhance potential disparities between nutrient needs and dietary intake, leading to malnutrition. Indeed, research suggests that malnutrition is a common condition among the elderly. Therefore, regular nutritional assessment should be done as an integral part of healthcare for elderly. Also, it is important to take in consideration all determinants of geroanthropometry. The physiologic changes associated with aging affect requirement for several essential nutrients. In general, the requirement for many nutrients decreases, concomitant with the decrease in energy needs. However, some nutrients are needed in higher amounts. Additionally, various psychosocial and socioeconomic changes that often attend aging may also alter dietary intake. Dietary planning is important part of nutritional care in the elderly. Also, some elderly persons can benefit with dietary supplements and oral nutritional supplements (enteral formulas) which can be prescribed by diagnosed or threatening malnutrition. Croatian guidelines for nutrition in the elderly have been developed by interdisciplinary expert group of Croatian clinicians, gerontologists, anthropologists, nutritionists and other professionals involved with care for elderly population. The guidelines are based on evidence from relevant medical literature and clinical experience of working group.

Arrhythmogenic right ventricular dysplasia and sudden cardiac death in Croatians' young athletes in 25 years.

The paper deals with the sudden cardiac death during training in male athletes in Croatia. The data are a part of a retrospective study dealing with 67 sudden death due to physical activity in men in Croatia during 25 years: from January 1, 1986 to December 31, 2010. Two of them suddenly died during training due to malignant ventricular arrhythmia because of the arrhythmogenic right ventricular dysplasia. First was a short trails runner aged 24, with no any previous physical discomforts, who suddenly collapsed and died during training. The second was a soccer player aged 13, with no any previous physical discomfort, who suddenly collapsed and died during training. A sudden cardiac death due to physical exercise in young athletes in Croatia suffered of arrhythmogenic right ventricular dysplasia reached 0.07/ 100.000 yearly (p = 0.00000), in all young athletes suffered of heart diseases reached 0.19/100 000 (p = 0.00005), and in the total male population aged 15-40 engaged in sports and recreational physical exercise: 0.71/100.0000 (p = 0.00001).

Physical activity and sudden cardiac death in elders--a Croatian study.

The paper deals with the sudden cardiac death in elders due to physical activity in Croatia and to compare it to other population groups who practice physical activity. The data are a part of a retrospective study dealing with 59 sudden death due to physical activity in men in Croatia: from January 1, 1988 to December 31, 2008. Fifteen aged 65 to 82 years were recreationally engaged in physical activity: six in swimming, four in tennis, one in driving a bicycle, one in jogging, two in bowling and one died during sexual act. Only one had symptoms of pectoral angina, two suffered from arterial hypertension, and two had congestive heart failure. Eleven were without symptoms before exercise. At forensic autopsy, fourteen had coronary heart disease, seven had critical coronary artery stenosis, three had occluded left descendens anterior coronary artery and four critical coronary stenosis, four had a recent myocardial infarctions, and eleven had myocardial scars due to previous myocardial infarctions. Twelve of them had left ventricular hypertrophy: 15-25 mm. In Croatia, about 7per cent of the entire male population undertake recreational physical activity, while 13 per cent of them are elders. A sudden cardiac death due to recreational physical activity in elders reached 1.71/100 000 yearly, in the entire male population engaged in recreational physical exercise: 0.75/100 000 (p = 0.05730), in the total male population aged 15-40 engaged in sports and recreational physical exercise: 0.57/100.0000 (p = 0.00387), in young athletes: 0.15/100 000 (p = 0.00000). Medical examination of all elderly persons has to be done before starting of recreational physical activity: by clinical examination, searching for risk factors for atherosclerosis, performing ECG at rest, stress ECG, and echocardiography and to repeat the medical examination at least once a year Physical activity should start with a warm-up period and with a gradually increasing load, and usually not to exceed 6-7 metabolic equivalents (METs).

Hypertrophic cardiomyopathy and sudden cardiac death due to physical exercise in Croatia in a 27-year period.

The paper deals with the sudden cardiac death during physical exercise in males in Croatia. The data are a part of a retrospective study dealing with 69 sudden death due to physical activity in men in Croatia during 27 years: from January 1, 1984 to December 31, 2010. Three of them suddenly died during training and two of them died during recreational physical exercise, probably because of malignant ventricular arrhythmia due to hyperthrophic cardiomyopathy. One had an obstructive form of hypertrophic cardiomyopathy with i.v. septum of 40 mm and four had a non-obstructive forms of hyperthrophic cardiomyopathy with left ventricular wall of 18-20-22-25 mm. First athlete was a short trails runner, aged 24, with no any previous physical discomforts, who suddenly collapsed and died during training. The second athlete was a soccer player aged 18, with no any previous physical discomfort, who suddenly collapsed and died during training. The third aged 15, was a school boy, basketball player, with no any previous physical discomfort, who collapsed and died during training. Two aged 25 and 34, were with no physical discomfort during exercise and died suddenly during recreational soccer games. A sudden cardiac death due to physical exercise in young athletes in Croatia suffered of hyperthropic cardiomyopathy reached 0.06/100 000 yearly (p = 0.00000) in 27 years, in teenagers 0.26/100 000 (p = 0.00226), in teenagers suffered of hypertrophic cardiomyopathy reached 0.10/100 000 (p = 0.00000), in all young athletes suffered of other heart diseases reached 0.19/100 000 (p = 0.00005), and in the total male population aged 15 or more, engaged in sports and recreational physical exercise: 0.71/100.0000 (p = 0.00001).

Replication of genetic variants from genome-wide association studies with metabolic traits in an island population of the Adriatic coast of Croatia.

Twenty-two single-nucleotide polymorphisms (SNPs) in 10 gene regions previously identified in obesity and type 2 diabetes (T2D) genome-wide association studies (GWAS) were evaluated for association with metabolic traits in a sample from an island population of European descent. We performed a population-based study using 18 anthropometric and biochemical traits considered as continuous variables in a sample of 843 unrelated subjects (360 men and 483 women) aged 18-80 years old from the island of Hvar on the eastern Adriatic coast of Croatia. All eight GWAS SNPs in FTO were significantly associated with weight, body mass index, waist circumference and hip circumference; 20 of the 32 nominal P-values remained significant after permutation testing for multiple corrections. The strongest associations were found between the two TCF7L2 GWAS SNPs with fasting plasma glucose and HbA1c levels, all four P-values remained significant after permutation tests. Nominally significant associations were found between several SNPs and other metabolic traits; however, the significance did not hold after permutation tests. Although the sample size was modest, our study strongly replicated the association of FTO variants with obesity-related measures and TCF7L2 variants with T2D-related traits. The estimated effect sizes of these variants were larger or comparable to published studies. This is likely attributable to the homogenous genetic background of the relatively isolated study population.

Extent of height variability explained by known height-associated genetic variants in an isolated population of the Adriatic coast of Croatia.

BACKGROUND: Human height is a classical example of a polygenic quantitative trait. Recent large-scale genome-wide association studies (GWAS) have identified more than 200 height-associated loci, though these variants explain only 2∼10% of overall variability of normal height. The objective of this study was to investigate the variance explained by these loci in a relatively isolated population of European descent with limited admixture and homogeneous genetic background from the Adriatic coast of Croatia. METHODOLOGY/PRINCIPAL FINDINGS: In a sample of 1304 individuals from the island population of Hvar, Croatia, we performed genome-wide SNP typing and assessed the variance explained by genetic scores constructed from different panels of height-associated SNPs extracted from five published studies. The combined information of the 180 SNPs reported by Lango Allen el al. explained 7.94% of phenotypic variation in our sample. Genetic scores based on 20~50 SNPs reported by the remaining individual GWA studies explained 3~5% of height variance. These percentages of variance explained were within ranges comparable to the original studies and heterogeneity tests did not detect significant differences in effect size estimates between our study and the original reports, if the estimates were obtained from populations of European descent. CONCLUSIONS/SIGNIFICANCE: We have evaluated the portability of height-associated loci and the overall fitting of estimated effect sizes reported in large cohorts to an isolated population. We found proportions of explained height variability were comparable to multiple reference GWAS in cohorts of European descent. These results indicate similar genetic architecture and comparable effect sizes of height loci among populations of European descent.

Common SNPs in FTO gene are associated with obesity related anthropometric traits in an island population from the eastern Adriatic coast of Croatia.

BACKGROUND: Multiple studies have provided compelling evidence that the FTO gene variants are associated with obesity measures. The objective of the study was to investigate whether FTO variants are associated with a broad range of obesity related anthropometric traits in an island population. METHODOLOGY/PRINCIPAL FINDINGS: We examined genetic association between 29 FTO SNPs and a comprehensive set of anthropometric traits in 843 unrelated individuals from an island population in the eastern Adriatic coast of Croatia. The traits include 11 anthropometrics (height, weight, waist circumference, hip circumference, bicondilar upper arm width, upper arm circumference, and biceps, triceps, subscapular, suprailiac and abdominal skin-fold thicknesses) and two derived measures (BMI and WHR). Using single locus score tests, 15 common SNPs were found to be significantly associated with "body fatness" measures such as weight, BMI, hip and waist circumferences with P-values ranging from 0.0004 to 0.01. Similar but less significant associations were also observed between these markers and bicondilar upper arm width and upper arm circumference. Most of these significant findings could be explained by a mediating effect of "body fatness". However, one unique association signal between upper arm width and rs16952517 (P-value = 0.00156) could not be explained by this mediating effect. In addition, using a principle component analysis and conditional association tests adjusted for "body fatness", two novel association signals were identified between upper arm circumference and rs11075986 (P-value = 0.00211) and rs16945088 (P-value = 0.00203). CONCLUSIONS/SIGNIFICANCE: The current study confirmed the association of common variants of FTO gene with "body fatness" measures in an isolated island population. We also observed evidence of pleiotropic effects of FTO gene on fat-free mass, such as frame size and muscle mass assessed by bicondilar upper arm width and upper arm circumference respectively and these pleiotropic effects might be influenced by variants that are different from the ones associated with "body fatness".

Suppurative tonsillitis and sudden cardiac death due to physical training in a young soccer player.

A teenager aged 17 was a professional soccer player, and was without symptoms. He died suddenly during physical exercise at the field. All reanimation efforts were unsuccessfull. At the forensic autopsy he had suppurative bacterial tonsillitis, subacute diffuse myopericarditis and narrowing of the ascending aorta of 10 mm. In Croatia the death rate among athletes reached 0.15/100,000, in athletes suffered of acute respiratory tract infections 0.34/100,000, in males who practice exercise recreatively 0.75/100,000 (p = 0.0014), in school children 1.0/100,000 (p = 0.0010). Physical exercise is contraindicated in acute respiratory tract infections. Every such case has to be treated by physician. When to start with physical training after suppurative-bacterial tonsillitis depends on disappearing of clinical signs, normalization of erythrocite sedimentation rate; of white cell count and serum level of C-reactive protein. Physical exercise is contraindicated in patients suffering of myopericarditis for at least 6 months. When to start exercise depends on disappearing of subjective symptoms and normalization of clinical and laboratory findings.

[Human lifespan: to live and outlive 100 years?]. / Ljudski vijek: dozivjeti i nadzivjeti 100 godina?

Aged population dominates in developed countries. Centenarians are a select group, and only one in 7,000 to 10,000 reach that age. Factors of longevity are numerous and include genetic predisposition (a locus on chromosome 4), environment, healthy lifestyle (hypocaloric diet, regular physical and mental exercise), accessible health services, and efficient health protection at old age. Centenarians are well adapted to the new life and compensate for the loss of functions with age. The limits of human life are extended, so that nowadays the oldest person has reached the age of 128. Some geographic areas are characterised by higher numbers of centenarians. This article mentions a few individuals who outlived 100 years in the world, Croatia, and neighbouring countries. Although some argue that the limits of human life cannot be extended over the age of 120 years, for now we cannot predict the actual limits of human life.