Association of collagen type I alpha 1 gene polymorphism with inguinal hernia

PURPOSE

A positive family history is an important risk factor for inguinal hernia development, suggesting a genetic trait for hernia disease. However, gene mutations responsible for abdominal wall hernia formation in humans have not yet been studied. We aimed to evaluate whether the functional Sp1 binding site polymorphism within intron 1 of the collagen type I, alpha 1 (COL1A1) gene was associated specifically with inguinal hernia disease.

METHODS

85 participants with surgically diagnosed inguinal hernia disease, and 82 physically active controls without any history of connective tissue disease and hernia were recruited for this case-control genetic association study. Polymerase chain reaction and restriction fragment length polymorphism and agarose gel electrophoresis techniques were used to detect these polymorphisms.

RESULTS

Significantly, more patients gave a positive family history for an inguinal hernia compared to healthy controls (OR 3.646, 95 % CI 1.375-9.670, P = 0.006). COL1A1 Sp1 SNP (rs 1800012) was identified. Results demostrated statistically significant deviation from HWE for cases (P = 0.007), but not for the controls (P = 0.276). Our results revealed an increased frequency of COL1A1 Sp1 Ss genotype in inguinal hernia patients (OR 3.593, 95 % CI 1.867-6.915, P = 0.000).

CONCLUSIONS

This results suggest that polymorphism of the COL1A1 Sp1 binding site is associated with an increased risk for developing inguinal hernias. So, rs 1800012 locus is a potential candidate region for susceptibility in molecular mechanism of inguinal hernia pathophysiology.

Could vital signs predict carbon monoxide intoxication?

OBJECTIVE

This retrospective study examined the correlation between carboxy haemoglobin (COHb) levels and vital signs in patients with carbon monoxide (CO) intoxication.

METHODS

Over a 10-year period, patients>16 years of age who presented to the emergency department due to CO intoxication were included. Age, gender, comorbidities, month/year of presentation, presenting symptoms, vital signs, blood pH, COHb level, treatment and outcome were recorded.

RESULTS

In total, 476 patients were included. The mean±SD age was 36.22±13.65 years; 96.4% of the patients had a normal Glasgow Coma Scale score, 91.0% had normal blood pressure and 80.0% had a normal heart rate. COHb levels were stratified into three groups: <10% (n=39), 10-20% (n=106) and >20% (n=205); levels could not be obtained in the remaining 126 patients. In patients with COHb levels>20%, 34 (16.6%) had alkalosis and nine (4.4%) had acidosis. Among patients with COHb levels>20%, 140 (68.3%) had normal vital signs.

CONCLUSIONS

Vital signs cannot be used as a prognostic marker of CO intoxication and, therefore, patients must be monitored closely.