PURPOSE: The purpose of this study was to investigate the influencing factors of influenza vaccination in the elderly participating in lifetime transitional health examination. METHODS: This study was a secondary analysis of data collected from lifetime transitional health examination (for 66-year-old people) conducted by the National Health Insurance Corporation (NHIC) from January 1 to December 31, 2008. Questionnaires were received from NHIC to obtain information regarding gender, chronic diseases, health-related behaviors, and ADL. A total of 255,333 participants who responded all the questions in the questionnaire were included in the analysis. Collected data were analyzed by descriptive statistics, chi2 test, and multiple logistic regression. RESULTS: The influenza vaccine coverage rate in 66-year-old people was 66.1%. The influenza vaccine coverage rate was higher in female elders and those with hypertension, diabetes, heart disease or past smoking, and lower in those with stroke, current smoking, drinking, no-exercise or ADL-dependency. CONCLUSION: Strategies for improving the influenza vaccination coverage rate in the elderly are needed. The strategies should give priority to the elderly with current smoking, drinking, and no-exercise, and home visiting programs are needed for the elderly with stroke and ADL-dependency.
Activities of Daily Living ; Aged* ; Chronic Disease ; Drinking ; Female ; Heart Diseases ; House Calls ; Humans ; Hypertension ; Influenza Vaccines ; Influenza, Human* ; Logistic Models ; National Health Programs ; Smoke ; Smoking ; Stroke ; Vaccination* ; Surveys and Questionnaires

Inhibitor development is one of the major adverse events associated with increased morbidity and mortality in patients with congenital hemophilia. Recent treatment for them is immune tolerance induction (ITI), which involves the administration of high doses of factor concentrates over a prolonged period, sometimes combined with immunosuppressive agents. We report a case of inhibitor elimination with Rituximab, and high-dose factor VIII concentrates in a 5-year-old boy with hemophilia A. The patient improved clinically, with fewer bleeding episodes. However, he continued to have low immunoglobulin levels, which led to recurrent infections. After an infusion of intravenous immunoglobulin, inhibitor titers increased rapidly and his ITI was deemed a failure. In conclusion, even though it failed in the present study, Rituximab may be an alternative adjuvant therapy to eliminate the inhibitor in patients with hemophilia. The appropriate schedule and long-term side effects need further investigation.
Appointments and Schedules ; Child, Preschool ; Factor VIII ; Hemophilia A ; Hemorrhage ; Humans ; Immune Tolerance ; Immunoglobulins ; Immunosuppressive Agents ; Male ; Mortality ; Rituximab

The Carney complex (CNC) is an autosomal dominant disorder characterized by endocrine and nonendocrine tumors. Loss-of-function variants of protein kinase A regulatory subunit 1 alpha (PRKAR1A) are common causes of CNC. Here, we present the case of a patient with CNC with a novel PRKAR1A missense variant. A 21-year-old woman was diagnosed with CNC secondary to acromegaly and adrenal Cushing syndrome. Genetic analysis revealed a novel missense heterozygous variant of PRKAR1A (c.176A>T). Her relatives, suspected of having CNC, also carried the same variant. RNA analysis revealed that this variant led to nonsense-mediated mRNA decay. In vitro functional analysis of the variant confirmed its role in increasing protein kinase A activity and cyclic adenosine monophosphate levels. This study broadens our understanding of the genetic spectrum of CNC. We suggest that PRKAR1A genetic testing and counseling be recommended for patients with CNC and their families.