Audiovestibular manifestations in patients with ankylosing spondylitis

Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown origin affecting up to 1% of the population. Little is known about audiovestibular impairment in patients with AS, especially the presence of cochleovestibular dysfunction in these patients. To investigate audiovestibular manifestations in AS, we studied a series of 50 consecutive patients who fulfilled the modified New York diagnostic criteria for AS and 44 matched controls. Individuals with history of cardiovascular disease, cerebrovascular complications, peripheral artery disease, renal insufficiency, syphilis, Meniere and other vestibular syndromes, infections involving the inner ear, barotrauma, or in treatment with ototoxic drugs were excluded. Most patients with AS were men (80%). The mean age at the time of study was 52.5 years, and mean age at the onset of symptoms was 34.4 years. Twenty-nine (58%) patients showed abnormal hearing loss in the audiogram compared to only 8 (18%) controls (p < 0.001). Values of audiometric tests (pure-tone average and speech reception threshold) yielded significant differences between patients and controls (p < 0.001). It is noteworthy that the audiogram shape disclosed a predominant pattern of high-frequency sensorineural hearing loss in AS patients (50%) compared to controls (18%) (p = 0.002). Also, AS patients exhibited abnormal vestibular tests more commonly than controls. AS patients had an increased frequency of head-shaking nystagmus (20%) compared to controls (0%) (p < 0.001). Moreover, patients (26%) showed a significantly increased frequency of abnormal caloric test compared to controls (0%) (p < 0.001). Finally, a significantly increased frequency of abnormal clinical test of sensory integration and balance with a predominant vestibular loss pattern was observed in patients (36%) compared to controls (5%) (p < 0.001). In conclusion, the current study demonstrates strong evidence for inner ear compromise in patients with AS

Geographical and genetic factors do not account for significant differences in the clinical spectrum of giant cell arteritis in southern europe

To investigate whether genetic and geographical differences may influence the clinical spectrum of giant cell arteritis (GCA), we compared the demographic and clinical features of patients with biopsy-proven GCA from Reggio Emilia (Northern Italy) and Lugo (Northwest Spain) during a 15-year period

Late holocene environments in Las Tablas de Daimiel (south central Iberian peninsula, Spain)

The use of a high resolution pollen record in combination with geochemical data from sediments composed mainly of layers of charophytes alternating with layers of vegetal remains plus some detrital beds permits the reconstruction of the environmental evolution of the last 3000 years in an inland wetland of the Mediterranean domain, thus introducing a new climatic dataset for the Late Holocene. Hydrological fluctuations, reflected in the relationship between emerged and aquatic vegetation and inorganic and organic C and N changes, can be related to aridity or humid phases, while relations among arboreal taxa (Quercus and Pinus) and Artemisia are used as temperature indicators. Five climatic periods have been identified: a Subatlantic Cold Period (<150 b.c.), cold and arid; the RomanWarm Period (150 b.c.–a.d. 270), warmer and wetter; the Dark Ages (a.d. 270–a.d. 950), colder and drier; the Medieval Warm Period (a.d. 950–a.d. 1400), warmer and wetter; and the Little Ice Age (>a.d. 1400) indicated by a cooling and drying trend. Despite the lack of any direct evidence of human action, there are some episodes related to deforestation during the Reconquista (Middle Ages) that mask the real climatic signal