New WHO Guidance Helps Countries to Institutionalize Simulation Exercises to Strengthen Health Emergency Readiness - World Health Organization (WHO)

Published October 12, 2026 11:34AMHow we reported this story: The author, Danielle Zickl, a health journalist, interviewed two experts, a physical therapist and a sports scientist, who explained why exercise is necessary for bone health. Whether you’re scrambling up a mountainside or shredding uneven singletrack on your bike, outdoor athletes need a sturdy foundation. While the focus is usually on cardiovascular stamina or muscle strength, strong bones matter just as much—and are often overlooked.

Granulomatosis with polyangiitis (GPA) is a systemic necrotizing granulomatous vasculitis classically involving the upper and lower respiratory tracts and kidneys. Timely diagnosis requires a high index of suspicion for the presenting symptoms. Otolaryngologic manifestations are commonly reported but most often involve the nasal and paranasal sinuses. Sensorineural hearing loss (SNHL) as the sole initial manifestation of GPA is uncommon and may contribute to diagnostic delay. We report a case of a 67-year-old male who presented with rapidly progressive bilateral SNHL that preceded pulmonary and renal manifestations by several months, during which the patient was treated for otitis externa and Eustachian tube dysfunction without improvement. Development of pulmonary symptoms prompted additional workup, which demonstrated markedly elevated cytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA) and proteinase 3-anti-neutrophil cytoplasmic antibody (PR3-ANCA), raising concern for GPA. Histopathology then confirmed the diagnosis. The patient was treated with high-dose corticosteroids and rituximab with serologic remission; however, his hearing loss was largely irreversible. This case