News in brief: Tasmanian stroke patients flown to Melbourne; Head injuries linked to smell loss; 3 Australian universities among best in world for medicine

25 Jul 2022

Tasmanian stroke patients flown to Melbourne

A lack of stroke specialists means that Tasmanians requiring specialist procedures for strokes and aneurysms will be flown to Melbourne for treatment, the ABC reports.

The Tasmanian Health Service said the staff shortage was because the state’s two interventional neuroradiologists were unavailable due to a combination of illness, isolation and leave requirements.

Patients requiring time-critical procedures such as stroke reperfusion, clot retrieval inserting coils to treat aneurysms will be transferred to the Austin Hospital in Melbourne until a neuroradiologist returns to work on Sunday, a spokesperson said.

Health service unions said the situation highlighted Tasmania’s dependence on a small number of key personnel particularly in some specialities,” he said.

Head injuries linked to smell loss

Olfactory tests should be considered in head injury patients, US researchers suggest, after finding physical trauma may be linked to smell loss.

A study of 5,961 Atherosclerosis Risk in Communities participants revealed those with prior head injury were more likely to report subjective olfactory dysfunction and have objective anosmia than those without (24% vs 20%, difference: 4%, 95% CI: 1% to 6% and 15% vs 13%, difference: 2%, 95% CI: 0.1% to 4%, respectively).

The condition — subjective and objective — was most prominent in individuals with two or more, or more severe, head injuries, the authors found, after performing logistic regression models, adjusted for sociodemographics and medical comorbidities including cognitive status.

Despite this, head-trauma patients had lower concordance between subjective and objective assessment (72% vs 77%, difference: -5%, 95% CI: -8% to -3%), the authors reported in JAMA Otolaryngology — Head & Neck Surgery.

“Taken together, there should be consideration of objective psychophysical olfactory assessment in patients with head injury; this is particularly important because poor olfaction has previously been associated with multiple negative health outcomes,” they wrote.

Potential mechanisms of smell loss include “shearing of the olfactory nerve fibres anchored to the bony cribriform plate and mechanical injury of the sinonasal tract, olfactory bulbs, and olfactory-eloquent cortical brain regions”, they suggested.

Severe depression, post-traumatic epilepsy and medications prescribed for traumatic brain injury management may also contribute to observed olfactory dysfunction, they noted.

“Although the current study focused on olfactory functioning in the chronic post-head injury time period, these proposed mechanisms suggest that it will be important to follow patients with traumatic brain injury over time to investigate olfactory performance in the acute, subacute, and long-term post-injury phases in futures studies.”

“This information will have the potential to inform our understanding of factors associated with persistent or worsening olfactory dysfunction vs recovery, which may inform future treatments for post-traumatic olfactory dysfunction,” they wrote.

3 Australian universities among best in world for medicine

Three Australian universities have been placed in the top 50 rankings for academic excellence in clinical medicine.

Melbourne University was ranked at 14 in the prestigious ShanghaiRanking (formerly Academic Ranking of World Universities or ARWU) Global Ranking of Academic Subjects, with Sydney University being placed at 27 and the University of Western Australia at 32.

The top rankings were dominated by US universities, with Harvard University, the University of California San Francisco (UCSF), Cambridge University (UK), University of Pennsylvania and Johns Hopkins University being the top five ranked institutions.

Other Australian universities appeared lower in the global rankings, including Monash and the University of NSW in the 51-75 ranking range and the University of Adelaide and the University of Queensland in the 76-100 range.

Universities are measured on research output, influence and quality, as well as international collaboration and the number of international academic awards.

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