Publications by authors named "Moloo H"
As future health care leaders who work and train in diverse clinical settings, resident physicians are uniquely positioned to advance sustainable health care systems. However, residents are insufficiently educated about health care sustainability and given limited opportunities to engage in planetary health. This article introduces and reports on the early outcomes of the Trainee-Led Research and Audit for Sustainability in Healthcare Canada (TRASH-CAN), a resident-driven initiative launched in 2023 with the aim of reducing Canadian health care's environmental impact.
View Article and Find Full Text PDFClimate change is a public health emergency, yet planetary health education is absent for many medical and health professions trainees. To perform a scoping review exploring the inclusion of planetary health in undergraduate and graduate medical education. A search strategy was developed with a health sciences librarian and run on 6 databases from their inception to February 2022: MEDLINE, Embase, APA PsycInfo, CINAHL, Global Health, and Scopus.
View Article and Find Full Text PDFPurpose: While there is limited patient-centred evidence (i.e., evidence that is important for patients and end-users) to inform the use of pharmacologic opioid minimization strategies (i.
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- The study focused on whether a home-based exercise program combined with nutritional guidance (prehabilitation) improves disease-free survival and return to treatment for older cancer patients with frailty compared to usual care.* -
- Out of 204 participants, results showed that the prehabilitation group and control group had similar rates of death or cancer recurrence (11% each), and slightly more patients returned to treatment in the prehabilitation group (29% vs. 23%).* -
- Ultimately, the research found no significant advantage of exercise prehabilitation on disease-free survival or treatment return, suggesting that future studies may need to be larger to detect meaningful effects.*
Article Synopsis
- Frailty in elderly patients is linked to higher rates of morbidity and mortality post-surgery, and its relationship with decisional regret (the feeling of regret about undergoing surgery) is not well understood.
- A study of 669 patients aged 65 and older undergoing elective noncardiac surgery found that 43.8% lived with frailty, and while frailty was initially related to increased decisional regret one year after surgery, this association weakened after adjusting for other factors like age, sex, and mental health.
- The results indicated that the type of surgery may influence the relationship between frailty and decisional regret, suggesting that more research is needed to fully understand these connections.
Article Synopsis
- Dexmedetomidine is being increasingly used in surgeries involving general anesthesia, but its impact on patient outcomes needs further evaluation.
- A systematic review of 44 randomized controlled trials with nearly 5904 participants indicated that intraoperative dexmedetomidine significantly improved recovery quality after surgery.
- The study found a 99% likelihood of any benefit from its use and an 88% chance of achieving a meaningful improvement in recovery, along with a reduction in chronic pain incidence.
Article Synopsis
- High rates of CT imaging are being used in emergency departments for patients with inflammatory bowel disease (IBD), despite guidelines suggesting more careful consideration of its use.
- A national survey involving 208 Canadian physicians revealed differing perceptions about CT's effectiveness in detecting IBD findings, with gastroenterologists being less likely to recommend it for certain conditions compared to emergency physicians and surgeons.
- The findings highlight the need for educational efforts to align physician practices with established guidelines on appropriate CT utilization for IBD in emergency settings.
Background: Preoperative anaemia is common in patient undergoing colorectal surgery. Understanding the population-level costs of preoperative anaemia will inform development and evaluation of anaemia management at health system levels.
Methods: This was a population-based cohort study using linked, routinely collected data, including residents from Ontario, Canada, aged ≥18 yr who underwent an elective colorectal resection between 2012 and 2022.
Background: Postoperative patient-centred outcome measures are essential to capture the patient's experience after surgery. Although a large number of pharmacologic opioid minimisation strategies (i.e.
View Article and Find Full Text PDFIntroduction: Dexmedetomidine is a promising pharmaceutical strategy to minimise opioid use during surgery. Despite its growing use, it is uncertain whether dexmedetomidine can improve patient-centred outcomes such as quality of recovery and pain.
Methods And Analysis: We will conduct a systematic review and meta-analysis following the recommendations of the .
Shared Care Models (SCMs), in which a team of clinicians share in patient care and resource utilization, represent an opportunity for surgeon-level system change. We aimed to identify the queues and stakeholders within a complex gastrointestinal surgical care pathway to demonstrate the implications of a SCM on system efficiency. A multidisciplinary group of surgeons and care navigators working in SCMs were asked to develop a patient encounter map through consensus to illustrate relevant queues and stakeholders within a SCM.
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- The study aims to compare the healing rates and outcomes of two anal fistula treatments: the traditional LIFT procedure and the newer BioLIFT procedure, which includes a bioprosthetic mesh.* -
- It will involve a systematic review and meta-analysis of various types of studies, focusing on adult patients undergoing either procedure, assessing primary healing rates, secondary healing rates, and complications.* -
- The analysis will utilize rigorous methodologies to evaluate the quality of the studies included, and will analyze potential differences in outcomes based on the complexity of the fistula and whether patients have previous LIFT experience.*
Background: Older adults with frailty are at an increased risk of adverse outcomes after surgery. Exercise before surgery (exercise prehabilitation) may reduce adverse events and improve recovery after surgery. However, adherence with exercise therapy is often low, especially in older populations.
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- - The study focuses on finding effective ways to differentiate Crohn's disease from cryptoglandular disease in patients with isolated perianal fistulas who showed no visible inflammation during traditional imaging tests like ileocolonoscopy and enterography.
- - Researchers used video capsule endoscopy to evaluate 45 adults with isolated perianal fistulas and discovered that 26% of these patients had signs of Crohn's disease, significantly higher than the 3% found in controls without perianal fistulas.
- - The study concludes that video capsule endoscopy is a promising tool for detecting small intestine inflammation in these patients, although more extensive research is necessary to confirm these findings.
Article Synopsis
- The text discusses a scoping review aimed at examining the effectiveness of strategies to minimize opioid use during surgery, in light of the ongoing opioid epidemic.
- The review will focus on randomized controlled trials that evaluate how these opioid minimization strategies impact patient-centered outcomes, using a multidisciplinary approach that involves patient partners and knowledge users.
- The study aims to compile a comprehensive overview of clinical trials, compare their outcomes with established recommendations, and identify effective strategies for reducing opioid use in surgical settings.
Background: The Consultation and Relational Empathy (CARE) Measure, a validated questionnaire designed to assess patients' perceptions of their physician's communication skills and empathy, has been used to assess empathy in medical specialties but has seldom been applied to surgery. We assessed empathy and communication skills among a group of surgeons within a single academic institution.
Methods: All surgeons within our department of surgery were invited to participate.
Variation in data provides an opportunity for health care providers to assess how patient care can be improved. Pan-Canadian colorectal cancer data show that, although long-term survival is similar among provinces, differences exist in other important aspects of care: length of stay, minimally invasive approach, readmission, and short-term mortality. Examining variation among stakeholders involved with colorectal cancer allows the opportunity to reflect on and optimize care.
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