Updated meta-analysis of randomized controlled trials comparing conventional excisional haemorrhoidectomy with LigaSure for haemorrhoids

Background:\ud To compare the surgical outcome of haemorrhoidectomy performed using LigaSure bipolar diathermy with conventional haemorrhoidectomy.\ud \ud Methods:\ud Only randomized and alternate allocated studies were included from the major electronic databases using the search terms "ligasure" and "haemorrhoids" Duration of operation, blood loss during operation, postoperative pain score, wound healing, in-hospital stay, time to return to normal activities and complications were assessed.\ud \ud Results:\ud The 11 trials contained a total of 1,046 patients; the largest study was based on 273 patients and two earlier studies were based on 34 patients. No significant gender mismatch between the groups was reported in any of the studies. The patients’ ages were similar between groups in the studies, as was disease severity. All 11 studies reported a shorter duration of the operation when using LigaSure compared to the conventional technique (p<0.001). The postoperative pain score (p=0.001) and blood loss during operation (p=0.001) were significantly reduced. After LigaSure haemorrhoidectomy wound healing (p=0.004) and the return to normal activities (p=0.001) were significantly faster than after conventional haemorrhoidectomy. However, the overall incidence of complications reported was not significantly different (p=0.056).\ud \ud Conclusions:\ud LigaSure is an effective instrument for haemorrhoidectomy which results in less blood loss, quicker wound healing and earlier return to work.\u

Caracterización socioproductiva de los productores hortícolas en el partido de Junín (Buenos Aires)

El partido de Junín se ubica al noroeste de la provincia de Buenos Aires, abarca 226337 hectáreas y cuenta con 90305 habitantes. La ciudad de Junín se configuró históricamente como el principal centro administrativo, turístico, educativo, industrial, de salud y comercial de la región. Debido a la aptitud de los suelos, se ubica en la zona núcleo de producción agropecuaria. Desde los 90 nuevos perfiles socioproductivos surgieron en gran cantidad de agrociudades intermedias, no solamente en el sector de campo extensivo, sino también en las zonas periurbanas. Los productores hortícolas son unos de los más característicos. El objetivo de este trabajo consiste en realizar una caracterización socioproductiva de los productores que integran el sector hortícola del partido de Junín. Para ello se elaboró un dispositivo metodológico basado en la realización de una encuesta en la que se relevan variables sociales y productivas. La metodología consiste en un barrido total de los productores hortícolas del partido de Junín. Se llega a la totalidad a partir de la conformación de un listado de productores en el que participaron las diferentes instituciones. A los fines de confirmar la llegada a la totalidad de los productores para corroborar el barrido se utiliza la fotointerpretación de Google Earth con imágenes del año 2016. Entre los principales resultados se encuentra que el 60% de los productores son de origen argentino, generalmente juninenses, y el 40% de origen boliviano, principalmente del sur. Los productores juninenses fueron quienes, en continuidad con la actividad productiva de los padres, tuvieron acceso a la propiedad de la tierra, mientras que los productores que llegan de otras zonas son arrendatarios. Sin embargo, los productores bolivianos desarrollaron la estrategia productiva e innovadora de la producción de hortalizas bajo cubierta. Otra estrategia desarrollada por estos productores corresponde a la organización familiar exclusiva del trabajo productivo. Del total de los productores, el 56% realiza venta directa en quinta, el 28% vende en ferias y el 76% en verdulerías locales. Sin embargo, la principal problemática percibida corresponde a los bajos precios del mercado y a la competencia. En este sentido, se considera que el sector hortícola del partido de Junín tiene potencial para el desarrollo de políticas públicas vinculadas a la comercialización y abastecimiento local de productos hortícolas frescos

Empathy at school project: Effects of didactics of emotions® on emotional competence, cortisol secretion and inflammatory profile in primary school children. A controlled longitudinal psychobiological study

Background: There is mounting evidence of the presence of chronic stress among children during primary school: girls and boys under the age of 15 years often experience anxiety, irritability and sleeping problems with negative consequences on scholastic climate and the spread of bullying and dropping out of school. The promotion of emotion regulation within school environment through innovative didactic methodologies represents a valuable tool for teachers and parents to reduce emotional distress and associated risk behaviours and to promote wellbeing. Aim: Our research aims to explore the psychological and biological consequences of teaching emotional training in an experimental group of Italian Primary School children. Methods: A sample of pupils (81 children aged between 6 and 8) was divided into an experimental group (33 subjects) and a control group (30 subjects). A further advanced group of 18 subjects, who have experienced the method in the previous school year, was also included. The experimental study lasted one school year (from October 2021 to May 2022). The following psychological tests were administered to all groups: TEC (Test of Emotion Comprehension) to measure the children's different emotional abilities and the Projective test (PT) 'A person in the rain', to identify the coping skills of children in a stressful condition. Morning salivary cortisol, IL-6 and TNF-alpha assays were conducted in all three groups. Psychological and biological tests were administered at the beginning of the study and at the end of the study. Results: The MR-Anova model for TEC score showed that there was not a significant group effect [Fgroup = 2.24, p = 0.114]. Pairwise comparisons showed that mean score significantly increased only in the Experimental group (pB < 0.001) and at the end of the project there was a significant difference between Experimental group and Control group (pB = 0.012). The mean score of PT test increased significantly from baseline to the end of the project for the Experimental group (pB < 0.001) and for the Advanced group (pB = 0.004). At the end of the project, there were significant differences between the Experimental group and the Control group (pB = 0.004) and between the Advanced group and the Control group (pB < 0.001). Salivary cortisol analysis revealed a significant effect between subjects [Fgroup = 9.66; p < 0.001] and significant effects within subjects with the main effect of the time [Ftime = 35.41; p < 0.001] and the significant interaction “time x group” [Ftimexgroup = 3.38; p = 0.040]. Pairwise comparisons showed that cortisol levels decreased significantly over time only in the Experimental group (pB < 0.001). Regarding to IL-6 levels, there was not a significant effect between subjects [Fgroups = 0.0481; p = 0.953]. The mean level decreased significantly for each group from baseline to post project (pB < 0.001). With respect to TNF-alpha levels, the mean levels decreased over time for all groups (pB = 0.006 for Experimental group; pB < 0.001 either for the Advanced or Control group). Conclusion: the results documented in the experimental groups who experienced didactics of emotion for at least one school year show a significant increase in children's ability to cope with reality, stress and anxiety, and an improvement of their emotional competence. Meanwhile, a significant reduction in the amount of salivary cortisol was observed in the experimental group at the end of the scholastic year; meantime a stable reduced amount of salivary cortisol in advanced group throughout the project was also observed. These findings show that an intervention through an emotional education program is able to regulate interpersonal skills and the stress axis response