Distancia anogenitalun nuevo biomarcador de endometriosis

Abstract

SUMMERY This thesis presents a way to work on innovative and exciting learning postmodern childhood education . They are proposed as interdisciplinary learning tools contemporary art and photography by a working methodology for artistic projects. General purpose Design and implement an innovative educational project based on contemporary art and research in Neuroeducation, through a methodology of artistic projects, which links the needs of postmodern art education and an exciting learning the preschoolers . Objectives - Link the project with the school curriculum, promoting understanding of education through art , postmodern , to guide teachers in early childhood education. - Provide new forms of representation and expression of the child in Children with a creative language , through contemporary art and photographic process. - Generate innovative experiences in education, generated through the advancement and inclusion of information and communications technology (ICT) and photography classroom practices. - Promote learning from the provisions identified by the Neuroeducation , to achieve an to achieve an exciting learning - Analyze the data obtained from the evaluation of teachers, photographs, observation, and verbal and nonverbal responses of students about the effectiveness and difficulties of such a method, collected in interviews with teachers. C) General Research Methodology A Theoretical Framework, which has been applied a methodology documentary conducting a comprehensive literature review of the proposed topic. The literature search showed that there are not many interrelated research, pragmatically, postmodern art education, the use of photographic and computer resources, and current concepts of neuroeducación in the kindergarten stage. - An Empirical Framework: The existence of this gap stressed the need to continue research with a field of qualitative approach, oriented to the application of a methodology of Action Research. Moreover, the exploratory research stands out by assuming a new proposal. to achieve an exciting learning - Analyze the data obtained from the evaluation of teachers, photographs, observation, and verbal and nonverbal responses of students about the effectiveness and difficulties of such a method, collected in interviews with teachers. C) General Research Methodology A Theoretical Framework, which has been applied a methodology documentary conducting a comprehensive literature review of the proposed topic. The literature search showed that there are not many interrelated research, pragmatically, postmodern art education, the use of photographic and computer resources, and current concepts of neuroeducación in the kindergarten stage. - An Empirical Framework: The existence of this gap stressed the need to continue research with a field of qualitative approach, oriented to the application of a methodology of Action Research Moreover, the exploratory research stands out by assuming a new proposal. Research based on photography as intrinsically, that is, when pictures are products of art and thought, they show that it has different connotations beyond the photograph itself. The aim would be that the photographs taken were display models, either to describe the contexts, to propose hypotheses as visual reasoning or to draw conclusions. The results, in educational research, when working with applications based on Visual Arts methodologies might be useful visual images were organized by photographic series, because these modes of thought normally require an intention and a roadmap own processes investigational, and because they can achieve visual interpretations and explanations of the issues and educational problems. Conclusions: Wanted learning through enjoyable and exciting art. It is believed that there is a need of collaboration of the artist in the school. Training in art and technology are essential to provide arts education or education through art. It is advisable to take part in it early and monitored them at different levels. The artistic project and resources such as photography, can supply books which are not adapted to children, or the center, or basic cognitive concepts of Education and school curriculum where this curriculum is developed. The art helps to develope abstract, critical and creative thinking, a postmodern art education. Through the artistic project work as artist, the functions that the Neuroeducation designated as indispensable to the attainment of learning they are working on. Joy, excitement and pleasure can be learnt; incite curiosity; capture interest; learn from experience and discovery. Distinguish and classify; work individuality and the complicate social relationships; be aware and pay attention to a new world. ANOGENITAL DISTANCE: A NEW MARKER OF ENDOMETRIOSIS Introduction The anogenital distance (DAG) is a marker of dimorphic genital development in placental mammals. Studies in animal models have shown that DAG is determined in utero and persists throughout life. Prenatal exposure to high levels of androgens, results in a longer DAG (Mendiola 2011). The DAG predicts changes in reproductive function, for example a shorter DAG in men is associated with poorer semen quality while in women there is a positive association between the DAG and the number of ovarian follicles and higher concentrations of serum testosterone levels (Mira Escolano 2014). Estrogens have been proposed as one of the most important factors in the pathogenesis of endometriosis (Ferrerro et al 2014). The antiestrogen therapy improves symptoms because of its direct effect on endometriotic lesions and indirectly due to the action on the immune system. Endometriosis is an estrogen-dependent disease, which may likely have an intrauterine etiology (Shah 2013). Upson (2015) shows that premature fetuses have a higher risk of endometriosis due to lack of estrogen, produced in the placental gestation to term, making it impossible to brake hypothalamo-hypophyseal-axis. Endometriosis is a cause of infertility. Anti-Mullerian hormone (AMH) appears to be the current biological marker accepted as a predictor of ovarian reserve. Hypothesis Women with endometriosis have shortened DAG Women with endometriosis have more profound shortened DAG. Women with endometriosis and the DAG shortened have lower AMH Material and methods Case-control study with cases of endometriosis of the department of Gynecology of the University Hospital Virgen de la Arrixaca. The AMH was analyzed. For each subject, AGD was measured in two ways. First DAGAC: was measured from the anterior clitoral surface to the upperof the anus and Second, AGDAH was measured from the posterior fourchette to the upperof the anus. Results The DAGAH in patients with endometriosis was significantly shorter (P-value <0.001) than in controls. The average value of AMH was 1.8 (SD 2.2) lower in the cases of endometriosis, to 3.3 (SD 2.0) in the control group, being these differences statistically significant between groups (P-value <0.001). Odds ratios were calculated using measurements of the DAG divided around the median and comparing the subgroup of deep endometriosis with controls. A statistically significant difference with an OR of 12.9 (95% CI 4.1 to 40.9) was also found (p <0001) in the category of shorter DAGAH, increasing the values of the OR to 95.7 (95% CI = 5.5-1,668) in analyzes adjusted for age and childbirth of the patients. Finally, the relation of serum AMH levels observed in controls and in cases of endometriosis that were not operated was analyzed and the OR was calculated after adjusting for age and births, and they were much lower in women with endometriosis which were not operated than in the control group. Discussion Endometriosis being an easily reproducible estrogen-dependent disease with a a probable intrauterine etiology and DAG one marker of estrogenic intrauterine environment which is maintained in adulthood and is related to fertility, we think it may be a new accessible and cheap clinical biomarker. The DAG could predict cases of endometriosis before clinical manifestation. It could be especially useful in deep endometriosis to increase control and to try to prevent disease progression. The DAG is also a marker of diminished ovarian reserve, which would be useful to guide patients on the possible difficulties in their fertility.