Chronic fatigue syndrome: aetiology, diagnosis and treatment

Chronic fatigue syndrome is characterised by intense fatigue, with duration of over six months and associated to other related symptoms. The latter include asthenia and easily induced tiredness that is not recovered after a night's sleep. The fatigue becomes so severe that it forces a 50% reduction in daily activities. Given its unknown aetiology, different hypotheses have been considered to explain the origin of the condition (from immunological disorders to the presence of post-traumatic oxidative stress), although there are no conclusive diagnostic tests. Diagnosis is established through the exclusion of other diseases causing fatigue. This syndrome is rare in childhood and adolescence, although the fatigue symptom per se is quite common in paediatric patients. Currently, no curative treatment exists for patients with chronic fatigue syndrome. The therapeutic approach to this syndrome requires a combination of different therapeutic modalities. The specific characteristics of the symptomatology of patients with chronic fatigue require a rapid adaptation of the educational, healthcare and social systems to prevent the problems derived from current systems. Such patients require multidisciplinary management due to the multiple and different issues affecting them. This document was realized by one of the Interdisciplinary Work Groups from the Institute for Rare Diseases, and its aim is to point out the main social and care needs for people affected with Chronic Fatigue Syndrome. For this, it includes not only the view of representatives for different scientific societies, but also the patient associations view, because they know the true history of their social and sanitary needs. In an interdisciplinary approach, this work also reviews the principal scientific, medical, socio-sanitary and psychological aspects of Chronic Fatigue Syndrome

Vasculitis necrotizante sistémica tipo poliarteritis nodosa: estudio de los marcadores de pronóstico

Tesis doctoral original inédita, leida el 14 de marzo de 1984 en la Universidad de Autónoma de Madrid, Facultad de Medicin

Non-linear tools and methodological concerns measuring human movement variability: an overview

In recent years, several works have explored variability using different approaches, trying to describe the variations in motor movement. Traditionally, movement variability was regarded as a system error due to noise of neuromuscular mechanisms, but alternative theories suggest that motor variability seems to reflect a functional behaviour improving motor control and enhancing learning. Controversial results have been reported about variability characteristics and its role in motor control and learning, and several works suggest that the main difficulty lies in how to measure this variability. In this work, we have outlined the most used non-linear tools to assess human variability, their applications, advantages and disadvantages. We have also suggested different methods about how to achieve a multidimensional approximation to motor variability. Finally, we have called attention to some methodological issues frequently reported as important aspects to take into account when measuring human movement variability

The role of motor variability in motor control and learning depends on the nature of the task and the individual’s capabilities

Recent studies have found that motor variability is actively regulated as an exploration tool to promote learning in reward and error-based tasks. Based on this functional role of variability, several researches have manipulated motor variability by practicing in order to maximize learning processes. However, the effectiveness of such variable practice as a tool to improve motor performance has shown several controversial results. The present work reviews how the interaction between the features of individuals with different motor capabilities (i.e. experience and brain disorders) and task constraints modulates the relation between motor variability and motor control and learning. Examining how the process of skill learning can be improved by the variability modulation according to individuals’ is not only of theoretical interest, but may also have several practical implications in motor learning and neuro-rehabilitation.Estudios recientes han demostrado que la variabilidad motora es activamente regulada como herramienta de exploración con objeto de incrementar el rendimiento motor tanto en tareas de aprendizaje basadas en la aplicación de recompensas como en la percepción del error. Basándose en este rol funcional de la variabilidad, varios investigadores han manipulado la variabilidad motora al practicar para maximizar los procesos de aprendizaje motor. Sin embargo, la efectividad de la práctica variable como herramienta para la mejora de la ejecución motora, ha mostrado resultados contradictorios en la literatura científica. El presente trabajo revisa cómo la interacción entre las características de individuos con diferentes capacidades motrices (i.e. experiencia y alteraciones neurológicas) y las características de las tareas modulan la relación entre la variabilidad motora, el control y el aprendizaje motor. El estudio de cómo los procesos de aprendizaje motor pueden ser mejorados mediante la manipulación de la carga de variabilidad al practicar no tiene sólo un interés teórico, sino que puede tener implicaciones prácticas en relación al aprendizaje motor o la neuro-rehabilitación