ABSTRACT The objective of this review was to examine the effectiveness of the Global Physical Activity Questionnaire and the International Short Form Physical Activity Questionnaire, in relation to practical evaluations that assess healthy physical condition as an instrument for assessing sedentary lifestyle A digital search was conducted in scientific databases of high impact factor according to electronic reference of Scimagojr, Scopus, Pubmed, and Ebsco. The effectiveness of the international and global physical activity questionnaire, in assessing sedentary lifestyle and prescribing physical exercise seem conditioned, compared to practical evaluations, which assess similar factors, however they provide basic indicators that should be taken into account at the beginning of prescribing physical activity, the need to apply sedentary level and physical fitness parameters in the adult population established by practical evaluations is evident.

RESUMEN El objetivo de esta revisión fue examinar la efectividad del cuestionario Global de actividad física y el Cuestionario Internacional de actividad física forma corta, en relación con las evaluaciones prácticas que valoran la condición física saludable como instrumento de valoración del sedentarismo. Se realizó una búsqueda digital en bases de datos científicas de alto factor de impacto según referencia electrónica de Scimagojr, Scopus, Pubmed y Ebsco. La efectividad del cuestionario internacional y global de actividad física, en la valoración del sedentarismo y prescripción del ejercicio físico parecen condicionados en comparación con las evaluaciones prácticas, que valoran factores similares, sin embargo, proveen indicadores básicos que debe tomarse en cuenta al inicio de prescribir actividad física, se evidencia la necesidad de aplicar parámetros de nivel sedentario y aptitud física en población adulta establecidos por evaluaciones prácticas.

Primary gastric choriocarcinoma (PGC) is an uncommon tumor. Due to its rarity, its pathogenesis is still unclear. The diagnosis is based on immunohistopathology, which is positive for human chorionic gonadotropin (hCG). It is a highly invasive and rapidly-disseminated hematogenous neoplasm, which leads to a poor prognosis. We present the case of a 57-year-old woman with upper gastrointestinal bleeding associated with weight loss. The gastroscopy showed, on the cardia and paracardial region, a 5x4-cm ulcerated polypoid lesion with circumscribed edges and without adjacent wall infiltration, with stigmas of recent bleeding and a pathological anatomy that demonstrates ulcerated pleomorphic malignancy with positive immunohistochemistry for pankeratin. Given the suspicion of poorly differentiated carcinoma and without evidence of metastasis, the patient underwent a total gastrectomy and the pathology was compatible with choriocarcinoma. Therefore, after the surgery, a serum hCG test was performed with a result of 714 mIU/ml, which further confirmed the diagnosis. Treatment with adjuvant chemotherapy was decided, and a tomographic and serological hCG follow-up was conducted, without the presence of active disease

El coriocarcinoma gástrico primario (CGP) es un tumor infrecuente. Debido a su rareza, su patogenia aún no es clara. El diagnóstico se basa en la inmunohistopatología, la cual es positiva para gonadotropina coriónica humana (hCG). Es una neoplasia altamente invasiva y de rápida diseminación hematógena, lo que conlleva a un pobre pronóstico. Se presenta el caso de una paciente mujer de 57 años con hemorragia digestiva alta asociada a baja de peso. La gastroscopia reporta, a nivel de cardias y región paracardial, lesión polipoidea ulcerada de 5x4 cm, con bordes circunscritos y sin presencia de infiltración de pared adyacente, con estigmas de sangrado reciente y anatomía patológica que informa neoplasia maligna pleomórfica ulcerada con inmunohistoquímica positiva para panqueratina. Ante la sospecha de carcinoma poco diferenciado y sin evidencia de metástasis, la paciente fue sometida a gastrectomía total y la patología fue compatible con coriocarcinoma. Por ello, posterior a la cirugía, se realiza estudio de hCG sérico con resultado de 714 mIU/ml, lo que confirmó aún más el diagnóstico. Se decide tratamiento adyuvante con quimioterapia y se realiza seguimiento tomográfico y serológico de hCG sin presencia de enfermedad activa

Persistent pain is prevalent in the elderly population, although it is not an inevitable part of aging. It is important to understand how to manage pain effectively in old age, particularly because an increasing number of individuals are becoming older, or living longer. Several problems, less common in younger adults, may complicate the treatment of pain. An accurate pain assessment is required for the most efficient strategy of pain treatment. Challenges to an effective pain assessment include: pain underreporting by patients, atypical manifestations of pain in elderly, age-associated pharmacodynamic and pharmacokinetic changes to specific drugs, other general age-related changes, and misconceptions about tolerance or addiction to opioids. However, physicians are able to provide geriatric patients with appropriate analgesia by using comprehensive assessment involving a multidisciplinary approach, and the appropriate use of various treatment modalities.