Perception of COVID-19 Vaccination Amongst Physicians in Colombia.

Introduction: The SARS-CoV-2/COVID-19 pandemic has triggered the need to develop rapidly effective and safe vaccines to prevent infection, particularly in those at-risk populations such as medical personnel. This study's objective was to assess the perception of COVID-19 vaccination amongst Colombian physicians featuring two different scenarios of COVID-19 vaccination. Methods: A cross-sectional analytical study was carried out through an online survey directed at medical staff in several cities in Colombia. The percentage of physicians who have a positive perception to be vaccinated and the associated factors that determine that decision were determined. A binomial regression analysis adjusted for age and sex was carried out, taking as a dependent variable the acceptance of free vaccination with an effectiveness of 60 and 80%. The most significant factors were determined in the non-acceptance of vaccination. Results: Between 77.0% and 90.7% of physicians in Colombia accept COVID-19 vaccination, according to the scenario evaluated where the vaccine's effectiveness was 60 or 80%, respectively. Medical specialty, having never paid for a vaccine, recommending the administration of the vaccine to their parents or people over 70 years, and dispensing the vaccine to their children, were the factors to consider to be vaccinated for free with an effectiveness of 60% and 80%. Conclusions: There is a high perception of the intention to vaccinate physicians in Colombia against COVID-19, and this is very similar to that of the general population.

[Immune response and gene therapy with adenoassociated viral vectors]. / Respuesta inmune y terapia génica con vectores virales adenoasociados.

In recent years, gene therapy has been positioned as a real and safe option in the development of therapeutic alternatives for the cure and prevention of different diseases. It consists in the insertion of genetic material in a defective tissue or cell, through the use of a vector. There are several considerations for selecting the most appropriate vector, including the potential for binding and entry to the target cell, the ability of the genetic material to transfer to the nucleus, the ability to express the insert, and the absence of toxicity. In the current scenario, the most commonly used viral vectors are those derived from adeno-associated viruses (AAV). Characteristics such as biosafety, low toxicity and selective tropism have enabled its evaluation as a therapeutic option in many monogenic or complex diseases. Despite their advantages, AAV vectors have drawbacks, the most important being the patient's immune response to the vector, especially the response mediated by neutralizing antibodies (NAb). NAbs decrease the transduction of the vector and prevent the expression of the gene it transports, limiting its clinical application. Therefore, identifying and quantifying the presence and activity of NAbs is the first step in any gene therapy protocol with AAV vectors. The presence of NAbs depends mainly on exposure to the virus in nature and varies drastically according to age, geographic location and health status of the person evaluated.

En los últimos años la terapia génica se ha posicionado como una opción real y segura en el desarrollo de alternativas terapéuticas para la cura y la prevención de diferentes enfermedades. Consiste en la inserción de material genético en un tejido o célula defectuosa, mediante el uso de un vector. Existen varias consideraciones para seleccionar el vector más apropiado, incluyendo el potencial de unión y entrada a la célula diana, la capacidad de transferencia del material genético al núcleo, la habilidad de expresión del inserto y la ausencia de toxicidad. En el panorama actual, los vectores virales más utilizados son los derivados de los virus adenoasociados (AAV). Características como su bioseguridad, baja toxicidad y tropismo selectivo, han posibilitado su evaluación como opción terapéutica en un amplio número de enfermedades monogénicas o complejas. A pesar de sus ventajas, los vectores AAV presentan inconvenientes, siendo el más importante la respuesta inmune del paciente al vector, especialmente la respuesta mediada por anticuerpos neutralizantes (NAb). Los NAb disminuyen la transducción del vector e impiden la expresión del gen que transporta, limitando su aplicación clínica. Por lo tanto, identificar y cuantificar la presencia y actividad de los NAbs, es el primer paso en cualquier protocolo de terapia génica con vectores AAV. La presencia de NAb depende principalmente de la exposición al virus en la naturaleza y varía drásticamente según edad, localización geográfica y estado de salud de la persona evaluada.

Respuesta inmune y terapia gó©nica con vectores virales adenoasociados / Immune response and gene therapy with adenoassociated viral vectors

En los ó;ºltimos aó;±os la terapia gó;©nica se ha posicionado como una opció;n real y segura en el desarrollo de alternativas terapó;©uticas para la cura y la prevenció;n de diferentes enfermedades. Consiste en la inserció;n de material genó;©tico en un tejido o có;©lula defectuosa, mediante el uso de un vector. Existen varias consideraciones para seleccionar el vector más apropiado, incluyendo el potencial de unió;n y entrada a la có;©lula diana, la capacidad de transferencia del material genó;©tico al nó;ºcleo, la habilidad de expresió;n del inserto y la ausencia de toxicidad. En el panorama actual, los vectores virales más utilizados son los derivados de los virus adenoasociados (AAV). Características como su bioseguridad, baja toxicidad y tropismo selectivo, han posibilitado su evaluació;n como opció;n terapó;©utica en un amplio nó;ºmero de enfermedades monogó;©nicas o complejas. A pesar de sus ventajas, los vectores AAV presentan inconvenientes, siendo el más importante la respuesta inmune del paciente al vector, especialmente la respuesta mediada por anticuerpos neutralizantes (NAb). Los NAb disminuyen la transducció;n del vector e impiden la expresió;n del gen que transporta, limitando su aplicació;n clínica. Por lo tanto, identificar y cuantificar la presencia y actividad de los NAbs, es el primer paso en cualquier protocolo de terapia gó;©nica con vectores AAV. La presencia de NAb depende principalmente de la exposició;n al virus en la naturaleza y varía drásticamente segó;ºn edad, localizació;n geográfica y estado de salud de la persona evaluada.

In recent years, gene therapy has been positioned as a real and safe option in the development of therapeutic alternatives for the cure and prevention of different diseases. It consists in the insertion of genetic material in a defective tissue or cell, through the use of a vector. There are several considerations for selecting the most appropriate vector, including the potential for binding and entry to the target cell, the ability of the genetic material to transfer to the nucleus, the ability to express the insert, and the absence of toxicity. In the current scenario, the most commonly used viral vectors are those derived from adeno-associated viruses (AAV). Characteristics such as biosafety, low toxicity and selective tropism have enabled its evaluation as a therapeutic option in many monogenic or complex diseases. Despite their advantages, AAV vectors have drawbacks, the most important being the patient’s immune response to the vector, especially the response mediated by neutralizing antibodies (NAb). NAbs decrease the transduction of the vector and prevent the expression of the gene it transports, limiting its clinical application. Therefore, identifying and quantifying the presence and activity of NAbs is the first step in any gene therapy protocol with AAV vectors. The presence of NAbs depends mainly on exposure to the virus in nature and varies drastically according to age, geographic location and health status of the person evaluated.

Cardiovascular Risk and Its Associated Factors in Health Care Workers in Colombia: A Study Protocol.

BACKGROUND: Cardiovascular diseases are the leading cause of mortality worldwide, for this reason, they are a public health problem. In Colombia, cardiovascular diseases are the main cause of mortality, having a death rate of 152 deaths per 100,000 population. There are 80% of these cardiovascular events that are considered avoidable. OBJECTIVE: The objective of the study is to determine the prevalence of the cardiovascular risk and its associated factors among the institution's workers in order to design and implement interventions in the work environment which may achieve a decrease in such risk. METHODS: An analytical cross-sectional study was designed to determine the cardiovascular risk and its associated factors among workers of a high complexity health care institution. A self-applied survey will be conducted considering sociodemographic aspects, physical activity, diet, alcohol consumption, smoking, level of perceived stress, and personal and family history. In a second appointment, a physical examination will be made, as well as anthropometric measurements and blood pressure determination. Also, blood samples for evaluating total and high density lipoprotein cholesterol, triglycerides, and fasting blood sugar will be taken. A ten-year global risk for cardiovascular disease will be determined using the Framingham score. A descriptive analysis of the population's characteristics and a stratified analysis by sex, age, and occupation will be made. Bivariate and multivariate analysis will be made using logistic regression models to evaluate the association between cardiovascular risk and the independent variables. The research protocol was approved by the Scientific and Technical Committee and the Ethics Committee on Research of the Fundación Cardiovascular de Colombia. RESULTS: The protocol has already received funding and the enrollment phase will begin in the coming months. CONCLUSIONS: The results of this study will give the foundation for the design, implementation, and evaluation of a program based on promoting healthy lifestyles, such as performing regular physical activity and healthy food intake in order to avoid and/or control the cardiovascular risk in the workers of a high complexity health care institution.

Variables pre-analíticas que afectan las concentraciones de homocisteína: aplicación para biobancos con fines de investigación / Pre-analytical variables that affect homocysteine concentrations: applications for research biobanks

Objetivo: El presente estudio evaluó el impacto de variables pre-analíticas sobre las concentraciones séricas de la homocisteína y su posible aplicación en biobancos con fines de investigación. Metodología: En diez adultos voluntarios auto declarados sanos, se tomaron muestras de sangre periférica bajo diferentes condiciones de ayuno, posición de toma de la muestra (supino versus sentada) y diferentes intervalos de tiempo entre la toma y la separación definitiva de componentes. Todas las alícuotas fueron almacenadas a - 800C en el biobanco hasta el momento de ser procesadas. La medición de homocisteína se hizo por duplicado en Immulite® 2000. Se realizó análisis de concordancia por medio de coeficiente de Lin (σ) y MANOVA. Resultados: La medición de homocisteína es altamente reproducible (σ=0.908, IC95% 0.861 a 0.955), sin que el ayuno o el tiempo de centrifugación de la muestra afecte su concentración. Sin embargo, la posición al momento de la toma de muestra, implica una reducción media de 14.2% (IC95% 8.4% a 20.0%) en la concentración de homocisteína en posición decúbito supino versus la toma en posición sentado. Conclusión: La homocisteína es un biomarcador estable, sin que su valor se vea alterado por variables pre-analíticas como los tiempos entre toma de muestra, centrifugación y separación de componentes (almacenamiento temporal a 4°C hasta 24 horas). Sin embargo, la postura del participante al momento de la toma de muestra produce una variabilidad significativa. Estos hallazgos reiteran el papel de un biobanco en la estandarización de los procesos de toma, manipulación, almacenamiento y gestión con criterios de excelencia. [Serrano NC, Páez MC, Bautista PK, Díaz-Martínez LA, Guío E. Variables pre-analíticas que afectan las concentraciones de homocisteína: Aplicación para biobancos con fines de investigación.

Objective: This study evaluated the impact of pre-analytical variables on serum concentrations of homocysteine, and its possible applications in biobanks for research purposes. Methods: Peripheral blood samples from ten self-reported healthy volunteers were obtained under different conditions of fasting and body position (supine and sitting). Blood samples were temporarily stored for different time intervals between its collection and its centrifugation. All aliquots were stored at -80ºC in our biobank until processing. Duplicate Homocysteine measurements were performed in Immulite® 2000. A concordance analysis was performed using Lin coefficient (σ) and MANOVA. Results: The measurement of homocysteine is highly reproducible (σ = 0.908, 95% CI 0861-0955) and fasting or time before centrifugation does not affect its concentration. However, we found an average reduction of 14.2% (95% CI 8.4% to 20.0%) for the Hcy levels in samples obtained when the subjects were in supine position as compared to the levels in sitting position. Conclusion: Homocysteine levels are stable, when the blood samples remain without centrifugation, up to 24 hours at 4ºC. However, body position of the participant at the time of sampling can affect Hcy levels. These findings highlight the role of biobanks in standardizing, handling and storing biological samples with excellence criteria. [Serrano NC, Páez MC, Bautista PK, Díaz-Martínez LA, Guío E. Pre-analytical variables that affect homocysteine concentrations: Applications for research biobanks.