♦ Background and Objective: Colombia is a country of diverse geographic regions, some with mountainous terrain that can make access to urban areas difficult for individuals who live in remote areas. In 2005, a program was initiated to establish remote peritoneal dialysis (PD) centers in Colombia to improve access to PD for patients with end-stage renal disease who face geographic or financial access barriers.

Objective: To establish the prevalence of type 2 diabetes, overweight/obesity, and metabolic syndrome in individuals aged >18 years in Bogotá, Colombia and the variables associated with diabetes prevalence. Research Design and Methods: This was a cross‑sectional population survey with a representative, probabilistic sample of Bogotá, Colombia collected between 2022 and 2023. The final sample size included 2,860 households, distributed among 19 localities of Bogotá. Clinical laboratory samples were taken from randomly selected individuals (n = 1,070). Data on the Adult Treatment Panel III (ATP III) and Latin American Diabetes Association (ALAD) criteria for metabolic syndrome were collected, including physical measurements. Results: The prevalence of type 2 diabetes in Bogotá was 11.0% (95% confidence interval [CI], 9.0–13.5%). According to the ATP III and ALAD criteria, the prevalence proportions of metabolic syndrome were 33.9% (95% CI, 29.5–38.6) and 29.3% (95% CI, 26.1–32.7), respectively. The age of ≥55 years, abdominal obesity, hypertriglyceridemia, and noneducational level had higher adjusted prevalence ratios (APRs) of diabetes. The APRs of metabolic syndrome were higher in adults with a low education level (LEL) and female sex, with the ATP III and ALAD criteria, and noninsured adults or those with unknown affiliation with the healthcare system, with the ATP III criteria. Conclusions: We found a higher prevalence of type 2 diabetes in adults in Bogotá than expected in previous studies. Intervention from public policy should be requested, especially in those of lowest socioeconomic and education levels, to avoid a future increase in this prevalence. Studies on other Colombian cities are required.

The contexts where there are mining and agriculture activities are potential sources of risk to human health due to contamination by chemical mixtures. These contexts are frequent in several Colombian regions. This study explored the potential association between the frequency of micronuclei and pesticides and elements in regions with ferronickel (Montelibano, Córdoba) and gold (Nechí, Antioquia) mining, and a closed native mercury mine (Aranzazu, Caldas), with an emphasis in the potential effect of selenium as a potential chelator. A cross-sectional study was carried out with 247 individuals. Sociodemographic, occupational, and toxicological variables were ascertained. Blood and urine samples were taken for pesticide analysis (5 organophosphates, 4 organochlorines, and 3 carbamates), 68 elements were quantified in hair, and micronuclei were quantified in lymphocytes. The mixtures of elements were grouped through principal component analysis. Prevalence ratios were estimated with robust variance Poisson regressions to explore associations. Interactions of selenium with toxic elements were explored. The highest concentrations of elements were in the active mines. The potentially most toxic chemical mixture was observed in the ferronickel mine. Pesticides were detected in a low proportion of participants (<2.5%), except paraoxon-methyl in blood (27.55%) in Montelibano and paraoxon-ethyl in blood (18.81%) in Aranzazu. The frequency of micronuclei was similar in the three mining contexts, with means between 4 to 7 (p = 0.1298). There was great heterogeneity in the exposure to pesticides and elements. The “hormetic effect” of selenium was described, in which, at low doses, it acts as a chelator in Montelibano and Aranzazu, and at high doses, it can enhance the toxic effects of other elements, maybe as in Nechí. Selenium can serve as a protective agent, but it requires adaptation to the available concentrations in each region to avoid its toxic effects.

Los errores históricos en investigación médica llevaron al mundo a la creación de los comités de ética en investigación en salud (CEI), que son organizaciones pluri y multidisciplinarias con profesionales de variadas competencias, especialidades y formas de pensamiento, cuya función es evaluar proyectos de investigación y su ejecución, con independencia para garantizar protección de los participantes e integridad científica. El presente artículo realiza una reflexión sobre la independencia de los comités, que se fundamenta en las categorías independencia, libertad y autonomía, en los principios bioéticos de Beauchamp y Childress, de Maliandi y Thüer aplicados a los CEI y publicaciones que han tratado el tema. Sobre la independencia de los comités, se concluye su importancia, la cual está relacionada con los miembros de los CEI, investigadores, financiadores, entes reguladores, e instituciones a las que pertenecen los CEI -educativas, de salud o centros de investigación públicos y privados-, con metas asociadas a investigaciones, publicaciones y contratos para evaluación de proyectos. Si bien es cierto hay compromiso institucional de respaldo a la independencia de los CEI, es necesario revisar cómo funciona en la realidad, cómo se relaciona con dilemas bioéticos, cómo se articula con los principios de respeto a la autonomía–individualidad, justicia–universalidad, no maleficencia–conservación y beneficencia–realización, con la ética convergente y cuál es el concepto de expertos que han investigado sobre el particular. Conclusión: En la actualidad no es posible garantizar la independencia de los CEI, para lo que se deben definir medidas y estrategias adicionales que la fortalezcan.

Propósito/Contexto. En el presente artículo se hace un análisis del rol que deben cumplir los comités de ética e investigación para proteger a los voluntarios que participan en los estudios, sin olvidar sus funciones de promoción de la investigación y generación de conocimiento como una responsabilidad social, lo cual con el tiempo se ha venido distorsionando. Metodología/Enfoque. Se realizó una revisión de la evolución de la ética en investigación, que surge como respuesta a malas prácticas que atentaron contra la dignidad humana, que obligaron a repensar la forma de investigar, con la aparición de normas internacionales, recomendaciones y reglamentación legal que promovió el consentimiento informado y la conformación de los comités de ética en investigación (CEI). Resultados/Hallazgos. Como parte de la secuencia de análisis se muestra cómo estos organismos han tomado importancia en la actualidad, al punto que en muchos sitios del planeta no se puede hacer investigación sin la aprobación de los comités. Esto va a favor de los sujetos en investigación, pero con un mal manejo y un inadecuado ejercicio de poder, pueden frenar la investigación, con un ejercicio de tiranía por parte de los CEI. Discusión/Conclusiones/Contribuciones. Este análisis se apoya en la bioética global de ten Have, que tiene en cuenta la responsabilidad y el deber de la investigación como un asunto global e intergeneracional, que debemos ejercer como ciudadanos del mundo. Neste artigo uma análise do papel do suporte para ser atendidas por comitês de ética e pesquisa para proteger os voluntários envolvidos no estudo, incluindo as suas funções de promoção da investigação e geração de conhecimento como uma responsabilidade social torna-se, que com o tempo foi distorcido. Para isso, realizou uma análise da evolução da ética em pesquisa, que é uma resposta a más práticas que solaparam a dignidade humana, o que nos obrigou a repensar a forma de investigar, com o surgimento de padrões internacionais, recomendações e regulamentos legais ele promoveu o consentimento informado e o estabelecimento de comitês de ética em pesquisa (CEP). Como parte da sequência que dá análise mostra como essas agências têm tomado importante hoje, a tal ponto que em muitos lugares do planeta não pode fazer investigação sem a aprovação dos comités. Isso vale para os sujeitos da pesquisa, mas má gestão e exercício abusivo de poder, pode retardar a investigação, com um exercício de tirania pelo CIS. Análise e reflexão é baseada em bioética global, ten Have, que leva em conta a responsabilidade eo dever de pesquisa como uma responsabilidade global e intergeracional, devemos agir como cidadãos globais.