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AIMS: To evaluate the prevalence of diabetic retinopathy (DR) in Brazilian adults with diabetes mellitus via a systematic review with meta-analysis. METHODS: A systematic review using PubMed, EMBASE, and Lilacs was conducted, searching for studies published up to February 2022. Random effect meta-analysis was performed to estimate the DR prevalence. RESULTS: We included 72 studies (n = 29,527 individuals). Among individuals with diabetes in Brazil, DR prevalence was 36.28% (95% CI 32.66-39.97, I2 98%). Diabetic retinopathy prevalence was highest in patients with longer duration of diabetes and in patients from Southern Brazil. CONCLUSION: This review shows a similar prevalence of DR as compared to other low- and middle-income countries. However, the high heterogeneity observed-expected in systematic reviews of prevalence-raises concerns about the interpretation of these results, suggesting the need for multicenter studies with representative samples and standardized methodology.
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INTRODUCTION: Gibberellins (GA) are terpenoids that serve as important plant hormones by acting as growth and response modulators against injuries and parasitism. In this study, we investigated the in vitro anti-NF-κB, anti-Candida, and antioxidant activity of gibberellin A4 (GA4) and A7 (GA7) compounds, and further determined their toxicity in vivo. METHODS: GA4 and GA7 in vitro toxicity was determined by MTT method, and nontoxic concentrations were then tested to evaluate the GA4 and GA7 anti-NF-κB activity in LPS-activated RAW-luc macrophage cell culture (luminescence assay). GA4 in silico anti-NF-κB activity was evaluated by molecular docking with the software "AutoDock Vina", "MGLTools", "Pymol", and "LigPlot+", based on data obtained from "The Uniprot database", "Protein Data Bank", and "PubChem database". The GA4 and GA7 in vitro anti-Candida effects against Candida albicans (MYA 2876) were determined (MIC and MFC). GA7 was also evaluated regarding the viability of C. albicans preformed biofilm (microplate assay). In vitro antioxidant activity of GA4 and GA7 was evaluated against peroxyl radicals, superoxide anions, hypochlorous acid, and reactive nitrogen species. GA4 and GA7 in vivo toxicity was determined on the invertebrate Galleria mellonella larvae model. RESULTS: Our data show that GA4 at 30 µM is nontoxic and capable of reducing 32% of the NF-κB activation on RAW-luc macrophages in vitro. In vitro results were confirmed via molecular docking assay (in silico), since GA4 presented binding affinity to NF-κB p65 and p50 subunits. GA7 did not present anti-NF-κB effects, but exhibited anti-Candida activity with low MIC (94 mM) and MFC (188 mM) values. GA7 also presented antibiofilm properties at 940 mM concentration. GA4 did not present anti-Candida effects. Moreover, GA4 and GA7 showed antioxidant activity against peroxyl radicals, but did not show scavenging activity against the other tested radicals. Both compounds did not affect the survival of G. mellonella larvae, even at extremely high doses (10 g/Kg). CONCLUSION: Our study provides preclinical evidence indicating that GA4 and GA7 have a favorable low toxicity profile. The study also points to GA4 and GA7 interference with the NF-κB via, anti-Candida activity, and a peroxyl radical scavenger, which we argue are relevant biological effects.
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PURPOSE: To evaluate retinal thickness and capillary density in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD) using swept-source optical coherence tomography (SS-OCT). METHODS: A cross-sectional study was conducted with T2D patients with mild or no diabetic retinopathy (DR) and nondiabetic controls. Inner retinal layer thickness was measured with SS-OCT. Retinal capillary density and the foveal avascular zone (FAZ) were measured with SS-OCT angiography (OCTA). SS-OCT parameters were compared in patients with and without diabetic kidney disease (DKD) and nondiabetic controls. RESULTS: 131 DKD eyes showed decreased ganglion cell layer plus (GCL+) (p = 0.005 TI; p = 0.022 I), retinal nerve fiber layer (RNFL) (p = 0.003), and central retinal thickness (CRT) (p = 0.032), as well as foveal avascular zone (FAZ) enlargement (p = 0.003) and lower capillary density in the superficial vascular plexus (p = 0.016, central quadrant), compared to controls. No statistically significant changes were found between diabetic patients without significant DKD and controls. CONCLUSION: Our findings suggest early neurovascular damage in patients with T2D; these changes were more significant in patients with DKD. Larger longitudinal studies are warranted to determine the role of early neurovascular damage in the pathophysiology of severe DR.
ABSTRACT
Forest fires and deforestation are the main threats to the Amazon forest. Extreme drought events exacerbate the impact of forest fire in the Amazon, and these drought events are predicted to become more frequent due to climate change. Fire escapes into the forest from agriculture and pasture areas. We assessed the potential drivers of deforestation and forest fires in the central Brazilian Amazon and show that over a period of 31 years (1985-2015) forest fires occurred only in years of extreme drought induced by El Niño (1997, 2009 and 2015). The association of forest fires with strong El Niños shows the vulnerability of forest to climate change. The areas deforested were closely associated with navigable rivers: 62% of the total deforestation from 2000 to 2018 was located within the 2 km of rivers. There was a notable increase in deforestation and forest fire during the 2015 El Niño in comparison to previous years. Only a small part of the forest that burned was deforested in the years following the wildfires: 7% (1997), 3% (2009) and 1.5% (2015). Forest close to roads, rivers and established deforestation is susceptible to deforestation and fire since these areas are attractive for agriculture and pasture. Indigenous land was shown to be important in protecting the forest, while rural settlement projects attracted both forest fire and deforestation. Of the total area in settlement projects, 40% was affected by forest fires and 17% was deforested. Rivers are particularly important for deforestation in this part of Amazonia, and efforts to protect forest along the rivers are therefore necessary. The ability to predict where deforestation and fires are most likely to occur is important for designing policies for preventative actions.