The DAPA-HF trial clearly showed that dapagliflozin was superior to placebo at preventing CV deaths and HF events. The relative and absolute risk reductions in death and hospitalizations were consistent across subgroups including patients with and without diabetes; so, in consequence, dapagliflozin represents the first in a new class of drug for HF with reduced EF. The recently published Dapagliflozin Effects on Biomarkers, Symptoms, and Functional Status in Patients With Heart Failure With Reduced Ejection Fraction (DEFINE-HF) trial is also described in this review as well as the thought-to-be mechanisms of action of SGLT2 inhibitors beyond their known glucose-lowering effects. There is a vast, ambitious, and promising ongoing clinical investigation program with dapagliflozin and other SGLT2 inhibitors, which may result in changes to the therapeutic approach to HF in a relatively short time. Copyright © 2020 Kaplinsky E.Background Premature adrenarche has been described as clinical and biochemical hyperandrogenism before the age of 8 years in girls and 9 years in boys and absence of signs of true puberty. Adrenal pathology such as adrenal tumors or non-classical congenital adrenal hyperplasia (NCCAH) and exogenous androgen exposure need to be excluded prior to diagnosing (idiopathic) premature adrenarche. Premature adrenarche is more common among black girls compared to white girls and other racial groups. Adrenal pathology such as NCCAH is less common as a cause for premature adrenarche compared with idiopathic premature adrenarche. The evaluation guidelines for premature adrenarche however are not individualized based on racial/ethnic differences. Few studies have been done to evaluate a largely black population with premature adrenarche to assess the incidence of adrenal pathology. Methods This cross-sectional retrospective study evaluated characteristics of prepubertal patients seen in an endocrine clinic for premature adrenarche. Results Two hundred and seventy three subjects had signs of early adrenarche. Three subjects were found to have CAH (2 with NCCAH and 1 with late diagnosis classical CAH). None were black. Exogenous androgen exposure was etiology in 4 additional subjects.  https://www.selleckchem.com/products/gcn2ib.html  These 7 patients were excluded from further analysis. The remaining subjects had idiopathic PA (n = 266); 76.7% were females. The mean age at initial visit was 6.42 +/- 1.97 years (with no racial difference) although black subjects were reported symptom onset at a significantly younger age compared to non-Hispanic white patients. Conclusions Our study showed organic pathology was very uncommon in a predominantly black population with premature adrenarche. Patient factors that influence the probability of an underlying organic pathology including race/ ethnicity should be considered to individualize evaluation. © The Author(s). 2020.in English, Portuguese, Objetivo Apresentar indicadores das desigualdades socioeconómicas no acesso aos serviços de saúde na Colombia, El Salvador, Paraguai e Peru. Métodos Este estudo transversal utilizou dados de pesquisas domiciliares representativas da realidade nacional na Colómbia, El Salvador, Peru e Paraguai com o objetivo de analisar as desigualdades relacionadas a renda no acesso aos serviços de saúde. Os domicílios que relataram a presença de um problema de saúde (doença/acidente) e nao buscaram cuidados de saúde profissionais foram considerados como domicílios que apresentavam barreiras no acesso aos serviços de saúde. Os indicadores de desigualdade foram o indice absoluto de desigualdade (slope index of inequality, SII) e o indice relativo de desigualdade. Resultados As tendencias relativas a desigualdade foram mistas nos quatro países. Todos apresentaram melhorias, mas ainda persistem grandes disparidades entre os quintis com renda mais alta e mais baixa, apesar das reformas nos sistemas de saúde. A desigualdade relativa foi mais elevada na Colómbia (60%), seguida do Paraguai (30%), Peru (20%) e El Salvador (20%). Conclusões O efeito das iniciativas políticas nacionais sobre a equidade no acesso aos serviços de saúde deve ser o tema de análises futuras. Também é preciso pesquisar o monitoramento nacional e regional das barreiras no acesso aos serviços e os fatores que explicam por que as pessoas nao buscam cuidados de saúde, mesmo quando apresentam um problema de saúde.Both the prevalence of atrial fibrillation (AF) and frailty are increasing with age, and they often occur simultaneously, leading them to become the central concerns in this aging society. The incidence of frailty in patients with AF is highly variable, ranging from 4.4% to 75.4%, depending on different evaluating instruments used. Moreover, the incidence of frailty among patients with AF is on the rise, which indicated that patients with AF are more prone to frailty compared to patients without AF. The relationship between AF and frailty is complicated. Frailty elevates the risk of stroke and mortality in AF patients and is also associated with longer hospitalizations. On the other hand, it may reduce the appropriate anticoagulation in AF patients. However, the evidence of the effects of frailty on anti-arrhythmic and interventional therapy in patients with AF is scarce. Frailty affects both the management and the prognosis of AF in the geriatric population. Vice versa, AF could worsen the frail state and may represent a marker of frailty. However, there are still questions need to be resolved, for example, the impact of frailty on the interventional therapy of patients with AF. Therefore, the geriatric assessment of frailty should be considered when planning individualized management of AF in older patients. Institute of Geriatric Cardiology.Background Left ventricular (LV) remodeling is the most common target organ damage in hypertension. Previously, our study found that plasma microRNA-29a (miR-29a) level was associated with the LV remodeling in hypertensive patients. However, the causal relationship between miR-29a and LV remodeling remains unknown. Thus, the aim of this study was to investigate the regulation mechanism of miR-29a in LV remodeling. Methods & Results Overexpression and knockdown miR-29a mice were generated by tail-intravenous injection of miR-29a-mimic and inhibitor lentivirus for one week respectively. Then the mice were subjected to angiotensin-II (AngII) induced LV remodeling by subcutaneous AngII capsule osmotic pumping into AngII for four weeks. AngII-induced LV remodeling mice as the model group (n = 9). Age-matched male SPF C57/BL6J mice (6-8 weeks old) were treated with the pumping of saline as a vehicle (n = 6). In vivo, overexpression miR-29a ameliorated AngII-induced LV remodeling, while knockdown miR-29a deteriorated LV remodeling.