Cardiovascular diseases are widely distributed throughout the world. Human parasitic infections are ubiquitous. Tropical parasites are increasingly recognized as causes of cardiovascular diseases. In this review, we address the most frequently reported parasites that directly infect the myocardium, including Trypanosoma cruzi, the protozoal causative agent of American trypanosomiasis (Chagas disease), and Taenia solium, the cestode causative agent of taeniasis and cysticercosis. We also discuss tropical endomyocardial fibrosis, trichinellosis and schistosomiasis. Health systems, attitudes, the perceptions of both patients and physicians as well as socioeconomic factors should all be explored and recognized as crucial factors for improving the control of cardiovascular diseases in the tropics. Clinicians throughout the world must remain aware of imported parasites as potential causes of cardiac diseases.

Chagas disease is a neglected parasitic anthropozoonosis of the Americas linked to social deprivation with no hope of eradication in the future. Having been the most common non-ischemic cause of dilating cardiomyopathy in Latin America, it now spreads beyond the geographical boundaries of its vector via imported and autochthonous transmission. We review the evidence on surgery in Chagasic heart failure and offer a brief narrative on the main aspects of translational management. There is very limited literature on surgery for Chagasic heart failure, especially assist devices and transplantation. This may be attributed to the often unsurmountable economic burden of this single-system parasymphatholytic heart failure to young sufferers who commonly have very limited access to the aforementioned procedures. Chagasic heart failure offers a so far neglected translational model of parasymphatholytic non-ischemic cardiac failure.

Objectives: To examine follow-up of autoantibody testing and health care utilization among patients with (sustained) celiac disease. MethOds: From the PHARMO Database Network, patients with a positive autoantibody test for deamidated gliadin peptide (anti-DGP), endomysial (EMA) or tissue transglutaminase (anti-tTG) (period 1998-2011) were classified as celiac disease patients. The first positive test served as index date. For patients with ≥ 12 months follow-up, autoantibody tests in the year after index date were assessed. Patients with a second positive test, using the same cut-off, between 6-12 months after index date were classified as 'sustained celiac disease' patients and matched 1:1 on gender, birth year and year of index date to celiac disease patients without a second positive test. For these patients, health care utilization in 2012 was determined. Results: 1,815 patients had at least one positive autoantibody test, of which anti-tTG was most common (86%). 1,724 patients had ≥ 12 months follow-up, of which 75% did not have any type of autoantibody test in the year after index date. 183 patients (11%) were classified as 'sustained celiac disease' patients. Of these, 63 were active in the database in 2012 and could be matched. The proportion of patients with at least one GP visit and/ or hospitalization in 2012 was lower among sustained celiac disease patients: 76% and 14% vs. 83% and 24% for patients without sustained celiac disease. However, the mean (±SD) number of GP visits was higher among sustained celiac disease patients (4.3 ± 7.3 vs. 3.4 ± 3.5) as was the mean (±SD) number of outpatient drug dispensings (21.6 ± 96.3 vs.10.5 ± 17.5). cOnclusiOns: This study shows limited follow-up autoantibody testing among patients with celiac disease and does not suggest higher health care utilization with sustained celiac disease. These findings are consistent with notion of patients managing the disease without engaging the health care system. HS2 tHe imPact oF diFFerent levelS oF clinical PHarmaciSt interventionS on tHe tHeraPeutic Plan and coSt Saving

Objectives: The potential high-unintended pregnancy rates have resulted in great productivity loss in China. Several contraceptive methods have been introduced by both the providers and the woman themselves to reduce the unintended pregnancy rates.A cost-benefit analysis on various hormonal contraceptive methods was performed in order to provide references for contraception selection in China. MethOds: A decision-tree model was used to compare contraception costs and effects among different contraceptive methods. All women were classified into three contraception profiles (continuation, discontinuation and switch, discontinuation and drop-out).Outcomes included no pregnancy, pregnancy with no birth and birth. All the probabilities, medical and medication data in this model were derived from the literature and interviews. Results: A comparison of total estimated yearly and cumulative costs indicated that contraceptive implants, transdermal contraceptive, extended-cycle OC, vaginal ring, and IUD were less costly, less than $281733.7 in a three-year study period. While transdermal contraceptive, extended-cycle OC and vaginal ring were not available in the Chinese market, contraceptive implants and IUD were the only two choices in China with lowest cumulative costs. The further cost-benefit analysis also demonstrated contraceptive implants as good value for money. Using contraceptive implants were proved to have the lowest cost of pregnancy from failure of $839.9, with a total cost of $26814.9, and a benefit-cost ratio of 2.2, far over 1.0. Sensitivity analysis by tornado diagrams showed that cost of pregnancies, age and proportion of discontinuation and switch might have the greatest impact on the costs and failure risks of contraceptive implants. cOnclusiOns: In order to reduce the unintended pregnancy rates, the implementation of hormonal contraception may lead to a benefit in terms of both costs and effects. And among all the hormonal contraception in the Chinese market, contraceptive implants tend to generate greater economic benefits. Note:1US dollar= 6.46 Chinese yuan.Objectives: China is a big country with a large population. Reproductive health education is not sufficient for women of childbearing age, which leads to high unintended pregnancy (UP) rate. These represent a significant cost to the health care system. This study analyzes the epidemiology and productivity loss of unintended pregnancy in China. MethOds: The study reviewed published scientific articles and policy documents related to unintended pregnancy in China. We retrieved literature from Wanfang and PubMed databases, and searched policy documents in websites of National Bureau of Statistics and National Center for Women and Children's health, China CDC. Results: Almost 10% of fertile women have UP in China each year. There are four different results of UP, including miscarriage, elective abortion, ectopic pregnancy and delivery. There are two methods of elective abortion, including operation abortion and drug abortion. The costs of operation a...