Objective: To evaluate the effect of statin therapy on biomarkers of vascular inflammation in people living with HIV (PLWH).

Methods: We conducted a living systematic review of randomized controlled trials (RCTs). We searched Scopus, PubMed, Cochrane Library, and Scilit up to April 4, 2025, with a predefined plan for ongoing evidence surveillance and updating. Nine RCTs involving 1 721 participants were included. Data were extracted on changes in key biomarkers, including interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), soluble CD14 (sCD14), soluble CD163 (sCD163), oxidized LDL (oxLDL), and lipoprotein-associated phospholipase A₂ (Lp-PLA₂). The Cochrane Risk of Bias (RoB 2) tool was used for quality assessment. This review is not intended to be retired from the living mode at this stage.

Results: Statin therapy significantly reduced key biomarkers of monocyte activation and vascular inflammation, particularly IL-6 and sCD14, with effects being most consistent and pronounced with pitavastatin. Pitavastatin also demonstrated greater efficacy in reducing oxLDL and Lp-PLA₂ compared to other statins. Reductions in hs-CRP were inconsistent across studies. A critical finding was that treatment duration was a major modifier of effect, with interventions lasting ≥12 months yielding substantially greater anti-inflammatory benefits. The mechanistic profile suggests statins specifically target the LPS-sCD14 pathway of innate immune activation, which is highly relevant to HIV pathogenesis.

Conclusions: Pitavastatin emerges as the most effective statin for reducing vascular inflammation in PLWH, offering a targeted strategy to mitigate cardiovascular disease risk in this population. These findings, derived from the current iteration of a living systematic review, support the use of long-term pitavastatin therapy for PLWH with evidence of residual inflammation and highlight the need for its inclusion in future clinical guidelines as new evidence continues to emerge.

Objective: To compare the efficacy and safety of levornidazole and levornidazole disodium phosphate in women with pelvic inflammatory disease.

Methods: Women from 12 hospitals in China received a 14-day treatment course comprising 7 days of intravenous therapy followed by 7 days of oral sequential therapy: intravenous levornidazole 0.5 g twice daily (Group A, n=49), levornidazole disodium phosphate 1.0 g once daily (Group B, n=49), or levornidazole disodium phosphate 0.5 g twice daily (Group C, n=46), followed by oral levofloxacin plus ornidazole for 7 days.

Results: Of the 144 patients in the full analysis set (FAS), 131 (91.00%) were included in the per-protocol set and 38 (29.00%) were microbiologically valid. In the FAS, clinical cure rates at day 14 were 77.55%, 83.67%, and 82.61% for Groups A, B, and C, respectively (P=0.745). Bacteriological clearance rates were 76.47%, 93.75%, and 100.00%, respectively (P=0.248). Drug-related adverse events occurred less frequently in Group B than in Group A (38.78% vs. 61.22%; P=0.025).

Conclusions: Daily administration of levornidazole disodium phosphate achieved clinical and bacteriological efficacy comparable to twice-daily levornidazole in women with pelvic inflammatory disease and was associated with significantly fewer drug-related adverse events.

Objective: To study assessed factors associated with mass drug administration (MDA) noncompliance for lymphatic filariasis in urban and rural Indonesian communities.

Methods: A cross-sectional analysis was conducted using a subset of nationally representative data from the 2023 Indonesian Health Survey (Survei Kesehatan Indonesia, SKI). Participants were classified as residing in urban (n=469 549) and rural (n=407 982) and interviewed regarding anti-filarial drugs intake over the past 5 years. Logistic regression models were constructed to identify factors associated with MDA noncompliance.

Results: A total of 877 531 individuals from 284 177 households across 514 districts in 38 provinces were included in the study. Among them, 136 526 (15.56%) took anti-filarial drugs in five years; of these, 27 113 (19.86%) never complied fully, revealing significant urban-rural disparities. In urban areas, noncompliance with MDA was associated with pre-working age group (aOR 1.58; 95% CI 1.21-2.07) and those with self-reported LF (aOR 1.47; 95% CI 1.13-1.91). Awareness of health facilities was protective against noncompliance (aOR 0.29; 95% CI 0.11-0.77). In contrast, rural noncompliance was associated with transportation cost barriers (aOR 1.55; 95% CI 1.21-1.99), children aged 2-5 years (aOR 1.43; 95% CI 1.08-1.87), mobile phone ownership (aOR 1.40; 95% CI 1.12-1.75), and self-reported LF (aOR 1.47; 95% CI 1.19-1.82).

Conclusions: Distinct demographic, socioeconomic, and accessibility factors influence MDA noncompliance in Indonesia. Targeted behavioral interventions in urban areas and improved communication and access in rural regions are essential for LF elimination.

Rationale: The emergence of fluoroquinolone-resistant Salmonella enterica serovar Typhi has become increasingly prevalent across South Asia, Southeast Asia, and sub-Saharan Africa, with resistance rates exceeding 90% in some regions. Hepatobiliary complications, particularly cholangitis and Mirizzi syndrome, are rare manifestations.

Patient concerns: A 13-year-old male developed high-grade fever, progressive jaundice, upper abdominal pain, and multiple episodes of non-bilious vomiting for 8 days.

Diagnosis: Fluoroquinolone-resistant Salmonella typhi complicated with acute gangrenous cholecystitis, Mirizzi syndrome and cholangitis.

Treatment: Emergency cholecystectomy and subsequent endoscopic retrograde cholangiography with biliary drainage were performed. Blood and bile cultures isolated a fluoroquinolone-resistant Salmonella enterica subspecies enterica serovar Typhi. The patient responded to intravenous ceftriaxone.

Outcomes: The patient was discharged after 9 days of admission, and the common bile duct stent was removed after 8 weeks following discharge.

Lessons: This case emphasizes the critical importance of culture-based diagnosis over serological testing in endemic areas and a multidisciplinary approach in complicated invasive salmonellosis.