Prevention of Dental Caries by Silver Diamine Fluoride.

The use of silver diamine fluoride (SDF) for management of dental caries has gained considerable attention due to recent regulatory clearance in the United States. The primary focus of policies, presentations, and publications has been the arrest of caries lesions (cavities) because of the material's unique ability to non-invasively achieve this elusive and clinically important goal. However, SDF also has proven efficacy in prevention, ie, decreasing the incidence of new caries lesions. Analysis of nine clinical trials in children shows that SDF prevented 61% of new lesions compared to controls. To prevent one new caries lesion, clinicians need to treat four primary teeth (one patient) or 12.1 permanent molars (three patients) with SDF. The preventive effect appears to be immediate and maintains at the same fraction over time. Direct comparisons of SDF applied once per year with alternative treatments show that SDF is more effective than other topical fluorides placed two to four times per year and more cost-effective than dental sealants. Enamel lesions may be even more responsive than cavitated dentin lesions. Annual application of SDF to high-risk surfaces (eg, mesial surfaces of permanent first molars where the distal surface of the second primary molar is carious) in patients with any risk of new caries lesions appears to be the most cost-effective approach available to prevent dental caries. SDF is an underutilized evidence-based preventive agent for dental caries.

[Ophthalmia neonatorum of the newborn and its treatments in Canadian medical publications: 1872-1985]. / L'ophtalmie du nouveau-né et ses traitements á la lecture des publications médicales canadiennes: 1872-1985.

In the 19th century the occurrence of ophthalmia neonatorum had reached alarming rates in the maternity wards not only of Europe but also across Canada. The impact of this blinding ocular infection on Canadian medicine from 1872 to 1985 is examined through a review of 80 medical journals, books, and lay press articles of that period. The prophylactic and therapeutic use of 2% silver nitrate introduced by Credé in 1880 to prevent neonatal blindness is reviewed. The signs, symptoms, and corneal complications of this disease as well as the multiple ocular drugs used during this era will be presented. The judicial consequences on midwives and obstetricians will be discussed. The subsequent use of colloidal silver based agents such as collargol, protargol and argyrol followed by the introduction of sulfonamides and finally the routine use of prophylactic topical antibiotics will be reviewed.

Silver. I: Its antibacterial properties and mechanism of action.

Silver products have two key advantages: they are broad-spectrum antibiotics and are not yet associated with drug resistance. This article, the first in a two-part series, describes the main mechanism of action of this metallic element.

Luis Simarro Lacabra [1851-1921]: from Golgi to Cajal through Simarro, via Ranvier?

Knowledge of cerebral structure and function in its modern form can be traced to the neurone doctrine based largely on the work of Santiago Ramón y Cajal [1852-1934] and his lifelong exploitation of the Golgi method. Cajal openly acknowledged his debt to the neuropsychiatrist Luis Simarro Lacabra [1851-1921] who introduced him to the method in 1887, and recalled that the sight of the silver-impregnated nerve cells was the turning point which led him to abandon general anatomy and concentrate on neurohistology. Simarro, who dissipated his free time in trying to improve not only the scientific but also the political world around him, was able to produce exciting Golgi preparations of the cerebral cortex after he returned from voluntary exile in Paris from 1880 to 1885. Certainly it was there that he learned the methods of experimental histology from Louis-Antoine Ranvier [1835-1922] whose laboratory exercises, in the guise of lectures, he attended assiduously.