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PubMed2004

Is povidone iodine an alternative to silver nitrate for renal pelvic instillation sclerotherapy in chyluria?

OBJECTIVE: To compare the efficacy and toxicity of 1% silver nitrate, 0.2% povidone iodine and 50% dextrose in renal pelvic instillation sclerotherapy (RPIS) for chyluria. PATIENTS AND METHODS: In a prospective randomized comparative study from January 1999 to June 2003, 106 patients (61 males and 45 females; mean age 36 years, sd 12, range 14-65) were randomized to receive 1% silver nitrate, 0.2% povidone iodine or 50% dextrose as RPIS. In all, nine doses were given at 8-h intervals, and patients followed at 6 weeks and then at 3-monthly intervals. Patients with 'persistence' or 'recurrence' of chyluria were treated with second course of RPIS using same sclerosant. RESULTS: The dextrose treatment was discontinued at mid-term because of poor success (one of 21 patients, P < 0.001). Of 85 patients, 44 received silver nitrate and 41 povidone iodine; both groups were well-matched and the mean follow-up was 28.4 and 23.3 months, respectively. 'Immediate clearance' was recorded in 91% and 98%, and recurrence in 21% and 22% of patients after the first course of RPIS, after silver nitrate and povidone, respectively; Kaplan-Meier estimates of 'disease-free duration' in the two groups (23.6 vs 20.1 months) were also similar (P = 0.7906). The cumulative success rate after two courses of RPIS was 82% (silver nitrate) and 83% (povidone; P = 1.0). Five (11%) patients in the silver nitrate and one (2%) in the povidone group had significant flank pain during treatment. CONCLUSIONS: Povidone iodine 0.2% is as effective for RPIS as 1% silver nitrate.

Adolescent↗
PubMed2005

The effect of silver nitrate on nasal septal cartilage.

Epistaxis from the anterior septum is frequently treated with a topical application of silver nitrate, which cauterizes the bleeding vessel. However, this treatment causes a septal perforation in a small percentage of patients. We report our study of the histologic effect of topical silver nitrate on samples of septal tissue obtained from 11 patients. We found that 30 seconds of exposure allowed silver nitrate to penetrate to a depth of approximately 1 mm. Longer exposure (45 and 60 sec) resulted in no significant additional penetration. Similarly, the amount of silver nitrate deposition into the chondrocytic lacunae did not vary significantly with the length of exposure. On the other hand, the depth of deposition into the extracellular matrix was positively associated with the duration of exposure. We found no direct evidence that silver nitrate exerted any damaging effect on septal cartilage. Instead, the development of septal perforations in patients who receive topical silver nitrate may be attributable to necrosis of the septal cartilage following damage to the overlying perichondrium, from which it derives its blood supply.

Chondrocytes↗
PubMed2002

Investigation of primary cell-biomaterial interactions using silver nitrate staining of nucleolar organising regions.

The quantification of silver nitrate staining of nucleolar organising regions (AgNORs) within the nucleus of the cell has been shown to give a relative measure of the metabolic activity of the cell. In the present study, silver nitrate staining was utilised to identify metabolic variations in cells cultured on different surfaces and compared with proliferative activity assessed using bromodeoxyuridine (BrdU) uptake. Primary osteoblast and periosteal cells, isolated from the calvaria of neonate rats, were cultured on tissue culture-grade (TCPS) and bacteriological-grade (BACPS) polystyrene petri dishes for 3, 5, 7 and 9 days (silver nitrate) or 14 days (BrdU). The phenotype of the cells was examined using RT-PCR of the mRNA for osteocalcin, collagen 1a, alkaline phosphatase and osteopontin. The number and area of AgNORs and the proportion of BrdU positive cells were statistically different in cells cultured on TCPS compared with BACPS at each culture period tested. The results suggest that the metabolic activity and proliferation of cells were affected by the substrate which they colonise.

Animals↗
PubMed1981

Effect of silver nitrate on pregnancy termination in cynomolgus monkeys.

The effect of intrauterine injection of 1% silver nitrate on pregnancy was studied in 13 cynomolgus monkeys. The monkeys received, in a random manner, intrauterine injections of 1 ml of either 1% silver nitrate (n = 7) or 0.9% NaCl solution (n = 6) between days 27 and 43 of pregnancy. Silver nitrate injection resulted in vaginal bleeding, beginning 1 or 2 days after treatment, that lasted for an average of 5.3 days. In all of these cases, pregnancy was terminated. Injection of normal saline had variable sequelae, but four of six monkeys were delivered of healthy offspring. All of the silver nitrate-treated animals recycled and, after remating, two of the seven subsequently became pregnant again and were delivered of normal healthy infants. This study demonstrates the efficacy of intrauterine injection of 1% silver nitrate in terminating early pregnancy.

Abortifacient Agents↗
PubMedDate not supplied

Effectiveness of silver nitrate compared to talc slurry as pleural sclerosing agent in rabbits. Influence of concomitant intrapleural lidocaine.

UNLABELLED: The ideal agent for producing pleurodesis has not been identified. Talc, the most commonly used, poses several problems. Another possibility is silver nitrate, which was widely used in the past. PURPOSE: To determine the influence of the intrapleural instillation of lidocaine in producing a pleurodesis with silver nitrate, to define the effect of lidocaine in the maturation of the collagen fibers, and to confirm that the pleurodesis after silver nitrate is stronger than after talc. METHODS: We studied three groups of 8 rabbits. Two groups received 0.5% silver nitrate; in one we had previously injected 0.5 ml of 2% lidocaine. The third group received 400 mg/kg talc (2 ml). The animals were sacrificed 28 days after the injection, and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of inflammation and fibrosis. The total amount of pleural collagen and the distribution of thick and thin collagen fibers were quantified. Collagen was identified using picrosirius red stain. RESULTS: In the two groups that received silver nitrate (without lidocaine: 3.5 + 03 and with lidocaine: 3.2 + 0.3), the macroscopic pleurodesis (scale 0 - 4) was significantly (p = 0.001) better than that resulting from talc (1.6 + 0.2). The mean degree of pleural fibrosis induced by silver nitrate (3.5 + 0.2) was significantly (p = 0.004) higher than that induced by talc (1.9 + 0.1). The previous instillation of lidocaine resulted in a tendency for decreased amounts of fibrosis (3.1 + 0.4). The mean amount (10(3)mm2) of pleural collagen was significantly (p = 0.009) greater in the rabbits that received silver nitrate (116.9 + 22.7) than in those that received talc (10.7 + 3.4). The injection of lidocaine slightly reduced the collagen (80.1 + 30.3). The distribution of collagen fibers did not differ among the groups. CONCLUSION: This rabbit model clearly confirms that intrapleural silver nitrate is more effective than talc for producing pleurodesis. The previous intrapleural instillation of lidocaine results in a decreasing trend in the amount of collagen, but does not change the effectiveness of the pleural fusion or modify the process of collagen maturation.

Anesthetics, Local↗
PubMed2005

Silver nitrate cautery in aphthous stomatitis: a randomized controlled trial.

BACKGROUND: Aphthous stomatitis is a painful, recurrent disease of the oral mucous membrane. Silver nitrate sticks have been used for a long time to provide pain relief for the duration of an aphthous ulceration, with only one application. Silver nitrate causes chemical cauterization and increases the depth of injury. OBJECTIVES: To study the effect of chemical cautery with silver nitrate in reducing pain of aphthous ulceration and to determine if this treatment shortens or prolongs healing. METHODS: In a randomized, patient-blinded, placebo-controlled study, 97 patients with painful minor oral aphthous ulceration were randomized to receive silver nitrate cautery or placebo. The severity of pain was rated on a three-category scale (severe, mild, none) and was recorded each day until the seventh day after the procedure. The lesion size was recorded at the time of the procedure and on the seventh day afterwards. In the treatment group, the ulcer was gently painted with a silver nitrate stick until it turned white. In the placebo group, the ulcer was gently painted with a placebo stick. RESULTS: In the treatment group, 33 of 47 patients (70%) evaluated and in the placebo group, four of 38 patients (11%) evaluated had reduction in severity of pain 1 day after the procedure. The difference was statistically significant (P < 0.001). On the seventh day after the procedure, the ulcers were completely re-epithelialized in 39 patients (83%) in the treatment group and in 34 patients (89%) in the placebo group. The difference was not statistically significant (P = 0.39). CONCLUSIONS: The results of our study showed that one application of silver nitrate can decrease the severity of pain in aphthous ulceration without significantly shortening or prolonging healing time. We did not observe any side-effects in our study. The effect is rapid and lasts for the duration of the lesion. The treatment is simple and cost-effective in patients with infrequent recurrences.

Administration, Oral↗
PubMed1980

Treatment of allergic and vasomotor rhinitis by the local application of silver nitrate.

A new, simple and effective local treatment of allergic and vasomotor rhinitis is presented. Using 15 per cent silver nitrate, bilateral chemical cautery of the anterior part of the nasal septum and inferior turbinates has been carried out at weekly intervals on 1 to 5 occasions, in 41 cases. No distinction was made between allergic rhinitis and vasomotor rhinitis. 92.6 per cent of cases belonged to the age group of 11 to 50 years. There was a slight predominance of female over male patients in this study. Only those cases were selected who had sneezing as the presenting symptom, while 17 per cent of these patients also suffered from asthma. The eosinophil count in the blood was below 5 per cent in 73.2 per cent of cases, and was above 10 per cent in 9.8 per cent of cases. Eosinophils were present in the nasal secretions of of 66.6 per cent of patients. Intestinal parasites were detected in the stools of 19.5 per cent of cases. No significant quantity of methaemoglobin was detected in the blood of any patient. Silver nitrate was applied after topical anaesthesia with 4 per cent lignocaine solution. The majority of patients had 2 to 4 applications. 68.3 per cent of patients had good relief, particularly from sneezing and watering of the nose. If patients treated with only a single application of silver nitrate are excluded from the series, 79.4 per cent patients reported relief. Significantly, out of 7 cases who were suffering from allergic rhinitis as well as asthma, 57.1 per cent of cases had freedom from the asthma. Among 3 patients who had no relief with earlier intranasal hydrocortisone injections, 66.6 per cent cases had good relief with silver nitrate. One patient who had good relief from allergic rhinitis developed anosmia after this treatment and some patients experienced transient sneezing and rhinorrhoea after the application of silver nitrate. Long-term results are awaited and it is suggested that further studies are necessary regarding the number of applications, the interval between applications, the strength of the silver nitrate solution, and the possible use of other chemical or physical agents for this mode of treatment.

Administration, Topical↗
PubMed1995

Comparison of silver nitrate and tetracycline as pleural sclerosing agents in rabbits.

The ideal agent to produce pleurodesis has not been identified. Tetracycline, the drug used most commonly in the 1980s, is no longer available. Talc either aerosolized or in a slurry is the agent used just most commonly at the present time, but there are concerns about its safety. Another possibility is silver nitrate, which was widely used in the past, but was abandoned on account of side effects. We hypothesized that lower concentrations of silver nitrate than had been used in the past would be effective in creating a pleurodesis in rabbits. The following medications in a total volume of 2 mL were instilled intrapleurally in three groups of ten anesthetized rabbits: 0.25% or 0.50% silver nitrate and 35 mg/kg tetracycline. Twenty-eight days after the injection, the animals were sacrificed and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of fibrosis and inflammation. The intrapleural injection of 0.50% silver nitrate produced an effective pleurodesis. The mean degree of gross pleurodesis in the rabbits that received 0.50% silver nitrate (3.4 +/- 1.2) did not differ significantly from that of the rabbits that received tetracycline (3.5 +/- 0.7) (scale 0 to 4). The mean degree of microscopic pleural fibrosis in the rabbits that received 0.50% silver nitrate (3.4 +/- 0.7) did not differ significantly from that of the rabbits that received tetracycline (3.9 +/- 0.3). However, 0.25% silver nitrate was ineffective in creating pleural fibrosis, either grossly or microscopically. No rabbits died after the intrapleural injection of the drugs. There were no observed side effects after the injection of silver nitrate. The present study demonstrates that 0.50% silver nitrate instilled into the pleural space is an effective agent for producing pleurodesis in the rabbit; its effect is comparable to tetracycline 35 mg/kg. This agent should be compared with tetracycline derivatives and talc in studies in humans.

Analysis of Variance↗
PubMed2005

Influence of antiinflammatory drugs (methylprednisolone and diclofenac sodium) on experimental pleurodesis induced by silver nitrate or talc.

STUDY OBJECTIVE: To determine whether the administration of antiinflammatory drugs interferes with experimental pleurodesis induced by silver nitrate or talc. STUDY DESIGN: Two groups of 30 white New Zealand rabbits were scheduled to receive an intrapleural injection of 0.5% silver nitrate or 400 mg/kg of talc. Each group was further classified into three subgroups (10 animals each), which received the following: (subgroup 1) the sclerosing agent only, (subgroup 2) the sclerosing agent plus 1 mg/kg of methylprednisolone, and (subgroup 3) the sclerosing agent plus 1.1 mg/kg of diclofenac sodium. The antiinflammatory agents were administered IM 24 h before the sclerosing agent and daily during the first week, followed by once-weekly injections until death at 28 days. At this time, the pleural cavity was macroscopically evaluated, and samples of pleura and lungs were collected for further microscopic examination. MEASUREMENTS AND RESULTS: The degree of pleural adhesions was higher after silver nitrate administration (p = 0.019). No reduction in the adhesions was observed after administering antiinflammatory drugs to this group (p > 0.05). Conversely, the adhesion score was significantly reduced after administration of both prednisolone (p = 0.028) and diclofenac (p = 0.032) to the animals that received talc. Administration of the antiinflammatory agents did not influence microscopic pleural or lung changes induced by silver nitrate or talc. CONCLUSION: These results show that the sustained systemic administration of antiinflammatory agents (steroidal or nonsteroidal) reduces the degree of pleural adhesions in animals with talc-induced pleurodesis but does not affect silver nitrate-induced pleurodesis. Extrapolation of these results to humans suggests that the use of antiinflammatory drugs should be avoided in patients with talc-induced pleurodesis and that appropriate clinical studies with silver nitrate should be conducted in patients chronically treated with these antiinflammatory agents.

Animals↗
PubMed1996

A silver tattoo of the nasal mucosa after silver nitrate cautery.

We report a silver tattoo of the nasal mucosa that occurred after silver nitrate cautery for nasal bleeding. This type of tattoo is a very rare potential mimic of melanoma and appears not to have been described before. It has similar features to an amalgam tattoo of the oral mucosa on histology and energy dispersive X-ray analysis (EDAX).

Aged↗
PubMed2003

The effect of concentration and pH of silver nitrate solution on nanoleakage.

PURPOSE: The purpose of this study was to evaluate the effects of concentration and pH of silver nitrate solution on nanoleakage in occlusal flat surfaces bonded with three dentin bonding systems. MATERIALS AND METHODS: The dentin bonding systems used in this study were Single Bond, PermaQuik, and Prompt L-Pop. Flat occlusal dentin surfaces from extracted human molars were bonded with one of the dentin bonding systems. The teeth from each subgroup (n = 4) were placed in one of the following silver nitrate solutions: 50% w/v, 25% w/v, 10% w/v, and 2% w/v (pH 3.4, 4.2, 4.4, and 4.9, resp), and 50% w/v buffered to pH 6 in total darkness for 24 h, rinsed in running water for 5 min, immersed in photodeveloping solution for 24 h, and exposed to light for 8 h. Specimens were sectioned, mounted on stubs, carbon coated and observed in a Field Emission SEM using backscattered electron mode. RESULTS: FE-SEM images showed that samples from different concentrations of silver nitrate solution had leakage patterns similar to that of samples from 50% w/v for all dentin bonding systems. The concentrations and pH values of silver nitrate solutions did not affect leakage patterns in any of the systems. CONCLUSION: A lower concentration of silver nitrate solution may be used in a nanoleakage study, although the present results need to be replicated to determine an ideal concentration.

Acid Etching, Dental↗
PubMed1978

The early development of the human skeleton: a radiographic study of fetuses impregnated with silver nitrate.

The use of a silver nitrate impregnation technique and radiography for delineation of the bones of the developing skeleton is not widely known. Using this method, a study of skeleton development was undertaken over a three-year period and special attention was paid to 20 fetuses under the age of 16 weeks. The dates at which ossification in cartilage occurred and the sequence of bone development were noted. Although the technique may be used to delineate skeletal dysplasias in the stillborn, it is best suited to fetuses aged 9--20 weeks. It may become possible to show the earliest age at which bone dysplasias affect the skeleton though this is speculative at the moment.

Bone Development↗
PubMed2002

Biocompatibility, encrustation and biodegradation of ofloxacine and silver nitrate coated poly-L-lactic acid stents in rabbit urethra.

The purpose of this study was to evaluate the biocompatibility, encrustation and biodegradation properties of silver nitrate and ofloxacine blended caprolactone-L-lactide copolymer coated self-reinforced poly-L-lactic acid (SR-PLLA) urospirals in situ in the male rabbit urethra. SR-PLLA urospirals coated with 10% by weight silver nitrate or 5% by weight ofloxacine blended copolymer or pure copolymer were inserted into the posterior urethra of 18 male rabbits. No prophylactic antibiotics were given. The animals were sacrificed 1 or 6 months after insertion. Urethral tissue reactions were histologically scored semiquantitavely and the appearence of the stents assessed using scanning electron microscopy. The biodegradation time of SR-PLLA stents was remarkably reduced by the caprolactone coating. Silver nitrate and ofloxacine blended copolymer coated urospirals caused less tissue reaction than urospirals with a pure copolymer coating. Silver nitrate coating effectively prevented biofilm formation and stent encrustation. Silver nitrate and ofloxacine blended copolymer coated SR-PLLA urospirals had good biocompatibility properties in rabbit urethra. In particular, coating with silver nitrate may provide possibilities of preventing bacterial adhesion to bioabsorbable stents.

Animals↗
PubMed2000

Silver nitrate is superior to talc slurry in producing pleurodesis in rabbits.

STUDY OBJECTIVE: The ideal agent for producing pleurodesis has not been identified. Although talc is the agent most commonly used at the present time, there are concerns about its safety. Silver nitrate is a possible alternative agent. The purpose of the present study was to compare the effectiveness of intrapleural silver nitrate and talc slurry in producing pleurodesis in rabbits. Additionally, the total amount of pleural collagen and the distribution of thick and thin collagen fibers were studied. DESIGN: Two groups of 10 rabbits received either 0.50% silver nitrate or 400 mg/kg talc in a total volume of 2 mL intrapleurally. The animals were killed 28 days after injection, and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of inflammation and fibrosis. Collagen was assessed with the van Gieson's and picrosirius stains. RESULTS: The macroscopic pleurodesis (scale, 0 to 4; mean +/- SEM) resulting from the intrapleural injection of silver nitrate (3.4+/-0.2) was significantly better (p<0.001) than that resulting from talc (1.6+/- 0.1). The mean degree of microscopic pleural fibrosis induced by silver nitrate (3.3+/-0.3) was significantly higher (p = 0.003) than that induced by talc (1.8+/-0.1). The mean amount of microscopic pleural collagen (van Gieson's) was significantly greater (p<0.001) in the rabbits that received silver nitrate (3.0+/-0.2) than in those that received talc (1.6+/-0.2). The distribution of thick and thin collagen fibers did not differ between the groups. CONCLUSIONS: We conclude that, in our rabbit model, intrapleural silver nitrate was more effective than talc in producing a pleurodesis.

Animals↗
PubMed2004

Randomized controlled trial on the treatment of otitis externa with one per cent silver nitrate gel.

Otitis externa (OE) and especially otomycosis can be very persistent and difficult to control. In the present study the efficacy of treatment of OE with a single instillation in the ear canal of one per cent silver nitrate in three per cent hypromellose gel compared to 0.1 per cent silver nitrate gel was tested in a single-blinded randomized controlled parallel group study. The outcome measure was complete resolution of the OE after one week. Forty-four patients with refractory, bacterial as well as fungal, OE entered the study, comprising 30 ears in each treatment arm. Eight patients defaulted from follow-up, five ears in each treatment arm. A single instillation of one per cent silver nitrate gel cured 23 (92 per cent) of 25 ears with OE, whereas with 0.1 per cent silver nitrate gel seven (28 per cent) of 25 ears treated were cured (Fisher-exact test, p-exact = 0.00010). In a non-controlled series of 120 ears 93.3 per cent needed only a single instillation of one per cent silver nitrate gel while another five per cent were cured after a second instillation a week later. There were no adverse reactions. OE can be treated effectively with instillation of one per cent silver nitrate gel and is particularly useful in recalcitrant otomycosis. The treatment method saves both cost and time.

Adult↗
PubMed2005

Intrapleural low-dose silver nitrate elicits more pleural inflammation and less systemic inflammation than low-dose talc.

STUDY OBJECTIVES: Several systemic effects have been described after talc pleurodesis. The aim of this study was to assess the systemic response induced by low, nonpleurodesis-inducing doses of talc and silver nitrate in an experimental model in rabbits. DESIGN: Groups of six rabbits were injected intrapleurally with talc, 100 mg/kg or 400 mg/kg, and silver nitrate, 0.1% or 0.5%. After 6, 24, or 48 h, samples of blood and pleural fluid were collected and assayed for leukocytes, percentage of neutrophils, lactate dehydrogenase, interleukin-8, and vascular endothelial growth factor (VEGF) levels. Preinjection blood samples were used as normal blood controls. MEASUREMENTS AND RESULTS: Silver nitrate 0.1% induced a more intense pleural inflammation than that produced by talc 100 mg/kg. In contrast, talc 100 mg/kg induced a more pronounced acute systemic response with higher values of WBCs and neutrophils, whereas silver nitrate 0.1% produced no significant increases in leukocytes or neutrophils. The serum interleukin-8 and VEGF levels increased in all groups, and decreased with time only in the silver nitrate 0.1% group. The highest serum VEGF levels were observed in the talc 100 mg/kg group. CONCLUSIONS: In conclusion, 0.1% silver nitrate produced an intense pleural inflammatory response with a less evident systemic response in comparison to 0.5% silver nitrate and talc 100 mg/kg or 400 mg/kg.

Animals↗