Tooth sensitivity is a common clinical problem. This multi-center randomized clinical trial assessed the effectiveness and safety of topical diammine silver fluoride. From two sites (Lima and Cusco, Peru), 126 adults with at least one tooth sensitive to compressed air were randomly assigned to either the experimental treatment or sterile water, and pain was assessed by means of a 100-mm visual analogue scale at 24 hours and 7 days. The diammine silver fluoride reduced pain at 7 days at both sites. At the Lima site, the average change in pain scores between baseline and day 7 for the silver fluoride group was -35.8 (SD = 27.7) mm vs. 0.4 (SD = 16.2) mm for the control group (P< 0.001). In Cusco, the average change in pain scores for the silver fluoride group was -23.4 (SD = 21.0) mm and -5.5 (18.1) mm for the control group (P = 0.002). No tissue ulceration, white changes, or argyria was observed. A small number of participants in the silver fluoride group experienced a mild but transient increase in erythema in the gingiva near the tooth. No changes were observed in the Gingival Index. We concluded that diammine silver fluoride is a clinically effective and safe tooth desensitizer.

We evaluated the Standard Q HIV/Syphilis Combo Test (SD Biosensor, South Korea), a dual rapid test using stored sera (N=400) in a laboratory setting in Lima, Peru. The sensitivity and specificity for HIV antibody detection was 100.0%(95% CI: 98.2%−100.0%) and 99.5%(95% CI: 97.2% −100.0%), respectively. For treponemal antibody detection the sensitivity and specificity was 97.5%(95%CI:94.3%−99.2%) and 100.0%(95%CI:98.2%−100.0%), respectively.

Background The HRDR-200 automated reader (Cellmic, LLC, CA, USA) is an opto-mechanical smartphone attachment that reads lateral flow-based rapid HIV/Syphilis combo assays. The reader may minimize human errors in interpreting rapid tests as well as provide a centralized data system for epidemiologic monitoring.Methods We enrolled men who have sex with men and transgender women >18 years old seeking services at a sexually transmitted disease clinic in Lima between October 2016 and April 2017. Venous blood was tested using two dual HIV and Syphilis rapid tests (SD BIOLINE HIV/Syphilis Duo (SD), Republic of Korea; and First Response HIV 1 + 2/Syphilis Combo (FR), India). HIV infection was confirmed with fourth-generation EIA tests, while Syphilis was confirmed with RPR, TPPA, and TPHA titers. Clinic staff visually inspected rapid tests, after which the tests were read by the HRDR-200. To assess how well the reader results correlated with visual inspection we calculated negative and positive percent agreement, concordance, and kappa statistic.ResultsOf 283 participants, 34% were HIV-infected and 46% had treponemal antibodies (69% of whom had reactive RPR titers). The concordance of reader results with visual inspection was high for both antibodies and both rapid assays (see Table).Syphilis 
AntibodyTest 
PositiveTest 
Negative% Positive Agreement 
(95% CI)% Negative Agreement
 (95% CI)ConcordanceKappa 
StatisticFRReader9918498.9 (94.5–99.9) 96.1 (92.3–98.4)0.97 (0.95–0.99)0.94 (0.89–0.98)Operator10517893.3 (86.7–97.2)99.4 (96.9–99.9)SDReader9818598.9 (94.4–99.9)95.6 (91.6–98.1)0.97 (0.94–0.99)0.93 (0.89–0.98)Operator10517892.3 (85.5–96.6)99.4 (96.9–99.9)HIV AntibodyFRReader8919498.8 (93.8–99.9)95.8 (92.0–98.2)0.97 (0.94–0.99)0.93 (0.88–0.97)Operator9618791.6 (84.2–96.3)99.4 (97.0–99.9)SDReader9718698.9 (94.3–99.9)100 (98.0–100)0.99 (0.98–0.99)0.99 (0.98–1.00)Operator96187100 (96.2–100)99.4 (97.0–99.9)ConclusionGiven the high correlation of the reader with visual inspection, further investigation is warranted into the potential utility of the reader for epidemiologic monitoring as well as for improving HIV and Syphilis diagnosis in areas without technicians trained in visual inspection of rapid tests.Disclosures All authors: No reported disclosures.