Cuban Public Health History: The 19th Century Board of Health in the City of Holguín.

INTRODUCTION In 19th century colonial Cuba, Boards of Health (Juntas de Sanidad) were created to administer public health, in tandem with and later replacing the older Royal Protomedicato Court (Real Tribunal de Protomedicato). Development of the Board of Health in the northeastern city of Holguín reflected local historical processes, as well as class relations and social issues characteristic of this period. Among the highlights of the Board's activities were epidemic control during cholera and smallpox outbreaks, monitoring the city's sanitary conditions, and support for charitable work. Studying the history of such epidemiological surveillance activities may benefit design and implementation of related current research and prevention/control campaigns. OBJECTIVE Describe the development of the 19th century Board of Health in the city of Holguín. EVIDENCE ACQUISITION The research was conducted through a critical analysis of primary sources contained in the Historical Archives of (today's) Holguín Province, specifically relevant documents from the regional and city government (Fondo Tenencia de Gobierno y Ayuntamiento) and town council (Cabildo). Cuban and international scientific publications were also consulted. DEVELOPMENT The Board of Health was the main institution conducting health and hygiene control and charitable activities in the city of Holguín during the 19th century. It was created mainly to take preventive measures against diseases affecting the population, an effort it undertook with support from the Urban Health Police. Its efforts to confront smallpox and cholera epidemics greatly helped to reduce the toll of these diseases on the population, albeit not sufficiently to prevent their reccurrence. Beginning in the 1870s, weakened government support eroded the Board's position, and health-related measures were implemented mainly by the Board of Charity, which focused on matters concerning the city's Civil Hospital. CONCLUSIONS Although established in 1820, Holguín's Board of Health carried out preventive actions most actively from 1850 to 1865, with support from the Urban Health Police. Its gradual disappearance from the health policy arena beginning in the 1870s reflects its failure as an institution, in large part due to weak government support. KEYWORDS Board of Health, prevention, epidemics, Cuba.

Comportamiento del traumatismo dentario en el sector anterior en pacientes de ocho a 18 años / Behaivior of the dental traumatism in the previous sector in patients from eight to 18 years old

RESUMEN Fundamento: entre todas las enfermedades que afectan el complejo bucal se encuentran los traumas dentarios que son alteraciones causadas por factores extrínsecos e intrínsecos que dificultan el funcionamiento normal del mismo. Objetivo: evaluar el comportamiento del traumatismo en el sector anterior en pacientes de ocho a 18 años de edad. Métodos: se realizó un estudio descriptivo de serie de casos en 15 pacientes atendidos en el servicio de la clínica estomatológica de Gibara Holguín, que cumplieron con los criterios de inclusión, en el período desde enero de 2015 hasta enero de 2016. Los datos se procesaron en Excel, se calcularon porcentajes. Para mayor comprensión la información se mostró en tablas. Resultados: el grupo de edad más afectado resultó el de ocho a 11 años de edad con un discreto predominio del sexo masculino. En el comportamiento del traumatismo dentario anterior según la severidad de la lesión predominó la infractura del esmalte, con nueve pacientes. Conclusiones: el diente más afectado fue el incisivo central superior al predominar la infractura del esmalte de acuerdo con la severidad de la lesión.

ABSTRACT Background: among all the illnesses affecting the buccal complex we can find the dental traumas, they are alterations caused by extrinsic and intrinsic factors that make difficult the normal functioning of it. Objective: to evaluate the behavior of the traumatism in the anterior sector in patient from eight to 18 years of age. Methods: a descriptive study of series of cases was carried out in 15 patients assisted in the service of the Gibara dentistry clinic from January of the 2015 until January of the 2016. Data was processed in Excel, and percentage was calculated. To a better understanding, the information was shown in charts. Results: the most affected age group was the one from eight to 11 years of age, with a discreet prevalence of the masculine sex. In the behavior of the dental anterior traumatism according to the severity of the lesion the in-fracture of the enamel prevailed with nine patients. Conclusions: the most affected tooth was the superior central incisive prevailing the in-fracture of the enamel according to the severity of the lesion.

Comportamiento del traumatismo dentario en el sector anterior en pacientes de ocho a 18 años / Behaivior of the dental traumatism in the previous sector in patients from eight to 18 years old

Fundamento: entre todas las enfermedades que afectan el complejo bucal se encuentran los traumas dentarios que son alteraciones causadas por factores extrínsecos e intrínsecos que dificultan el funcionamiento normal del mismo. Objetivo: evaluar el comportamiento del traumatismo en el sector anterior en pacientes de ocho a 18 años de edad. Métodos: se realizó un estudio descriptivo de serie de casos en 15 pacientes atendidos en el servicio de la clínica estomatológica de Gibara Holguín, que cumplieron con los criterios de inclusión, en el período desde enero de 2015 hasta enero de 2016. Los datos se procesaron en Excel, se calcularon porcentajes. Para mayor comprensión la información se mostró en tablas. Resultados: el grupo de edad más afectado resultó el de ocho a 11 años de edad con un discreto predominio del sexo masculino. En el comportamiento del traumatismo dentario anterior según la severidad de la lesión predominó la infractura del esmalte, con nueve pacientes. Conclusiones: el diente más afectado fue el incisivo central superior al predominar la infractura del esmalte de acuerdo con la severidad de la lesión (AU)

Background: among all the illnesses affecting the buccal complex we can find the dental traumas, they are alterations caused by extrinsic and intrinsic factors that make difficult the normal functioning of it. Objective: to evaluate the behavior of the traumatism in the anterior sector in patient from eight to 18 years of age. Methods: a descriptive study of series of cases was carried out in 15 patients assisted in the service of the Gibara dentistry clinic from January of the 2015 until January of the 2016. Data was processed in Excel, and percentage was calculated. To a better understanding, the information was shown in charts. Results: the most affected age group was the one from eight to 11 years of age, with a discreet prevalence of the masculine sex. In the behavior of the dental anterior traumatism according to the severity of the lesion the in-fracture of the enamel prevailed with nine patients. Conclusions: the most affected tooth was the superior central incisive prevailing the in-fracture of the enamel according to the severity of the lesion (AU)

El comportamiento epidemiológico de los tratamientos pulporradiculares en la Clínica Estomatológica de Gibara, 2016-2017 / Root canal therapy epidemiological behavior at the Stomatological Clinic of Gibara, 2016-2017

RESUMEN Introducción: la mayoría de las urgencias estomatológicas se deben a patologías pulpares y periapicales; la enfermedad más diseminada en los seres humanos. Objetivo: caracterizar el comportamiento epidemiológico del tratamiento pulporradicular en una clínica estomatológica. Métodos: se realizó un estudio transversal en 110 pacientes, en la Clínica Estomatológica Docente de Gibara, Holguín; desde septiembre de 2016 a marzo del 2017, en cuanto a: grupos de edades, sexo, grupo dentario afectado, sustancias irrigadoras del conducto utilizadas, condición pulpar y número de sesiones. Resultados: el tratamiento pulporradicular se presentó con mayor frecuencia en el grupo etario de 48 a 53 años, un 23,63%; con predominio del sexo femenino del 61,82%. El grupo dentario más afectado fue el de los incisivos con el 53,64%. La sustancia irrigadora más utilizada fue el metronidazol hasta un 47,27%; seguida por hipoclorito de sodio con el 39,09%; y la clorhexidina en un 13,64%. Predominó la pulpitis irreversible en un 75,46% sobre la necrosis pulpar con el 24,54%. La mayoría de los tratamientos se realizaron en varias sesiones con 104 casos, para el 94,55%. Conclusiones: el tratamiento pulporradicular se presentó con mayor frecuencia en los incisivos, en el sexo femenino, en el grupo de 48 a 53 años. La sustancia irrigadora más utilizada fue el metronidazol. Predominó la pulpitis irreversible y la mayoría de los tratamientos se realizaron en varias sesiones. Se sugiere fomentar las acciones de promoción y prevención de salud en la adolescencia, que les permita conservar la salud bucal.

ABSTRACT Introduction: most of stomatological emergencies are due to pulpal and periapical pathologies. They are the most widespread disease in humans. Objective: to characterize the epidemiological behavior of root octopus treatment in a stomatological clinic. Methods: a cross-sectional study was carried out in 110 patients in the Teaching Stomatological Clinic of Gibara, Holguín, Cuba from September 2016 to March 2017, regarding: age groups, sex, affected tooth group, irrigating substances of the duct used, pulpar condition and number of sessions. Results: root octopus treatment was frequent in the 48 to 53 age groups with a 23.63%, with a predominance of females up to 61.82%. The most affected dental group was that of the incisors, with 53.64%. The most used irrigating substance was metronidazole with 47.27%, followed by sodium hypochlorite 39.09% and chlorhexidine 13.64%. Predominantly irreversible pulpitis with 75.46% on pulpal necrosis, represented by 24.54% and most of the treatments were performed in several sessions with 104 cases for 94.55%. Conclusions: root octopus treatment was frequent in the groups of incisors, females, and ages from 48 to 53. The most used irrigating substance was metronidazole. Irreversible pulpitis predominated and the majority of treatments were performed in several sessions. Promotion and prevention are suggested as actions for adolescence groups, to preserve oral health.