Sozial- und Präventivmedizin
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Editorial Comment Biography Historical Article
Snow and Farr: a scientific duet.
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Biography Historical Article
The changing assessments of John Snow's and William Farr's cholera studies.
This article describes the epidemiological studies of cholera by two major British investigators of the mid-nineteenth century, John Snow and William Farr, and it asks why the assessments of their results by contemporaries was the reverse of our assessment today. In the 1840s and 1850s Farr's work was considered definitive, while Snow's was regarded as ingenious but flawed. ⋯ A major change in thinking about disease causation was needed before Snow's work could be widely accepted. William Farr's later studies contributed to that acceptance.
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Biography Historical Article
Changing images of John Snow in the history of epidemiology.
Ever since the end of the 19th century, the story of John Snow and his investigations into the contagiousness of cholera has fascinated epidemiologists. Several different lessons have been extracted from the interpretation and reinterpretation of Snow's work--according to prevailing insights. The story of John Snow continues to evolve, even into the 21st century.
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The changing health care environment necessitates careful re-evaluation of all costly elective procedures. Low back surgery is a typical example. This article reviews the current literature addressing the efficacy of surgery and invasive percutaneous treatments for discogenic sciatica. ⋯ Various percutaneous techniques are available but there is no solid scientific evidence of efficacy. The benefits of open discectomy, principally reduced duration of pain, appear to justify its use in carefully selected patients when discogenic sciatica fails to improve with conservative measures. Though elective, the procedure will probably continue to be available under managed care, but with increasing scrutiny of operative indications.