Letters
On: “Of
to the Editor
jogging“
To the Editor: Dr. Burch’s recent Annotation’ indicates that the American Automobile Association reported that 8,300 joggers were killed and over 100,009 were injured in 1977 by virtue of being hit by automobiles. His reference’ is the March 22, 1978, edition of the Wall Street Journal, which indeed stated these figures on page 1, but with reference to the incidence of pedestrian deaths! The American Automobile Association has informed me that in 1977 total pedestrian injuries (ages 0 to over 65 years) were estimated to be 100,000 and pedestrian deaths were 8,700.’ The breakdown of total deaths and injuries by circumstance is shown in Table I. (Total 1977 traffic deaths, including pedestrian deaths, was 49,500).
I. Total pedestrian deaths and injuries by category Table
Crossing or entering street, or at intersection Walking Standing in roadway Pushing or working on vehicle in roadway Other labor in roadway Playing in roadway Other activities in roadway Other activities not in roadway Total
69,242 8,261 4,131 2,283 1,087 3,913 11,957 7,826 108,700
1 am certain that the incidence of joggers killed by automobile is finite, although it is not known.’ Both driver and jogger, I will allow, are too frequently reckless when in a situation of confrontation: prudence by both is in order. Dr. Burch’s conclusion that “jogging.. (is). . a serious and dangerous disease of the environment.. .“I strikes me as faulting the victim, not the perpetrator. Perhaps it is the automobile and its driver that should be considered the etiological agents of pedestrian deaths. *Note added in proof: Pedestrian deaths in the 1967-1977 period declined by 7%, the jogging boom notwithstanding (see ref. 3, page 58). Paul Miluy, Ph.D. Mt. Sinai School of Medicine New York, N. Y. 10029 REFERENCES 1. 2. 3. 4.
Burch, G. E.: Of jogging, AM. HEART J. 97:407, 1979. Burch, G. E.: Personal communication. National Safety Council: Accident Facts, 1978, pages 55 and 61. Hartung, M.: Personal communication. National Headquarters, American Automobile Association.
Long-term
prognosis
To the Editor: I read with interest the Lockwood’ on the long-term
136
of bacterial
endocarditis
paper by McNeill, Strong, and prognosis of bacterial endocardi-
tis in the April, 1978, issue of AMERICAN HEART JOURNAL. Unfortunately, there are inconsistencies between the numbers given in the table, the figure, and the text. For example: the number of patients surviving 1 year after multiple organism infection is three out of five in the table, vs. 100 per cent in Fig. 1. For cases with sterile culture the numbers are four survivors out of 16 (25 per cent) in the table, 31 per cent in Fig. 1, and the discussion gives yet another number-28 per cent. The text gives no explanation for these differences. Though the differences are slight, they give the reader a feeling of doubt as to the reliability of the results of this interesting study. M. Liron, M.D. Dept. of internal Medicine ‘%” ‘Rokach” (Hadassah) Hospital Tel-Aviv, Israel REFERENCE 1.
McNeill, Bacterial long-term
K. M., Strong, J. E., Jr., and Lockwood, W. R.: endocarditis: An analysis of factors affecting survival, AM. HEART J. 95448, 1978.
Reply To the Editor; Dr. Liron quite properly points out three discrepancies in our article (AM. HEART J. 95:448,1978). The correct figures as obtained from the original chart reviews are as follows: Sterile cultures were found in 16 patients of whom five survived a year. Multiple organisms were isolated from five patients, ail five of whom survived a year. The other numbers as given in the table and the text are errors I overlooked while proofreading the typescript following a major revision. William R. Lockwood, M.D. Associate Professor Department of Medicine School of Medicine University of Mississippi Medical Center 2500 N. State St. Jackson, Miss, 39216
Programmed atrial bundle stimulation
versus
programmed
His
To the Editor: We have read with great interest the paper entitled “Study of the temporal effects on conduction and refractoriness of the His-Purkinje system in man” by Dr. Reddy and associates in the September, 1978, issue of the JOURNAL.' This paper clearly demonstrated temporal stability of refractoriness in the HisPurkinje system. Results of the study provide baseline data for future investigations of antiarrhythmic drugs acting on the distal part of the A-V conduction system. However, in over 90 per cent of the cases investigated programmed atria1 stimulation proved to be ineffective in assessing refractoriness of the His-Purkinje system because of A-V nodal refractoriness. Theoretically, programmed His bundle stimulation seems
July, 1979, Vol. 98, No. 1
On: “Of
to the Editor
jogging“
To the Editor: Dr. Burch’s recent Annotation’ indicates that the American Automobile Association reported that 8,300 joggers were killed and over 100,009 were injured in 1977 by virtue of being hit by automobiles. His reference’ is the March 22, 1978, edition of the Wall Street Journal, which indeed stated these figures on page 1, but with reference to the incidence of pedestrian deaths! The American Automobile Association has informed me that in 1977 total pedestrian injuries (ages 0 to over 65 years) were estimated to be 100,000 and pedestrian deaths were 8,700.’ The breakdown of total deaths and injuries by circumstance is shown in Table I. (Total 1977 traffic deaths, including pedestrian deaths, was 49,500).
I. Total pedestrian deaths and injuries by category Table
Crossing or entering street, or at intersection Walking Standing in roadway Pushing or working on vehicle in roadway Other labor in roadway Playing in roadway Other activities in roadway Other activities not in roadway Total
69,242 8,261 4,131 2,283 1,087 3,913 11,957 7,826 108,700
1 am certain that the incidence of joggers killed by automobile is finite, although it is not known.’ Both driver and jogger, I will allow, are too frequently reckless when in a situation of confrontation: prudence by both is in order. Dr. Burch’s conclusion that “jogging.. (is). . a serious and dangerous disease of the environment.. .“I strikes me as faulting the victim, not the perpetrator. Perhaps it is the automobile and its driver that should be considered the etiological agents of pedestrian deaths. *Note added in proof: Pedestrian deaths in the 1967-1977 period declined by 7%, the jogging boom notwithstanding (see ref. 3, page 58). Paul Miluy, Ph.D. Mt. Sinai School of Medicine New York, N. Y. 10029 REFERENCES 1. 2. 3. 4.
Burch, G. E.: Of jogging, AM. HEART J. 97:407, 1979. Burch, G. E.: Personal communication. National Safety Council: Accident Facts, 1978, pages 55 and 61. Hartung, M.: Personal communication. National Headquarters, American Automobile Association.
Long-term
prognosis
To the Editor: I read with interest the Lockwood’ on the long-term
136
of bacterial
endocarditis
paper by McNeill, Strong, and prognosis of bacterial endocardi-
tis in the April, 1978, issue of AMERICAN HEART JOURNAL. Unfortunately, there are inconsistencies between the numbers given in the table, the figure, and the text. For example: the number of patients surviving 1 year after multiple organism infection is three out of five in the table, vs. 100 per cent in Fig. 1. For cases with sterile culture the numbers are four survivors out of 16 (25 per cent) in the table, 31 per cent in Fig. 1, and the discussion gives yet another number-28 per cent. The text gives no explanation for these differences. Though the differences are slight, they give the reader a feeling of doubt as to the reliability of the results of this interesting study. M. Liron, M.D. Dept. of internal Medicine ‘%” ‘Rokach” (Hadassah) Hospital Tel-Aviv, Israel REFERENCE 1.
McNeill, Bacterial long-term
K. M., Strong, J. E., Jr., and Lockwood, W. R.: endocarditis: An analysis of factors affecting survival, AM. HEART J. 95448, 1978.
Reply To the Editor; Dr. Liron quite properly points out three discrepancies in our article (AM. HEART J. 95:448,1978). The correct figures as obtained from the original chart reviews are as follows: Sterile cultures were found in 16 patients of whom five survived a year. Multiple organisms were isolated from five patients, ail five of whom survived a year. The other numbers as given in the table and the text are errors I overlooked while proofreading the typescript following a major revision. William R. Lockwood, M.D. Associate Professor Department of Medicine School of Medicine University of Mississippi Medical Center 2500 N. State St. Jackson, Miss, 39216
Programmed atrial bundle stimulation
versus
programmed
His
To the Editor: We have read with great interest the paper entitled “Study of the temporal effects on conduction and refractoriness of the His-Purkinje system in man” by Dr. Reddy and associates in the September, 1978, issue of the JOURNAL.' This paper clearly demonstrated temporal stability of refractoriness in the HisPurkinje system. Results of the study provide baseline data for future investigations of antiarrhythmic drugs acting on the distal part of the A-V conduction system. However, in over 90 per cent of the cases investigated programmed atria1 stimulation proved to be ineffective in assessing refractoriness of the His-Purkinje system because of A-V nodal refractoriness. Theoretically, programmed His bundle stimulation seems
July, 1979, Vol. 98, No. 1
