New York state journal of medicine
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Perioperative cerebrovascular accidents after general surgical procedures are rare, but devastating and often fatal. The purpose of this study was to identify the perioperative, intraoperative, and postoperative factors associated with perioperative strokes after general surgical procedures. Over a five-year period, 19 patients of 24,641 general and vascular surgical procedures (0.08%) suffered a perioperative stroke. ⋯ Only one patient had an intracerebral hemorrhage. Although the exact mechanism of perioperative stroke remains uncertain, its association with abnormal cardiograms, lack of association with carotid bruits, and lack of intracerebral hemorrhage all suggest that emboli from the heart is the major cause in most patients. These data indicate that a perioperative stroke is associated with a very high mortality rate (26%) and is a potentially predictable complication in the majority of patients.
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In New York State it is illegal to sell tobacco products to persons under the age of 18 years. In most communities, compliance with this law is poor. This study provides estimates of teenage cigarette smoking and the illegal sale of cigarettes to minors in 1990 in each of New York's 57 counties and in New York City. ⋯ Data available on the cigarette consumption and purchasing habits of teenage smokers reveal that nearly 21.9 million packs of cigarettes were sold illegally to minors in 1991 in New York State. This finding underscores the fact that cigarette sales to underage youth in New York is big business, representing $39.5 million in sales annually. Government officials should consider levying an illegal drug profit tax on the cigarette industry to recover the millions in profits derived annually from the illegal sale of cigarettes to children.