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Introduction: Alcohol consumption, particularly excessive drinking, incurs a high societal cost. This study aimed to apply current state-specific data from 1 state, Minnesota, to established national methods for estimating the societal cost of excessive alcohol consumption for 2 purposes: first, to update the cost estimate for the state and, second, to understand the potential benefits of using state-specific data versus a national apportionment strategy for economic burden estimates.Methods: In 2021, established methods were used to apply alcohol-attributable fractions for health care, lost productivity, crime, and other effects (e.g., motor vehicle crashes) to 2019 Minnesota data. The main outcome measure was the annual prevalence cost (incurred and paid each year) of excessive alcohol use in Minnesota from the societal perspective. Secondary outcome measures were the cost of specific outcomes (e.g., crime), different types of consumption (e.g., drinking during pregnancy), the cost to government payers, and the cost per drink.Results: The societal cost of alcohol use in Minnesota in 2019 was nearly $8 billion dollars (2019 USD) or $1,383 per resident. This estimate is substantially higher than a previous estimate on the basis of apportionment of a national estimate.Conclusions: The cost of alcohol use in Minnesota is considerable. Geographically specific and current cost estimates can inform decision making about the public health impact of excessive alcohol use and the cost effectiveness of prevention strategies. Evidence-based prevention strategies to reduce alcohol use include increased alcohol taxes, enhanced enforcement of laws prohibiting sales to minors, and electronic screening and brief intervention. [ABSTRACT FROM AUTHOR]

Objectives: To determine the epidemiology of pediatric traumatic brain injury (TBI) in a midwestern state and to examine differences between metropolitan and nonmetropolitan residents. Design: Population-based case series. Participants: Patients aged 0-19 years sustaining TBI in 1993 that resulted in hospitalization or death. Interventions: None. Main Outcome Measures: Incidence, mortality and case-fatality rates, length of hospital stay, discharge status, and Glasgow Outcome Scale score. Results: Nine hundred seventy-seven patients met inclusion criteria. Incidence, mortality, and case-fatality rates were 73.5 per 100000, 9.3 per 100000, and 12.8 per 100, respectively. Higher median household incomes and percentages of adult high-school graduates in a patient's census block group correlated with lower incidence. Median length of stay was 2 days. Of those included in the study, 720 patients (74%) were discharged home with self-care. Three hundred fifty-seven patients met criteria for severe TBI; 346 (97%) were assigned Glasgow Outcome Scale scores, of which 161 (47%) had disabilities or died. Severe TBI was associated with nonmetropolitan residence, higher median household income, and certain injury mechanisms. Incidence was similar for metropolitan and nonmetropolitan residents. Median headregion Abbreviated Injury Score, Injury Severity Score, and mortality and case-fatality rates were higher for nonmetropolitan residents. Conclusions: This study reports the lowest incidence of pediatric TBI that results in death or hospitalization to date. One half of severely injured patients suffered poor outcomes. A greater proportion of nonmetropolitan than metropolitan residents suffered severe TBI and had higher mortality and case-fatality rates. [ABSTRACT FROM AUTHOR]

Since the 1980s, minimally invasive procedures have made inroads into gynecologic surgery. This article describes the progression of technological developments that have led gynecologists to attempt and master more and more minimally invasive surgical techniques over the last 30 years. It describes the minimally invasive gynecologic surgeries that are done today and reviews evidence that shows these procedures lead to faster recovery, fewer complications, and better outcomes.