Posttraumatic Pancreatitis Four Days after Renal Injury with Massive Retroperitoneal Hematoma

A 25-year-old man accidentally fell from a cliff and hit his right flank on the ground while camping. Initially, he was able to barely walk, but he ultimately became unable to walk at all due to severe flank pain. He had no remarkable personal or family history and was a social drinker. Upon arrival, he showed clear consciousness but was in a hemorrhagic shock state. Enhanced computed tomography (CT) revealed extravasation of contrast medium from the injured right kidney with massive retroperitoneal hematoma. He underwent massive blood transfusion and tracheal intubation followed by renal embolization. His vital signs stabilized on hospital day 2, and he was extubated on day 3. On days 4 and 5, a blood examination revealed increased levels of amylase (360 and 904 IU/L, respectively). Enhanced CT on day 5 did not show signs of severe acute pancreatitis. The maximum amylase level was 1041 IU/L on day 6 and decreased day by day without deterioration of the severity of his acute pancreatitis. He was discharged on day 14. The subacute phase of posttraumatic acute pancreatitis in the present case may have been induced not by direct injury to the pancreas but by several causative factors, such as shock, increased pressure of the retroperitoneal space, or the release of inflammatory mediators from injured tissues or hematoma.

Wine-related lifestyle segmentation in the context of urban Indian consumers

Purpose The purpose of this study is to understand consumers in the emerging wine market of India to ensure the best services. To this end, factors were identified to describe Indian wine consumer behavior and further segments for consumers were created based on the factors identified. Design/methodology/approach The research design is descriptive in nature and based on primary data. Data was collected by a structured questionnaire from 232 respondents in five major cities of India (Mumbai, Delhi NCR, Bangalore, Pune and Hyderabad). The scale was mainly adopted from wine-related lifestyle approaches. Findings The principal component factor analysis resulted in six factors, namely, drinking ritual, consumption reason (social), consumption reason (mood, enjoyment and relaxation), consumption practice, consumption planning and quality. Cluster analysis resulted in a three-cluster solution. These clusters were named as cautious social drinker, loner regular drinker and highly engaged drinker based on the attributes possessed. Originality/value The segmentation of urban Indian wine consumers will be helpful for marketers to identity and describe the differences in attributes and behaviors, to create customized promotions to match the needs.

Characteristics of Patients that Substitute Medical Cannabis for Alcohol

AimsA substitution effect occurs when patients substitute Medical Cannabis (MC) for another drug. Over three-quarters (76.7%) of New England dispensary members reported reducing their use of opioids and two-fifths (42.0%) decreased their use of alcohol after starting MC (Piper et al. 2017). The objective of this exploratory study was to identify any factors which differentiate alcohol substituters from those that do not modify their alcohol use after starting MC (non-substituters).MethodsAmong dispensary patients (N=1,477), over two-thirds with chronic pain, that completed an online survey, 7.4% indicated that they regularly consumed alcohol. Comparisons were made to identify any demographic or health history characteristics which differentiated alcohol substituters (N=47) from non-substituters (N=65). Respondents selected from among a list of 37 diseases and health conditions (e.g. diabetes, sleep disorders) and the total number was calculated.ResultsSubstituters and non-substituters were indistinguishable in terms of sex, age, or prior drug history. Substituters were significantly more likely to be employed (68.1%) than non-substituters (51.1%). Substituters also reported having significantly more health conditions and diseases (3.3±2.0) than non-substituters (2.4±1.4).ConclusionsThis small study offers some insights into the profile of patients whose self-reported alcohol intake decreased following initiation of MC. Alcohol substituters had more other health conditions but also were more likely to be employed which may indicate that they fit a social drinker profile. Additional prospective or controlled research into the alcohol substitution effect following MC with a sample with more advanced alcohol misuse may be warranted.Short summaryA substitution effect with medical cannabis replacing prescription opioids has been reported but less is known for alcohol. This study evaluated characteristics which might differentiate alcohol substituters (N=47) from non-substituters (N=65) among dispensary members. Substituters were significantly more likely to be employed and have more health conditions than non-substituters.