Hawaii Medical Journal

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Two adult cases, one of secondary syphilis and one of Listeria monocytogenes bacteremia, in which antibiotic desensitization therapy was utilized to assist treatment of active infection in the face of severe penicillin allergy. Clinical considerations are discussed that led to the decision to employ a formal desensitization procedure. Antibiotic desensitization protocols can facilitate optimal and safe antibiotic therapy in the appropriate clinical setting.

OBJECTIVE: To describe the ocular signs and symptoms of patients complaining of eye irritation due to volcanic fog (vog). METHODS: The study utilized a non-comparative, retrospective chart review of 30 patients who had a chief complaint of eye irritation, which the subjects attributed to vog. Ocular signs and symptoms are described and related to the ambient concentration of sulfur dioxide (SO(2)), particulate matter sized 2.5 microns (PM(2.5)), and vog visibility in O'ahu during the period of the study...

This article describes the activities performed by cancer patient navigators in community-based and hospital settings. The case study demonstrates the depth and breadth of navigation activities and illustrates how hospital-based and community-based navigators work together to help individuals access cancer care and complete cancer treatment.

No abstract text is available yet for this article.

SIGNIFICANCE: The Pacific Regional Cancer Coalition (PRCC) provides regional leadership in the U.S. Affiliated Pacific Islands (USAPI) to implement the Regional Comprehensive Control Plan: 2007-2012, and to evaluate its coalition and partnerships. The Pacific Center of Excellence in the Elimination of Disparities (CEED), aims to reduce cancer disparities and conducts evaluation activities relevant to cancer prevention and control in the USAPI. PURPOSE: The PRCC Self (internal) and Partner (external) Assessments were conducted to assess coalition functioning, regional and national partnerships, sustainability, and the role of regionalism for integrating all chronic disease prevention and control in the Pacific...

Samoan women exhibit high rates of obesity, which can possibly be attenuated through diet and physical activity. Obesity, and body fatness in particular, is associated with increased risk for chronic diseases. Ancestry, physical activity, and dietary patterns have been associated with body composition. Using a cross-sectional design, the relative importance of proportion of Pacific Islander (PI) ancestry, level of physical activity, and macronutrients among healthy women in Honolulu, Hawai'i, ages 18 to 28 years was examined...

UNLABELLED: Beginning more than 10 years after the release of polychlorinated biphenyl (PCB) contamination in the favored fishing grounds of Merizo village, an increase in the proportional cancer mortality rate was observed among residents of the village. This increased rate continued for approximately 20 years after which it returned to near island-wide Guam levels. Although the temporal association between PCB contamination of the environment of this village and an increase in cancer mortality is intriguing, it does not necessarily demonstrate a cause and effect relationship...

OBJECTIVE: Breast cancer rates are increasing among Samoan and other Pacific Islander women, yet studies of their social support needs are nearly non-existent. The purpose of this paper is to report on the cultural dimensions of social support among Samoan breast cancer survivors in Southern California. METHODS: Data for this paper came from a larger one-and-a-half year study of the social support needs of Samoan breast cancer survivors and their family and friends...

The Federated States of Micronesia (FSM) and other countries throughout the Pacific are facing an epidemic of non-communicable disease health problems. These are directly related to the increased consumption of unhealthy imported processed foods, the neglect of traditional food systems, and lifestyle changes, including decreased physical activity. The FSM faces the double burden of malnutrition with both non-communicable diseases and micronutrient deficiencies, including vitamin A deficiency and anemia. To help increase the use of traditional island foods and improve health, the Island Food Community of Pohnpei has initiated a program in the FSM to support and promote local food policies, along with its Go Local awareness campaign...

BACKGROUND: Death remains one of the most important and significant activities in Yap, an event that involves the entire island. A death of a Yapese not only unites the family, it initiates a complex series of reaffirmed kinship ties, rituals and exchanges that refocus the entire community and create new social identities for the participants. How these ties, exchanges, and identities are changing due to new economic challenges and new social pressures were the focus of this preliminary study, which sought to document the resiliency or fragility of traditional structures, measured in the efforts around death and dying in Yap and to identify ways that the health care system can intervene to improve palliative care...

BACKGROUND: The impact on health care delivery due to the impending shortage of primary care physicians is of national concern. To meet the growing health care needs of Hawai'i and the Pacific, the Imi Ho'ala Post-Baccalaureate Program (IHP) provides educational opportunities for students from disadvantaged backgrounds to pursue careers in medicine. Students selected to participate in the IHP have demonstrated a commitment to serve in areas of need of Hawai'i and the Pacific. IHP alumni enter the John A...

BACKGROUND: Culturally competent health care providers are needed to eliminate healthcare disparities. In the State of Hawai'i, Native Hawaiians suffer some of the worst health disparities. Prior to implementing a cultural competency curriculum to address these disparities, the John A. Burns School of Medicine's Department of Native Hawaiian Health Cultural Competency Curriculum Development team asked Native Hawaiian patients about their experiences and recommendations. METHODS: We conducted four focus groups of Native Hawaiians to obtain recommendations on physician training, to be incorporated into the curriculum...

INTRODUCTION: Initial efforts to teach cultural competency at the University of Hawai'i John A. Burns School of Medicine began in the late 1990s through the Native Hawaiian Center of Excellence. With the formation of the Department of Native Hawaiian Health in 2003, cultural competency training was added as a key area of focus for the department. A multidisciplinary team was formed to do the ground work. Physicians (Family Medicine and Internal Medicine) and an administrator (MBA now at Queens Medical Center) from the Department of Native Hawaiian Health were joined by a cultural anthropologist (Department of Family Medicine and Community Health), a social worker (UH Myron B...

INTRODUCTION: Traditional Hawaiian thought places children in a position of prominence in the family. Yet in Hawai'i, Native Hawaiian children and adolescents face significant inequity in health outcomes. From prenatal alcohol and tobacco use, late or no prenatal care, macrosomia as well as low birth rates, to exclusive breastfeeding rates at 6 months, and high rates of infant mortality, Native Hawaiians face inequities in pre and early childhood indicators. During childhood and adolescence, Native Hawaiians experience high rates of obesity, and physical, mental and sexual abuse...

Under the Compacts of Free Association (COFA), people from the Freely Associated States--the Republic of Palau (ROP), the Republic of the Marshall Islands (RMI), and the Federated States of Micronesia (FSM)--have been migrating to the United States in increasing numbers. In 1996, Congress passed broad welfare reform (Personal Responsibility and Work Opportunity Reconciliation Act) which limited certain federal benefits previously available to COFA migrants, including Medicaid benefits. Prior to July 2010, the State of Hawai'i had continued to include COFA migrants under its state-funded Medicaid program...

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JABSOM takes its responsibility to improve health among Hawai'i's people to heart. The school's vision is, ALOHA: to Attain Lasting Optimal Health for All, a theme adopted through a strategic planning process which engaged JABSOM's partners in the health and life sciences including its private sector collaborators and its sister colleges throughout the University of Hawai'i's ten-campus system. JABSOM's ability to collaborate and contribute in these areas has been irrevocably enhanced by tobacco-related funding that the State of Hawai'i has committed to develop the Kaka'ako campus...

The authors describe a unique presentation of celiac disease as multiple non-traumatic fractures in a young male without gastrointestinal complaints. A 29-year-old man presented with back pain and was found to have a non-traumatic compression fracture of the lumbar and thoracic spine on plain X-ray. Dual-energy x-ray absorptiometry (DXA) confirmed osteoporosis at the L3/L4 vertebral bodies. Parathyroid hormone (PTH), calcium, and vitamin D levels were normal. He had no gastrointestinal complaints, but serologic studies were positive to include an elevated gliadin IgA Ab, gliadin IgG Ab, and an elevated tissue transglutaminase IgA Ab...