Hawaii Medical Journal Articles For 1993

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    Breast-feeding versus formula: cost comparison.
    ( 1993-01) Jarosz, L A
    Peterkin and Walker published in 1976 a cost estimate of feeding a baby in the U.S. At that time, they found there was little difference in cost between breast-feeding and formula feeding. Since then, however, the cost of formula has risen drastically--more than 150% during the 1980s. One researcher estimated that food and feeding equipment cost $855 in the first year. Whereas the cost of formula is quite apparent when a family buys it, the cost of breast-feeding is hidden.
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    Health care and more health care.
    ( 1993-01) Reppun, J I
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    "Buy right".
    ( 1993-01) Reppun, J I
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    Cross-cultural dream use in Hawaii.
    ( 1993-02) Pagel, J F ; Vann, B H
    Cultural variations in the narrative content of dreams have been reported in many studies. This basic cultural difference in dream language and representations has been used to support psychoanalytic theories of dreaming, especially that of the Jungian-based schools. Others have postulated that such variations reflect the cultural differences that each individual experiences during waking life. This "continuity" hypothesis proposes that a high correlation exists between an individual's waking life and his or her dream content. The biologic framework of dreams, sleep/dream-state physiology, is cross-culturally consistent, and the incidence of dream related pathology also is remarkedly similar between differing cultures.
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    Vaginal birth after cesarean section in Hawaii. Experience at Kapiolani Medical Center for Women and Children.
    ( 1993-02) Brody, C Z ; Kosasa, T S ; Nakayama, R T ; Hale, R W
    Medical records at Kapiolani Medical Center for Women and Children were reviewed for cases that had a trial of labor subsequent to prior cesarean section during the period January 1990 to July 1991. All cases were > or = delivered 36 weeks' gestation. During the 19-month period, 356/483 or 73.5% cases with a trial of labor had successful vaginal births after previous cesarean sections (VBAC). The majority of the others that did not were due to failure of progression in labor. The incidence of scar separation was 5/483 (1.04%). There were 5/483 neonates with Apgar scores of < or = 6 at 5 minutes, giving a perinatal morbidity rate of 1.04%. There were no maternal deaths. Oxytocin induction resulted in successful VBAC in 30/47 (63.8%) cases. This study concludes that a trial of labor for vaginal birth after cesarean section is well established at our institution. In addition, the rates of successful VBAC, its complications and outcomes, are comparable to national averages.
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    Quality improvement: how does it differ from quality assurance?
    ( 1993-02) Hawk, A B ; Miyamura, J B
    Quality improvement? How does it differ from Quality assurance? The "Total Quality Management" movement which has been so successful in improving the quality of manufactured products in Japan and more recently in the United States has arrived in American service industries, including health care. Although a minority of health care institutions has adopted the Continuous Quality Improvement (CQI) or Total Quality Management (TQM) philosophy and techniques on their own, the new Joint Commission on Accreditation of Health Care Organizations (JCAHO) standards to be phased in over the next 3 years require all accredited hospitals to "adopt the new philosophy".
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    Pulmonary balloon dilation for valvular and arterial stenosis.
    ( 1993-02) Ho, E C
    The use of balloon catheters to dilate obstructed vascular lesions represents one of the major advances in cardiology and dates back to 1964 when Dotter and Judkins reported their experience in dilating arteriosclerotic obstructive lesions. Since that time, the technique of balloon dilation has been used extensively for coronary and peripheral vascular lesions but also has been applied to such diverse cardiac lesions as pulmonic stenosis, mitral stenosis, aortic stenosis, aortic coarctation, superior vena caval and pulmonary venous obstructions. Balloon dilation has been used for both valvular and arterial pulmonary stenosis. The purpose of this study is to report on our initial experience in Hawaii with balloon dilation of valvular pulmonic stenosis and also with dilation of peripheral pulmonary artery stenosis due to congenital causes and as a residual postoperative lesion.
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    Do we need second generation lithotripters in Hawaii?
    ( 1993-03) Crocco, N B ; Stenson, R V
    The Kidney Stone Center of the Pacific (KSCoP) currently provides statewide services for kidney lithotripsy. The non-invasive technique uses shock waves to disintegrate kidney stones. Extracorporeal shock wave lithotripsy (ESWL) can be used successfully in 85% to 90% of kidney stone patients when surgery is indicated.
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    A rare case of cholera in Hawaii.
    ( 1993-03) Yamada, G M
    Cholera is the most fatal of the infectious diarrheas but only rarely encountered in Hawaii. Two cases previously have been documented in the Islands. We describe an elderly patient, without obvious risk factors, who contracted cholera. Early consideration of cholera as a diagnostic possibility is recommended in patients with unexplained, profuse diarrhea. The unique features of this case are discussed in this report.