Malignancy is one of the most common causes and must be excluded. Hyperparathyroidism and other causes of hypercalcemia can coexist with malignancy. If calcium levels have been mildly elevated for months or years, malignancy is an unlikely cause. Hypercalcemia from malignancy usually is rapidly progressive; thus, rapidly rising calcium levels should increase suspicion of malignancy.
Kailua-Kona on Hawaiiâs Big Island is the site of Kona Brewing Companyâs brewery and first restaurant. The brewpub opened in November 1998. Prominently featured ohia wood found throughout the pub came from South Kona.
1 Koko Crater is a large tuff cone that visually dominates the area. 2  Within the crater are horse stables and the Koko Crater Botanical Garden specializing in cacti and succulents. 3  Hanauma Bay is a tuff ring breached by the ocean.his eastern end of O Ê» ahu is quite scenic and most of the area is part of Koko Head Regional Park, administered by the City & County of Honolulu. The following features and natural areas are found between Koko Head and the eastern end of the island at MakapuÊ»u :