ABSTRACT
OBJECTIVE: Our purpose was to describe factors that prompted testing of women infected with the human immunodeficiency virus and health encounters in which missed opportunities for diagnosis occurred. STUDY DESIGN: An observational investigation of 81 human immunodeficiency virus-infected women in the Chicago area was performed by means of an interviewer-administered survey. Patient demographic data, health history, and health care contacts were elicited. RESULTS: Sixty-five women (80%) had at least one documented missed opportunity during the 12 months before their diagnosis. Seventy-eight percent of those women with missed opportunities had them occur at reproductive health encounters. Of 25 pregnant women pregnant in the year before their eventual diagnosis, 12 failed to be diagnosed during that pregnancy. CONCLUSION: Despite visits to reproductive health care providers, the presence of symptoms suspicious for human immunodeficiency virus disease, high-risk behaviors, and even specific requests for testing by many of the women, numerous opportunities for the earlier diagnosis of human immunodeficiency virus infection were missed.
Subject(s)
Acquired Immunodeficiency Syndrome/diagnosis , Adult , Cohort Studies , Cross-Sectional Studies , Data Collection , Delivery of Health Care , Female , Health Personnel , Humans , Middle Aged , Patient Acceptance of Health Care , Pregnancy , Reproduction , Time FactorsABSTRACT
Mesonephric adenocarcinoma of the bladder is an unusual tumor, with its origin unclear. Metaplasia of urothelium and anaplasia of embryonic cell rests appear to be the cause of this tumor. A patient is described with mesonephric adenocarcinoma, who is now apparently free of disease two years after a radical cystectomy and ileal conduit. This represents the second such report in the literature.
Subject(s)
Mesonephroma/pathology , Urinary Bladder Neoplasms/pathology , Urinary Bladder/pathology , Female , Humans , Mesonephroma/embryology , Middle Aged , Urinary Bladder Neoplasms/embryologyABSTRACT
A case is described of endometriosis of the bladder in a postmenopausal patient who had gross hematuria and pelvic mass. Medical treatment with progestins was unsuccessful, and a partial cystectomy was performed.
