Arch Intern Med
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Randomized Controlled Trial Clinical Trial
Outpatient urine culture: does collection technique matter?
Dysuria is one of the most common presenting complaints of young women, and urinalysis is one of the most common laboratory tests performed. Despite the fact that the midstream clean-catch technique is commonly used for urine collection, contaminated urine cultures occur with distressing regularity. The midstream clean-catch technique is time-consuming to explain, frequently not performed correctly by patients, costly for supplies, often embarrassing for patients and staff, and of unproven benefit. Therefore, we designed a study to compare various methods of obtaining specimens for culture from acutely dysuric young women. ⋯ In young, outpatient women with symptoms suggestive of a urinary tract infection, the midstream clean-catch technique does not decrease contamination rates.
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In jurisdictions that permit euthanasia or physician-assisted suicide, patients with cancer comprise the largest group to die by these methods. We investigated the personal attitudes toward these practices of patients receiving palliative care for advanced cancer. ⋯ Many patients with advanced cancer favor policies that would allow them access to both euthanasia and physician-assisted suicide if pain and physical symptoms became intolerable. For patients who would actually make requests for a physician-hastened death, however, psychological considerations may be at least as salient as physical symptoms.