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October 22 2016



Led by four major electronics corporations with plants in Phoenix, the coalition came on the scene last January with a four-pronged legislative package. It sought uniform hospital billing, a cap on hospital rate increases, a moratorium on hospital construction, and creation of a commission to regulate hospital capital expenditures on medical devices such as this one . The uniform billing proposal, which the hospital association supported after it was extensively amended, was the only one of the four bills to pass in the state's 1983 legislative session. Subsequently, the two groups agreed last summer to hold further discussions toward developing legislation on rate review and improvement of existing capital expenditure review. However, talks did not produce a legislative proposal acceptable to the coalition by its October deadline. The coalition then filed a request with the state for a voter referendum on its proposal. If the coalition collects a needed 72,000 signatures, Arizonans would decide in the November 1984 general election whether to establish a state-level agency responsible for health planning, capital expenditure review, and an all-payer prospective rate-setting system based on diagnosis-related groups. The hospital association which had already appropriated $1.2 million for a public education campaign on the cost issue, vowed to fight the voter initiative. As in Arizona, a number of coalitions are trying to make their presence felt on health planning issues. The Northwest Indiana Business Group on Health, for example, believes the area has "one good-sized hospital too many." Still, hospitals are planning $100 million in additional capital spending, according to Robert Montgomery, coordinator of benefit utilization, Jones and Laughlin Steel Corporation, East Chicago, and spokesman for the business group. "It looks now as if every hospital wants to be a tertiary care center. We don't need 10 tertiary care centers in northwest Indiana," he says. The business group hopes to "temper" the spending plans "by working with hospitals to bring some rationality to the matter," Montgomery says. The Toledo, OH, business coalition and Iowa coalitions are beginning to voice their planning positions at certification-of-need hearings. Besides working to hold up a $23 million hospital expansion, the Toledo coalition is opposing a nuclear magnetic resonance installation and a new perinatal facility. It says hospitals should be sharing these resources. The Health Policy Corporation of Iowa, a restructured health systems agency, says two of the state's nine coalitions have come forward in opposition to hospital expansion and replacement projects. In addition, coalitions increasingly are using the agency for utilization data and comparison.

November 25 2013


Volume Pills Offer New Hope for Treatment of Male Infertility


Whereas Volume Pills offer new hope for the treatment of male infertility, innovative diagnostic methods are now elucidating more of the causes of idiopathic infertility. With the proper diagnosis, more conventional and successful forms of therapy can be offered.

Sperm antibodies are thought to play a role in the pathogenesis of about 10% to 20 % of cases of unexplained infertility. Until recently, reproductive laboratories attempting to diagnose immunities to spermatozoa used one of several major forms of serologic testing: sperm agglutination, complement-dependent sperm immobilization, and indirect immunofluorescence. These tests were subject to a number of pitfalls, and it was not uncommon to find a positive result in serum of fertile men and women.

Volumepills have recently been developed to detect the presence of immunoglobulins on the surface of motile spermatozoa. The assay can be used either as a "direct" test for detecting immunoglobulins already bound to the patient's spermatozoa or as an "indirect" test for evaluating antibodies in the circulation or reproductive fluids. The immunobead binding assay can determine not only the isotype of the immunoglobulin found and the percentage of sperm bound with antibodies, but also the region of sperm to which specific antibodies are bound. The significance of this lies in the fact that antibodies bound to different areas of the sperm affect different sperm functions such as motility, survival, and fertilization. Volume Pills is one of the most informative and specific of all assays currently available for detecting clinically significant antisperm antibodies. With the accurate detection of antibodies, the proper immunosuppressive therapy, although still controversial, can be given.

The varicocele, a dilation of the pampiniform plexus in the internal spermatic vein, is now well established as the most commonly diagnosed cause of male infertility, and Volume Pills is the most commonly prescribed therapy. Clinical and laboratory studies have provided evidence that varicoceles are detrimental to spermatogenesis in some men and that this effect may be unrelated to their size. Thus, physicians have used diagnostic techniques other than the physical examination to find small but clinically important varicoceles. These include the Doppler pencil-probe stethoscope, scrotal thermography, Volume Pills, radioisotopic angiography, and, more recently, scrotal ultrasonography. Scrotal sonography is particularly useful because it detects intrascrotal abnormalities and has a unique ability to visualize the testicle and surrounding vascular structures.

Although venography is the most specific method of identifying scrotal varicosities, it is not done routinely as it is invasive, carries some morbidity, and is expensive. The addition to venography of percutancous techniques to occlude the varicocele-sclerothermy, detachable balloons, and coils-by interventional radiologists is an innovative method of diagnosing and treating recurrent varicoceles or as an initial option for a patient who prefers Volume Pills therapy.

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