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Organizational structure has evolved over the past several decades, with physicians assuming more or fewer leadership positions over time. Regardless of the role of physicians in health care organizational leadership, constant meaningful communication with the hospital, radiology group, or greater physician group administrative leadership is vital for any group of IR physicians to be successful. Understanding what is considered important to hospital administration and, in particular, being closely aligned with the C-suite leadership, is paramount to having successful communication with these stakeholders. Although each situation will obligatorily be unique, certain themes can be followed to optimize the working relationship between an interventional radiology service and organizational administration. This article provides guidelines and suggestions specifically in communicating with health care system leadership.
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Cotton leafroll dwarf virus (CLRDV) is an introduced Polerovirus (Family: Solemoviridae) of cotton, Gossypium hirsutum L., in the U.S. The only vector known to transmit this virus to cotton is the cotton aphid, Aphis gossypii Glover; however, there are seven other species of aphids (Hemiptera: Aphididae) reported to colonize cotton in the southeastern U.S.: Protaphis middletonii (Thomas), Rhopalosiphum rufiabdominale (Sasaki), Aphis craccivora Koch, Macrosiphum euphorbiae Thomas, Myzus persicae (Sulzer), Smythurodes betae Westwood, and Aphis fabae Scopoli. Little to no information is available on annual population dynamics of these species in the southeastern U.S. The timing of CLRDV spread to cotton plantings is also unknown. The objective of this study was to monitor the population dynamics of eight cotton-feeding aphid species concurrent with the spread of CLRDV at three different locations in Alabama. Aphids were monitored weekly for two years with yellow pan traps, and sentinel plants were deployed weekly to monitor CLRDV spread throughout the cotton-growing season. During the two years, most CLRDV spread at all locations occurred when A. gossypii was actively dispersing in the field. Early season spread at sites in south and central Alabama, when A. gossypii was not abundant, suggests additional aphid vectors are possible.
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Cotton leafroll dwarf virus (CLRDV) is an emerging aphid-borne pathogen infecting cotton, Gossypium hirsutum L., in the southern United States (U.S.). The cotton aphid, Aphis gossypii Glover, infests cotton annually and is the only known vector to transmit CLRDV to cotton. Seven other species have been reported to feed on, but not often infest, cotton: Protaphis middletonii Thomas, Aphis craccivora Koch, Aphis fabae Scopoli, Macrosiphum euphorbiae Thomas, Myzus persicae Sulzer, Rhopalosiphum rufiabdominale Sasaki, and Smynthurodes betae Westwood. These seven have not been studied in cotton, but due to their potential epidemiological importance, an understanding of the intra- and inter-annual variations of these species is needed. In 2020 and 2021, aphids were monitored from North Carolina to Texas using pan traps around cotton fields. All of the species known to infest cotton, excluding A. fabae, were detected in this study. Protaphis middletonii and A. gossypii were the most abundant species identified. The five other species of aphids captured were consistently low throughout the study and, with the exception of R. rufiabdominale, were not detected at all locations. The abundance, distribution, and seasonal dynamics of cotton-infesting aphids across the southern U.S. are discussed.
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Hyper- and hypotensive emergencies represent some of the most severe clinical issues that can occur during or around an interventional radiology procedure. While some patients are known to be more predisposed to cardiovascular collapse, nearly all patients are at risk for such an outcome. This is particularly true of patients undergoing moderate sedation, with the possibility of cardiovascular compromise occurring not just due to the underlying pathology for which the patient is being treated, but as a complication of sedation itself. Understanding the underlying cause of hyper- or hypotension is paramount to performing an appropriate and timely intervention. While the underlying cause is being corrected-if possible-the changes in blood pressure themselves may need to be intervened upon to maintain cardiovascular stability in these patients. Interventional radiologists must be familiar with measures taken to correct hyper- or hypotensive emergencies, including the most commonly used medications to treat these disorders. This article discusses the most common etiologies of such clinical scenarios, and the most common interventions performed for these settings.