Percutaneous image-guided cryoneurolysis is safe and effective for the management of several well-described syndromes involving neuropathic pain. Additional rigorous prospective study is warranted to further define the efficacy and specific role of these interventions.

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Type A behavior (hard-driving, competitive, time-urgent, hostile-irritable) has been linked to high stress levels and the risk of eventual cardiovascular problems (i.e., coronary heart disease, CHD). However, this pattern of behavior closely resembles the traditional masculine instrumental (goal-oriented) orientation, and, if kept within limits, may be viewed as adaptive in success-oriented, middle-class college students. Hypothetically then, Type A behavior may be displayed by a broad group of individuals, and only in those cases when it is allowed to reach extreme proportions is stress sufficient enough to confer risk. This article considers two lines of reasoning. Is greater self-control required for college women to be Type As, because it involves crossing into traditional male role behavior? Type A women displayed significantly better self-control then Type B women; the opposite result was disclosed for college men with Type As displaying poorer self-control than Type Bs. The question of whether risk-conferring Type A behavior would result from poorer self-control was answered in the affirmative. Self-control assumed moderator status; poorer self-control in both male and female Type As was associated with high levels of day-to-day stress relative to Type As with better self-control. Self-control did not influence stress level in Type Bs. This moderator effect suggests that only Type As who cannot contain their behavior within adaptive limits will be vulnerable to excessive stress and at risk for CHD.

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Purpose To explore subspecialty workforce considerations surrounding invasive procedures performed by radiologists. Materials and Methods The 2015 Centers for Medicare & Medicaid Services Physician and Other Supplier Public Use File was used to identify all invasive procedures (Current Procedural Terminology code range, 10000-69999) billed by radiologists for Medicare fee-for-service beneficiaries. Radiologists were categorized by subspecialty according to the majority of their billable work-relative value units (wRVUs). Those without a single subspecialty majority work effort were deemed generalists. Procedures were categorized into three tiers of complexity (high, ≥4.0 wRVUs; mid, 1.6-3.9 wRVUs; low, ≤1.5 wRVUs). Total and tiered generalist versus subspecialist workforce composition was assessed. Results Just 25 unique services comprised more than 75% of invasive procedures performed by radiologists. Of radiologists who performed procedures, 57.5% were generalists, 15.8% were interventionalists, and 26.8% were other subspecialists. Of the radiologists who performed low-, mid-, and high-complexity procedures, generalists accounted for 46.3%, 30.9%, and 23.1%, respectively; interventionalists accounted for 35.4%, 30.9%, and 75.2%, respectively; and other subspecialists accounted for 18.3%, 14.6%, and 1.7%, respectively. Generalists were the dominant providers of six of the top 10 low-complexity and seven of the top 10 midcomplexity procedures. Interventionalists were the dominant providers of all top 10 high-complexity procedures. Nationally, over twice as many U.S. counties had local access to generalists (869 counties) for invasive procedures versus interventionalists (347 counties) or other subspecialists (380 counties). Conclusion Among radiologists, generalists perform far more procedures in more geographic locations and are more likely to serve patients with less complex service needs than are interventionalists or other subspecialists. Practices and professional societies must remain vigilant to ensure that the subspecialty evolution in radiology does not exacerbate patient access disparities. © RSNA, 2018 Online supplemental material is available for this article.