Respiratory Disease in Migrant Farmworkers

INTRODUCTION

Respiratory problems are prevalent among persons who work in agriculture, however, publications examining the respiratory status in LatinX farmworkers are limited. The purpose of this study is to assess the respiratory status of LatinX farmworkers across New York State.

METHODS

This is a retrospective analysis of data gathered from Spanish language OSHA respiratory questionnaires completed between January 2017 and March 2019. The best of three peak flows were compared with predicted normal values derived from regressions using age, gender, and height.

RESULTS

Key information was present in 162 Spanish questionnaires. Rates of reported respiratory symptoms were low, less than 2%; 11.7% farmworkers smoked. Best of three peak flows showed a mean of 97.2 ± 16.8% of predicted.

DISCUSSION

New York LatinX farmworkers do not appear to have abnormal rates of respiratory symptoms or low peak flows.

Bone marrow biopsy and aspiration: a departmental financial comparison in a rural hospital

Objective

The purpose of this study was to compare the charges and payments associated with bone marrow aspiration and biopsies performed by hematology/oncology specialists versus interventional radiology specialists at Bassett Medical Center located in a rural area of New York State. Charges pertained to what the hospital charged for the procedure and payment refers to the reimbursement the hospital received. Our secondary objectives were to compare specimen quality by procedure and to determine whether body mass index was associated with which specialist performed the procedure.

Results

The median charge was significantly higher in the interventional radiology group ($5254 USD) compared to the hematology/oncology group ($413 USD), p < 0.0001. Median payments were also higher in the interventional radiology ($1392 USD) compared to the hematology/oncology group ($1109 USD), p < 0.0001. Adequacy of the samples obtained by either profession was similar. Disease process was not associated with adequacy of the sample. There was no statistically significant difference in the proportion of males and females in the respective groups or in the mean age. However, the patients’ in the interventional radiology group had a significantly higher mean BMI (34.3) compared to those in the hematology/oncology group (28.6), p = 0.0014.

Pulmonary blastomycosis in rural Upstate New York: A case series and review of literature

In a rural medical center in Upstate New York, we observed an increase in pulmonary blastomycosis cases. Herein, we highlight the increased prevalence of blastomycosis in our region, and our experience with the diagnostic dilemma resulting in delayed diagnosis. This delay may have resulted in an increased mortality. A high index of suspicion may help hasten the diagnosis in an otherwise nonendemic area. A single-center retrospective case series of all patients diagnosed with culture-proven blastomycosis is reported at the Bassett Medical Center from 2007 to 2019. Eight cases of confirmed pulmonary blastomycosis were identified. All patients resided in a rural area along the Susquehanna River Basin. Only one case had a travel history to an endemic state. Males accounted for 100% of cases. There was a 50% mortality rate from acute respiratory distress syndrome. Bronchoalveolar lavage (BAL) reliably made the diagnosis. About 40% of patients had a false-negative blastomycosis serology. There was an average delay of 2.5 months from presentation to correct diagnosis due to a lack of consideration for blastomycosis. BAL resulted in a correct diagnosis, while serology was not reliable to exclude the diagnosis. Physicians should include blastomycosis in the diagnostic differential cases of nonresolving pneumonia in Upstate New York, an area not previously considered as endemic. Bronchoalveolar remains the evaluation method of choice if blastomycosis is suspected.