[Cryptogenic organizing pneumonia--case report].

INTRODUCTION: Cryptogenic organising pneumonia is a particular form of inflammatory and fibroproliferative lung disease. The disease onset is subacute with cough, dyspnoea, fever, weight loss, and elevation of biological inflammatory markers. Chest imaging usually shows multifocal alveolar opacities predominating in the subpleural regions. Lung biopsy reveals budding connective tissue filling the distal airspaces. CASE OUTLINE: A 57-year-old electrician complaining of cough, dyspnoea, and fatigue was diagnosed with pneumonia and treated with antibiotics and antihistaminics. After clinical and radiographic progression of the disease, open lung biopsy was performed, some 15 months after the disease onset. The diagnosis of cryptogenic organising pneumonia was made. The patient was treated with oral and inhalatory corticosteroids and finally with cytostatics, which led to a partial improvement of his condition. However, work capacity was lost and the quality of life seriously deteriorated. CONCLUSION: The diagnosis is established by combining clinical, radiological and histological criteria. Similarities with other disease processes can lead to a delayed or erroneous diagnosis. Most patients respond well to corticosteroid therapy (prednisone or methyl-prednisolone). Relapses are frequent but can generally be controlled.

[Morbidity patterns of workers employed in pharmaceutical-chemical industry].

INTRODUCTION: Work in pharmaceutical-chemical industry is characterized by exposure to numerous hazards, both physical (microclimate, illumination, noise) and chemical (organic solvents). Organic solvents can cause damage to many organic systems and have carcinogenic, teratogenic and mutagenic effects. OBJECTIVE: The aim of this study was to analyze patterns of chronic morbidity of workers employed in pharmaceutical-chemical industry during 2002. METHOD: The study was conducted in the pharmaceutical-chemical industry "Zdravlje" Leskovac in 2002. A total of 143 workers in workplaces with special working conditions exposed to chemical hazards as well as 40 workers from control group took part in the study. The physical examinations of the participants were performed at the Department of Occupational Health in Health Center, Leskovac. RESULTS: Heart diseases were the most frequent both among exposed workers (17.8%) and in control group (33.3%). Respiratory diseases were at the second place (16.9% in the exposed group, and 7.4% in control group). Arterial hypertension was diagnosed in 14.7% workers occupationally exposed to hazards, and in 12.5% workers from control group (p > 0.05). Chronic bronchitis was diagnosed in 175% of the exposed workers and in only 5.0% of controls (p > 0.05). The highest prevalence of diseases in both groups was observed among workers aged 40-49 years, with 20-29 years of exposure working time. 73.4% of the exposed workers and 85% of control workers were capable of work (p > 0.05). CONCLUSION: Workers occupationally exposed to hazards in pharmaceutical-chemical industry have higher prevalence of various diseases compared to non-exposed workers, which can be the result of work, working conditions and work activity. Preventive measures should be directed towards the decrease of occupational hazards and unfavorable working conditions and increase of work protection. Regular physical examinations of workers are of prime importance for the prevention of occupational morbidity, traumatism and invalidity.

[Work ability evaluation in neurosarcoidosis--a case report].

Sarcoidosis is a multisystemic granulomatous disease of unknown etiology which affects most frequently the hilar lymph nodes and lungs. Symptomatic involvement of the central nervous system may develop in patients diagnosed with sarcoidosis or it may be the initial manifestation of the disease. This is a case report of 48-year old female patient admitted to our clinic for evaluation of working ability. The patient had a total of 24 years of service and occupational exposure and she has been employed as supplies procurement officer. On admission, she complained of the following discomforts: eye-lid pain, intellectual fatigue, psychic uneasiness, forgetfulness, dyspnea and productive cough. Neurological findings indicated the presence of the right eye ophthalmoplegia, psychoorganic syndrome and neurosarcoidosis. Ophthalmological examination evidenced bilateral ptosis and presence of anisocoria. Magnetic resonance imaging revealed discrete focal lesions of the pons (paracentral left) and parietal corona radiata of the left hemisphere. Based on performed examinations and diagnostics procedures, final evaluation of patient's working ability concluded that the patient was not capable of psychic strains and jobs associated with material accountability.