Selected Properties of the Surface Layer of C45 Steel Samples after Slide Burnishing.

This paper presents the experimental results of a study investigating the impact of the machining fluid type, the variable factor, used in slide burnishing on 2D and 3D surface roughness; surface topography; Abbott-Firestone curve shape; microhardness; and SFE (surface free energy). In the experiment, pre-ground, ringed samples of C45 steel were used. The results showed an over eight-fold decrease in the value of the Ra (arithmetical mean deviation) parameter and over a five-fold decrease in the Rt (total height of profile) parameter in relation to their values after grinding. The parameters Rpk (reduced peak height), Rk (core roughness depth), and Rvk (reduced valley depth) were also reduced. The Abbott-Firestone curve after slide burnishing changed its angle of inclination (it was more flattened), and the material ratio Smr increased. The reduction in the Rpk and Rk parameters and increased material ratio will most likely contribute to restoring the functionality of these surfaces (increased resistance to abrasive wear). After slide burnishing, the maximum 25% increase in microhardness was obtained compared to the value after grinding, while the layer thickness was 20 µm. The surface energy of elements subjected to slide burnishing using various machining fluids slightly increased, or its value was close to that of the ground surface. The most favourable properties of the surface layer in terms of mating between two elements were obtained for a part that was slide-burnished with a mixture of oil + polymethyl methacrylate (PMM) + molybdenum disulphide (MoS2).

New International Guidelines and Consensus on the Use of Lung Ultrasound.

Following the innovations and new discoveries of the last 10 years in the field of lung ultrasound (LUS), a multidisciplinary panel of international LUS experts from six countries and from different fields (clinical and technical) reviewed and updated the original international consensus for point-of-care LUS, dated 2012. As a result, a total of 20 statements have been produced. Each statement is complemented by guidelines and future developments proposals. The statements are furthermore classified based on their nature as technical (5), clinical (11), educational (3), and safety (1) statements.

Influence of Slide Burnishing Parameters on the Surface Layer Properties of Stainless Steel and Mean Positron Lifetime.

This paper presents the results of an experimental study on the impact of slide burnishing on surface roughness parameters (Sa, Sz, Sp, Sv, Ssk, and Sku), topography, surface layer microhardness, residual stress, and mean positron lifetime (τmean). In the study, specimens of X6CrNiTi18 stainless steel were subjected to slide burnishing. The experimental variables were feed and slide burnishing force. The slide burnishing process led to changes in the surface structure and residual stress distribution and increased the surface layer microhardness. After slide burnishing, the analyzed roughness parameters decreased compared with their pre-treatment (grinding) values. The slide burnishing of X6CrNiTi18 steel specimens increased their degree of strengthening e from 8.77% to 42.74%, while the hardened layer thickness gh increased after the treatment from about 10 µm to 100 µm. The maximum compressive residual stress was about 450 MPa, and the maximum depth of compressive residual stresses was gσ = 1.1 mm. The positron mean lifetime τmean slightly yet systematically increased with the increase in burnishing force F, while an increase in feed led to changes of a different nature.

Factors Predictive for Immunomodulatory Therapy Response and Survival in Patients with Hypersensitivity Pneumonitis-Retrospective Cohort Analysis.

Hypersensitivity pneumonitis (HP) is one of the interstitial lung diseases with clearly established diagnostic criteria. Nevertheless, pharmacologic treatment recommendations are still lacking. Most specialists use steroids as first-line drugs, sometimes combined with an immunosuppressive agent. Aim: The aim of the present retrospective study was to establish predictive factors for treatment success and survival advantage in HP patients. Methods: We analyzed the short-term treatment outcome and overall survival in consecutive HP patients treated with prednisone alone or combined with azathioprine. Results: The study group consisted of 93 HP patients, 54 (58%) with fibrotic HP and 39 (42%) with non-fibrotic HP. Mean (± SD) VCmax % pred. and TL,co % pred. before treatment initiation were 81.5 (±20.8)% and 48.3 (±15.7)%, respectively. Mean relative VCmax and TL,co change after 3−6 months of therapy were 9.5 (±18.8)% and 21.4 (±35.2)%, respectively. The short-term treatment outcomes were improvement in 49 (53%) patients, stabilization in 16 (17%) patients, and progression in 28 (30%) patients. Among those with fibrotic HP, improvement was noted in 19 (35%) cases. Significant positive treatment outcome predictors were fever after antigen exposure, lymphocyte count in broncho-alveolar lavage fluid (BALF) exceeding 54%, RV/TLC > 120% pred., and ill-defined centrilobular nodules in high-resolution computed tomography (HRCT). An increased eosinophil count in BALF and fibrosis in HRCT were significant negative treatment outcome predictors. The presence of fibrosis in HRCT remained significant in a multivariate analysis. A positive response to treatment, as well as preserved baseline VCmax (% pred.) and TLC (% pred.), predicted longer survival, while fibrosis in HRCT was related to a worse prognosis. Conclusion: Immunomodulatory treatment may be effective in a significant proportion of patients with HP, including those with fibrotic changes in HRCT. Therefore, future trials are urgently needed to establish the role of immunosuppressive treatment in fibrotic HP.

Analysis of the Effectiveness of Removing Surface Defects by Brushing.

The paper presents the results of a study on the effectiveness of removing surface defects by brushing. Damage to machine components usually begins on their surface or in the surface layer area. This determines the development of methods, conditions, and process parameters that will positively affect the stereometric and physical properties of the surface layer. Experiments were conducted in which surface defects were generated on a specially designed test stand. By controlling the load and speed of the defect generator it was possible to affect the geometry, depth, and width of the surface defect. A FEM simulation of the brushing treatment was carried out in order to determine the effect of fibers passing through a surface defect in the form of a groove with a small depth and width. It was shown that for certain conditions of brushing treatment, surface defects could be removed effectively. Moreover, the microhardness of the surface layer after the brushing process was analyzed. Changes in microhardness due to brushing reached up to 50 µm for EN AW-2024 aluminum alloy and up to 150 µm for AZ91HP magnesium alloy. The results demonstrated that brushing was an effective method for strengthening the surface layer and that the value of strengthening in the area of defects depended on the effectiveness of their removal.

Study on the Surface Layer Properties and Fatigue Life of a Workpiece Machined by Centrifugal Shot Peening and Burnishing.

This paper presents the results of research on the impact of finishing method on surface topography, surface roughness (parameters Ra, Rt, Rpk, Rk, Rvk), surface layer microhardness, residual stresses and fatigue life. Ring samples made of C45 steel were used to conduct the experiments. The following finishing machining methods were selected: slide burnishing, ball burnishing, centrifugal shot peening, centrifugal shot peening + slide burnishing and centrifugal shot peening + ball burnishing. In the first stage, the use of combined shot peening + burnishing enables microhardness to be increased on the surface layer, the values of residual stresses to be increased and the creation of characteristic machining traces on the surface, the so-called "dimples" (effect of centrifugal shot peening). On the other hand, burnishing (slide burnishing or ball burnishing) is aimed at smoothing the surface and providing favorable stereometric properties to the surface layer. It was noted that, after finishing, the surface roughness parameters decreased from 59% to 83% in relation to the reference surface. The exception is the centrifugal shot peening technology. The use of burnishing (slide or ball burnishing) after centrifugal shot peening reduces the surface roughness parameters by a maximum of 82% compared to the value after centrifugal shot peening. The highest increase in microhardness was obtained after centrifugal shot peening + slide burnishing (ΔHV = 105 HV 0.05), while the highest thickness gh (gh = 120 µm) was obtained after centrifugal shot peening + ball burnishing. The combination of centrifugal shot peening and ball burnishing results in the highest absolute value of compressive residual stresses σmax = 602 MPa and depth gσ = 0.41 mm). Application of an additional operation after centrifugal shot peening increases fatigue life from 27% to 49%. ANOVA analysis of variance confirms the significance of the processing effect of centrifugal shot peening combined with slide burnishing (CSP + SB) and centrifugal shot peening + ball burnishing (CSP + BB) on the analyzed dependent surface.

Non-Destructive Detection of Real Defects in Polymer Composites by Ultrasonic Testing and Recurrence Analysis.

This paper presents results of ultrasonic non-destructive testing of carbon fibre-reinforced plastics (CFRPs) and glass-fibre reinforced plastics (GFRPs). First, ultrasonic C-scan analysis was used to detect real defects inside the composite materials. Next, the composite materials were subjected to drilling in the area of defect formation, and measured forces were used to analyse the drilling process using recurrence methods. Results have confirmed that recurrence methods can be used to detect defects formed inside a composite material during machining.

Influence of Semi-Random and Regular Shot Peening on Selected Surface Layer Properties of Aluminum Alloy.

This paper attempts to compare regular shot peening (RSP) and semi-random shot peening (SRSP). A characteristic of the first method is that the peening elements hit the treated surface in sequence, with a regular distance maintained between the dimples. The other method (SRSP) is a controlled modification of the shot-peening process, which is random by nature. The shot-peening method used in this study differs from conventional shot peening (shot blasting and vibratory shot peening) in that it allows controlled and repeatable determination of the configuration and distribution of impacts exerted by the peening element on the workpiece surface, which makes the process more repeatable and easier to model. Specimens of EN-AW 7075 aluminum alloy were used for testing. The following variables were used in the experiments: ball diameter, impact energy, and distance between the dimples. Microhardness distribution in the surface layer, 2D surface roughness, and surface topography were analyzed. FEM simulations of the residual stress distribution in the surface layer were performed. It has been found that regular shot peening results in reduced surface roughness, while semi-random shot peening leads to higher surface layer hardening.

Analysis of Surface Properties of Nickel Alloy Elements Exposed to Impulse Shot Peening with the Use of Positron Annihilation.

The paper presents the results of experimental studies on the impact of impulse shot peening parameters on surface roughness (Sa, Sz, Sp, Sv), surface layer microhardness, and the mean positron lifetime (τmean). In the study, samples made of the Inconel 718 nickel alloy were subjected to impulse shot peening on an originally designed stand. The variable factors of the experiment included the impact energy, the diameter of the peening element, and the number of impacts per unit area. The impulse shot peening resulted in changes in the surface structure and an increase in surface layer microhardness. After the application of impulse shot peening, the analyzed roughness parameters increased in relation to post-milling values. An increase in microhardness was obtained, i.e., from 27 HV 0.05 to 108 HV 0.05 at the surface, while the maximum increase the microhardness occur at the depth from 0.04 mm to 0.08 mm. The changes in the physical properties of the surface layer were accompanied by an increase in the mean positron lifetime τmean. This is probably related to the increased positron annihilation in point defects. In the case of small surface deformations, the increase in microhardness was accompanied by a much lower increase in τmean, which may indicate a different course of changes in the defect structure consisting mainly in modification of the dislocation system. The dependent variables were subjected to ANOVA analysis of variance (it was one-factor analysis), and the effect of independent variables was evaluated using post-hoc tests (Tukey test).

Echocardiographic signs of pulmonary hypertension in patients with newly recognized hypersensitivity pneumonitis, prevalence and clinical predictors.

BACKGROUND: Hypersensitivity pneumonitis (HP) is the third, according to frequency, interstitial lung disease, with the estimated incidence rate of 1-2/100,000. In HP patients, the extensive inflammatory lesions encompassing both small airways and lung parenchyma, as well as subsequent development of lung fibrosis, may result in respiratory insufficiency and secondary pulmonary hypertension (PH). The aim of the present retrospective study was to assess the prevalence of echocardiographic signs of PH and its' clinical predictors, in newly recognized HP patients. METHODS: Consecutive HP patients, recognized in single pulmonary unit between 2005 and 2017, in whom echocardiography was performed at diagnosis, entered the present study. HP diagnosis was verified in every patient according to current diagnostic recommendations. The results of high resolution computed tomography of the chest (HRCT) were re-evaluated by two independent radiologists, blinded to clinical data. Echocardiographic signs of PH were defined as pulmonary artery systolic pressure (PASP) exceeding 36 mmHg. Regression analysis was applied to calculate PH risk, and receiver operator characteristic curves (ROC) were plotted to investigate diagnostic utility of various parameters in PH prediction. RESULTS: PASP exceeding 36 mmHg was noted in 26 out of 70 patients (37%)-with equal frequency among patients with fibrotic and non-fibrotic HP. Significant predictors of PH on echocardiography were: partial oxygen tension in arterialized capillary blood (PaO2) <69 mmHg, lung transfer capacity for carbon monoxide (TLCO) <42% of predicted, six minutes walking test (6MWT) distance <455 meters, and 6MWT desaturation rate >8%. In case of TLCO <42% of predicted, probability of PH on echocardiography was increased by five-fold, in case of 6MWT desaturation rate >8%-by four fold. CONCLUSIONS: The best predictors of PASP >36 mmHg on echocardiography in HP patients at diagnosis were: TLCO <42% and 6MWT desaturation rate >8%. Neither the presence of lung fibrosis on HRCT, nor the duration of the disease or patients age, were helpful in PH prediction.

Clinical Impact of Vertical Artifacts Changing with Frequency in Lung Ultrasound.

BACKGROUND: This study concerns the application of lung ultrasound (LUS) for the evaluation of the significance of vertical artifact changes with frequency and pleural line abnormalities in differentiating pulmonary edema from pulmonary fibrosis. STUDY DESIGN AND METHODS: The study was designed as a diagnostic test. Having qualified patients for the study, an ultrasound examination was performed, consistent with a predetermined protocol, and employing convex and linear transducers. We investigated the possibility of B-line artifact conversion depending on the set frequency (2 MHz and 6 MHz), and examined pleural line abnormalities. RESULTS: The study group comprised 32 patients with interstitial lung disease (ILD) (and fibrosis) and 30 patients with pulmonary edema. In total, 1941 cineloops were obtained from both groups and analyzed. The employment of both types of transducers (linear and convex) was most effective (specificity 91%, specificity 97%, positive predictive value (PPV) 97%, negative predictive value (NPV) 91%, LR(+) 27,19, LR(-) 0.097, area under curve (AUC) = 0.936, p = 7 × 10-6). INTERPRETATION: The best accuracy in differentiating the etiology of B-line artifacts was obtained with the use of both types of transducers (linear and convex), complemented with the observation of the conversion of B-line artifacts to Z-line.

Recommendations for Lung Ultrasound in Internal Medicine.

A growing amount of evidence prompts us to update the first version of recommendations for lung ultrasound in internal medicine (POLLUS-IM) that was published in 2018. The recommendations were established in several stages, consisting of: literature review, assessment of literature data quality (with the application of QUADAS, QUADAS-2 and GRADE criteria) and expert evaluation carried out consistently with the modified Delphi method (three rounds of on-line discussions, followed by a secret ballot by the panel of experts after each completed discussion). Publications to be analyzed were selected from the following databases: Pubmed, Medline, OVID, and Embase. New reports published as of October 2019 were added to the existing POLLUS-IM database used for the original publication of 2018. Altogether, 528 publications were systematically reviewed, including 253 new reports published between September 2017 and October 2019. The new recommendations concern the following conditions and issues: pneumonia, heart failure, monitoring dialyzed patients' hydration status, assessment of pleural effusion, pulmonary embolism and diaphragm function assessment. POLLUS-IM 2020 recommendations were established primarily for clinicians who utilize lung ultrasound in their everyday clinical work.

Selected Properties of the Surface Layer of C45 Steel Parts Subjected to Laser Cutting and Ball Burnishing.

In this article, we report the results of experimental studies on the impact of ball burnishing parameters on the roughness, microstructure and microhardness of the surface layer of laser-cut C45 steel parts. We also analysed the distribution of residual stresses generated in the surface layer of these parts. Laser-cut parts often require finishing to improve the quality of their surface. The tests performed in this study were aimed at assessing whether ball burnishing could be used as a finishing operation for parts of this type. Ball burnishing tests were performed on an FV-580a vertical machining centre using a mechanically controlled burnishing tool. The following parameters were varied during the ball burnishing tests: burnishing force Fn, path interval fw and the diameter of the burnishing ball dn. Ball burnishing of laser-cut C45 steel parts reduced the surface roughness parameters Sa and Sz by up to 60% in relation to the values obtained after laser cutting. Finish machining also led to the reorganization of the geometric structure of the surface, resulting in an increase in the absolute value of skewness Ssk. This was accompanied by an increment in microhardness (maximum microhardness increment was ΔHV = 95 HV0.05, and the thickness of the hardened layer was gh = 40 µm) and formation of compressive residual stresses in the surface layer.

Can a New Scoring System Improve Prediction of Pulmonary Hypertension in Newly Recognised Interstitial Lung Diseases?

INTRODUCTION: Pulmonary hypertension (PH) is a well-recognised complication of interstitial lung diseases (ILD), which worsens prognosis and impairs exercise capacity. Echocardiography is the most widely used, non-invasive method for PH assessment. The aim of our study was to identify the factors predictive for echocardiographic signs of PH in newly recognised ILD patients. METHODS: Ninety-three consecutive patients (28F/65M) with different ILD were prospectively evaluated from January 2009 to March 2014. Pulmonary function testing, 6-min walk distance (6MWD), initial and sixth minute room air oxygen saturation, NT-proBNP and echocardiography were assessed in each patient. Echocardiographic PH probability was determined according to the 2009 ESC/ERS guidelines. RESULTS: In 41 patients (Group B) increased PH possibility has been diagnosed on echocardiography, in 52 patients (Group A)-low PH probability. Most pronounced differences (p ≤ 0.0005) between groups B and A concerned: age, 6MWD, room air oxygen saturation at 6 min, DLCO and TLC/DLCO index (57.6 vs 43.8 years; 478 vs 583 m; 89.1% vs 93.4%; 54.8% predicted vs 70.5% predicted and 1.86 vs 1.44; respectively). Univariate analysis showed four-fold increased probability of PH when TLC/DLCO exceeded 1.67. A scoring system incorporating age, TLC/DLCO index, 6MWD and room air oxygen saturation at 6 min provided high diagnostic utility, AUC 0.867 (95% CI 0.792-0.867). CONCLUSION: ILD patients with TLC/DLCO index > 1.67 have a high likelihood of PH and should undergo further evaluation. The composite model of PH prediction, including age, 6-min walk test and TLC/DLCO was highly specific for recognition of PH on echocardiography.

Correlation of bronchoalveolar lavage lymphocyte count with the extent of lung fibrosis and with plethysmographic lung volumes in patients with newly recognized hypersensitivity pneumonitis.

INTRODUCTION: Hypersensitivity pneumonitis (HP) is an increasingly recognized interstitial lung disease, presenting with elevated total cell counts and high percentage of lymphocytes in bronchoalveolar lavage fluid (BALF). Despite many publications, there is no consensus in the literature concerning BALF cellular composition in patients with prolonged course of HP. AIM: The aim of the present retrospective study was to investigate the influence of disease duration, smoking habits, and the extent of lung fibrosis on BALF cells' population in patients with newly recognized HP. MATERIAL AND METHODS: In total, 94 patients (49 females, 45 males), mean age 52 (±12) years, with HP recognized according to recently proposed criteria, were enrolled into the present study. Chest CT scans were retrospectively reviewed by two independent radiologists. BALF evaluation was performed as a part of routine diagnostics according to recent recommendations. RESULTS: Percentage of lymphocytes in BALF was significantly lower in patients with lung fibrosis (stage 1 and 2) comparing to those without lung fibrosis (stage 0). Significant correlation was also found between the percentage of BALF lymphocytes and plethysmographic lung volumes, but not with lung transfer capacity for carbon monoxide (TLCO% pred). Smoking did not influence BALF results in our study group. CONCLUSIONS: BALF lymphocytosis correlated with the presence and the extent of lung fibrosis on chest CT as well as with plethysmographic lung volumes but did not with TLCO and smoking habits in newly recognized HP pneumonitis.

Effect of the Application of Different Surface Treatment Methods on the Strength of Titanium Alloy Sheet Adhesive Lap Joints.

This study investigated the effect of the different surface treatment methods on the strength of Ti6Al4V titanium alloy sheet adhesive joints. The following surface treatment methods were used: alkaline degreasing, anodizing, vibratory shot peening, and anodizing with vibrational shot peening. The following tests/measurements were carried out during the experiment: surface roughness measurements; microhardness measurements (conducted by the Vickers hardness test method); and strength tests of single-lap adhesive joints fabricated with the use of two epoxy adhesives, rigid and flexible, both based on epoxy resin Epidian 5. It has been found that the application of anodizing followed by vibratory shot peening leads to increased strength of adhesive joints, irrespective of the type of applied epoxy adhesive.

Effect of Centrifugal Shot Peening on the Surface Properties of Laser-Cut C45 Steel Parts.

This article presents the results of experimental studies of the impact of centrifugal shot peening parameters on the roughness, microstructure, and microhardness of the surface layer of laser-cut C45 steel parts. Residual stress distributions and the presence of iron oxides on the surface of these elements were also examined. Centrifugal shot peening tests were performed on an FV-580a vertical machining center while using a specially designed peening head. The parameters that were varied during centrifugal shot peening included tangential speed of the tool vg and feed rate vf. The use of centrifugal shot peening for finish machining of laser-cut C45 steel parts allowed for obtaining a four-fold reduction in the surface roughness parameters Ra and Rz. As a result of shot peening, the geometrical structure of the surface of the steel parts was modified and it acquired new beneficial features, such as large values of the rounding radii of the micropeaks and high material ratios (Rmrmax = 92%). At the same time, the surface layer was hardened (microhardness increased by 16%) and a compressive residual stress layer was produced on the surface of the workpieces. Additionally, as the shot impacted the processed surface, combustion products were "blasted" or "sheared" off it. Shot peening using the proposed technique can be successfully performed while using CNC machines.

Patient satisfaction as an element of healthcare quality - a single-center Polish survey.

OBJECTIVES: The aims of the study were to define the level of patient satisfaction with services provided by selected departments of the Institute, and to identify changes that should be introduced to the process of quality management in healthcare services. MATERIAL AND METHODS: A total of 455 patients from three departments of the National Institute of Geriatrics, Rheumatology and Rehabilitation in Warsaw, hospitalized between January 2016 and March 2018 were assessed retrospectively. Statistical analyses were conducted with the use of IBM SPSS Statistics 25 software. RESULTS: Patients at the Institute gave the highest rates to the courtesy and kindness of doctors and nurses (mean 4.77 and 4.73, respectively), the doctor's interest in a patient's well-being, and the nurses' dexterity in performing medical procedures (4.63 and 4.72, respectively) The lowest-rated were the quality of meals (mean 3.77) and the waiting time for hospital admission on an appointed day (mean 4.07). The study demonstrated statistically significant differences in evaluations made by female and male patients: women had worse opinions about maintenance of intimacy during medical procedures, whereas men gave lower ratings to the size of served meals. The level of satisfaction in all analyzed aspects increased with older age. However, a higher level of patient education correlated negatively with satisfaction from the waiting time for hospital admission on an appointed day, the ability to receive information about the disease and treatment process, cleanliness and accessibility of bathrooms and toilets, or the ability to easily move around the Institute. CONCLUSIONS: Accessibility of medical services, as well as attitudes and competences of the medical staff, are all key factors in ensuring quality care. The conditions of a hospital stay also shape the patients' opinions in a significant way. Therefore, taking into account the patients' opinions should become an important goal in the process of improving healthcare quality.

Methotrexate treatment efficacy in sarcoidosis might be related to TNF-α polymorphism: real life preliminary study.

INTRODUCTION: Methotrexate therapy improves lung function in selected sarcoidosis patients. Variation in TNF gene was associated with response to treatment. Aim: To determine the predictive role of-308 G/A, -857C/T, -863 C/A and -1031 T/C TNF-α polymorphism in the efficacy of MTX for progressive pulmonary sarcoidosis. MATERIAL AND METHODS: Twenty-eight sarcoidosis patients treated with MTX (6-24 months) were genotyped for TNF-α polymorphisms: -1031 T/C, -857C/T, -308 G/A and -863 C/A. Pulmonary function test (PFT) were performed every 6 months to determine treatment response, until the drug withdrawal. RESULTS: No correlation between the initial clinical presentation of sarcoidosis and TNF α polymorphisms was found, neither for every allele nor for combined genotypes distribution. According to PFT evaluation we have discovered 3 types of response to MTX: early (ER), late (LR) and No-response (NR). TNF-α-308 A allele carriers have got significantly higher chance to be LR, p=0.02, RRI:83%. TNF-α-308 GG genotype transferred the 3-fold higher probability of early vs late response to MTX, p=0.02. Combined genotyping allowed to distinguish LR from ER and NR groups. ER and NR patients are genetically similar (-857CC-308GG). LR are "genetically" different group of patients (-857C/T-308GG or -857CC-308A/G) with 5-fold greater probability to be LR than TNF-α-857CC-308GG patients, p=0,005 sensitivity 85%, specificity: 43%, PPV 58%, NPV 75%. TNF-α-308GG-857CC patients have significantly lower chance to be LR comparing to other response type p=0.03 OR=0,075 95% CI=0.07-0.08. CONCLUSION: Two types of positive response to MTX therapy (early and late) in chronic respiratory sarcoidosis are associated with polymorphic changes in TNF gene.

Factors predisposing to non-tuberculous mycobacterial lung disease in the patients with respiratory isolates of non-tuberculous mycobacteria.

INTRODUCTION: An increasing incidence rate of respiratory isolates of non-tuberculous mycobacteria (NTM) has been noted recently in most European countries as well as in the US. Despite many publications, there is no consensus concerning the importance of different factors in promoting NTM lung disease (NTMLD). The aim of the present retrospective study was to analyse patients with positive NTM respiratory isolates in search of factors predisposing to NTMLD. MATERIAL AND METHODS: 73 patients, 23 males, 50 females, median age 62.2 years, in whom NTM have been cultured from respiratory specimen (sputum and/or bronchial washings), in the period 2010-2015, entered the study. RESULTS: NTMLD (according to ATS/IDSA) has been recognised in 36 patients, airways colonisation by NTM - in 37 patients. NTMLD was diagnosed more often in the patients infected with M. kansasii, M. abscessus and M. avium/M. intracellulare comparing to those infected with M.xenopi, M. gordonae and M. fortuitum (p < 0.0001). The proportion of females to males was significantly higher in the NTMLD group comparing to the colonisation group (p < 0.007). Previous tuberculosis or mycobacteriosis were noted significantly more frequently in the group of patients with NTMLD comparing to the colonisation group (28% vs 8%, p = 0.038). Univariate regression analysis revealed M. kansasii, female gender, and previous tuberculosis or mycobacteriosis as significant predictors of NTMLD. CONCLUSIONS: The risk factors of NTMLD recognition in the presented group of patients were the following: female gender, M. kansasii isolation, as well as past tuberculosis or mycobacteriosis.