Major differences in the epidemiologic and clinical features of M. kansasii infection and other NTM have important diagnostic and clinical implications.

These cases underscore the strong link between silicosis and multiple distinct syndromes of autoimmune diseases. Vigilance is warranted for the recognition of autoimmune complications in persons with known silicosis; so too is consideration of the occupational exposure history in persons presenting with manifestations of autoimmune disease.

Background. Typical pulmonary carcinoids represent less than 5% of primary lung tumors. In patients with typical bronchial carcinoid, formal surgical resection still remains the gold-standard treatment. Data regarding long-term outcome in using flexible bronchoscope-based modalities under conscious sedation is very limited. Objectives. We sought to investigate, over extended follow-up period, the effectiveness of endobronchial resection for carcinoid tumors with curative intent using flexible bronchoscopy. Methods. Nd:YAG laser photoresection using flexible bronchoscope under conscious sedation. Follow-up included repeat bronchoscopy every 6 months and chest CT every year. Results. Ten patients aged 24 to 70 years with endobronchial carcinoid were treated. The tumor location was variable: 2 left Main bronchus, 1 left upper lobe bronchus, 2 right main bronchus, 2 right middle lobe bronchus and 3 right lower lobe bronchus. No major complications were observed. The patients required between 2 and 4 procedures. Patients were followed for a median period of 29 months with no evidence of tumor recurrence. Conclusions. Endobronchial laser photoresection of typical bronchial carcinoids using flexible bronchsocopy under conscious sedation is an effective treatment modality for a subgroup of patients that provides excellent long-term results that are similar to outcome obtained by more invasive procedures.

The incidence of nontuberculous mycobacteria (NTM) infection among people with bronchiectasis varies between different geographical areas and accordingly between different series [1, 2]. Studies are largely based on bronchiectasis referral centres, which routinely screen for NTM in respiratory secretions. Therefore, the reported estimates of NTM prevalence in bronchiectasis may be exaggerated. Studies from bronchiectasis centres show conflicting results regarding risk factors for NTM: older age was found to increase risk in some but not other centres [1-4]. Due to the small numbers of patients in these studies, it is usually not possible to determine the effect of NTM infection on prognosis. Utilising the population registry of Israel's largest health maintenance organisation [5], we aimed to determine the incidence, risk factors and prognosis of NTM infection among patients with bronchiectasis. The database was searched for adults with bronchiectasis on January 1, 2010, excluding cystic fibrosis and idiopathic pulmonary fibrosis. We searched for laboratory codes indicating NTM between January 2010 and December 2016. We defined three categories of NTM. 1) "Growth": a single culture positive for any NTM. 2) "Colonisation": at least two cultures positive for the same NTM species. 3) "Treated": either of the above categories, treated with three or more antimycobacterial drugs. Medication use was determined from pharmacy reports. Socioeconomic status (SES) was based on the SES score of the clinic neighbourhood as defined by the Israeli Central Bureau of Statistics [6]. Mortality and hospitalisations during follow-up (2010-2016) were compared between patients with and without NTM infection. Multivariate logistic regression was used to identify the NTM risk factors. The Cox time dependent model was used to identify prognostic factors that influence hospitalisation and mortality. On January 1, 2010, the database included 2 710 432 adults. Of these, 6347 had a diagnosis of bronchiectasis (234 in 100 000). 6274 patients were without NTM infection prior to January 1. Of them, only 1871 (30%) patients had mycobacterial cultures available. In the general population (without bronchiectasis), 1476 (0.055%) people had NTM from respiratory specimens during follow up. Among people with bronchiectasis (n=6274), 105 (1.7%) grew NTM during follow-up. Only 30 (0.48%) cases had two or more cultures of the same NTM species, representing colonisation. Treatment with a combination of three or more antimycobacterial drugs was found in 12 (0.19%) patients. The incidence of NTM growth among all patients with bronchiectasis (n=6274) was estimated in four strata of age: 18-39, 40-59, 60-79 and ⩾80 years. The corresponding incidence of NTM growth were 1.1%, 2.2%, 1.9% and 0.9%, respectively (p=0.030). 50% of patients were 60-80 years old with a similar age distribution between patients with and without available mycobacterial cultures. Overall, 43% of patients with bronchiectasis in our study had emigrated from areas where tuberculosis is comm...