The study aims to determine what forms of tuberculosis (TB) are the most common in high prevalence region, establishes the drug sensitivity of Mycobacterium tuberculosis in the region, and reveals the key risk factors of the disease as well as assesses the health status of adolescents with tuberculosis. For 10 years, regional anti-tuberculosis hospital in Smolensk has been collecting data from all TB patients aged 14-34 years. Diagnosis of tuberculosis was based on specific radiological data and detection of M. tuberculosis in sputum or bronchial lavage fluid. In total, the study involved 129 TB cases in adolescents aged 14-17 and 420 TB cases in young people. Sixty-five adolescents had close family or periodic contact with TB patients (50.6%), but only eight out of 65 (12%) had received complete course of chemistry prevention. Sixty-two adolescents had social risk factors (48%). Those patients significantly more often had extended pulmonary TB (28.3% versus 16.7%), complicated (36.7% versus 16.9%), and destructive (41.7% versus 26.2%) cases. Eighty out of the 129 (62%) had one or more concomitant diseases; they had significantly higher rate of extended and complicated TB cases. Two hundred and fourteen out of the 420 young patients had drug resistance of M. tuberculosis. Resistant TB cases significantly more often developed in unemployed (83.2% versus 71.8%), heavy drinkers and smokers (59.3% versus 43.7%), and in ex-prisoners (26.6% versus 15%). In conclusion, a comprehensive approach to examination and treatment of adolescents with TB should be performed. History and clinical data can be beneficially used to predict of drug resistance before results of cultural investigation.

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Objective. To study bone strength in children with latent tuberculosis infection who receive anti-tuberculosis drugs. Patients and methods. A quantitative ultrasound examination of the strength of the tubular bones of the upper and lower extremities was conducted in 120 children with mycobacteria tuberculosis infection (experimentak group). У 73 children who received preventive treatment with anti-tuberculosis drugs (isoniazid, pyrazinamide) bone strength examination was repeated after 6 months (comparison group). The control group comprised 42 children belonging to the 2nd health status group. Results. At the first examination, according to osteodensitometry, children of the experimental group had a decreased bone density in tubular bones as compared to the age-related norms in 34.2% of cases, which had no statistically significant differences with the control group. The children of the comparison group were examined after 6 months, about 60% of children had a decrease of bone density of varied degree, the average Z-score 1.5 ± 0.8, which is significantly lower than in the experimental group. According to the study results, a significant statistical correlation was found between the intake of anti-tuberculosis drugs and bone strength in children with latent tuberculosis χ2 = 10.588, р < 0.012. Conclusion. As was found, a long-term intake of anti-tuberculosis drugs has an effect on bone strength in children. In the outpatient settings, clinical monitoring of bone strength permits to ensure the safety of the administered long-term preventive therapy of tuberculosis. Key words: children, bone strength, tuberculosis, treatment, osteodensitometry, chemoprophylaxis, anti-tuberculosis drugs

Vitamin D plays an important role in decreasing the risk of developing type 2 diabetes by influencing calcium metabolism, thereby reducing β-cell dysfunction and preventing insulin resistance. The findings of research works are contradictory enough, although some of them demonstrated an inverse relationship between vitamin D levels and the incidence of type 2 diabetes. The article describes the biological mechanisms of relationships between vitamin D levels and type 2 diabetes, reviews the results of the studies conducted and summarizes the available data. Key words: vitamin D, type 2 diabetes mellitus, insulin resistance

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