Ekaterina K. Markelova

The article emphasizes the focus on the problems of emotional burnout of doctors in the process of postgraduate education. The authors claim that burnout has a certain impact on both professional and personal growth, which means it requires its own special consideration. The subject of the study is the level of emotional burnout of doctors during postgraduate education. The purpose of the work is to identify the degree of emotional burnout of doctors during postgraduate education and the reasons for it. The objectives of the study included: theoretical justification of the nature of emotional burnout as a social phenomenon, diagnosis of its current level, as well as the development of practical recommendations for educational organizations. The methodological basis includes theoretical methods (analysis, synthesis, generalization) and empirical method — survey. The study included 55 people: residents — 36, graduate students — 19. The results of the study showed that the level of emotional burnout in graduate students is much lower than in residents, but in both this level changes at different stages of training. The authors highlighted the symptoms of burnout that should be paid special attention to, which made possible to formulate recommendations, including the introduction of a psychologist to the staff of the educational institution, providing the study of educational software methods of stress management, time management strategies and relaxation exercises: creating a system of encouragement, material and moral, for professional and scientific achievements; development of mentoring not only within the framework of residency and graduate school, but starting from the student years, the creation and maintenance of a favorable and inclusive educational environment by the teaching staff. The implementation of these measures will create optimal opportunities for the development of the personality of each student and reduce the level of his emotional burnout.

Background. Monocyte chemoattractant protein-1 (MCP-1) plays a crucial role in inflammatory processes by recruiting monocytes and macrophages to sites of inflammation. Inflammation is closely linked to poor control of diabetes mellitus (DM), characterized by significant glycemic fluctuations and prolonged hyperglycemia, as well as subclinical, low-grade inflammation of adipose tissue in type 2 DM. Elevated levels of MCP-1 have been associated with both type 1 and type 2 DM; however, data on its role in the pathogenesis of latent autoimmune diabetes in adults (LADA) are extremely limited. Aim. To evaluate MCP-1 levels and their association with glycemic control parameters in patients with different types of DM (type 1 DM, type 2 DM, and LADA). Materials and methods. Between February and November 2023, 80 individuals participated in the study, divided into four groups: patients with type 1 DM (n = 22), type 2 DM (n = 22), LADA (n = 14), and healthy volunteers (n = 22). The median ages were 26 years [21; 32] for type 1 DM, 41 years [33; 51] for type 2 DM, 41 years [33; 46] for LADA, and 33 years [26; 40] for healthy controls. Inclusion criteria were age between 18 and 55 years, body mass index up to 35 kg/m², and a diagnosis of one of the specified forms of DM. Exclusion criteria included other systemic autoimmune diseases, pancreatic diseases, and the use of immunosuppressive therapy. Results. MCP-1 levels were significantly higher in patients with type 1 DM (213 [162; 263] pg/ml) and type 2 DM (228 [168; 294] pg/ml) compared to healthy volunteers (174 [151; 207] pg/ml; p 0.05). Patients with LADA showed a non-significant trend toward elevated MCP-1 levels (218.51 [160; 268] pg/ml; p 0.05). ROC analysis indicated that MCP-1 is not suitable as an additional marker for the differential diagnosis of LADA. Conclusion. Elevated MCP-1 levels in patients with type 1 and type 2 DM suggest its possible involvement in the pathogenesis of these diabetes types. The lack of significant MCP-1 elevation in patients with LADA limits its utility as a diagnostic marker for this condition.

BACKGROUND: Latent autoimmune diabetes in adults (LADA) is considered an intermediate form between type 1 (T1DM) and type 2 diabetes mellitus (T2DM). However, the molecular mechanisms underlying its unique clinical and pathogenetic features remain insufficiently studied. Identifying differentially expressed genes (DEGs) in LADA compared to T1DM is essential for developing more personalized diagnostic and therapeutic approaches.OBJECTIVE: To identify DEGs in peripheral blood mononuclear cells (PBMCs) of patients with LADA compared to those with T1DM, and to evaluate differences in DEGs between these patient groups and healthy volunteers.MATERIALS AND METHODS: The study included 60 participants (23 T1DM patients with disease duration of up to 1 year, 15 LADA patients with disease duration of up to 5 years, and 22 healthy volunteers). The median age of LADA patients was 40 [34; 45] years, and for T1DM patients, 26 [21; 31] years. This was a single-center, cross-sectional observational study. PBMCs were isolated from all participants, and single-cell RNA sequencing (scRNA-seq) was performed. Differential gene expression analysis was conducted using a pseudo-bulk approach (pyDEseq2, pRESULTS: In LADA patients, reduced expression of HLA-G, SPARC, and C20orf204 and increased expression of AC002460.2 were observed compared to healthy volunteers (pIFIT1, CASP3, LAMP3, HIST1H2BN). When comparing LADA to T1DM, only one transcript, C20orf204, showed statistically significant differential expression (pCONCLUSION: The findings indicate that LADA and T1DM share similar molecular patterns, with LADA exhibiting moderate changes in the expression of genes associated with immune regulation and inflammation. The minimal differences between these forms of diabetes highlight their pathogenetic similarity.