[A clinical and economic analysis of the use of dapagliflozin in patients with chronic heart failure in the entire spectrum of left ventricular ejection fraction in the Russian Federation].

AIM: To estimate the cost-effectiveness of dapagliflozin across the range of ejection fraction in patients with heart failure (HF) in Russian Federation. MATERIALS AND METHODS: Cost-effectiveness model was developed for estimate the use of dapagliflozin as part of standard therapy in patients with HF regardless of ejection fraction is unknown. The calculation of costs was carried out in a mathematical model adapted to the conditions of Russian healthcare system by using Russian costs inputs and patient population characteristics. RESULTS: In the model, dapagliflozin therapy yielded a mean of 0.209 additional life-years compared with standard of care in 10 years horizon. The incremental cost of 1 additional life-year was 665,715 RUB, which does not exceed the threshold of willingness to pay 2,235,202 RUB. CONCLUSION: Thus, the intensification of chronic HF therapy with dapagliflozin is cost effective. The use of dapagliflozin in a cohort of 1000 target patients over 10 years will avoid 146 hospitalizations and 39 emergency visits due to HF, as well as prevent 32 deaths from cardiovascular diseases.

[Assessment of the efficacy and safety of alemtuzumab in patients with highly active relapsing-remitting multiple sclerosis in Russian population]. / Otsenka effektivnosti i bezopasnosti alemtuzumaba u patsientov s vysokoaktivnym techeniem rasseyannogo skleroza v rossiiskoi populyatsii.

OBJECTIVE: To evaluate the severity and frequency of infusion reactions (IR) in patients with highly active relapsing-remitting multiple sclerosis (MS) In Russian population receiving alemtuzumab therapy. MATERIAL AND METHODS: In retrospective study, we analyzed data from 50 patients with highly active relapsing-remitting multiple sclerosis (MS) from six Regional MS Centers in the Russian Federation who received two courses of alemtuzumab between 2018 and 2022. RESULTS: Among all IRs, the most frequently reported were hives-like rashes, which were registered in 27 people, mostly of mild severity (70.6%). Headaches were the second most common IR, observed in 17 patients (34%). When comparing the group of patients who underwent music therapy (MT) with those who received alemtuzumab therapy without MT, no statistically significant difference was found in the frequency and severity of IRs. CONCLUSION: All patients experienced IRs of varying degrees of severity. A decrease in the score on the EDSS disability scale was noted. MT did not affect the occurrence or severity of IRs.

LIM-kinase 1 effects on memory abilities and male courtship song in Drosophila depend on the neuronal type.

The signal pathway of actin remodeling, including LIM-kinase 1 (LIMK1) and its substrate cofilin, regulates multiple processes in neurons of vertebrates and invertebrates. Drosophila melanogaster is widely used as a model object for studying mechanisms of memory formation, storage, retrieval and forgetting. Previously, active forgetting in Drosophila was investigated in the standard Pavlovian olfactory conditioning paradigm. The role of specific dopaminergic neurons (DAN) and components of the actin remodeling pathway in different forms of forgetting was shown. In our research, we investigated the role of LIMK1 in Drosophila memory and forgetting in the conditioned courtship suppression paradigm (CCSP). In the Drosophila brain, LIMK1 and p-cofilin levels appeared to be low in specific neuropil structures, including the mushroom body (MB) lobes and the central complex. At the same time, LIMK1 was observed in cell bodies, such as DAN clusters regulating memory formation in CCSP. We applied GAL4 × UAS binary system to induce limk1 RNA interference in different types of neurons. The hybrid strain with limk1 interference in MB lobes and glia showed an increase in 3-h short-term memory (STM), without significant effects on long-term memory. limk1 interference in cholinergic neurons (CHN) impaired STM, while its interference in DAN and serotoninergic neurons (SRN) also dramatically impaired the flies' learning ability. By contrast, limk1 interference in fruitless neurons (FRN) resulted in increased 15-60 min STM, indicating a possible LIMK1 role in active forgetting. Males with limk1 interference in CHN and FRN also showed the opposite trends of courtship song parameters changes. Thus, LIMK1 effects on the Drosophila male memory and courtship song appeared to depend on the neuronal type or brain structure.

[Ferroptosis-associated lesion as a potential target for cardiovascular disease: A review].

Cell death is an important feature of the development of multicellular organisms, a critical factor in the occurrence of cardiovascular diseases. Understanding the mechanisms that control cell death is crucial to determine its role in the development of the pathological process. However, the most well-known types of cell death cannot fully explain the pathophysiology of heart disease. Understanding how cardiomyocytes die and why their regeneration is limited is an important area of research. Ferroptosis is an iron-dependent cell death that differs from apoptosis, necrosis, autophagy, and other forms of cell death in terms of morphology, metabolism, and protein expression. Ferroptotic cell death is characterized by the accumulation of reactive oxygen species resulting from lipid peroxidation and subsequent oxidative stress, which can be prevented by iron chelates (eg, deferoxamine) and small lipophilic antioxidants (eg, ferrostatin, liproхstatin). In recent years, many studies have been carried out on ferroptosis in the context of the development of atherosclerosis, myocardial infarction, heart failure, and other diseases. In addition to cardiovascular diseases, the review also presents data on the role of ferroptosis in the development of other socially significant diseases, such as COVID-19, chronic obstructive pulmonary disease. With the study of ferroptosis, it turned out that ferroptosis participates in the development of bacterial infection associated with the persistence in the host body of Pseudomonas aeruginosa. The review summarizes the recent advances in the study of ferroptosis, characterizing this type of cell death as a novel therapeutic target.

Unifying principles of cryopreservation protocols for new plant materials based on alternative cryoprotective agents (cpas) and a systematic approach.

This review addresses a frequently encountered problem of designing an effective cryopreservation procedure for new (not previously cryopreserved) or difficult plant materials. This problem hinders worldwide efforts of applying cryopreservation across a wide genetic base of wild and a number of cultivated plants. We review recent advances in modifications of routinely applied cryoprotective solutions (CPAs) and suggest a practical approach to protocol development which embraces the physiological complexity of plant tissues as well as a wide spectrum of behaviours under CPA treatment. We suggest that vegetative plant materials are classified into four categories based on their size, structure, and the response to osmotic and chemical stresses provoked by CPA mixtures of varied composition and concentration, including alternative osmoprotection and vitrification solutions. A number of up to 15 preset protocols designed specifically for each category is then applied to the material. The protocols resulting in the best regrowth are then combined into the optimized procedure. The main advantage of this system over a conventional "trial-and-error" search for working cryopreservation protocol is a minimal amount of starting materials required for the tests and a relatively accurate prediction of material behaviour under cryopreservation stress provided by the relatively few CPAs treatments. The unifying principles revealed by this approach could broaden a spectrum of wild species and materials which can be safely conserved by cryopreservation. Also anticipated is application of this approach to plant materials of biotechnological value as well as cultivars of agricultural and horticultural crops which do not respond well to standard protocols developed for their kind. doi.org/10.54680/fr23110110112.

[Gut microbiota in patients with relapsing-remitting multiple sclerosis]. / Mikrobiota kishechnika u patsientov s remittiruyushchim rasseyannym sklerozom.

Microorganisms in human life play a huge role: in particular, those that coexist with the host organism, inhabiting the skin, upper respiratory tract, external genitalia and especially the digestive tract. The intestinal microbiota, including bacteriome, mycobiome and virome, not only takes part in the digestion process, but also provides the synthesis of a number of vitamins. The intestinal microbiome also serves as the basis for a system of extensive bidirectional neuroendocrine pathways that connect microbiota with various regions of the central nervous system, the hypothalamic-pituitary-adrenal system, and the peripheral parts of the autonomic nervous system. This system of connections has got the name of gut-brain axis and has attracted close attention of scientists over the past two decades, since a targeted impact on the intestinal flora is potentially capable of changing the nature of nervous system regulatory influences on the whole body. It is especially important to study patterns of functioning of the gut-brain axis in patients with the nervous system pathology, namely neurodegenerative and demyelinating diseases. Methods for their treatment continue to improve, and perhaps the correction of the gut microbiotic composition will serve as an additional therapeutic approach. The review article describes current views on the role of the intestinal microbiota, provides the latest data on the composition of bacteriome, mycobiome, and virome in patients with relapsing-remitting multiple sclerosis.

Levamisole-associated multifocal inflammatory encephalopathy: clinical and MRI characteristics, and diagnostic algorithm.

Levamisole-associated multifocal inflammatory encephalopathy (LAMIE) is a devastating adverse effect of levamisole (LEV) treatment. In Russia, people often use LEV without a doctor's prescription for anthelmintic prophylaxis. LAMIE often misdiagnosed as the first episode of MS or acute disseminated encephalomyelitis (ADEM). The aim of our study was to describe clinical, laboratory and morphological characteristics of LAMIE, magnetic resonance imaging (MRI) patterns and create an algorithm for the differential diagnosis. This study was a prospective observational study with retrospective analysis of cases. It was performed at two hospitals with ambulatory service for MS. We included 43 patients with LAMIE with follow-up was from 1 year to 5 years. Age was 19-68 y.o. with female predominance. The most typical manifestations of LAMIE were cerebellar, pyramidal and cognitive symptoms, and majority of patients had biphasic course of the disease. Three main types of MRI patterns were described: ADEM-like, MS-like, atypical demyelination. About 40% of patients had CSF specific oligoclonal bands synthesis, but only 20 % of them converted to MS during the period from 1 month until 2 years. The CSF albumin levels and immunoglobulin G index were elevated in LAMIE patients compared to reference values. We described results of brain biopsy in two cases. Therefore LAMIE should be considered in patients with demyelinating or inflammatory conditions with biphasic onset of the disease and variable MRI presentation.

Effect of Antioxidants on the Production of MCP-1 Chemokine by EA.hy926 Cells in Response to IL-6.

An elevated level of circulatory interleukin 6 (IL-6) is a biomarker for cytokine storm of various etiologies, including COVID-19, and contributes to poor prognosis. Vascular endothelial cells are one of the main targets of pathological action of IL-6. IL-6 activates the trans-signaling pathway via the formation of the IL-6/sIL-6Ra/gp130 receptor complex and subsequent activation of the JAK/STAT3 signaling pathway and PI3K/AKT and MEK/ERK kinases in some cases. Previously, it was shown by the authors' group and other researchers that reactive oxygen species (ROS), including mitochondrial ROS (mito-ROS), contribute to the induction of IL-6 expression in the endothelium, mainly due to increased activation of the transcription factor NF-kB. We have also shown that the mitochondria-targeted antioxidant SkQ1 (Plastoquinolyl-10(6'-decyltriphenyl)phosphonium) prevented tumor necrosis factor (TNF)-induced cytokine storm and death in mice. In the aortas of these animals, SkQ1 also prevented the increase in the expression of NF-kB-dependent genes, including the cytokine IL-6 and the chemokine MCP-1. In the current work, the hypothesis of mito-ROS involvement in the IL-6-signaling-mediated proinflammatory gene expression in endothelial cells is tested. SkQ1 suppressed the expression and secretion of the MCP-1 chemokine, induced by IL-6 in combination with sIL-6-Ra, but not the expression of ICAM-1 adhesion molecules in EA.hy926 human endothelial cells. Using specific inhibitors, the authors have shown that, in EA.hy926 cells, IL-6-induced expression of MCP-1 and ICAM-1 depends on the signaling protein and transcription activator STAT3 and, in some cases, on JNK, PI3K, and MEK1/2 kinases and is independent of p38 kinase. In this model, IL-6 induced rapid STAT3 activation, while ERK1/2 activation was less pronounced, and there was no IL-6 effect on Akt and JNK activation. SkQ1 partially suppressed STAT3 and ERK1/2 activation. Thus, we have shown that SkQ1 suppresses not only NF-kB-dependent expression of IL-6 and other proinflammatory genes but also IL-6-induced activation of JAK/STAT3 and STAT3-dependent expression of MCP-1, which probably contributes to the overall therapeutic effect of SkQ1.

[New opportunities in the treatment of patients with multiple sclerosis (Resolution of the Council of Experts on April 23, 2022, Moscow, JSC «BIOCAD¼)]. / Novye vozmozhnosti v terapii patsientov s rasseyannym sklerozom¼ (Rezolyutsiya soveta ekspertov 23 aprelya 2022 goda, Moskva, AO «BIOKAD¼).

One of the target areas for the development of the Russian pharmaceutical industry at present is the development of next-in-class drugs medicines. These are original, patent-protected drugs that act on known biological targets, improved or modified in structure and mechanism of action compared to existing, successfully proven medicine. The article presents the results of an expert council on the management of patients with multiple sclerosis and the place of new original medicines of the JSC BIOCAD company (SamPEG-IFN-ß1a and divozilimab) in multiple sclerosis therapy algorithm.

[Genome-Wide Analysis of DNA Methylation in Cd4+ T Lymphocytes of Patients with Primary Progressive Multiple Sclerosis Indicates Involvement of This Epigenetic Process in the Disease Immunopathogenesis].

The pathogenesis of multiple sclerosis (MS), a chronic disease of the CNS, includes autoimmune and neurodegenerative components. In most cases, patients develop relapsing-remitting MS (RRMS), while 10-15% of patients develop primary progressive MS (PPMS), which differs from RRMS in the mechanisms of the pathological process, some demographic, and some clinical characteristics. These differences may be explained by the epigenetic regulation of gene expression in PPMS including DNA methylation as one of the key epigenetic processes. The features of DNA methylation in various cell populations in PPMS patients remain understudied. The goal of this study is to identify differentially methylated CpG sites (DMSs) of the genome of CD4+ T lymphocytes, which characterize PPMS. The study included eight treatment-naive PPMS patients and eight healthy controls. Genome-wide analysis of DNA methylation of CD4+ T lymphocytes was performed using high-density DNA microarrays. We have identified 108 DMSs, which distinguish PPMS patients from healthy controls. In PPMS patients 81% of the DMSs are hypermethylated. More than a half of the identified DMSs are located in known genes in CpG islands and adjacent regions, which indicates a high functional significance of these DMSs in PPMS development. Analysis of the overrepresentation of DMS-containing genes in the main biological processes demonstrates their involvement in the regulation of cell adhesion to the extracellular matrix and the development of the immune response, i.e., antigen processing and presentation, and development of the immune system. Genome-wide analysis of DNA methylation in CD4+ T lymphocytes of PPMS patients indicates the involvement of this epigenetic process in the immunopathogenesis of the disease. These results may help better understand the pathogenesis of this severe form of MS.

A New In Vitro Blood Hyperviscosity Model.

We developed a model of blood hyperviscosity avoiding extreme impact on the blood. The model shows reproducibility in rat blood under common storage conditions (4±1°C; stabilization with citrate-phosphate-glucose additive solution). Storage of rat blood under these condition leads to impairment of its rheological properties, which manifested in an increase in blood viscosity in a wide range of shear rates (3-300 sec-1). An increase in blood viscosity appeared the first day of storage and reached a maximum on the third day. During further 11-day storage, the blood viscosity did not change significantly. A hybrid macromolecular compound O-(3-(3,5-di-tert-butyl-4-hydroxyphenyl)propanoyl)-(1→6)-α-D-glucan improved the hemorheological properties during storage. The most pronounced effect was observed on the third day of storage and manifested in a decrease in blood viscosity in the range of shear rates of 50-300 sec-1. Thus, storage of rat blood with citrate-phosphate-glucose additive solution for 3 days at 4±1°C reproduces the phenomenon of blood hyperviscosity; this model can be used to screen agents with hemorheological activity.

Parent-of-origin effects on nuclear chromatin organization and behavior in a Drosophila model for Williams-Beuren Syndrome.

Prognosis of neuropsychiatric disorders in progeny requires consideration of individual (1) parent-of-origin effects (POEs) relying on (2) the nerve cell nuclear 3D chromatin architecture and (3) impact of parent-specific miRNAs. Additionally, the shaping of cognitive phenotypes in parents depends on both learning acquisition and forgetting, or memory erasure. These processes are independent and controlled by different signal cascades: the first is cAMPdependent, the second relies on actin remodeling by small GTPase Rac1 - LIMK1 (LIM-kinase 1). Simple experimental model systems such as Drosophila help probe the causes and consequences leading to human neurocognitive pathologies. Recently, we have developed a Drosophila model for Williams-Beuren Syndrome (WBS): a mutant agnts3 of the agnostic locus (X:11AB) harboring the dlimk1 gene. The agnts3 mutation drastically increases the frequency of ectopic contacts (FEC) in specific regions of intercalary heterochromatin, suppresses learning/memory and affects locomotion. As is shown in this study, the polytene X chromosome bands in reciprocal hybrids between agnts3 and the wild type strain Berlin are heterogeneous in modes of FEC regulation depending either on maternal or paternal gene origin. Bioinformatic analysis reveals that FEC between X:11AB and the other X chromosome bands correlates with the occurrence of short (~30 bp) identical DNA fragments partly homologous to Drosophila 372-bp satellite DNA repeat. Although learning acquisition in a conditioned courtship suppression paradigm is similar in hybrids, the middle-term memory formation shows patroclinic inheritance. Seemingly, this depends on changes in miR-974 expression. Several parameters of locomotion demonstrate heterosis. Our data indicate that the agnts3 locus is capable of trans-regulating gene activity via POEs on the chromatin nuclear organization, thereby affecting behavior.

Genome Analysis of the Probiotic Strain Enterococcus faecium Ef79OSAU.

We report here the draft genome sequence of Enterococcus faecium strain Ef79OSAU, which was isolated from swine feces. The characteristics of strain Ef79OSAU reveal the absence of pathogenicity factors, a wide range of antimicrobial activity in vitro, and antilisteriosis activity in vivo. Analysis of the E. faecium Ef79OSAU genome revealed a cluster of genes encoding enterocin A without genetic determinants of pathogenicity.

[Methotrexate-induced lung damage in a patient with rheumatoid arthritis].

We herein report a case of interstitial lung disease secondary to the use of methotrexate in a patient with rheumatoid arthritis. Differential diagnosis between pneumonitis caused by methotrexate in patients treated with basic methotrexate therapy and interstitial pulmonary disease associated with rheumatoid arthritis is based on the clinical examination and instrumental data. The main condition for favorable clinical outcome in all drug-induced lung disease is drug withdrawal, what was proven in our report.

Ammonium-free medium is critical for regeneration of shoot tips of the endangered species Pogostemon yatabeanus cryopreserved using droplet-vitrification.

BACKGROUND: Pogostemon yatabeanus, synonym Dysophylla yatabeana, (Labiatae) is an endangered wild species in Korea. It has has a limited natural habitat and requires urgent conservation measures. OBJECTIVE: To develop an efficient cryopreservation protocol using in vitro shoot tips to complement traditional conservation approaches in case seeds are unavailable, or insufficient in number for conservation programs. MATERIALS AND METHODS: Node-cutting induced shoot tips of in vitro plants were produced and cryopreserved using a droplet-vitrification method following improvements in preculture, osmoprotection, vitrification solution (VS) and regrowth treatments. The starting protocol included preculture with 10% sucrose for 31 h, followed by osmoprotection with C4-35% (17.5% glycerol + 17.5% sucrose) for 40 min, and cryoprotection with A3-80% (33.3% glycerol + 13.3% DMSO + 13.3% EG + 20.1% sucrose) for 60 min on ice, cooling and warming using aluminum foil strips, and regrowth in MS hormone-free medium. RESULTS: Shoot tips of Pogostemon yatabeanus were sensitive to the osmotic stress evidenced by low survival after step-wise preculture with 17.5% sucrose and cryopreservation without osmoprotection. Among VS tested, including PVS2, PVS3 and their alternatives, A3-80% on ice for 60 min resulted in the highest post-cryopreservation survival (80%) and regeneration (20%). Post-cryopreservation regeneration significantly improved (up to 73%) by incubation of cryopreserved shoot tips on ammonium-free medium followed by GA X3-containing medium and medium without growth regulators. CONCLUSION: Cryopreservation of in vitro shoot tips using droplet-vitrification was developed as a complementary conservation approach for D. yatabeana. Adjustment of medium composition during the recovery stage was important for regeneration of healthy plants from both cryoprotected-control and cryopreserved shoot tips.

[Drug therapy of atrial fibrillation in elderly patients.]

Currently, studies of the causes of atrial fibrillation are actively conducted. However, molecular and cellular mechanisms of atrial fibrillation have not been precisely established so far. Great success in the treatment of atrial fibrillation was achieved thanks to the development of surgical methods. However, these approaches, unfortunately, are not always applicable to elderly and senile patients. Antiarrhythmic drugs used in atrial fibrillation, exhibit a large number of side effects. Much attention of researchers is now attracted by fundamentally new directions in the drug treatment of atrial fibrillation. These include predserdno-selective antifibrillatory funds. Drugs, the action of which is aimed at at atrial remodeling, inflammation and fibrosis, so is of interest. Effective suppression of atrial remodeling, inflammation and fibrosis prevents the formation of a permanent form of atrial fibrillation. A new approach to the treatment of atrial fibrillation, taking into account the vegetative status of the patient, will undoubtedly increase its effectiveness.

[Optimization of treatment of acute poisoning with severe psychodisleptics]. / Optimizatsiya lecheniya ostrykh otravlenii psikhodisleptikami tyazheloi stepeni.

OBJECTIVE: To increase the efficacy of acute poisoning with severe psychodisleptics. MATERIAL AND METHODS: Fifty-two patients with acute psychoactive substance poisoning were studied. Patients of the main group (n=27) received cytoflavin infusion in combination with inhaled sedation with sevoflurane in addition to conventional therapy. The comparison group consisted of 25 patients who received conventional therapy. RESULTS AND CONCLUSION: Augmentation of conventional therapy with cytoflavin in combination with inhaled sedation with sevoflurane, affecting various links in the pathogenesis of acute severe poisoning with psychodisleptics, made it possible to cope in a shorter time.

[New tools for early detection of multiple sclerosis progression: MSProDiscuss questionnaire]. / Novye instrumenty dlya rannego vyyavleniya progressirovaniya rasseyannogo skleroza. Oprosnik MSProDiscuss.

Diagnosis of secondary progressive multiple sclerosis (SPMS) is based on a history of gradual worsening of neurological symptoms within 6-12 months without exacerbations following an initial relapsing-remitting (RRMS) disease course. In the absence of reliable MRI, immunological and clinical markers, it is hardly possible to achieve objectivity in determining the transition of MS to a progressive stage. This often leads to a long period of diagnostic uncertainty, which prevents timely therapeutic decisions. Physicians expressed an unmet need for a tool that could be used in routine clinical practice to assess the risks of progression to SPMS quickly and reliably, in an easy-to-interpret output for a joint discussion with the patient. From a wide range of disease symptoms and lifestyle factors reflecting the progression to SPMS and obtained by analysis of large clinical data (3294 cases) and a survey of patients and specialists, significant were identified and ranked by categories according to combined expert opinion. A mathematical model was developed and validated, and an electronic version of the MSProDiscuss questionnaire created. Test sensitivity for SPMS diagnosis is 0.82, specificity 0.84, interrater reliability 0.95. Median time for completion of the questionnaire was 2.16 minutes per patient. Physicians of the Russian Federation who used the questionnaire confirmed its high feasibility. Thus, the methodology of the questionnaire development based on the combined opinion of patients and physicians, along with the large clinical data, made it possible to obtain high sensitivity, specificity and reproducibility of the test and takes little time with a clear output. MSProDiscuss may be useful not only in the differential diagnosis of RRMS and SPMS, but also to determine the risks of progression to SPMS, which is of great clinical importance.

[Diagnosis and prediction of the course of primary open-angle glaucoma by the level of local cytokines]. / Diagnostika i prognozirovanie pervichnoi otkrytougol'noi glaukomy po urovnyu mestnykh tsitokinov.

Glaucoma is the leading cause of irreversible blindness in all countries and is expected to increase in patients with this pathology in the coming years. Currently, the development of the disease is associated with a change in the interleukin profile of the lacrimal fluid, but the diagnostic significance of interleukins has not been sufficiently studied. PURPOSE: To determine the diagnostic significance of interleukins at the local level to improve the diagnosis and prognosis of glaucoma. MATERIAL AND METHODS: The study examined the content of interleukins in the lacrimal fluid of 109 patients with stage II glaucoma and 52 healthy individuals by sandwich-variant of enzyme-linked immunosorbent assay (ELISA) with calculation of the information content of immune parameters. RESULTS: The study has established high diagnostic significance for the verification of glaucoma IL-2, IL-17, IL-8, which is proposed to be used in laboratory diagnosis and prognosis of the disease. CONCLUSION: The created regression model provides high-accuracy prediction of the course of glaucoma progression with increasing IL-2, IL-17, IL-8.

[Analysis of the dynamics of repeated admissions of patients to inpatient compulsory treatment in Moscow]. / Analiz dinamiki povtornykh postuplenii patsientov na prinuditel'noe lechenie v psikhiatricheskii statsionar Moskvy.

OBJECTIVE: To explore the dynamics of admission of patients for repeated compulsory treatment to a medical setting providing general and specialized psychiatric care. MATERIAL AND METHODS: The dynamics of admission of patients for repeated compulsory treatment in the «Moscow Psychiatric clinical hospital No5¼ for the period 1991-2019 was analyzed based on medical records of two groups of patients: the main group (n=1325) and the comparison group (n=15 100). RESULTS AND CONCLUSION: Over the past 5 years, there is a decrease in repeated admissions of patients to compulsory treatment who have committed a new socially dangerous act. This positive dynamic is due to compliance with the principles of continuity and phasing between inpatient and outpatient units of compulsory treatment. The transition of patients from inpatient compulsory treatment to compulsory treatment in outpatient settings is an effective measure to prevent patients from committing repeated socially dangerous acts.