Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Хронический гастрит: клинические варианты и лечение
Хронический гастрит: клинические варианты и лечение
Вялов С.С. Хронический гастрит: клинические варианты и лечение. Consilium Medicum. 2017; 19 (8): 103–109. DOI: 10.26442/2075-1753_19.8.103-109
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
В статье обсуждаются вопросы диагностики и лечения хронических гастритов, дифференциальный диагноз. Существуют практические трудности в диагностике патологии желудка, ограничивающие детализацию диагноза. Необходим рутинный скрининг атрофии и дисплазии у пациентов с патологией желудка. Для выявления воспалительных заболеваний желудка целесообразно использовать гастропанель. Для повышения эффективности купирования симптоматики возможно добавление прокинетика в схему терапии, для уменьшения частоты рецидивов – применение гастропротектора ребамипида.
Ключевые слова: хронический гастрит, атрофия, Helicobacter pylori, ребамипид, прокинетики.
Key words: chronic gastritis, atrophy, Helicobacter pylori, rebamipide, prokinetics.
Ключевые слова: хронический гастрит, атрофия, Helicobacter pylori, ребамипид, прокинетики.
________________________________________________
Key words: chronic gastritis, atrophy, Helicobacter pylori, rebamipide, prokinetics.
Полный текст
Список литературы
1. Correa P. Chronic gastritis: a clinico-pathological classification. Am J Gastroenterol 1988; 83: 504.
2. Wyatt JI, Dixon MF. Chronic gastritis – a pathogenetic approach. J Pathol 1988; 154: 113.
3. Rugge M, Meggio A, Pennelli G et al. Gastritis staging in clinical practice: the OLGA staging system. Gut 2007; 56: 631.
4. Вялов С.С. Комплексная терапия рецидивирующих гастродуоденитов. Рациональная фармакотерапия в гастроэнтерологии. Материалы XII конференции. М., 2012; с. 4–5. / Vialov S.S. Kompleksnaia terapiia retsidiviruiushchikh gastroduodenitov. Ratsional'naia farmakoterapiia v gastroenterologii. Materialy XII konferentsii. M., 2012; s. 4–5. [in Russian]
5. Jönsson KA, Gotthard R, Bodemar G, Brodin U. The clinical relevance of endoscopic and histologic inflammation of gastroduodenal mucosa in dyspepsia of unknown origin. Scand J Gastroenterol 1989; 24: 385.
6. Elta GH, Appelman HD, Behler EM et al. A study of the correlation between endoscopic and histological diagnoses in gastroduodenitis. Am J Gastroenterol 1987; 82: 749.
7. Tytgat GN. The Sydney System: endoscopic division. Endoscopic appearances in gastritis/duodenitis. J Gastroenterol Hepatol 1991; 6: 223.
8. Miki K, Urita Y. Using serum pepsinogens wisely in a clinical practice. J Dig Dis 2007; 8: 8.
9. Urita Y, Hike K, Torii N et al. Serum pepsinogens as a predicator of the topography of intestinal metaplasia in patients with atrophic gastritis. Dig Dis Sci 2004; 49: 795.
10. Ricci C, Vakil N, Rugge M et al. Serological markers for gastric atrophy in asymptomatic patients infected with Helicobacter pylori. Am J Gastroenterol 2004; 99: 1910.
11. Haj-Sheykholeslami A, Rakhshani N, Amirzargar A et al. Serum pepsinogen I, pepsinogen II, and gastrin 17 in relatives of gastric cancer patients: comparative study with type and severity of gastritis. Clin Gastroenterol Hepatol 2008; 6: 174.
12. Вялов С.С. Язвенная болезнь и Маастрихт-4: внедрение в клиническую практику. Эффективная фармакотерапия в гастроэнтерологии. 2012; 6: 16–22. / Vialov S.S. Iazvennaia bolezn' i Maastrikht-4: vnedrenie v klinicheskuiu praktiku. Effektivnaia farmakoterapiia v gastroenterologii. 2012; 6: 16–22. [in Russian]
13. Вялов С.С. Этиология гастритов и восстановление слизистой оболочки верхних отделов ЖКТ. Доктор.ру. 2014; 3 (91): 70–7. / Vialov S.S. Etiologiia gastritov i vosstanovlenie slizistoi obolochki verkhnikh otdelov ZhKT. Doktor.ru. 2014; 3 (91): 70–7. [in Russian]
14. Howden CW, Hunt RH. The relationship between suppression of acidity and gastric ulcer healing rates. Aliment Pharmacol Ther 1990; 4: 25.
15. Talley NJ. AGA medical position statement: evaluation of dyspepsia. Gastroenterology 2005; 129: 1753.
16. Инструкция к медицинскому применению препарата Метоклопрамид. / Instruktsiia k meditsinskomu primeneniiu preparata Metoklopramid. [in Russian]
17. Veldhuyzen van Zanten SJ, Jones MJ, Verlinden M, Talley NJ. Efficacy of cisapride and domperidone in functional (nonulcer) dyspepsia: a meta-analysis. Am J Gastroenterol 2001; 96: 689.
18. Drossman DA, Hasler WL. Rome IV – Functional GI disorders: disorders of Gut-Brain interaction. Gastroenterology 2016; 150 (6): 1262–79.
19. Вялов С.С. Особенности диагностики и лечения функциональных нарушений желудочно-кишечного тракта. Справочник поликлинического врача. 2012; 8: 54–9. / Vialov S.S. Osobennosti diagnostiki i lecheniia funktsional'nykh narushenii zheludochno-kishechnogo trakta. Handbook for Practitioners Doctors. 2012; 8: 54–9. [in Russian]
20. Arakawa T, Higuchi K, Fujiwara Y et al. 15th anniversary of rebamipide: looking ahead to the new mechanisms and new applications. Dig Dis Sci 2005; 50 (Suppl. 1.): S3–S11.
21. Zhang S, Qing Q, Bai Y et al. Rebamipide helps defend against nonsteroidal anti-inflammatory drugs induced gastroenteropathy: a systematic review and meta-analysis. Dig Dis Sci 2013; 58 (7): 1991–2000.
22. Han X, Jiang K, Wang B et al. Effect of Rebamipide on the Premalignant Progression of Chronic Gastritis: A Randomized Controlled Study. Clin Drug Investig 2015; 35 (10): 665–73. DOI: 10.1007/s40261-015-0329-z.
23. Kamada T, Sato M, Tokutomi T et al. Rebamipide improves chronic inflammation in the lesser curvature of the corpus after Helicobacter pylori eradication: a multicenter study. Biomed Res Int 2015; 2015: 865146. DOI: 10.1155/2015/865146.
24. Nishizawa T, Nishizawa Y, Yahagi N et al. Effect of supplementation with rebamipide for Helicobacter pylori eradication therapy: a systematic review and meta-analysis. J Gastroenterol Hepatol 2014; 29 (Suppl. 4): 20–4. DOI: 10.1111/jgh.12769.
25. Лапина Т.Л., Ивашкин В.Т. Современные подходы к лечению язвенной болезни желудка и двенадцатиперстной кишки. Болезни органов пищеварения. 2001; 3 (1): 10–5. / Lapina T.L., Ivashkin V.T. Sovremennye podkhody k lecheniiu iazvennoi bolezni zheludka i dvenadtsatiperstnoi kishki. Bolezni organov pishchevareniia. 2001; 3 (1): 10–5. [in Russian]
26. Terano A, Arakawa T, Sugiyama T et al. Rebamipide, a gastro-protective and anti-inflammatory drug, promotes gastric ulcer healing following eradication therapy for Helicobacter pylori in a Japanese population: a randomized, double-blind, placebo-controlled trial. J Gastroenterol 2007; 42 (8): 690–3.
2. Wyatt JI, Dixon MF. Chronic gastritis – a pathogenetic approach. J Pathol 1988; 154: 113.
3. Rugge M, Meggio A, Pennelli G et al. Gastritis staging in clinical practice: the OLGA staging system. Gut 2007; 56: 631.
4. Vialov S.S. Kompleksnaia terapiia retsidiviruiushchikh gastroduodenitov. Ratsional'naia farmakoterapiia v gastroenterologii. Materialy XII konferentsii. M., 2012; s. 4–5. [in Russian]
5. Jönsson KA, Gotthard R, Bodemar G, Brodin U. The clinical relevance of endoscopic and histologic inflammation of gastroduodenal mucosa in dyspepsia of unknown origin. Scand J Gastroenterol 1989; 24: 385.
6. Elta GH, Appelman HD, Behler EM et al. A study of the correlation between endoscopic and histological diagnoses in gastroduodenitis. Am J Gastroenterol 1987; 82: 749.
7. Tytgat GN. The Sydney System: endoscopic division. Endoscopic appearances in gastritis/duodenitis. J Gastroenterol Hepatol 1991; 6: 223.
8. Miki K, Urita Y. Using serum pepsinogens wisely in a clinical practice. J Dig Dis 2007; 8: 8.
9. Urita Y, Hike K, Torii N et al. Serum pepsinogens as a predicator of the topography of intestinal metaplasia in patients with atrophic gastritis. Dig Dis Sci 2004; 49: 795.
10. Ricci C, Vakil N, Rugge M et al. Serological markers for gastric atrophy in asymptomatic patients infected with Helicobacter pylori. Am J Gastroenterol 2004; 99: 1910.
11. Haj-Sheykholeslami A, Rakhshani N, Amirzargar A et al. Serum pepsinogen I, pepsinogen II, and gastrin 17 in relatives of gastric cancer patients: comparative study with type and severity of gastritis. Clin Gastroenterol Hepatol 2008; 6: 174.
12. Vialov S.S. Iazvennaia bolezn' i Maastrikht-4: vnedrenie v klinicheskuiu praktiku. Effektivnaia farmakoterapiia v gastroenterologii. 2012; 6: 16–22. [in Russian]
13. Vialov S.S. Etiologiia gastritov i vosstanovlenie slizistoi obolochki verkhnikh otdelov ZhKT. Doktor.ru. 2014; 3 (91): 70–7. [in Russian]
14. Howden CW, Hunt RH. The relationship between suppression of acidity and gastric ulcer healing rates. Aliment Pharmacol Ther 1990; 4: 25.
15. Talley NJ. AGA medical position statement: evaluation of dyspepsia. Gastroenterology 2005; 129: 1753.
16. Instruktsiia k meditsinskomu primeneniiu preparata Metoklopramid. [in Russian]
17. Veldhuyzen van Zanten SJ, Jones MJ, Verlinden M, Talley NJ. Efficacy of cisapride and domperidone in functional (nonulcer) dyspepsia: a meta-analysis. Am J Gastroenterol 2001; 96: 689.
18. Drossman DA, Hasler WL. Rome IV – Functional GI disorders: disorders of Gut-Brain interaction. Gastroenterology 2016; 150 (6): 1262–79.
19. Vialov S.S. Osobennosti diagnostiki i lecheniia funktsional'nykh narushenii zheludochno-kishechnogo trakta. Handbook for Practitioners Doctors. 2012; 8: 54–9. [in Russian]
20. Arakawa T, Higuchi K, Fujiwara Y et al. 15th anniversary of rebamipide: looking ahead to the new mechanisms and new applications. Dig Dis Sci 2005; 50 (Suppl. 1.): S3–S11.
21. Zhang S, Qing Q, Bai Y et al. Rebamipide helps defend against nonsteroidal anti-inflammatory drugs induced gastroenteropathy: a systematic review and meta-analysis. Dig Dis Sci 2013; 58 (7): 1991–2000.
22. Han X, Jiang K, Wang B et al. Effect of Rebamipide on the Premalignant Progression of Chronic Gastritis: A Randomized Controlled Study. Clin Drug Investig 2015; 35 (10): 665–73. DOI: 10.1007/s40261-015-0329-z.
23. Kamada T, Sato M, Tokutomi T et al. Rebamipide improves chronic inflammation in the lesser curvature of the corpus after Helicobacter pylori eradication: a multicenter study. Biomed Res Int 2015; 2015: 865146. DOI: 10.1155/2015/865146.
24. Nishizawa T, Nishizawa Y, Yahagi N et al. Effect of supplementation with rebamipide for Helicobacter pylori eradication therapy: a systematic review and meta-analysis. J Gastroenterol Hepatol 2014; 29 (Suppl. 4): 20–4. DOI: 10.1111/jgh.12769.
25. Lapina T.L., Ivashkin V.T. Sovremennye podkhody k lecheniiu iazvennoi bolezni zheludka i dvenadtsatiperstnoi kishki. Bolezni organov pishchevareniia. 2001; 3 (1): 10–5. [in Russian]
26. Terano A, Arakawa T, Sugiyama T et al. Rebamipide, a gastro-protective and anti-inflammatory drug, promotes gastric ulcer healing following eradication therapy for Helicobacter pylori in a Japanese population: a randomized, double-blind, placebo-controlled trial. J Gastroenterol 2007; 42 (8): 690–3.
2. Wyatt JI, Dixon MF. Chronic gastritis – a pathogenetic approach. J Pathol 1988; 154: 113.
3. Rugge M, Meggio A, Pennelli G et al. Gastritis staging in clinical practice: the OLGA staging system. Gut 2007; 56: 631.
4. Вялов С.С. Комплексная терапия рецидивирующих гастродуоденитов. Рациональная фармакотерапия в гастроэнтерологии. Материалы XII конференции. М., 2012; с. 4–5. / Vialov S.S. Kompleksnaia terapiia retsidiviruiushchikh gastroduodenitov. Ratsional'naia farmakoterapiia v gastroenterologii. Materialy XII konferentsii. M., 2012; s. 4–5. [in Russian]
5. Jönsson KA, Gotthard R, Bodemar G, Brodin U. The clinical relevance of endoscopic and histologic inflammation of gastroduodenal mucosa in dyspepsia of unknown origin. Scand J Gastroenterol 1989; 24: 385.
6. Elta GH, Appelman HD, Behler EM et al. A study of the correlation between endoscopic and histological diagnoses in gastroduodenitis. Am J Gastroenterol 1987; 82: 749.
7. Tytgat GN. The Sydney System: endoscopic division. Endoscopic appearances in gastritis/duodenitis. J Gastroenterol Hepatol 1991; 6: 223.
8. Miki K, Urita Y. Using serum pepsinogens wisely in a clinical practice. J Dig Dis 2007; 8: 8.
9. Urita Y, Hike K, Torii N et al. Serum pepsinogens as a predicator of the topography of intestinal metaplasia in patients with atrophic gastritis. Dig Dis Sci 2004; 49: 795.
10. Ricci C, Vakil N, Rugge M et al. Serological markers for gastric atrophy in asymptomatic patients infected with Helicobacter pylori. Am J Gastroenterol 2004; 99: 1910.
11. Haj-Sheykholeslami A, Rakhshani N, Amirzargar A et al. Serum pepsinogen I, pepsinogen II, and gastrin 17 in relatives of gastric cancer patients: comparative study with type and severity of gastritis. Clin Gastroenterol Hepatol 2008; 6: 174.
12. Вялов С.С. Язвенная болезнь и Маастрихт-4: внедрение в клиническую практику. Эффективная фармакотерапия в гастроэнтерологии. 2012; 6: 16–22. / Vialov S.S. Iazvennaia bolezn' i Maastrikht-4: vnedrenie v klinicheskuiu praktiku. Effektivnaia farmakoterapiia v gastroenterologii. 2012; 6: 16–22. [in Russian]
13. Вялов С.С. Этиология гастритов и восстановление слизистой оболочки верхних отделов ЖКТ. Доктор.ру. 2014; 3 (91): 70–7. / Vialov S.S. Etiologiia gastritov i vosstanovlenie slizistoi obolochki verkhnikh otdelov ZhKT. Doktor.ru. 2014; 3 (91): 70–7. [in Russian]
14. Howden CW, Hunt RH. The relationship between suppression of acidity and gastric ulcer healing rates. Aliment Pharmacol Ther 1990; 4: 25.
15. Talley NJ. AGA medical position statement: evaluation of dyspepsia. Gastroenterology 2005; 129: 1753.
16. Инструкция к медицинскому применению препарата Метоклопрамид. / Instruktsiia k meditsinskomu primeneniiu preparata Metoklopramid. [in Russian]
17. Veldhuyzen van Zanten SJ, Jones MJ, Verlinden M, Talley NJ. Efficacy of cisapride and domperidone in functional (nonulcer) dyspepsia: a meta-analysis. Am J Gastroenterol 2001; 96: 689.
18. Drossman DA, Hasler WL. Rome IV – Functional GI disorders: disorders of Gut-Brain interaction. Gastroenterology 2016; 150 (6): 1262–79.
19. Вялов С.С. Особенности диагностики и лечения функциональных нарушений желудочно-кишечного тракта. Справочник поликлинического врача. 2012; 8: 54–9. / Vialov S.S. Osobennosti diagnostiki i lecheniia funktsional'nykh narushenii zheludochno-kishechnogo trakta. Handbook for Practitioners Doctors. 2012; 8: 54–9. [in Russian]
20. Arakawa T, Higuchi K, Fujiwara Y et al. 15th anniversary of rebamipide: looking ahead to the new mechanisms and new applications. Dig Dis Sci 2005; 50 (Suppl. 1.): S3–S11.
21. Zhang S, Qing Q, Bai Y et al. Rebamipide helps defend against nonsteroidal anti-inflammatory drugs induced gastroenteropathy: a systematic review and meta-analysis. Dig Dis Sci 2013; 58 (7): 1991–2000.
22. Han X, Jiang K, Wang B et al. Effect of Rebamipide on the Premalignant Progression of Chronic Gastritis: A Randomized Controlled Study. Clin Drug Investig 2015; 35 (10): 665–73. DOI: 10.1007/s40261-015-0329-z.
23. Kamada T, Sato M, Tokutomi T et al. Rebamipide improves chronic inflammation in the lesser curvature of the corpus after Helicobacter pylori eradication: a multicenter study. Biomed Res Int 2015; 2015: 865146. DOI: 10.1155/2015/865146.
24. Nishizawa T, Nishizawa Y, Yahagi N et al. Effect of supplementation with rebamipide for Helicobacter pylori eradication therapy: a systematic review and meta-analysis. J Gastroenterol Hepatol 2014; 29 (Suppl. 4): 20–4. DOI: 10.1111/jgh.12769.
25. Лапина Т.Л., Ивашкин В.Т. Современные подходы к лечению язвенной болезни желудка и двенадцатиперстной кишки. Болезни органов пищеварения. 2001; 3 (1): 10–5. / Lapina T.L., Ivashkin V.T. Sovremennye podkhody k lecheniiu iazvennoi bolezni zheludka i dvenadtsatiperstnoi kishki. Bolezni organov pishchevareniia. 2001; 3 (1): 10–5. [in Russian]
26. Terano A, Arakawa T, Sugiyama T et al. Rebamipide, a gastro-protective and anti-inflammatory drug, promotes gastric ulcer healing following eradication therapy for Helicobacter pylori in a Japanese population: a randomized, double-blind, placebo-controlled trial. J Gastroenterol 2007; 42 (8): 690–3.
________________________________________________
2. Wyatt JI, Dixon MF. Chronic gastritis – a pathogenetic approach. J Pathol 1988; 154: 113.
3. Rugge M, Meggio A, Pennelli G et al. Gastritis staging in clinical practice: the OLGA staging system. Gut 2007; 56: 631.
4. Vialov S.S. Kompleksnaia terapiia retsidiviruiushchikh gastroduodenitov. Ratsional'naia farmakoterapiia v gastroenterologii. Materialy XII konferentsii. M., 2012; s. 4–5. [in Russian]
5. Jönsson KA, Gotthard R, Bodemar G, Brodin U. The clinical relevance of endoscopic and histologic inflammation of gastroduodenal mucosa in dyspepsia of unknown origin. Scand J Gastroenterol 1989; 24: 385.
6. Elta GH, Appelman HD, Behler EM et al. A study of the correlation between endoscopic and histological diagnoses in gastroduodenitis. Am J Gastroenterol 1987; 82: 749.
7. Tytgat GN. The Sydney System: endoscopic division. Endoscopic appearances in gastritis/duodenitis. J Gastroenterol Hepatol 1991; 6: 223.
8. Miki K, Urita Y. Using serum pepsinogens wisely in a clinical practice. J Dig Dis 2007; 8: 8.
9. Urita Y, Hike K, Torii N et al. Serum pepsinogens as a predicator of the topography of intestinal metaplasia in patients with atrophic gastritis. Dig Dis Sci 2004; 49: 795.
10. Ricci C, Vakil N, Rugge M et al. Serological markers for gastric atrophy in asymptomatic patients infected with Helicobacter pylori. Am J Gastroenterol 2004; 99: 1910.
11. Haj-Sheykholeslami A, Rakhshani N, Amirzargar A et al. Serum pepsinogen I, pepsinogen II, and gastrin 17 in relatives of gastric cancer patients: comparative study with type and severity of gastritis. Clin Gastroenterol Hepatol 2008; 6: 174.
12. Vialov S.S. Iazvennaia bolezn' i Maastrikht-4: vnedrenie v klinicheskuiu praktiku. Effektivnaia farmakoterapiia v gastroenterologii. 2012; 6: 16–22. [in Russian]
13. Vialov S.S. Etiologiia gastritov i vosstanovlenie slizistoi obolochki verkhnikh otdelov ZhKT. Doktor.ru. 2014; 3 (91): 70–7. [in Russian]
14. Howden CW, Hunt RH. The relationship between suppression of acidity and gastric ulcer healing rates. Aliment Pharmacol Ther 1990; 4: 25.
15. Talley NJ. AGA medical position statement: evaluation of dyspepsia. Gastroenterology 2005; 129: 1753.
16. Instruktsiia k meditsinskomu primeneniiu preparata Metoklopramid. [in Russian]
17. Veldhuyzen van Zanten SJ, Jones MJ, Verlinden M, Talley NJ. Efficacy of cisapride and domperidone in functional (nonulcer) dyspepsia: a meta-analysis. Am J Gastroenterol 2001; 96: 689.
18. Drossman DA, Hasler WL. Rome IV – Functional GI disorders: disorders of Gut-Brain interaction. Gastroenterology 2016; 150 (6): 1262–79.
19. Vialov S.S. Osobennosti diagnostiki i lecheniia funktsional'nykh narushenii zheludochno-kishechnogo trakta. Handbook for Practitioners Doctors. 2012; 8: 54–9. [in Russian]
20. Arakawa T, Higuchi K, Fujiwara Y et al. 15th anniversary of rebamipide: looking ahead to the new mechanisms and new applications. Dig Dis Sci 2005; 50 (Suppl. 1.): S3–S11.
21. Zhang S, Qing Q, Bai Y et al. Rebamipide helps defend against nonsteroidal anti-inflammatory drugs induced gastroenteropathy: a systematic review and meta-analysis. Dig Dis Sci 2013; 58 (7): 1991–2000.
22. Han X, Jiang K, Wang B et al. Effect of Rebamipide on the Premalignant Progression of Chronic Gastritis: A Randomized Controlled Study. Clin Drug Investig 2015; 35 (10): 665–73. DOI: 10.1007/s40261-015-0329-z.
23. Kamada T, Sato M, Tokutomi T et al. Rebamipide improves chronic inflammation in the lesser curvature of the corpus after Helicobacter pylori eradication: a multicenter study. Biomed Res Int 2015; 2015: 865146. DOI: 10.1155/2015/865146.
24. Nishizawa T, Nishizawa Y, Yahagi N et al. Effect of supplementation with rebamipide for Helicobacter pylori eradication therapy: a systematic review and meta-analysis. J Gastroenterol Hepatol 2014; 29 (Suppl. 4): 20–4. DOI: 10.1111/jgh.12769.
25. Lapina T.L., Ivashkin V.T. Sovremennye podkhody k lecheniiu iazvennoi bolezni zheludka i dvenadtsatiperstnoi kishki. Bolezni organov pishchevareniia. 2001; 3 (1): 10–5. [in Russian]
26. Terano A, Arakawa T, Sugiyama T et al. Rebamipide, a gastro-protective and anti-inflammatory drug, promotes gastric ulcer healing following eradication therapy for Helicobacter pylori in a Japanese population: a randomized, double-blind, placebo-controlled trial. J Gastroenterol 2007; 42 (8): 690–3.
Авторы
С.С.Вялов
ФГАОУ ВО «Российский университет дружбы народов». 117198, Россия, Москва, ул. Миклухо-Маклая, д. 6
svialov@mail.ru
People’s Friendship University of Russia. 117198, Russian Federation, Moscow, ul. Miklukho-Maklaia, d. 6
svialov@mail.ru
ФГАОУ ВО «Российский университет дружбы народов». 117198, Россия, Москва, ул. Миклухо-Маклая, д. 6
svialov@mail.ru
________________________________________________
People’s Friendship University of Russia. 117198, Russian Federation, Moscow, ul. Miklukho-Maklaia, d. 6
svialov@mail.ru
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.