Материалы доступны только для специалистов сферы здравоохранения.
Чтобы посмотреть материал полностью
Авторизуйтесь
или зарегистрируйтесь.
Тактика дифференциального диагноза и лечения недифференцированного колита, синдрома раздраженного кишечника и воспалительных заболеваний кишечника - Справочник поликлинического врача №4 (2018)
Тактика дифференциального диагноза и лечения недифференцированного колита, синдрома раздраженного кишечника и воспалительных заболеваний кишечника
Вялов С.С. Тактика дифференциального диагноза и лечения недифференцированного колита, синдрома раздраженного кишечника и воспалительных заболеваний кишечника. Справочник поликлинического врача. 2018; 4: 29-36
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения.
Чтобы посмотреть материал полностью
Авторизуйтесь
или зарегистрируйтесь.
Аннотация
В статье приведены результаты исследования оптимальной диагностической тактики при подозрении воспалительного процесса в кишке и дифференциальный диагноз колитов. Проведен анализ естественного течения воспалительных заболеваний кишечника, а также влияния терапии на прогноз заболевания. Обсуждается прогрессирование раздражения кишечника до неспецифических воспалительных изменениaй с потенциалом перехода в специфическое воспаление. Приводятся результаты исследования применения месалазина при воспалительных заболевания кишечника, а также недифференцированных колитах.
Ключевые слова: колит, недифференцированный колит, недифференцируемый колит, болезнь Крона, язвенный колит, месалазин.
Key words: colitis, indeterminate colitis, undifferentiated colitis, Crohn's disease, ulcerative colitis, mesalazine.
Ключевые слова: колит, недифференцированный колит, недифференцируемый колит, болезнь Крона, язвенный колит, месалазин.
________________________________________________
Key words: colitis, indeterminate colitis, undifferentiated colitis, Crohn's disease, ulcerative colitis, mesalazine.
Полный текст
Список литературы
1. Вялов С.С. «Кишечный экспресс»: диагностика и лечение болезней печени в общей практике. Справочник поликлинического врача. 2018; 2: 36–48. / Vyalov S.S. "Hepatic express": diagnosis and treatment of liver diseases in general practice. Handbook for Practitioners Doctors. 2018; 1: 44–50. [in Russian]
2. Sutton E, Bellini G, Lee D et al. Whelan Colorectal cancer rate rising among younger people. Sci News 2016.
3. Schiller LR. Chronic diarrhea. Gastroenterology 2004; 127: 287.
4. Mearin F, Lacy BE, Chang L et al. Bowel Disorders. Gastroenterology 2016; 150 (6): 1393–407.
5. Hahn BA, Saunders WB, Maier WC. Differences between individuals with self-reported irritable bowel syndrome (IBS) and IBS-like symptoms. Dig Dis Sci 1997; 42: 2585.
6. Beattie RM, Walker-Smith JA, Murch SH. Indications for investigation of chronic gastrointestinal symptoms. Arch Dis Child 1995; 73: 354.
7. Mowat C, Cole A, Windsor A et al. Guidelines for the management of inflammatory bowel disease in adults. Gut 2011; 60: 571.
8. ASGE Standards of Practice Committee, Shen B, Khan K et al. The role of endoscopy in the management of patients with diarrhea. Gastrointest Endosc 2010; 71: 887.
9. Mosli MH, Zou G, Garg SK et al. C-Reactive Protein, Fecal Calprotectin, and Stool Lactoferrin for Detection of Endoscopic Activity in Symptomatic Inflammatory Bowel Disease Patients: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2015; 110: 802.
10. Poullis A, Foster R, Mendall MA, Fagerhol MK. Emerging role of calprotectin in gastroenterology. J Gastroenterol Hepatol 2003; 18: 756.
11. Burgmann T, Clara I, Graff L et al. The Manitoba Inflammatory Bowel Disease Cohort Study: prolonged symptoms before diagnosis – how much is irritable bowel syndrome? Clin Gastroenterol Hepatol 2006; 4: 614.
12. Safroneeva E, Vavricka S, Fournier N et al. Systematic analysis of factors associated with progression and regression of ulcerative colitis in 918 patients. Aliment Pharmacol Ther 2015; 42: 540–8.
13. Ивашкин В.Т., Шелыгин Ю.А., Халиф И.Л., Белоусова Е.А. и др. Клинические рекомендации Российской Гастроэнтерологической Ассоциации и Ассоциации Колопроктологов России по диагностике и лечению язвенного колита. Колопроктология. 2017; 1 (59). / Ivashkin V.T., Shelygin Iu.A., Khalif I.L., Belousova E.A. i dr. Klinicheskie rekomendatsii Rossiiskoi Gastroenterologicheskoi Assotsiatsii i Assotsiatsii Koloproktologov Rossii po diagnostike i lecheniiu iazvennogo kolita. Koloproktologiia. 2017; 1 (59). [in Russian]
14. Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease; Eighth Nineth Ed. Philadelphia: Saunders Elsevier, 2010: 1975–2013.
15. Desreumaux P, Ghosh S. Review article: mode of action and delivery of 5-aminosalicylic acid new evidence. Aliment Pharmacol Ther 2006; 24 (Suppl. 1): 2–9.
16. Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis, 28 January 2017.
17. Brunner M et al. Gastrointestinal transit and 5-ASA release from a new mesalazine extended-release formulation. Aliment Pharmacol Ther 2003; 17: 395–402.
18. Tenjarla S et al. Release of 5-aminosalicylate from an MMXR mesalamine tablet during transit through a simulated gastrointestinal tract system. Adv Ther 2007; 24 (4): 826–40.
19. D’Haens G. et al. Once daily MMXR mesalazine for the treatment of mild-to-moderate ulcerative colitis: a phase II, dose-ranging study. Aliment Pharmacol Ther 2006; 24: 1087–97.
20. Lichtenstein GR et al. Effect of once- or twice-daily MMXR mesalamine (SPD476) for the induction of remission of mild-to-moderately active ulcerative colitis. Clin Gastroenterol Hepatol 2007; 5: 95–102.
21. Kamm MA et al. Once-daily, high-concentration MMXR mesalamine in active ulcerative colitis. Gastroenterology 2007; 132: 66–75.
22. Kamm MA et al. Randomised trial of once- or twice-daily MMXR mesalazine for maintenance of remission in ulcerative colitis. Gut 2008; 57: 893–902.
23. Kamm MA et al. Effect of extended MMXR mesalamine therapy for acute, mild-to-moderate ulcerative colitis. Inflamm Bowel Dis 2009; 15 (1): 1–8.
24. D’Haens G, Sandborn WJ, Barrett K et al. Once-Daily MMXR mesalamine for Endoscopic Maintenance of Remission of Ulcerative Colitis. Am J Gastroenterol 2012; 107 (7): 1064–77.
25. Kane S, Katz S, Jamal MM et al. Strategies in maintenance for patients receiving long-term therapy (SIMPLE): A study of MMXR mesalamine for the long-term maintenance of quiescent ulcerative colitis. Inflamm Bowel Dis 2012; 18: 1026–33.
26. D’Haens G, Inglis S, Magee E et al. Remission status and maintenance therapy outcomes in patients with mild-to-moderate ulcerative colitis (UC): Results from the MOMENTUM study. J Crohn’s Colitis 2014; 8 (1): S217 (abstract P365).
27. Шапина М.В., Халиф И.Л. Применение препаратов 5-аминосалициловой кислоты для лечения язвенного колита в различных режимах дозирования. Мед. совет. 2015; 15: 44–50. / Shapina M.V., Khalif I.L. Primenenie preparatov 5-aminosalitsilovoi kisloty dlia lecheniia iazvennogo kolita v razlichnykh rezhimakh dozirovaniia. Med. sovet. 2015; 15: 44–50. [in Russian]
2. Sutton E, Bellini G, Lee D et al. Whelan Colorectal cancer rate rising among younger people. Sci News 2016.
3. Schiller LR. Chronic diarrhea. Gastroenterology 2004; 127: 287.
4. Mearin F, Lacy BE, Chang L et al. Bowel Disorders. Gastroenterology 2016; 150 (6): 1393–407.
5. Hahn BA, Saunders WB, Maier WC. Differences between individuals with self-reported irritable bowel syndrome (IBS) and IBS-like symptoms. Dig Dis Sci 1997; 42: 2585.
6. Beattie RM, Walker-Smith JA, Murch SH. Indications for investigation of chronic gastrointestinal symptoms. Arch Dis Child 1995; 73: 354.
7. Mowat C, Cole A, Windsor A et al. Guidelines for the management of inflammatory bowel disease in adults. Gut 2011; 60: 571.
8. ASGE Standards of Practice Committee, Shen B, Khan K et al. The role of endoscopy in the management of patients with diarrhea. Gastrointest Endosc 2010; 71: 887.
9. Mosli MH, Zou G, Garg SK et al. C-Reactive Protein, Fecal Calprotectin, and Stool Lactoferrin for Detection of Endoscopic Activity in Symptomatic Inflammatory Bowel Disease Patients: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2015; 110: 802.
10. Poullis A, Foster R, Mendall MA, Fagerhol MK. Emerging role of calprotectin in gastroenterology. J Gastroenterol Hepatol 2003; 18: 756.
11. Burgmann T, Clara I, Graff L et al. The Manitoba Inflammatory Bowel Disease Cohort Study: prolonged symptoms before diagnosis – how much is irritable bowel syndrome? Clin Gastroenterol Hepatol 2006; 4: 614.
12. Safroneeva E, Vavricka S, Fournier N et al. Systematic analysis of factors associated with progression and regression of ulcerative colitis in 918 patients. Aliment Pharmacol Ther 2015; 42: 540–8.
13. Ivashkin V.T., Shelygin Iu.A., Khalif I.L., Belousova E.A. i dr. Klinicheskie rekomendatsii Rossiiskoi Gastroenterologicheskoi Assotsiatsii i Assotsiatsii Koloproktologov Rossii po diagnostike i lecheniiu iazvennogo kolita. Koloproktologiia. 2017; 1 (59). [in Russian]
14. Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease; Eighth Nineth Ed. Philadelphia: Saunders Elsevier, 2010: 1975–2013.
15. Desreumaux P, Ghosh S. Review article: mode of action and delivery of 5-aminosalicylic acid new evidence. Aliment Pharmacol Ther 2006; 24 (Suppl. 1): 2–9.
16. Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis, 28 January 2017.
17. Brunner M et al. Gastrointestinal transit and 5-ASA release from a new mesalazine extended-release formulation. Aliment Pharmacol Ther 2003; 17: 395–402.
18. Tenjarla S et al. Release of 5-aminosalicylate from an MMXR mesalamine tablet during transit through a simulated gastrointestinal tract system. Adv Ther 2007; 24 (4): 826–40.
19. D’Haens G. et al. Once daily MMXR mesalazine for the treatment of mild-to-moderate ulcerative colitis: a phase II, dose-ranging study. Aliment Pharmacol Ther 2006; 24: 1087–97.
20. Lichtenstein GR et al. Effect of once- or twice-daily MMXR mesalamine (SPD476) for the induction of remission of mild-to-moderately active ulcerative colitis. Clin Gastroenterol Hepatol 2007; 5: 95–102.
21. Kamm MA et al. Once-daily, high-concentration MMXR mesalamine in active ulcerative colitis. Gastroenterology 2007; 132: 66–75.
22. Kamm MA et al. Randomised trial of once- or twice-daily MMXR mesalazine for maintenance of remission in ulcerative colitis. Gut 2008; 57: 893–902.
23. Kamm MA et al. Effect of extended MMXR mesalamine therapy for acute, mild-to-moderate ulcerative colitis. Inflamm Bowel Dis 2009; 15 (1): 1–8.
24. D’Haens G, Sandborn WJ, Barrett K et al. Once-Daily MMXR mesalamine for Endoscopic Maintenance of Remission of Ulcerative Colitis. Am J Gastroenterol 2012; 107 (7): 1064–77.
25. Kane S, Katz S, Jamal MM et al. Strategies in maintenance for patients receiving long-term therapy (SIMPLE): A study of MMXR mesalamine for the long-term maintenance of quiescent ulcerative colitis. Inflamm Bowel Dis 2012; 18: 1026–33.
26. D’Haens G, Inglis S, Magee E et al. Remission status and maintenance therapy outcomes in patients with mild-to-moderate ulcerative colitis (UC): Results from the MOMENTUM study. J Crohn’s Colitis 2014; 8 (1): S217 (abstract P365).
27. Shapina M.V., Khalif I.L. Primenenie preparatov 5-aminosalitsilovoi kisloty dlia lecheniia iazvennogo kolita v razlichnykh rezhimakh dozirovaniia. Med. sovet. 2015; 15: 44–50. [in Russian]
2. Sutton E, Bellini G, Lee D et al. Whelan Colorectal cancer rate rising among younger people. Sci News 2016.
3. Schiller LR. Chronic diarrhea. Gastroenterology 2004; 127: 287.
4. Mearin F, Lacy BE, Chang L et al. Bowel Disorders. Gastroenterology 2016; 150 (6): 1393–407.
5. Hahn BA, Saunders WB, Maier WC. Differences between individuals with self-reported irritable bowel syndrome (IBS) and IBS-like symptoms. Dig Dis Sci 1997; 42: 2585.
6. Beattie RM, Walker-Smith JA, Murch SH. Indications for investigation of chronic gastrointestinal symptoms. Arch Dis Child 1995; 73: 354.
7. Mowat C, Cole A, Windsor A et al. Guidelines for the management of inflammatory bowel disease in adults. Gut 2011; 60: 571.
8. ASGE Standards of Practice Committee, Shen B, Khan K et al. The role of endoscopy in the management of patients with diarrhea. Gastrointest Endosc 2010; 71: 887.
9. Mosli MH, Zou G, Garg SK et al. C-Reactive Protein, Fecal Calprotectin, and Stool Lactoferrin for Detection of Endoscopic Activity in Symptomatic Inflammatory Bowel Disease Patients: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2015; 110: 802.
10. Poullis A, Foster R, Mendall MA, Fagerhol MK. Emerging role of calprotectin in gastroenterology. J Gastroenterol Hepatol 2003; 18: 756.
11. Burgmann T, Clara I, Graff L et al. The Manitoba Inflammatory Bowel Disease Cohort Study: prolonged symptoms before diagnosis – how much is irritable bowel syndrome? Clin Gastroenterol Hepatol 2006; 4: 614.
12. Safroneeva E, Vavricka S, Fournier N et al. Systematic analysis of factors associated with progression and regression of ulcerative colitis in 918 patients. Aliment Pharmacol Ther 2015; 42: 540–8.
13. Ивашкин В.Т., Шелыгин Ю.А., Халиф И.Л., Белоусова Е.А. и др. Клинические рекомендации Российской Гастроэнтерологической Ассоциации и Ассоциации Колопроктологов России по диагностике и лечению язвенного колита. Колопроктология. 2017; 1 (59). / Ivashkin V.T., Shelygin Iu.A., Khalif I.L., Belousova E.A. i dr. Klinicheskie rekomendatsii Rossiiskoi Gastroenterologicheskoi Assotsiatsii i Assotsiatsii Koloproktologov Rossii po diagnostike i lecheniiu iazvennogo kolita. Koloproktologiia. 2017; 1 (59). [in Russian]
14. Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease; Eighth Nineth Ed. Philadelphia: Saunders Elsevier, 2010: 1975–2013.
15. Desreumaux P, Ghosh S. Review article: mode of action and delivery of 5-aminosalicylic acid new evidence. Aliment Pharmacol Ther 2006; 24 (Suppl. 1): 2–9.
16. Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis, 28 January 2017.
17. Brunner M et al. Gastrointestinal transit and 5-ASA release from a new mesalazine extended-release formulation. Aliment Pharmacol Ther 2003; 17: 395–402.
18. Tenjarla S et al. Release of 5-aminosalicylate from an MMXR mesalamine tablet during transit through a simulated gastrointestinal tract system. Adv Ther 2007; 24 (4): 826–40.
19. D’Haens G. et al. Once daily MMXR mesalazine for the treatment of mild-to-moderate ulcerative colitis: a phase II, dose-ranging study. Aliment Pharmacol Ther 2006; 24: 1087–97.
20. Lichtenstein GR et al. Effect of once- or twice-daily MMXR mesalamine (SPD476) for the induction of remission of mild-to-moderately active ulcerative colitis. Clin Gastroenterol Hepatol 2007; 5: 95–102.
21. Kamm MA et al. Once-daily, high-concentration MMXR mesalamine in active ulcerative colitis. Gastroenterology 2007; 132: 66–75.
22. Kamm MA et al. Randomised trial of once- or twice-daily MMXR mesalazine for maintenance of remission in ulcerative colitis. Gut 2008; 57: 893–902.
23. Kamm MA et al. Effect of extended MMXR mesalamine therapy for acute, mild-to-moderate ulcerative colitis. Inflamm Bowel Dis 2009; 15 (1): 1–8.
24. D’Haens G, Sandborn WJ, Barrett K et al. Once-Daily MMXR mesalamine for Endoscopic Maintenance of Remission of Ulcerative Colitis. Am J Gastroenterol 2012; 107 (7): 1064–77.
25. Kane S, Katz S, Jamal MM et al. Strategies in maintenance for patients receiving long-term therapy (SIMPLE): A study of MMXR mesalamine for the long-term maintenance of quiescent ulcerative colitis. Inflamm Bowel Dis 2012; 18: 1026–33.
26. D’Haens G, Inglis S, Magee E et al. Remission status and maintenance therapy outcomes in patients with mild-to-moderate ulcerative colitis (UC): Results from the MOMENTUM study. J Crohn’s Colitis 2014; 8 (1): S217 (abstract P365).
27. Шапина М.В., Халиф И.Л. Применение препаратов 5-аминосалициловой кислоты для лечения язвенного колита в различных режимах дозирования. Мед. совет. 2015; 15: 44–50. / Shapina M.V., Khalif I.L. Primenenie preparatov 5-aminosalitsilovoi kisloty dlia lecheniia iazvennogo kolita v razlichnykh rezhimakh dozirovaniia. Med. sovet. 2015; 15: 44–50. [in Russian]
________________________________________________
2. Sutton E, Bellini G, Lee D et al. Whelan Colorectal cancer rate rising among younger people. Sci News 2016.
3. Schiller LR. Chronic diarrhea. Gastroenterology 2004; 127: 287.
4. Mearin F, Lacy BE, Chang L et al. Bowel Disorders. Gastroenterology 2016; 150 (6): 1393–407.
5. Hahn BA, Saunders WB, Maier WC. Differences between individuals with self-reported irritable bowel syndrome (IBS) and IBS-like symptoms. Dig Dis Sci 1997; 42: 2585.
6. Beattie RM, Walker-Smith JA, Murch SH. Indications for investigation of chronic gastrointestinal symptoms. Arch Dis Child 1995; 73: 354.
7. Mowat C, Cole A, Windsor A et al. Guidelines for the management of inflammatory bowel disease in adults. Gut 2011; 60: 571.
8. ASGE Standards of Practice Committee, Shen B, Khan K et al. The role of endoscopy in the management of patients with diarrhea. Gastrointest Endosc 2010; 71: 887.
9. Mosli MH, Zou G, Garg SK et al. C-Reactive Protein, Fecal Calprotectin, and Stool Lactoferrin for Detection of Endoscopic Activity in Symptomatic Inflammatory Bowel Disease Patients: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2015; 110: 802.
10. Poullis A, Foster R, Mendall MA, Fagerhol MK. Emerging role of calprotectin in gastroenterology. J Gastroenterol Hepatol 2003; 18: 756.
11. Burgmann T, Clara I, Graff L et al. The Manitoba Inflammatory Bowel Disease Cohort Study: prolonged symptoms before diagnosis – how much is irritable bowel syndrome? Clin Gastroenterol Hepatol 2006; 4: 614.
12. Safroneeva E, Vavricka S, Fournier N et al. Systematic analysis of factors associated with progression and regression of ulcerative colitis in 918 patients. Aliment Pharmacol Ther 2015; 42: 540–8.
13. Ivashkin V.T., Shelygin Iu.A., Khalif I.L., Belousova E.A. i dr. Klinicheskie rekomendatsii Rossiiskoi Gastroenterologicheskoi Assotsiatsii i Assotsiatsii Koloproktologov Rossii po diagnostike i lecheniiu iazvennogo kolita. Koloproktologiia. 2017; 1 (59). [in Russian]
14. Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease; Eighth Nineth Ed. Philadelphia: Saunders Elsevier, 2010: 1975–2013.
15. Desreumaux P, Ghosh S. Review article: mode of action and delivery of 5-aminosalicylic acid new evidence. Aliment Pharmacol Ther 2006; 24 (Suppl. 1): 2–9.
16. Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis, 28 January 2017.
17. Brunner M et al. Gastrointestinal transit and 5-ASA release from a new mesalazine extended-release formulation. Aliment Pharmacol Ther 2003; 17: 395–402.
18. Tenjarla S et al. Release of 5-aminosalicylate from an MMXR mesalamine tablet during transit through a simulated gastrointestinal tract system. Adv Ther 2007; 24 (4): 826–40.
19. D’Haens G. et al. Once daily MMXR mesalazine for the treatment of mild-to-moderate ulcerative colitis: a phase II, dose-ranging study. Aliment Pharmacol Ther 2006; 24: 1087–97.
20. Lichtenstein GR et al. Effect of once- or twice-daily MMXR mesalamine (SPD476) for the induction of remission of mild-to-moderately active ulcerative colitis. Clin Gastroenterol Hepatol 2007; 5: 95–102.
21. Kamm MA et al. Once-daily, high-concentration MMXR mesalamine in active ulcerative colitis. Gastroenterology 2007; 132: 66–75.
22. Kamm MA et al. Randomised trial of once- or twice-daily MMXR mesalazine for maintenance of remission in ulcerative colitis. Gut 2008; 57: 893–902.
23. Kamm MA et al. Effect of extended MMXR mesalamine therapy for acute, mild-to-moderate ulcerative colitis. Inflamm Bowel Dis 2009; 15 (1): 1–8.
24. D’Haens G, Sandborn WJ, Barrett K et al. Once-Daily MMXR mesalamine for Endoscopic Maintenance of Remission of Ulcerative Colitis. Am J Gastroenterol 2012; 107 (7): 1064–77.
25. Kane S, Katz S, Jamal MM et al. Strategies in maintenance for patients receiving long-term therapy (SIMPLE): A study of MMXR mesalamine for the long-term maintenance of quiescent ulcerative colitis. Inflamm Bowel Dis 2012; 18: 1026–33.
26. D’Haens G, Inglis S, Magee E et al. Remission status and maintenance therapy outcomes in patients with mild-to-moderate ulcerative colitis (UC): Results from the MOMENTUM study. J Crohn’s Colitis 2014; 8 (1): S217 (abstract P365).
27. Shapina M.V., Khalif I.L. Primenenie preparatov 5-aminosalitsilovoi kisloty dlia lecheniia iazvennogo kolita v razlichnykh rezhimakh dozirovaniia. Med. sovet. 2015; 15: 44–50. [in Russian]
Авторы
С.С.Вялов
1 ФГАОУ ВО «Российский университет дружбы народов». 117198, Россия, Москва, ул. Миклухо-Маклая, д. 8, корп. 1;
2 ФГБОУ ВО «Московский государственный технический университет им. Н.Э.Баумана (национальный исследовательский университет)». 105005, Россия, Москва, ул. 2-я Бауманская, д. 5, стр. 1;
3 Global Medical System clinic & hospitals, French clinic. 121099, Россия, Москва, 1-й Николощеповский пер., д. 6, стр. 1
svialov@mail.ru
1 People’s Friendship University of Russia. 117198, Russian Federation, Moscow, ul. Miklukho-Maklaia, d. 8, korp. 1
2 Bauman Moscow State Technical University. 105005, Russian Federation, Moscow, ul. 2-ya Baumanskaya, d. 5, str. 1;
3 GMS clinic & hospitals, French clinic. 121099, Russian Federation, Moscow, 1-j Nikoloshepovskij per., d. 6, str. 1
svialov@mail.ru
1 ФГАОУ ВО «Российский университет дружбы народов». 117198, Россия, Москва, ул. Миклухо-Маклая, д. 8, корп. 1;
2 ФГБОУ ВО «Московский государственный технический университет им. Н.Э.Баумана (национальный исследовательский университет)». 105005, Россия, Москва, ул. 2-я Бауманская, д. 5, стр. 1;
3 Global Medical System clinic & hospitals, French clinic. 121099, Россия, Москва, 1-й Николощеповский пер., д. 6, стр. 1
svialov@mail.ru
________________________________________________
1 People’s Friendship University of Russia. 117198, Russian Federation, Moscow, ul. Miklukho-Maklaia, d. 8, korp. 1
2 Bauman Moscow State Technical University. 105005, Russian Federation, Moscow, ul. 2-ya Baumanskaya, d. 5, str. 1;
3 GMS clinic & hospitals, French clinic. 121099, Russian Federation, Moscow, 1-j Nikoloshepovskij per., d. 6, str. 1
svialov@mail.ru
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.