Miguel Bayones MD¹, Ana Ramírez MD¹, Jose Ruiz MD², Carlos Sierra MS³, Claudio Tombazzi⁴

¹Internal Medicine Service, Bejuma District Hospital, Bejuma, Venezuela
²Research Service, Memphis VA Medical Center, Memphis, USA
³University of Kentucky School of Medicine, University of Kentucky, Lexington, USA
⁴University of Tennessee School of Medicine, University of Tennessee, Memphis, USA