[1
]School of Medicine; Universidad Espíritu Santo - Ecuador; Guayaquil Ecuador
[2
]Department of Neurological Sciences; Hospital-Clínica Kennedy; Guayaquil Ecuador
[3
]Gastroenterology Department; Vanderbilt University; Nashville Tennessee USA
[4
]Langone Medical Center; School of Medicine; New York University; New York New York
USA
[5
]The Atahualpa Project; Community Center; Atahualpa Ecuador