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Diabetic Retinopathy Investigation

Diabetic Retinopathy

Diabetic Retinopathy

Practice Essentials Diabetes mellitus (DM) is a major medical problem throughout the world. Diabetes causes an array of long-term systemic complications that have considerable impact on the patient as well as society, as the disease typically affects individuals in their most productive years. [1] An increasing prevalence of diabetes is occurring throughout the world. [2] In addition, this increase appears to be greater in developing countries. The etiology of this increase involves changes in diet, with higher fat intake, sedentary lifestyle changes, and decreased physical activity. [3, 4] Patients with diabetes often develop ophthalmic complications, such as corneal abnormalities, glaucoma, iris neovascularization, cataracts, and neuropathies. The most common and potentially most blinding of these complications, however, is diabetic retinopathy, [5, 6, 7] which is, in fact, the leading cause of new blindness in persons aged 25-74 years in the United States. Approximately 700,000 persons in the United States have proliferative diabetic retinopathy, with an annual incidence of 65,000. An estimate of the prevalence of diabetic retinopathy in the United States showed a high prevalence of 28.5% among those with diabetes aged 40 years or older. [8] (See Epidemiology.) The exact mechanism by which diabetes causes retinopathy remains unclear, but several theories have been postulated to explain the typical course and history of the disease. [9, 10] See the image below. In the initial stages of diabetic retinopathy, patients are generally asymptomatic, but in more advanced stages of the disease patients may experience symptoms that include floaters, distortion, and/or blurred vision. Microaneurysms are the earliest clinical sign of diabetic retinopathy. (See Clinical Presentat Continue reading >>

Investigation Of The Severity Level Of Diabetic Retinopathy Using Supervised Classifier Algorithms

Investigation Of The Severity Level Of Diabetic Retinopathy Using Supervised Classifier Algorithms

Diabetic retinopathy is a condition that occurs in individuals with several years of diabetes mellitus and causes a characteristic group of lesions in the retina and progressively damages it. Detecting retinal fundus diseases in advance helps ophthalmologists to apply proper treatments that may cure the disease or decrease its severity and thus protect patients from vision loss. Diabetic retinopathy is usually diagnosed by ophthalmologists using dilated images that are captured by pouring a chemical solution into the patients eye, which causes inconvenience and irritation to the patient. In this paper, we propose a method to detect lesion exudates automatically with the aid of a non-dilated retinal fundus image to help ophthalmologists diagnose the disease. The exudates from the low contrast images are detected and localised using a neighbourhood based segmentation technique. A support vector machine (SVM) and probabilistic neural network (PNN) classifiers are proposed to assess the severity of the disease, and the results are compared with the same segmentation technique. The average classification accuracy for the SVM and PNN classifiers are determined to be 97.89% and 94.76%, respectively. Do you want to read the rest of this article? ... Mahendran et al. in 2015 have detected and localized the EXs [37] by applying segmentation technique (neighborhood based). SVM and PNN classifiers were used to get the disease severity. ... Continue reading >>

Diagnosis

Diagnosis

Print Diabetic retinopathy is best diagnosed with a dilated eye exam. For this exam, drops placed in your eyes widen (dilate) your pupils to allow your doctor to better view inside your eyes. The drops may cause your close vision to blur until they wear off, several hours later. During the exam, your eye doctor will look for: Abnormal blood vessels Swelling, blood or fatty deposits in the retina Growth of new blood vessels and scar tissue Bleeding in the clear, jelly-like substance that fills the center of the eye (vitreous) Retinal detachment Abnormalities in your optic nerve In addition, your eye doctor may: Test your vision Measure your eye pressure to test for glaucoma Look for evidence of cataracts Fluorescein angiography With your eyes dilated, your doctor takes pictures of the inside of your eyes. Then your doctor will inject a special dye into your arm and take more pictures as the dye circulates through your eyes. Your doctor can use the images to pinpoint blood vessels that are closed, broken down or leaking fluid. Optical coherence tomography Your eye doctor may request an optical coherence tomography (OCT) exam. This imaging test provides cross-sectional images of the retina that show the thickness of the retina, which will help determine whether fluid has leaked into retinal tissue. Later, OCT exams can be used to monitor how treatment is working. Treatment Treatment, which depends largely on the type of diabetic retinopathy you have and how severe it is, is geared to slowing or stopping progression of the condition. Early diabetic retinopathy If you have mild or moderate nonproliferative diabetic retinopathy, you may not need treatment right away. However, your eye doctor will closely monitor your eyes to determine when you might need treatment. Work with Continue reading >>

Genetic Investigation Of Complement Pathway Genes In Type 2 Diabetic Retinopathy: An Inflammatory Perspective

Genetic Investigation Of Complement Pathway Genes In Type 2 Diabetic Retinopathy: An Inflammatory Perspective

Genetic Investigation of Complement Pathway Genes in Type 2 Diabetic Retinopathy: An Inflammatory Perspective Ming Ming Yang ,1,2 Jun Wang ,3 Hong Ren ,4 Yun Duan Sun ,1 Jiao Jie Fan ,1 Yan Teng ,1and Yan Bo Li 3 1Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China 2The Centre for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150001, China 3Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China 4Operating Room, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China Received 16 November 2015; Revised 10 January 2016; Accepted 12 January 2016 Copyright 2016 Ming Ming Yang et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Diabetic retinopathy (DR) has complex multifactorial pathogenesis. This study aimed to investigate the association of complement pathway genes with susceptibility to DR. Eight haplotype-tagging SNPs of SERPING1 and C5 were genotyped in 570 subjects with type 2 diabetes: 295 DR patients (138 nonproliferative DR [NPDR] and 157 proliferative DR [PDR]) and 275 diabetic controls. Among the six C5 SNPs, a marginal association was first detected between rs17611 and total DR patients ( , OR = 0.53 for recessive model). In stratification analysis, a significant decrease in the frequencies of G allele and GG homozygosity for rs17611 was observed in PDR patients compared with diabetic controls ( = 0.016, OR = 0.37, resp.); it was linked with a disease progression. A haplotype AA defined by the major alleles of Continue reading >>

Diabetic Retinopathyupdate On Prevention Techniques, Present Therapies, And New Leads

Diabetic Retinopathyupdate On Prevention Techniques, Present Therapies, And New Leads

Diabetic RetinopathyUpdate on Prevention Techniques, Present Therapies, and New Leads 1Undergraduate Student, Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, US 2Assistant Professor, Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, US Correspondence: Patrice E Fort, PhD, 1000 Wall Street, Ann Arbor, Michigan, 48105, US. [email protected] See other articles in PMC that cite the published article. Diabetic retinopathy is the major ocular complication associated with diabetes, and represents the leading cause of legal blindness in the working-age population of developed countries. Although classically diagnosed based on abnormalities of the retinal microvasculature, diabetic retinopathy is now widely recognized as a neurovascular disease. While all patients with diabetes are at increased risk for eye disease including diabetic retinopathy, proactive measures, and timely intervention can prevent or delay subsequent vision loss. Systemic management of diabetes by combined control of glycemia, blood pressure, and serum lipid levels remains the most important method of preventing diabetic retinopathy onset and progression. Once detected, surgical and medical interventions including photocoagulation, vitrectomy, and intravitral drug injection can help preserve vision. However, the need for improved detection methods and therapies that will allow earlier diagnosis and treatment remains apparent. This review summarizes current techniques for the prevention and intervention for diabetic retinopathy, and examines ongoing developments in the search for new endpoints and therapies as they apply to preventing vision loss associated with diabetes. Keywords: Diabetes, retinopathy, prevention, trea Continue reading >>

Investigation Of The Severity Level Of Diabetic Retinopathy Using Supervised Classifier Algorithms

Investigation Of The Severity Level Of Diabetic Retinopathy Using Supervised Classifier Algorithms

Investigation of the severity level of diabetic retinopathy using supervised classifier algorithms Author links open overlay panel G.Mahendrana A method for investigating the severity of diabetic retinopathy is proposed. Earlier diagnosis of the disease prevents vision loss in diabetic patients. The exudates are the major symptoms and are detected via a segmentation algorithm. The degree of severity is assessed using the SVM and PNN classifier algorithms. The SVM classifier is found to provide better results than the PNN classifier. Diabetic retinopathy is a condition that occurs in individuals with several years of diabetes mellitus and causes a characteristic group of lesions in the retina and progressively damages it. Detecting retinal fundus diseases in advance helps ophthalmologists to apply proper treatments that may cure the disease or decrease its severity and thus protect patients from vision loss. Diabetic retinopathy is usually diagnosed by ophthalmologists using dilated images that are captured by pouring a chemical solution into the patients eye, which causes inconvenience and irritation to the patient. In this paper, we propose a method to detect lesion exudates automatically with the aid of a non-dilated retinal fundus image to help ophthalmologists diagnose the disease. The exudates from the low contrast images are detected and localised using a neighbourhood based segmentation technique. A support vector machine (SVM) and probabilistic neural network (PNN) classifiers are proposed to assess the severity of the disease, and the results are compared with the same segmentation technique. The average classification accuracy for the SVM and PNN classifiers are determined to be 97.89% and 94.76%, respectively. Continue reading >>

Potential Confounders In An Investigation Of The Vision-related Functional Burden Of Diabetic Retinopathy

Potential Confounders In An Investigation Of The Vision-related Functional Burden Of Diabetic Retinopathy

Potential Confounders in an Investigation of the Vision-Related Functional Burden of Diabetic Retinopathy 1Imperial College London, London, United Kingdom JAMA Ophthalmol. Published online February 15, 2018. doi:10.1001/jamaophthalmol.2017.6703 To the Editor We thank Willis et al 1 for their study investigating the prevalence of functional burden among patients in the United States with diabetic retinopathy of varying levels of severity. The authors found that the vision-related functional burden was significantly greater in those with severe nonproliferative diabetic retinopathy and proliferative diabetic retinopathy compared with those without retinopathy. Feng R, Sivakumaran P. Potential Confounders in an Investigation of the Vision-Related Functional Burden of Diabetic Retinopathy. JAMA Ophthalmol. Published online February 15, 2018. doi:10.1001/jamaophthalmol.2017.6703 New! JAMA Network Open is now accepting submissions. Learn more. Customize your JAMA Network experience by selecting one or more topics from the list below. Challenges in Clinical Electrocardiography Clinical Implications of Basic Neuroscience Health Care Economics, Insurance, Payment Scientific Discovery and the Future of Medicine United States Preventive Services Task Force JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Facial Plastic Surgery JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA OtolaryngologyHead & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) AMA Manual of Style Art and Images in Psychiatry Breast Cancer Screening Guidelines Colorectal Screening Guidelines Declaration of Helsinki Depression Screening Guidelines Evidence-Based Medicine: An Oral History Fishbein Fellowship Genomics and P Continue reading >>

Dietary Intake And Diabetic Retinopathy: A Systematic Review

Dietary Intake And Diabetic Retinopathy: A Systematic Review

Dietary intake and diabetic retinopathy: A systematic review Affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore Affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore Affiliations: Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Duke-NUS Medical School, Office of Clinical Sciences, Singapore Affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore Affiliations: Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Duke-NUS Medical School, Office of Clinical Sciences, Singapore Affiliations: Singapore Institute for Clinical Sciences, A*STAR, Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Affiliations: Singapore Institute for Clinical Sciences, A*STAR, Singapore, Saw Swee Hock School of Public Health, National University of Singapore, Singapore * E-mail: [email protected] Affiliations: Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Duke-NUS Medical School, Office of Clinical Sciences, Singapore The evidence linking dietary intake with diabetic retinopathy (DR) is growing but unclear. We conducted a systematic review of the association between dietary intake and DR. We systematically searched PubMed, Embase, Medline, and the Cochrane Central register of controlled trials, for publications between January 1967 and January 2017 using standardized criteria for diet and DR. Interventional and observational studies investigating micro- and macro-nutrient intakes; food and beverage consumptions; and dietary patterns were included. Study quality was evaluated using a modified Newcastle-Ottawa scale for observational studies, and the Cochrane colla Continue reading >>

Management Of Diabetic Retinopathy

Management Of Diabetic Retinopathy

We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Sub-Saharan Africa faces an epidemic of diabetes. Visual loss from diabetic retinopathy (DR) is both preventable and treatable. This article reviews the epidemiology and clinical features of DR and current evidence-based interventions in three areas: primary prevention of retinopathy by optimum medical management, early detection of pre-symptomatic disease and management of established retinopathy to prevent or mitigate visual loss. There are significant challenges to DR care in resource poor environments. Appropriate provision of effective interventions by health services can reduce social and economic costs associated with patient care. International Diabetes Federation has estimated that the number of adults with diabetes in Africa will expand by 98%, from 12.1 million in 2010 to 23.9 million in 2030 1 . Diabetes causes visual impairment through early-onset cataract and diabetic retinopathy (DR), a progressive disease of the retinal microvasculature. Cataract and DR are the second and sixth leading causes of global visual impairment, respectively 2 . Both are included in the list of nine target diseases of Vision 2020, a joint programme of WHO and the International Agency for the Prevention of Blindness. The 2009 WHO Malawi national STEPwise approach to surveillance (STEPS) survey estimated a prevalence of diabetes of 5.6% in adults aged 25 to 64 years. 90% of these have type II Continue reading >>

Diabetic Retinopathy - Exams And Tests

Diabetic Retinopathy - Exams And Tests

Diabetic retinopathy can be detected during a dilated eye exam by an ophthalmologist or optometrist. An exam by your primary doctor, during which your eyes are not dilated, is not an adequate substitute for a full exam done by an ophthalmologist. Eye exams for people with diabetes can include: Visual acuity testing. Visual acuity testing measures the eye's ability to focus and to see details at near and far distances. It can help detect vision loss and other problems. Ophthalmoscopy and slit lamp exam. These tests allow your doctor to see the back of the eye and other structures within the eye. They may be used to detect clouding of the lens (cataract), changes in the retina, and other problems. Gonioscopy. Gonioscopy is used to find out whether the area where fluid drains out of your eye (called the drainage angle) is open or closed. This test is done if your doctor thinks you may have glaucoma, a group of eye diseases that can cause blindness by damaging the optic nerve. Tonometry. This test measures the pressure inside the eye, which is called intraocular pressure (IOP). It is used to help detect glaucoma. Diabetes can increase your risk of glaucoma. Your doctor may also do a test called an optical coherence tomography (OCT) to check for fluid in your retina. Sometimes a fluorescein angiogram is done to check for and locate leaking blood vessels in the retina, especially if you have symptoms, such as blurred or distorted vision, that suggest damage to or swelling of the retina. Fundus photography can track changes in the eye over time in people who have diabetic retinopathy and especially in those who have been treated for it. Fundus photography produces accurate pictures of the back of the eye (the fundus). An eye doctor can compare photographs taken at different ti Continue reading >>

Investigation Of Prolactin-related Vasoinhibin In Sera From Patients With Diabetic Retinopathy

Investigation Of Prolactin-related Vasoinhibin In Sera From Patients With Diabetic Retinopathy

Investigation of prolactin-related vasoinhibin in sera from patients with diabetic retinopathy Department of Gastroenterology and Endocrinology, Center of Internal Medicine, Georg-August-University, Robert-Koch-Strae 40, 37075 Gttingen, Germany1Endokrinologikum Gttingen, Von-Siebold-Strae 3, Gttingen, Germany (Correspondence should be addressed to J Triebel; Email: jakob.triebel{at}gmx.de) Objective In vitro experiments and in vivo studies on rodents demonstrate that N-terminal 14, 15, 16, 17, and 18 kDa fragments prolactin-related vasoinhibin (PRL-V) of human PRL are natural inhibitors of neovascularization in the retina and elsewhere. These N-terminal PRL fragments belong to a family of peptides named vasoinhibins, which act as endogenous regulators of angiogenesis and vascular function. These observations led to the hypothesis that PRL-V could play a role in the pathophysiology of diabetic retinopathy in humans. The purpose of this study was to investigate whether patients with diabetes mellitus and diabetic retinopathy have aberrant concentrations of PRL-V in the circulating blood. Research design We performed a casecontrol study and developed a new technique to semi-quantitatively determine PRL-V in serum samples from 48 male subjects. The case group consisted of 21 patients with diabetes mellitus and proliferative or non-proliferative diabetic retinopathy. The control group consisted of 27 healthy subjects with no history of diabetes mellitus. Methods For the detection of PRL-V, we developed a new analytical method, consisting of immunologic and laser-induced fluorescence techniques. Results The case group had significantly lower PRL-V serum concentrations than the control group (P=0.041). There was no significant difference between patients with proliferative an Continue reading >>

Heritability Of The Severity Of Diabetic Retinopathy: The Find-eye Study | Iovs | Arvo Journals

Heritability Of The Severity Of Diabetic Retinopathy: The Find-eye Study | Iovs | Arvo Journals

Clinical and Epidemiologic Research| September 2008 Heritability of the Severity of Diabetic Retinopathy: The FIND-Eye Study From the Family Investigation of Nephropathy and Diabetes (FIND) Genetic Analysis and Data Coordinating Center, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio. Members affiliations are listed in the Appendix. From the Family Investigation of Nephropathy and Diabetes (FIND) Genetic Analysis and Data Coordinating Center, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio. Members affiliations are listed in the Appendix. From the Family Investigation of Nephropathy and Diabetes (FIND) Genetic Analysis and Data Coordinating Center, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio. Members affiliations are listed in the Appendix. From the Family Investigation of Nephropathy and Diabetes (FIND) Genetic Analysis and Data Coordinating Center, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio. Members affiliations are listed in the Appendix. From the Family Investigation of Nephropathy and Diabetes (FIND) Genetic Analysis and Data Coordinating Center, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio. Members affiliations are listed in the Appendix. From the Family Investigation of Nephropathy and Diabetes (FIND) Genetic Analysis and Data Coordinating Center, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio. Members affiliations are listed in the Appendix. From the Family Investigation of Nephropathy and Diabetes (FIND) Genetic Analysis and Data Coordinating Center, Department of Epidem Continue reading >>

Investigation Of Diabetic Retinopathy Using Gmm Classifier

Investigation Of Diabetic Retinopathy Using Gmm Classifier

Investigation of diabetic retinopathy using GMM classifier Abstract: Diabetes is a severe eye disease affecting various parts of the body including the eye. If diabetes is not properly controlled for more than 8 years, the retinal blood vessels in the human eye are damaged. The eye pathologies due to the damage of the blood vessel in the retina cause diabetic retinopathy which is a severe eye disease leading to vision loss. The major symptoms for this disease are the exudates which are due to the leakage of lipids and proteins from the damaged blood vessels. To prevent the people suffering by diabetic retinopathy from the vision loss, this disease should be diagnosed in an earlier stage. The chemical solutions applied into the patient's eye for capturing dilated retinal images cause irritation to the human eye. So, the nondilated retinal images are collected for diagnosis from the STARE web database. The input retinal images are preprocessed and segmented by using Fuzzy C-means segmentation technique. The features are extracted by Gabor filter and the features are compared by Speeded UP Robust Features (SURF) and Scale Invariant Feature Transform SIFT algorithms. Gaussian Mixture Model (GMM) classifier is used to identify whether the input retinal images are normal or abnormal images. The average classifier accuracy of GMM classifier in this research work is found to be 97.78%. Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

Diabetic retinopathy, also known as diabetic eye disease, is a medical condition in which damage occurs to the retina due to diabetes and is a leading cause of blindness.[1] It affects up to 80 percent of people who have had diabetes for 20 years or more.[2] At least 90% of new cases could be reduced if there were proper treatment and monitoring of the eyes.[3] The longer a person has diabetes, the higher his or her chances of developing diabetic retinopathy.[4] Each year in the United States, diabetic retinopathy accounts for 12% of all new cases of blindness. It is also the leading cause of blindness for people aged 20 to 64 years.[5] Signs and symptoms[edit] Normal vision The same view with diabetic retinopathy. Emptied retinal venules due to arterial branch occlusion in diabetic retinopathy (fluorescein angiography) Diabetic retinopathy often has no early warning signs. Even macular edema, which can cause rapid vision loss, may not have any warning signs for some time. In general, however, a person with macular edema is likely to have blurred vision, making it hard to do things like read or drive. In some cases, the vision will get better or worse during the day. In the first stage which is called non-proliferative diabetic retinopathy (NPDR) there are no symptoms, the signs are not visible to the eye and patients will have 20/20 vision. The only way to detect NPDR is by fundus photography, in which microaneurysms (microscopic blood-filled bulges in the artery walls) can be seen. If there is reduced vision, fluorescein angiography can be done to see the back of the eye. Narrowing or blocked retinal blood vessels can be seen clearly and this is called retinal ischemia (lack of blood flow). Macular edema in which blood vessels leak their contents into the macular regi Continue reading >>

Dietary Marine -3 Fatty Acids And Incident Sight-threatening Retinopathy In Middle-aged And Older Individuals With Type 2 Diabetesprospective Investigation From The Predimed Trial

Dietary Marine -3 Fatty Acids And Incident Sight-threatening Retinopathy In Middle-aged And Older Individuals With Type 2 Diabetesprospective Investigation From The Predimed Trial

1Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clnic, Institut dInvestigacions Biomdiques August Pi i Sunyer, Barcelona, Spain 2CIBER Fisiopatologa de la Obesidad y Nutricin, Instituto de Salud Carlos III, Madrid, Spain 3Human Nutrition Unit, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Institut dInvestigaci Sanitria Pere Virgili, Rovira i Virgili University, Reus, Spain 4Department of Ophthalmology, University of Navarra, Pamplona, Spain 5Department of Nutrition and Food Science, School of Pharmacy, University of Barcelona, Barcelona, Spain 6Cardiovascular Risk and Nutrition Research Group, Institut Hospital del Mar dInvestigacions Mdiques, Barcelona Biomedical Research Park, Barcelona, Spain 7Department of Preventive Medicine, University of Valencia, Valencia, Spain 8Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain 9Department of Preventive Medicine, University of Malaga, Malaga, Spain 10Institute of Health Sciences, Instituto de Investigacin Sanitaria de Palma, Palma de Mallorca, Spain 11Department of Internal Medicine, Hospital Clnic, Institut dInvestigacions Biomdiques August Pi i Sunyer, Barcelona, Spain 12Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain 13Department of Cardiology, University Hospital of Alava, Vitoria, Spain 14Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain 15Department of Internal Medicine, Bellvitge Biomedical Research InstituteHospital Universitari de Bellvitge, L'Hospitalet de Llobregat, FIPEC (Research Foundation for Cardiovascular Disease Prevention), Barcelona, Spain Continue reading >>

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