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Small economies, such as the Peruvian and Chilean, are immersed in the global arena of emergent economies, so evaluating them from a home based point of view (Porter, 1990) would be limited and of little use. This fact turns Porter's national diamond framework insufficient for that purpose (Moon, Rugman and Verbeke, 1998). This paper analyzes these economies from a global view that would include local as well as foreign markets; in other words, it applies the International Competitiveness Double Diamond approach proposed by Moon, Rugman & Verbeke (1998), and Moon & Lee (2004). Information from the World Bank, the International Monetary Fund, the World Economic Forum, the Inter-American Development Bank and other sources was gathered to draw up the double diamond. The empirical analyses show that Chile is more competitive globally, while Peru is locally. To sum up, the results imply that Chile is more attractive to direct foreign investment than Peru. [ABSTRACT FROM AUTHOR]

Background: Motivation for the study. There are few studies describing the variation of COVID-19-associated multisystem inflammatory syndrome (MIS-C) in Peru across pandemic waves., Background: Main findings. Cases of MIS-C decreased during the first three years of the pandemic, with higher frequency in the second wave with clinical features similar to Kawasaki disease., Background: Implications. MIS-C is a post-infectious complication of SARS-CoV-2. Its diagnostic suspicion is important weeks after peak infections, especially in children who have not yet received COVID-19 vaccines., Background: This study aimed to describe the characteristics of multisystemic inflammatory syndrome associated with COVID-19 (MIS-C) in the first three years of the pandemic in children in a pediatric hospital in Peru. We conducted an observational, descriptive study with data from 73 patients and described the clinical and laboratory characteristics, treatment and complications according to the wave of the pandemic and whether they had shock. The median age was 6 years, gastrointestinal and mucocutaneous manifestations were frequent in the three waves. Kawasaki disease-like phenotype was present in 34 (46.6%) patients and 21 (28.8%) patients developed shock. The most commonly used treatment was immunoglobulin (95.9%), followed by acetylsalicylic acid (94.5%) and corticosteroid (86.3%). Five (7%) patients had coronary aneurysm and 17 (23.3%) were admitted to the intensive care unit (ICU). Patients with shock had greater laboratorial alteration and need for mechanical ventilation. In conclusion, MIS-C has decreased in the first three years of the pandemic, possibly due to COVID-19 vaccination in children.

Settings: Hemophilia is a coagulation disorder that occurs in one in 5000 male births. Patients with untreated severe hemophilia A have hemorrhagic complications, including joint bleeds and decreased survival. Emicizumab is a monoclonal antibody approved by the United States for routine prophylaxis of pediatric and adult patients with severe hemophilia A with factor VIII inhibitors., Objectives: To perform a cost-effectiveness study of emicizumab prophylaxis for children and adults with severe hemophilia A compared with the current disease management in the Peruvian Ministry of Health and Social Security Health Insurance., Methods: The patient transition between medical states was modeled with Markov methodology, and the lifetime costs and incremental effects of emicizumab compared to current management were estimated. The budgetary impact of emicizumab was estimated by projecting annual net costs and its five-year present value., Results: In the Ministry of Health, emicizumab would generate savings between 14.6 and 16.0 per child and 11.8 per adult, in current US$ million. Social Security Health Insurance savings would be 12.8 to 14.9 per child and 40.1 per adult. In addition, this strategy would generate effectiveness gains, measured in quality-adjusted life-years, of 0.36 per child and 0.56 per adult and 0.25 per child, and 0.36 per adult in those respective institutions. The budgetary impact would be a net annual saving of 12.8 and 15.0 US$ million in those entities., Conclusions: The current management of hemophilia A is very costly and has health outcomes inferior to those possible with emicizumab. This drug would produce significant savings and better patient health. The Ministry of Health and Social Health Insurance should implement hemophilia prophylaxis and treatment protocols and finance this drug.

The morphology of cystacanths and adults of Profilicollis altmani (Perry, 1942) Van Cleave, 1947 (Polymorphidae) were studied from the Pacific mole crab Emerita analoga (Stimpson) (Crustacea, Hippidae) and Belcher's gull Larus belcheri (Vigors) (Aves, Laridae), respectively, in Peru. Comparative morphometrics with accounts of other populations of P. altmani from elsewhere off the Pacific and Atlantic coasts of North and South America revealed marked intraspecific population variations. We report scanning electron micrographs (SEM) of new features, not before noted or captured in line drawings by earlier observers. We further present microscope images that reveal internal details not previously reported or possible to see with SEM. Energy dispersive X-ray analysis (EDXA) revealed unusual patterns in the chemistry of proboscis hooks especially the high sulfur and diminished phosphorous and calcium in hook tips and low sulfur and high levels of phosphorous and calcium at mid hooks. The size and shape of all hooks of the cystacanths are reported for the first time. Histopathological studies in L. belcheri from Peru are also included. Cystacanths of P. altmani from California were also analyzed for molecular patterns and compared with other sequences reported from other locations. The molecular data and the analysis of our new sequences of cytochrome oxidase I (COI) showed that haplotypes of P. altmani had low genetic variation; the species is not geographically structured, and within its clade no monophyletic group is formed., (© O.M. Amin et al., published by EDP Sciences, 2022.)

Background: Neoechinorhynchus cylindratus Van Cleave (Zoo Anz 43: 177-1990, 1913) Van Cleave (Ill Natl Hist Surv Bull 13:225-257, 1919) is a North American acanthocephalan originally described from Micropterus salmoides (Lacépède) in Pelican Lake, Minnesota. It is common in Centrarchids but also not infrequent in fishes of other families., Purpose: A unique population of N. cylindratus was discovered in Peru. It needed to be described and its introduction into Peru investigated., Methods: Standard processing of specimens and staining in Borax carmine and fast green for creating whole mounts were employed. Literature sources were available from the OMA personal collection., Results: The descriptive accounts of N. cylindratus have been rather stable over the years since its original description. It has been, however, oddly identified from Gambusia affinis (Baird and Girard) in Peru. Females of the Peruvian specimens were, however, not typical in having a terminal-near terminal gonopore at odds with the sub-ventral position characteristic of the usual populations of N. cylindratus in North America. We describe the Peruvian material and outline the distinct morphological variations from the North American populations in the position of the female gonopore, among other characters. We also explain its introduction into Peru and the translocation of the position of female gonopore to the terminal position., Conclusions: The translocation to the terminal position of the female gonopore in the Peruvian material is attributed to host related developmental factors. The route of introduction of N. cylindratus into Peru through the introduction of G. affinis from the United States has been accounted for. It may be comparable to the introduction of the same acanthocephalan species into northern Mexico via the documented introduction of its primary host, M. salmoides, also from the United States into Mexico in 1930. The introduction of Acanthocephalus dirus Van Cleave (Ill Natl Hist Surv Bull 13:225-257, 1919) (Van Cleave and Townsend, 1936) into Mexico is also discussed., (© 2021. Witold Stefański Institute of Parasitology, Polish Academy of Sciences.)

Purpose: Adult T-cell leukemia/lymphoma (ATLL) is an aggressive disease caused by the human T-cell leukemia virus type 1. Real-world data of ATLL in Latin America are lacking., Patients and Methods: We analyzed patients with ATLL (acute, lymphomatous, chronic, and smoldering) encountered in 11 Latin American countries between 1995 and 2019. Treatment response was assessed according to the 2009 consensus report. Survival curves were estimated using the Kaplan-Meier method and log-rank test., Results: We identified 253 patients; 226 (lymphomatous: n = 122, acute: n = 73, chronic: n = 26, and smoldering: n = 5) had sufficient data for analysis (median age 57 years). Most patients with ATLL were from Peru (63%), Chile (17%), Argentina (8%), and Colombia (7%). Hypercalcemia was positively associated with acute type (57% v lymphomatous 27%, P = .014). The median survival times (months) were 4.3, 7.9, 21.1, and not reached for acute, lymphomatous, chronic, and smoldering forms, with 4-year survival rates of 8%, 22%, 40%, and 80%, respectively. First-line zidovudine (AZT)-interferon alfa (IFN) resulted in an overall response rate of 63% (complete response [CR] 24%) for acute. First-line chemotherapy yielded an overall response rate of 41% (CR 29%) for lymphomatous. CR rate was 42% for etoposide, cyclophosphamide, vincristine, doxorubicin, and prednisone versus 12% for cyclophosphamide, vincristine, doxorubicin, and prednisone-like regimen ( P < .001). Progression-free survival at 1 year for acute type patients treated with AZT-IFN was 67%, whereas 2-year progression-free survival in lymphomatous type patients who achieved CR after chemotherapy was 77%., Conclusion: This study confirms Latin American ATLL presents at a younger age and has a high incidence of lymphomatous type, low incidence of indolent subtypes, and worse survival rates as compared with Japanese patients. In aggressive ATLL, chemotherapy remains the preferred choice for lymphomatous favoring etoposide-based regimen (etoposide, cyclophosphamide, vincristine, doxorubicin, and prednisone), whereas AZT-IFN remains a good first-line option for acute subtype., Competing Interests: Denisse A. CastroConsulting or Advisory Role: Johnson & Johnson del Perú S.A. Camila PeñaHonoraria: Janssen, Bristol Myers Squibb/MedarexConsulting or Advisory Role: JanssenTravel, Accommodations, Expenses: Tecnofarma Victoria OteroEmployment: AstraZeneca Eloisa RivaHonoraria: SanofiTravel, Accommodations, Expenses: Roemmers Maria A. Torres-VieraSpeakers' Bureau: Takeda Jorge J. CastilloConsulting or Advisory Role: Janssen, Roche/Genentech, Beigene, AbbVie/PharmacyclicsResearch Funding: Pharmacyclics, AbbVie, Janssen, BeiGene, TG Therapeutics Juan Carlos RamosResearch Funding: miRagen Luis VillelaConsulting or Advisory Role: Jazz Pharmaceuticals, Roche-Syntex, AstraZeneca LATAMSpeakers' Bureau: Amgen Mexico, AbbVieNo other potential conflicts of interest were reported.