Las cláusulas patológicas en los convenios arbitrales

The article analyzes the pathological clauses that are sometimes presented in the arbitral agreements and which constitute a disadvantage for the normal development of arbitration, and for that reason the following paper will cover the antecedents of the arbitral agreement, the principles that frames it, and its treatment in the Peruvian legislation, so that it will develop with the greater amplitude and understanding the pathologies in the arbitral agreements, the legal effects that produce and the solution to this problem.El artículo analiza las cláusulas patológicas que en ocasiones se presentan en los convenios arbitrales y que constituyen un hándicap para el desarrollo normal del arbitraje, y es en razón de ello que el presente trabajo en un inicio abarcará los antecedentes del convenio arbitral, los principios que lo enmarcan y su tratamiento en la legislación peruana, para luego pasar a desarrollar con mayor amplitud y entendimiento las patologías en los convenios arbitrales, los efectos jurídicos que producen y la solución a este problema

Breve análisis del delito de tráfico de drogas en la legislación peruana

El presente trabajo trae consigo un análisis del delito del tráfico ilícito de drogas, se abarcan sus antecedentes en la historia del Perú, su legislación actual del tipo, así como dos casos, los cuales servirán como referente para dilucidar los problemas que engloban los atenuantes y agravantes de este delito. Asimismo, podremos identificar los sujetos intervinientes y el bien jurídico protegido, que ayudarán a realizar un análisis normativo con la estructura sistemática de nuestra legislación.The following paper sets an analysis of drug trafficking illicit crime, covering its background in Peru history, its current legislation, as well as two cases which will serve as a reference to elucidate the problems including the mitigating and aggravating factors of this crime. Furthermore, we will be able to identify the intervening subjects and the protected legal right, which will help to carry out a normative analysis with the systematic structure of our legislation

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030