Piotr Pysz

Background: A persistent connection between the atria, known as a patent foramen ovale (PFO), is present in approximately 25% of the general population. PFO closure is indicated in patients under 60 years of age who have experienced an embolic stroke of undetermined source (ESUS) or transient ischemic attack (TIA) confirmed by neurological imaging, and in selected cases of peripheral embolism. Follow-up after the procedure is indicated to confirm the position of the occluder, assess the effectiveness of the closure, and evaluate any potential thrombus formation on the device. Methods: We analyzed data from 75 consecutive patients who underwent percutaneous PFO closure procedures and were followed up for at least one year. The procedure was performed under fluoroscopy and transesophageal echocardiography (TEE) guidance, and occluder size selection was made using TEE multiplanar imaging (MPR). All patients had standard transthoracic echocardiography (TTE) at 1 and 6–12 months after the procedure. To assess the long-term efficacy, contrast-enhanced transcranial Doppler (ce-TCD) was performed at 12 months to record high-intensity transient signals (HITSs). Cases with positive ce-TCD had TEE performed. Results: During follow-up evaluations after 1 and 6–12 months (TTE), we did not observe any device dislodgements, thrombi, or residual leaks visible in TTE. ce-TCD detected HITSs in eight patients, prompting additional TEE examinations performed in seven cases. In five out of seven patients, a leak around the occluder was identified, including two patients with grade 2 HITSs. Conclusions: Assessing the effectiveness of PFO occluder placement is crucial for the residual embolic risk and thus the necessity of antithrombotic therapy. Even low grades of HITSs observed in ce-TCD help to identify patients with residual leaks confirmed in TEE.

In the economic history of twentieth-century Poland, two periods merit particular comparison: the interwar years and the time of systemic transformation. In 1918 and 1989, the Polish economy faced the formidable challenge of constructing a competitive economic order. Despite the temporal distance and substantial differences separating these two turbulent historical episodes, they share a common feature – strong destabilizing tendencies in the monetary sphere. The article aims to compare these two periods through the lens of the ordoliberal principle of stable money. Ordoliberalism regards this principle as necessary for establishing and maintaining a competitive economic order. The article employs a comparative analytical method, drawing on an institutional approach and the theoretical framework of the ordoliberal competitive order. The analysis reveals that in both cases, monetary policy played a fundamental role in overcoming inflationary crises and restoring confidence in the state and the market. In both periods, efforts were made to ensure financial stability through the institutional establishment of independent central banks. Despite elements aligned with ordoliberal thinking, both cases lacked the complete embedding of monetary policy within a long-term, normative vision of economic order.

Purpose | The aim of the paper is to discuss the possibility of using economic theory to shape a socio-economic order that offers a chance of resolving the polycrisis that afflicts today’s global economy and, more broadly, the whole civilisation. Research method | Through a critical analysis of the available literature on the subject, the main trends in economic thought are examined in terms of the economic policy trilemma formulated in the article, which involves the stability of the economic order, the efficiency of the economic process and the prevailing ethical values. Results | The findings support the conclusion that ordoliberalism is the most suitable approach when it comes to addressing the challenges outlined in the article and re solving the trilemma in question. Originality / value / implications / recommendations | Research of this kind implies a return of thinking in terms of economic order, and thus contributes to theories that seek to overcome the crisis in both the real economy and the theory of economics.

Research background: To a limited extent, modern researchers are interested in ordoliberalism, as a theory of the socio-economic system, which is confirmed by the results of the bibliometric analysis. In conducted studies, the assumptions of ordoliberalism are used partially, for example, for research on: the role of the state in the economy, the antitrust law, the theoretical assumptions of the SME, the determinants of German economic policy after World War II. Purpose of the article: The aim of this article is to present the possibilities offered by the ordoliberal theory that predispose it to determine a socio-economic order which makes it possible to tackle the dysfunctions and crises that afflict today’s economy. Methods: The research methodology involves a critical analysis of the works of the most essential representatives of ordoliberal thought, particularly Walter Eucken and others, from the perspective of the above-mentioned purpose of the study. This requires examining German-, Polish- and English-language publications by authors recognised as representatives of mainstream ordoliberalism. Findings & Value added: As a result of the conducted analysis, the hypothesis about the existence of the elements of ordoliberal theory that allow it to respond to the challenges of the modern world, including economic, social, environmental and climate crises and pandemic threats has been confirmed. Research of this kind implies a return of thinking in terms of economic order, and thus contributes to the theories that seek to overcome the crisis in both the real economy and the theory of economics.

Between December 2014 and March 2021, 144 patients with aortic (Ao) or mitral (Mi) paravalvular leaks (PVLs) were enrolled at 21 sites in 10 countries. Safety data were available for 137 patients, who were included in the safety analysis fraction (SAF), 93 patients with Mi PVLs and 44 patients with Ao PVLs. The full analysis set (FAS) comprised 112 patients with available stratum (aortic/mitral leak) as well as baseline (BL), 180-day or later assessments (2 years). Procedural success (implantation of the device with a proper closure of the PVL, defined as reduction in paravalvular regurgitation of ≥one grade as assessed by echocardiography post implantation) was achieved in 91.3% of FAS patients with Mi PVLs and in 90.0% of those with Ao PVLs. The proportion of patients suffering from significant or severe heart failure (HF), classified as New York Heart Association (NYHA) class III/IV, decreased from 80% at baseline to 14.1% at 2-year follow-up (FAS). The proportion of FAS patients needing hemolysis-related blood transfusion decreased from 35.5% to 3.8% and from 8.1% to 0% in Mi patients and Ao patients, respectively. In total, 35 serious adverse events (SAEs) were reported in 27 patients (19.7%) of the SAF population. The SAEs considered possibly or probably related to the device included device embolization (three patients), residual leak (two patients) and vascular complication (one patient). During follow-up, 12/137 (8.8%) patients died, but none of the deaths was considered to be device-related. Patients implanted with the Occlutech Paravalvular Leak Device (PLD) showed long-lasting improvements in clinical parameters, including NYHA class and a reduced dependency on hemolysis-related blood transfusions.

Current pharmacotherapy for hypertrophic cardiomyopathy (HCM) is not disease-specific and has suboptimal efficacy, often necessitating interventional treatment. EXPLORER-HCM was a phase 3, randomized, double-blind, placebo-controlled, multicenter clinical trial investigating the effects of mavacamten, a first-in-class selective cardiac myosin inhibitor, in patients with HCM, left ventricular outflow tract obstruction (LVOTO) and New York Heart Association (NYHA) class II or III symptoms. The primary endpoint was defined as either a ≥1.5 ml/kg/min increase in peak oxygen consumption (pVO₂) and ≥1 NYHA class reduction or a ≥3.0 ml/kg/min pVO2 increase without NYHA class worsening. Secondary endpoints evaluated changes in post-exercise LVOT gradient, pVO2, NYHA class, Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (KCCQ-CSS), and Hypertrophic Cardiomyopa-thy Symptom Questionnaire Shortness-of-Breath subscore (HCMSQ-SoB). A total of 251 patients were randomized to receiving mavacamten or placebo. The primary endpoint and all secondary endpoints were met significantly more frequently in the mavacamten arm versus placebo. The safety profile of mavacamten was similar to that of placebo. In conclusion, disease-specific treatment with mavacamten in patients with obstructive HCM led to reduced LVOTO and improvement in both objective functional parameters and patient-related health status.

Cel-Celem artykułu jest polemika z poglądami o rzekomym statycznym charakterze ordoliberalizmu, na którego gruncie-zdaniem krytyków-nie podejmuje się kwestii związanych z dynamiką ładu społeczno-gospodarczego. Rozważania zmierzają do weryfikacji hipotezy, iż ordoliberalni myśliciele uwzględniali tę problematykę implicite w swych programach