Gender Politics of "Illiberal Pragmatics" in the Polish Defense Sector

Since 2015, the illiberal Law and Justice (Prawo i Sprawiedliwość [PiS]) government in Poland has engaged in campaigns against "gender ideology," rolling back several equality mechanisms and provisions, and mainstreaming traditionalist values into state policy. Following from this, scholarship has predominantly addressed PiS gender politics through the concepts of anti-gender backlash and gender backsliding. Against this background, Polish defense policy constitutes a puzzling realm that significantly escapes these frameworks, revealing instead a mix of backsliding, institutional and discursive continuity, and positive gender change. While the displacement of the Plenipotentiary for Equal Treatment office has erased similar bodies in the defense sector, the government has swiftly created a National Action Plan on Women, Peace and Security, strengthened the Armed Forces Women's Council, and continued prior policy and discourse on women's service. Meanwhile, the increased defense preparations following the war in eastern Ukraine have doubled women's percentage in the armed forces, partially regendering the very idea and practice of defense. To explore this ambiguity, the article draws from feminist institutionalism and multi-sited sociological methods. It proposes to move beyond backlash towards the analytical concept of illiberal pragmatics - a complex, gendered logic of governance which seeks to balance illiberals' dedication to national sovereignty with pragmatic political, security, demographic, and economic considerations. Under illiberal pragmatics, women's interests are pursued within a more conservative framework, with gender norms simultaneously upheld and destabilized across different realms. Nevertheless, the key feature of illiberal gender politics lies not in backsliding, but in a pragmatic balancing act between national integrity and structural pressures for change

COVID-19 impact on kidneys

Introduction and purposeThe COVID-19 pandemic, which has been ongoing since early 2020, has significantly affected the health care system worldwide. SARS-CoV-2 virus being the etiological factor of the disease has a high affinity for the renal organ. The purpose of this study was to provide an overview of the current knowledge of the problem of frequent AKI in the course of coronavirus infection, the impact of COVID-19 disease in patients with chronic kidney disease and on renal replacement therapy or dialysis.Review methodIn the process of writing, we used available articles and scientific papers in Pubmed and Google Scholar databases based on keywords: COVID-19, SARS-CoV-2, AcuteKidneyInjury, ChronicKidneyDisease.State of knowledgeSARS-CoV-2 virus enters target cells through the ACE2 receptor. In the pathophysiology of AKI in the course of COVID-19, a key role is attributed to secondary damage mechanisms such as cytokine storm, hypoperfusion with hypoxia, endothelial dysfunction. The incidence of acute kidney injury ranges from 5.1% to 36.6%. The development of AKI, renal transplant status, the presence of chronic kidney disease or renal replacement therapy is associated with an increased risk of severe course and higher mortality on COVID-19. SummaryThe COVID-19 pandemic has posed new logistical and therapeutic challenges to the health care system. Due to the high tropism of SARS-CoV-2 to the kidneys and the frequent occurrence of AKI during the course of the infection, nephrology patients, those on renal replacement therapy and those awaiting transplantation should be placed under special surveillance. Patients in these groups are at particular risk for a severe course of COVID-19

Nutritional treatment in chronic kidney disease - review article

INTRODUCTION: Chronic Kidney Disease (CKD) is a condition affecting nearly 16% of the population. It is a disease that cannot be completely cured with modern medical capabilities. However, it is possible to halt the progression of the disease and postpone renal replacement therapy through pharmacotherapy. In order to monitor the progression of the disease, GFR should be determined.        PURPOSE OF THE WORK: This article reviews the potential impact of typical Western diet and eating habits on the occurrence and progression of chronic kidney disease. Reducing the intake of animal protein, foods rich in sodium potassium and phosphorus, and increasing the intake of fruits, vegetables and fiber help prevent or delay end-stage renal disease. The literature on the role of a low-protein plant-based diet in patients with CKD was also reviewed.        DESCRIPTION OF THE STATE OF KNOWLEDGE: In addition to pharmacological methods, whose main goal is to reduce proteinuria and control blood pressure, drug therapy can be supported by non-pharmacological methods. One of them is the use of a low-protein diet and adequate provision of macro- and micronutrients in the diet.         SUMMARY: In order to support pharmacotherapy in the treatment of chronic kidney disease, the use of an appropriate diet plays an important role. According to the literature, the most important is restriction of protein supply, weight reduction in obese patients and supplementation of micronutrient deficiencies that occur

The problem of pregnancy complicated by chronic kidney disease

Chronic kidney disease (CKD) in high-risk pregnancies is a challenge for multidisciplinary teams of doctors. Due to the fact that the disease affects both the mother and the fetus, and the course of the pregnancy. The following article reviews the literature about the interaction between pregnancy and CKD and dialysis therapy. Even pregnancy itself can lead to a worsening of kidney dysfunction. The risk of this consequence increases with the degree of renal failure, therefore renal parameters and other pregnancy test results should be monitored. On the other hand, the most common complications of chronic kidney disease in pregnancy described in the literature include pre-eclampsia, preterm labor, intrauterine growth restriction (IUGR) or low birth weight, surgical delivery by caesarean section and miscarriage. Dialysis therapy also leads to abnormalities in the course of pregnancy, and patients require constant monitoring during its course. Attention is also drawn to the high percentage of newborns requiring intensive postpartum care. Due to the risk for the fetus and mother mentioned in the article, nephrologists and gynecologists should cooperate closely from the pre-contraceptive period in order to reduce the risk of sequelae and better control of the underlying disease

Aristolochic acid nephropathy - still real danger

Arystolocholic acid nephropathy is chronic kidney disease caused by the use of substances of natural origin that contain arystolocholic acid. The effects of their use are arystolochic acid nephropathies, which include "Chinese Herbs" nephropathy. The course of the disease is very fast, resulting in progression to end-stage renal disease, and in the future it results in the development of urinary tract cancer. That is why it is so important to recognize it early and start treatment. However, due to disease progression, some patients require dialysis and even kidney transplantation. Although the World Health Organization is trying to stop the spread of the use of harmful substances, there are still reports of this nephropathy appearing in some populations. Despite warnings from the Food and Drug Administration regarding the safety of botanicals containing arystolochic acid and its classification as a human carcinogen, products containing it are still available for purchase online. The purpose of the literature review below is to analyze the latest knowledge on aristolochic acid nephropathy and its associated complication

Cardiac sympathetic hyperactivity in chronic kidney disease — a comparison between haemodialysis and peritoneal dialysis patients

BACKGROUND: The effect of renal replacement therapy on cardiac sympathetic function in patients with chronic kidney disease has not yet been completely elucidated. The aim of this study was to evaluate the impact of renal replacement therapy on the activity of cardiac sympathetic nervous system. MATERIAL AND METHODS: Thirty-four patients with chronic kidney disease were studied: 14 patients (6 men, mean age 48 ± 11 years) were receiving peritoneal dialysis (PD) and 20 patients (20 men, mean age 52 ± 10 years) were receiving haemodialysis (HD). Patients with diabetes and heart failure were excluded from the study. All patients underwent resting gated myocardial perfusion and 123I-mIBG myocardial scintigraphy from which early and late heart to mediastinum ratios (HRM) and myocardial washout rate (WR) values were calculated. RESULTS: PD and HD patients did not differ with respect to left ventricular ejection fraction (52 ± 9% vs. 57 ± 7%) and summed rest score (3.8 ± 2.4 vs. 3.5 ± 0.3). Similarly, early (1.89 ± 0.23 vs. 1.87 ± 0.27) and late (1.76 ± 0.47 vs. 1.74 ± 0.25) HMR, and washout rate (35.5 ± 15.8% vs. 31.3 ± 9.4%) were not significantly different between the two groups of patients. CONCLUSIONS: These results suggest that the applied method of renal replacement therapy has no significant influence on global activity of cardiac sympathetic nervous system

What does the future look like - home hemodialysis

Home hemodialysis (HHD) is a discovery from 1961 that is now experiencing a revival. It is a convenient and modern method of renal replacement therapy that allows the patient to undergo hemodialysis sessions at home. Due to the growing interest in home hemodialysis, we decided to present the potential of this renal replacement method, show both its benefits and complications resulting from its use. Undoubtedly, HHD has many benefits resulting mainly from the possibility of regulating the duration of the sessions and increasing their frequency. However, this method is also burdened with numerous complications. There are training courses in the use of HHD for patients who have just been diagnosed with end-stage renal disease as well as for patients undergoing dialysis using other methods. Appropriate patient selection is an important factor for the success of home therapy. There is a fierce battle in the home hemodialysis machine market. Manufacturers are outdoing each other in innovative technologies to ensure ease of use, trouble-free operation and minimize complications. The costs of home hemodialysis include more components than the dialysis treatment itself. Home hemodialysis gives patients comfort and independence above all. This is part of nephrology that undoubtedly requires a lot of work and development, but is certainly an invention of the 21st century

A fungal peritonitis in patient after heart transplant treated by continous ambulatory peritoneal dialysis — case report

Grzybicze zapalenie otrzewnej (GZO) jest rzadkim, choć ciężkim powikłaniem dializoterapii otrzewnowej (DO). Najczęściej prowadzi do zakończenia stosowania DO, często przyczynia się do śmierci pacjenta. Czynnikami ryzyka wystąpienia GZO są: zaawansowany wiek, płeć żeńska, uprzednia antybiotykoterapia i leczenie immunosupresyjne. Czynnikiem etiologicznym są najczęściej drożdżaki, zwykle Candida albicans. W artykule przedstawiono opis przypadku 63-letniej pacjentki po transplantacji serca leczonej immunosupresyjnie, u której rozwinęła się niewydolność nerek. Z tego powodu chora była leczona nerkozastępczo za pomocą DO. Po 12 miesiącach terapii ciągłą ambulatoryjną DO rozwinęło się dializacyjne zapalenie otrzewnej o ciężkim przebiegu. Jak wykazały badania mikrobiologiczne, jego przyczyną była infekcja grzybicza wywołana przez Candida albicans. Dzięki szybkiej i właściwej diagnostyce, usunięciu cewnika Tenckhoffa, zastosowaniu celowanej terapii przeciwgrzybiczej i zmianie metody leczenia na hemodializę uzyskano przeżycie chorej.Fungal peritonitis (FP) is a rare but very severe complication of peritoneal dialysis. It usually leads to method failure, even to the patient’s death. The risk factors predisposing to FP are: older age, female gender, prior antibiotic use, immunosuppressive treatment. The most common cause of FP are yeasts, mainly Candida albicans. We present a case report of a 63-year-old women on immunosuppressive treatment because of heart transplant, with end-stage renal disease (ESRD). The patient underwent renal replacement therapy — peritoneal dialysis. Twelve months after continuous ambulatory peritoneal dialysis begun, we observed severe peritonitis. The cause of peritonitis was fungal infection caused by Candida albicans. Quick and proper diagnostic, Tenckhoff’s catheter removing, antifungal therapy and transfer on hemodialysis made patient’s survival possible

Zaciskające zapalenie osierdzia u chorego dializowanego otrzewnowo

Zaciskające zapalenie osierdzia (ZZO) jest rzadkim zaburzeniem o różnorodnej etiologii, przebiegającym zwykle z klinicznymi objawami prawokomorowej niewydolności serca. Najczęściej bywa poprzedzone ostrym wysiękowym zapaleniem osierdzia i stanowi jego przewlekłe powikłanie. Jest ono poważnym wyzwaniem zarówno w zakresie diagnostyki, jak i leczenia. W diagnostyce pomocne są następujące badania: zdjęcie radiologiczne klatki piersiowej, elektrokardiogram, echokardiografia, cewnikowanie serca, tomografia komputerowa. W terapii u chorych wydolnych krążeniowo podejmuje się próby postępowania zachowawczego; u osób z cechami niewydolności krążenia, zwłaszcza ostrej, wybiera się leczenie chirurgiczne. Zabieg perikardiektomii u większości pacjentów powoduje znaczącą poprawę, lecz obarczony jest 4-18-procentowym ryzykiem zgonu. Autorzy przedstawiają przypadek pacjentki z zaciskającym zapaleniem osierdzia leczonej ciągłą ambulatoryjną dializą otrzewnową, u której z powodu wystąpienia cech ostrej niewydolności krążenia wykonano zabieg perikardiektomii

Zabieg pomostowania tętnic wieńcowych u pacjenta dializowanego otrzewnowo

Choroba niedokrwienna serca pozostaje jedną z najważniejszych przyczyn zgonów u pacjentów ze schyłkową niewydolnością nerek. Z roku na rok rośnie liczba pacjentów leczonych nerkozastępczo, którzy są poddawani zabiegowi pomostowania aortalno- wieńcowego. Mimo postępu, jaki dokonał się w kardiochirurgii, chorobowość i umieralność okołooperacyjna u pacjentów dializowanych utrzymują się na wysokim poziomie. W pracy przedstawiono satysprzypadek pacjenta dializowanego otrzewnowo, u którego wykonano zabieg pomostowania aortalno- -wieńcowego. W okresie okołooperacyjnym kontynuowano poprzednią metodę dializoterapii. Można zatem przypuszczać, że pacjenci dializowani otrzewnowo, poddawani zabiegom kardiochirurgicznym, mogą w okresie okołozabiegowym stosować dializę otrzewnową. Forum Nefrologiczne 2011, tom 4, nr 1, 33–3