ABSTRACT
We present successful surgical treatment of a patient with chronic kidney disease (CKD) and hyperparathyroidism undergoing renal replacement therapy. At baseline, parathyroidectomy via cervical access was performed for parathyroid adenomas. After 6 years, clinical and laboratory relapse of disease required thoracoscopic resection of atypically located anterior mediastinal adenoma. This case demonstrates that this disease is one of the most difficult in modern medicine requiring a special approach in diagnosis and treatment. Patients with CKD and hyperparathyroidism need for follow-up, control of total and ionized serum calcium, inorganic phosphorus and parathormone, osteodensitometry, ultrasound and scintigraphy of thyroid and parathyroid glands, and, if necessary, CT or MRI of the neck and chest organs.
Subject(s)
Adenoma , Parathyroid Neoplasms , Parathyroidectomy , Humans , Parathyroid Neoplasms/surgery , Parathyroid Neoplasms/complications , Parathyroid Neoplasms/diagnosis , Parathyroidectomy/methods , Adenoma/surgery , Adenoma/complications , Adenoma/diagnosis , Treatment Outcome , Neoplasm Recurrence, Local/surgery , Parathyroid Glands/surgery , Middle Aged , Thoracoscopy/methods , Male , Female , Mediastinal Neoplasms/surgery , Mediastinal Neoplasms/complications , Mediastinal Neoplasms/diagnosis , Hyperparathyroidism, Secondary/surgery , Hyperparathyroidism, Secondary/etiology , Hyperparathyroidism, Secondary/diagnosis , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/diagnosis , Mediastinum/surgeryABSTRACT
Trends in interannual variation in maturation and spawning terms of various age cohorts in the Eastern Baltic cod population in 1997-2009 were studied. Specific features in the age structure of the mature population part that were established by the end of the first decade of the 21st century were clarified. The role of cod age cohorts in the current population reproduction was considered taking into account the data on cod recruitment and fecundity.