The present study substantiates the economic basis for regulating land relations in the agricultural sector, outline the main stages of the formation and development of land relations in Russia. It also carries out a comparative analysis of land relations in Russia and foreign countries, presents theoretical aspects of economic regulation of land relations in the agricultural sector and considers domestic and foreign experience of the regulation of land relations. The activities of human society in connection with land are carried out on the basis of social relations, the key element of which is land relations. Transformations and regulation of land relations occur in the process of agrarian transformations. Historically, it has been proven that the implementation of agrarian reforms that change the socioeconomic situation, the working conditions of people, the production and marketing of products, does not bring about solid results without a proper transformation of land relations. The unique role of land relations in the system of agrarian reforms suggests that agrarian restructuring must begin with land reform.

Primary hyperparathyroidism (PHPT) is the leading cause of hypercalcemia. Total serum calcium level >3.5 mmol/L is associated with a high risk of a hypercalcemic crisis, manifesting with nausea, vomiting, dehydration, myalgia’s, abdominal pain, acute pancreatitis, acute kidney injury (AKI), cardiac rhythm disorders and disturbances of consciousness. We report here a case of PHPT, manifested with hypercalcemic crisis during pregnancy. A 30-year-old woman in the first trimester of pregnancy admitted complaining on loss of appetite, nausea, vomiting, lower abdomen pain, weakness, and leg pain during the last 10 days. She had a history of two uncomplicated pregnancies, and two episodes of renal colic, her kidney function was normal 2 weeks prior to admission. Work-up showed hypochloremia, hypokalemia, hyponatremia, total serum calcium was 5.34 mmol/L, and serum creatinine 226 µmol/L, and she underwent urgent hemodialysis (HD). Her parathyroid hormone (PTH) was 948 pg/mL, and imaging revealed missed miscarriage 9-10 weeks, soft tissue mass 30x20x33mm near the lower pole of the left lobe of the thyroid gland, small stones in renal calices, and polysegmental pneumonia. She received antibiotics, calcimimetics, and every-day hemodiafiltration (HDF), and underwent vacuum aspiration of uterine cavity and surgical removal of the parathyroidoma. Her PTH shortly returned to the reference level, and serum creatinine dropped to 140 µmol/L after kidney replacement therapy (KRT) secession. Pathology confirmed the diagnosis of parathyroid adenoma. PHPT should be included in the diagnostic algorithm of AKI in pregnancy along with vomiting of pregnant, sepsis, pre-eclampsia and other causes. Successful management of PHPT complications in pregnancy demands multidisciplinary team.

Журнал для непрерывного медицинского образования врачей Евсиков Андрей Иванович (Andrey I. Evsikov) -врач-хирург отделения общей онкологии № 71 ГБУЗ ГКБ им. С.П. Боткина ДЗМ,

Diabetes is disease of both the endo- and exocrine parts of the pancreas. Pancreatic exocrine insufficiency (PEI) can occur in every 2–3 patients with diabetes and affect not only the quality, but also life expectancy. At the same time, the diagnosis and treatment of PEI is not getting enough attention. The endocrinologist, as the main specialist leading patients with diabetes, can diagnose and treat patients with pancreatic exocrine insufficiency and diabetes using adequate doses of pancreatic enzyme replacement therapy (PERT).