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Chronic renal disease (CKD) is a social problem affecting millions of patients characterized by loss of renal function and related to metabolic diseases. The approach from the dietary point of view to this problem could be a perfect strategy to slow down the progression of the disease and at the same time the problems of malnutrition typical of CKD. Several studies show that the Mediterranean diet (MD) may play a key role in the control of the early stages of the disease. Even if the MD showed to be the best diet for the control of metabolic diseases and for the general well-being, in the case of the patient with CKD, should be adapted in what is called the DASH diet, characterized by the typical roles of the MD but with a controlled intake of minerals and proteins.

Background: Secondary hyperparathyroidism is a common acquired disorder seen in chronic renal failure. Its pathophysiology is mainly due to hyperphosphatemia and vitamin D deficiency and resistance. When medical treatment fails, subtotal and total parathyroidectomy with autotransplantation are the standard procedures, although both are associated with high recurrence rates.Methods and Results: 4 patients experienced persistence and 9 relapse. The first 4 were subjected to reoperation after 6 months for the persistence of symptoms due to the finding of a supernumerary adenomatous gland while the remaining patients at the reoperation showed in 5 cases 2 more glands in over thymic position, and 4 an hyperplasia of the residual glandular tissue. A classic cervicotomy was sufficient to remove the residual parathyroid in patients with persistent hyperparathyroidism. For cases of recurrent hyperparathyroidism it was enough a medial approach and sometimes lateral for the complete excision of the hyperplastic tissue. The advent of the intraoperative technique of parathyroid hormone dosage allowed a better performance of the surgical technique for the last 3 patients undergoing reoperation. After reoperation all patients had immediate regression of clinical symptoms with normalization of serum calcium and PTH levels. Conclusions: On the basis of these considerations, diagnostic imaging has a not negligible role because during the first intervention helps to have an idea of the possible location of the glands and thus to avoid the risk of recurrence and relapse due to ectopic or supernumerary tissue.

‘We are what we eat’, said the philosopher Feuerbach. In fact, the quality of the food we eat affects our mind as well: the brain, which represents 2% of our body weight, consumes about 20% of the calories we eat each day. Follow a few rules could therefore help to feed properly our brain, so it works to the best of its ability. It is important to know properties of foods especially regarding their aminoacidic composition because aminoacids are components of neurotransmitters, molecules needed for brain transmission and function. It is also possible to choose specific food to prevent or support different diseases that affects nervous system.