The Formation of a Mercantilist State and the Economic Growth of the United Kingdom 1453-1815

military, sovereignty, mercantilism, political economy, taxation

Surgical excision of renal cell carcinoma with caval and intra-atrial tumour thrombus extension using deep hypothermic circulatory arrest

Surgery for tumour thrombus extension in Renal Cell Carcinoma may be associated with a good prognosis if no distant metastases are identified and if the thrombus can be completely excised. The surgical approach chosen will depend on the level of tumour thrombus extension. We present a case of Renal Cell Carcinoma in the right kidney with tumour thrombus extension into the right atrium. This was successfully removed by right radical nephrectomy and excision of the atrial thrombus using cardio-pulmonary bypass and deep hypothermic circulatory arrest. This is the first procedure of its kind to be undertaken in Malta.peer-reviewe

In situ N2O emissions are not mitigated by hippuric and benzoic acids under denitrifying conditions

This research was financially supported under the National Development Plan, through the Research Stimulus Fund, administered by the Department of Agriculture, Food and the Marine (Grant numbers RSF10/RD/SC/716 and 11S138).peer-reviewedRuminant urine patches deposited onto pasture are a significant source of greenhouse gas nitrous oxide (N2O) from livestock agriculture. Increasing food demand is predicted to lead to a rise in ruminant numbers globally, which, in turn will result in elevated levels of urine-derived N2O. Therefore mitigation strategies are urgently needed. Urine contains hippuric acid and together with one of its breakdown products, benzoic acid, has previously been linked to mitigating N2O emissions from urine patches in laboratory studies. However, the sole field study to date found no effect of hippuric and benzoic acid concentration on N2O emissions. Therefore the aim of this study was to investigate the in situ effect of these urine constituents on N2O emissions under conditions conducive to denitrification losses. Unadulterated bovine urine (0 mM of hippuric acid, U) was applied, as well as urine amended with either benzoic acid (96 mM, U + BA) or varying rates of hippuric acid (8 and 82 mM, U + HA1, U + HA2). Soil inorganic nitrogen (N) and N2O fluxes were monitored over a 66 day period. Urine application resulted in elevated N2O flux for 44 days. The largest N2O fluxes accounting for between 13% (U) and 26% (U + HA1) of total loss were observed on the day of urine application. Between 0.9 and 1.3% of urine-N was lost as N2O. Cumulative N2O loss from the control was 0.3 kg N2O–N ha− 1 compared with 11, 9, 12, and 10 kg N2O–N ha− 1 for the U, U + HA1, U + HA2, and U + BA treatments, respectively. Incremental increases in urine HA or increase in BA concentrations had no effect on N2O emissions. Although simulation of dietary manipulation to reduce N2O emissions through altering individual urine constituents appears to have no effect, there may be other manipulations such as reducing N content or inclusion of synthetic inhibitory products that warrant further investigation.Department of Agriculture, Food and the Marin

Outcome of Nephrectomies in Malta since 2000

Aim: To audit the oncological results and perioperative surgical outcome of nephrectomies performed in Malta since year 2000. Method: A retrospective index case list of all nephrectomies carried out by three urological surgeons at St Luke’s and Mater Dei Hospitals from 1st September 2000 to 31st March 2012 was compiled from departmental data. Clinical, radiological and histological data were compiled from the case notes and hospital intranet computerised investigation results. Clinical staging of all patients was revised using the Union Internationale Contre le Cancer TNM staging 2009. All the patients who underwent nephrectomy for clear cell renal cell carcinoma were stratified according to individual predicted prognosis based on the SSIGN score developed by the Mayo clinic. Results: Between September 2000 and March 2012, 319 nephrectomies were carried out at the Urology Unit, of these 288 were carried out for malignancy, 218 of which were clear cell renal cell carcinoma (RCC). 112 complications were recorded for the whole cohort; two patients died from perioperative complications. 80 patients passed away, 51 of these as a direct consequence of their renal cell cancer. Median duration of follow up was 42.7 months. A Cox model reveals that a SSIGN score greater than 6 significantly worsens survival rate for RCC (p<<0.001). Conclusion: Morbidity following surgery, mortality rates, and oncological results in our single centre study are acceptable when compared to larger series.peer-reviewe