The use of Methotrexate in ectopic pregnancy

Department of Obstetrics and Gynecology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Introduction. Ectopic pregnancy is one of the major emergencies in obstetrics and gynecology, being associated with a high rate of intra-abdominal bleeding if it is not diagnosed in a timely manner and is not subject to proper management. Aim of the study. To determine the effectiveness of Methotrexate in the treatment of ectopic pregnancy and which are the ß-HCG values to which it has the highest sensitivity. Materials and methods. A retrospective study was conducted during 2016-2019, in which we found out 320 cases, of which 45 cases were treated with Methotrexate solution - a single dose. Inclusion criteria was : ß-HCG ≤ 5000 mIU / mL in tubal pregnancy with gestational sac diameter ≤ 4 cm, lack of cardiac activity and no free fluid in Douglas space; Patients with ß- HCG ≥ 5000 mIU / mL and gestational sac diameter ≥ 4cm and presence of cardiac activity were excluded. Results. The success rate from a single dose of Methotrexate represented u = 10 cases - 22.8%, compared with failure u = 35 cases - 77.8%, which required surgery. The average age of the patients was 30 years, including the patients between 18-42 years. The success rate decreased with the older age of the patient. Pregnancies with more frequent occurrence at primiparity 7 cases - 70% and multiparity 3 cases - 30%. The average term of pregnancy at the time of diagnosis 4.3 weeks, p = 0.472. The success rate decreased with the increase of the gestation term. The diameter of the gestational sac was 2.3-4cm, and the success rate decreased in patients with gestational sac greater than 4cm, p = 0.132. The highest success rate was found in patients with a gestational sac of 2-3 cm in diameter - 67.2%. The study showed us a significant difference in the location of the pregnancy, although 56% were pregnancies located on the right (u = 26 patients) and 44% were located on the left (u = 29 patients). The β-HCG value ranged from 329-5200 mIU / mL, with an average of 1234 mIU / mL. Surgery against ineffectiveness required 35 cases (77.85%) that resulted in increased ß-HCG or tubal rupture and abdominal pain. All cases u = 35 (77.8%) resulted in surgical laparoscopy. In u = 7 cases, were detected tubal miscarriages performing salpingoplasty as treatment in 20% of cases and in 80% of cases was performed laparoscopic tubectomy. Conclusions. Our study demonstrated a low rate of efficacy of the conservative method of treatment of tubal pregnancy in evolution by administering Methotrexate. The data comes to contradict the beneficial experience and the weight of the success cases offered by the specialized literature in the conduct of patients with this pathology. If we strictly adhered to the inclusion criteria and the protocol of administration, it would be interesting to carry out an evaluation of the pharmacokinetics of the indigenous Methotrexate production preparation

Types of tree growth and fruit setting in F1 apple hybrids

1656 F1 hybrid apple seedlings, belonging to 127 combinations, have been screened according to their growing and fruit setting types, as it was phenotypically expressed. LESPINASSE (1977; 1992) amalgamated these two traits into a single one which was named ";ideotype";. The screened F1 individuals have been considered as resembling one of the following four architectural ideotypes of the trees indicated by Lespinasse: columnar, spur, standard and weeping. Different ratios of spur, standard and columnar F1 individuals were obtained depending on genitors and on the fact that a certain genitor had been used as a maternal or paternal partner in direct/reciprocal crosses. The monogenic inheritance of the columnar ideotype, proposed by Kelsey and Brown (1992); Lane (1992), does not seem to be the only genetic mechanism involved in the inheritance of this trait. Our experimental results suggest the polygenic determination of this ideotype as more probable than the monogenic one

Architectural ideotype of pear seedling in five hybrid combinations

The architectural ideotype - type of growing - was studied in a topcross experiment with five hybrid combinations in which Cluj 72-2-100 selection, typical spur, was used as a maternal tester. The analyzed seedlings were at the end of their sixth year of vegetation. There were no significant differences among the five hybrid combinations concerning the distributions of F1 seedling in the four accepted ideotypes (columnar, spur, standard, and weeping). A high variability was found for ideotype (between 18.8% in Cluj 72-2-100 x Napoca and 34.4% in Cluj 72-2-100 x Red Bartlett). The participation rate of genotype in the phenotypic manifestation of this character is relatively low. The coefficient of heritability in broad sense was 0.29 and the coefficient of heritability in narrow sense was very low, 0.001

Maturity of F1 grape hybrids originated in Pink Traminer

In eight hybrid combinations in which one of the parents (either maternal of paternal) was cv. Pink Traminer (Gewurztraminer), 2.284 F1 individuals have been analyzed concerning the maturity of grapes. Obvious differences were noted among different combinations and within the same combination, depending on whether Pink Traminer had been used as a maternal or paternal genitor. These data suggest a possible maternal effect on the analyzed characteristic. Grape maturity seemed to be polygenicall inherited, heritability (in broad sense) showing high values while the one in narrow sense small and very small values, suggesting that additivity is not playing the most important role in the inheritance of this character in grapes