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1767 Business Centre Drive, Suite 302, Reston, Virginia 22090-5332, USA 2004 July Tenth International Congress of Toxicology, ICT-X, Tampere, Finland. Return to the Table of Contents. Presentations at the First Regional Congress of the Medical Women's International Association, Near East and Africa Region, 29 November-3December 1993, Safari Park Hotel in Nairobi Kenya. Compiled by ; Medical Women's Association, Family Care International. Nairobi, Kenya. Kenya Medical Women's Association. 38pages. National Council for Population and Development, Division of Primary Health Care, MOH and The POLICY Project 1999. "Population and Family Planning Projections, 1989 to 2020 Kenya ; ." November 1998 Workshop Report. Nairobi: NCPD and North Carolina: Research Triangle Institute. Ndhlovu L. 1998. "Determinants of quality family planning services: a case study of Kenya." In: Clinic-based family planning and reproductive health services in Africa: findings from situation analysis studies. Edited by Kate Miller, Ian Askew, Majorie C Horn and Lewis Ndhlovu. New York, New York, Population Council. 107-24. Ndhlovu L., J. Solo, R. Miller, K. Miller and A. Ominde. 1997. "An assessment of clinic-based family planning services in Kenya: results from the 1995 Situation Analysis Study." New York: The Population Council and Nairobi: Division of Family Health, Ministry of Health. 43 pages. Obwaka W., J.K. Rumingo, P.N. Ndavi and C. Sekadde-Kigondu. 1997. "Correlates of contraceptive failure among clients attending an antenatal clinic in Nairobi." East African Medical Journal. 74, 9: 561-5. Olenick I. 1998. "HIV-infected women who have access to health care may safely use IUD." International Family Planning Perspectives. 24, 4: 203. Ojwang S.B. and B. Omugo. 1991. "Contraceptive use among women admitted with abortion in Nairobi." East African Medical Journal. 68, 3: 197-203. Parker R.B. 1990. "Long commentary in gynaecology: vasectomy in Kenya --acceptance, sociodemographic characteristics and psychological sequelae." Unpublished ; . 61pages. Pati S. 1997. "The unmet need for postpartum contraception: integration of LAM into programs to meet this need." In : Belagio and beyond: breastfeeding and LAM in reproductive health. End of project conference of the Breastfeeding and CH Division, Institute for Reproductive Health, a WHO Collaborating Center On Breastfeeding. 1997: May 13-16. Washington, DC: Georgetown University, Institute for Reproductive Health. 5 pages. Plummer F.A., J.N. Simonson, D.W. Cameron, J.O. Ndinya-Achola, K. Gakinya, P. Karasira, P. Piot, A.R. Ronald, J. Kimata and L.J. D'Costa. 1987. "Genital ulcer and oral contraceptives facilitate male-female transmission of HIV." Unpublished. May 27. 17 pages. Pollack A. 1993. "Postpartum IUDs: challenges and possibilities." In: Re-thinking Postpartum Health Care. Proceedings of a seminar presented under the Population Council's Robert H. Ebert Program on Critical Issues in Reproductive Health and Population, December 10-11, 1992. New York, NY: The Population Council. 69-71. POLICY Project. April 2000. Projections of Condom Use in Kenya, 1998-2003: Both Total and Public Sector Condoms revised ; . POLICY Project working paper. Nairobi. 5 pages. Qureshi Z.P. and M.M. Solomon. 1995. "A survey of the knowledge and attitudes of men in Machakos town towards vasectomy Journal of Obstetrics and Gynaecology of Eastern and ." Central Africa. 11, 1: 10-3. Rogo K., L. Bohmer and C. Ombaka. 1999. Developing Strategies to Reduce Maternal Morbidity and Mortality Due to Unsafe Abortion at the Community Level. Nairobi, Kenya: Pacific Institute for Women's Health and Center for the Study of Adolescence. 125 pages and tamsulosin.
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The incidence of restenosis varies between 2070%, depending on the length, degree and morphology of the lesions, the patency of runoff vessels, and length of time post-stenting. Because of the significant risk of late restenosis, PTA has generally been limited to patients with a partial stenosis that is discrete and short in length. Intimal hyperplasia caused by proliferation of smooth muscle cells and matrix formation is a key factor in the development of restenosis. Negative remodeling may also occur, causing constriction of the vessel. Catheter-based endovascular irradiation brachytherapy ; has been investigated as an adjunctive procedure to prevent restenosis following femoropopliteal PTA. Coronary artery brachytherapy has been successfully used as an adjunct to percutaneous coronary intervention PCI ; to treat in-stent restenosis in native coronary arteries or saphenous vein grafts. U.S. Food and Drug Administration FDA ; Three brachytherapy devices have received Premarket Approval PMA ; from the U.S. Food and Drug Administration FDA ; for use in coronary arteries The NovosteTM Beta-CathTM System Novoste Corp. ; and the GALILEOTM Intravascular Radiotherapy System Guidant Corp. ; deliver beta radiation, while the Cordis CheckmateTM System delivers gamma radiation. There are no brachytherapy devices approved specifically for use in peripheral arteries. Literature Review The Vienna 2 trial Minar, et al., 2000 ; was a single-blind randomized controlled trial n 113 ; to determine the efficacy of endovascular brachytherapy for prophylaxis of restenosis after femoropopliteal PTA. Patients were randomized to receive PTA and brachytherapy n 57 ; or PTA alone n 56 ; . The primary endpoint of the study was patency after six months. Follow-up was conducted by investigators unaware of treatment allocation and included measurement of the ankle-brachial index, duplex sonography and angiography. The overall recurrence rate at six months was 15 28.3% ; of 53 in the PTA + brachytherapy group and 29 53.7% ; of 54 in the PTA group. The patency rates at 12 months were 63.6% in the PTA + brachytherapy group and 35.3% in the PTA group. While a significant reduction of recurrence was demonstrated, restenosis was not prevented in about a third of patients. The investigators speculated that the dose used in the trial may not have been adequate for complete inhibition of neointimal hyperplasia. They also concluded that the catheter position may have been a factor, since poor centering of the source within the arterial lumen may result in areas of under-dosage and over-dosage. The authors stated that because it is not clear whether radioactive therapy prevents restenosis or simply delays it, long-term studies are needed to determine long-term safety and efficacy. Pokrajac et al. 2000 ; published a subgroup analysis of patients in the Vienna 2 trial considered to be at increased risk. This trial evaluated the results of PTA + brachytherapy compared to PTA alone in patients with 1 ; restenosis after a previous PTA rather than de novo lesions 2 ; occlusion rather than stenosis 3 ; PTA length 10 cm; and 4 ; diabetes. The authors reported that, when brachytherapy was added compared to the results of PTA alone, there was a significant decrease at six months in restenosis rates for patients in all of these subgroups except for diabetics. For diabetics, the recurrence rate was only slightly reduced when compared to PTA alone, however. Krueger et al. 2002 ; conducted a randomized single-blinded controlled trial n 30 ; to determine whether endovascular brachytherapy immediately following PTA of de novo femoropopliteal stenoses lowers the stenosis rate. After successful PTA and placement of a centering catheter, patients were randomized to receive centered endovascular irradiation irradiation group ; or no irradiation control group ; . Patients were blinded to randomization. Angiographic follow-up was available for 22 patients at six months 10 in the irradiation group ; and 12 patients at 12 months six in the irradiation group ; . At six months, the change in degree of stenosis in the irradiation group was -14.7 20.8 versus 37.7% 27.3 in the control group, and at 12 months, -9.5% 34.5% vs. 45.5% 40.7%, respectively. Duplex sonography, treadmill testing and interviews were performed on the day before and day after PTA, and after one, three, six, nine, and 12 months. 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