Media releases

Understanding substance abuse and addiction

Substance abuse is an enormous social problem in South Africa

Friday, June 22 2018

Drug and alcohol abuse take their toll on thousands of South Africans every day, but no matter how hopeless the situation seems, it is never too late to turn things around by seeking help.

Substance abuse is an enormous social problem in South Africa, as elsewhere, and it’s increasing every day.
Alcohol, marijuana (dagga), cocaine, tik and heroin are some of the most frequently used substances in this country, according to the South African Depression and Anxiety Group (SADAG). Although there is no magic wand when it comes to treating substance abuse and addiction, help is available for patients and their families.

“Given some of the frightening statistics on substance abuse in the country, there is an urgent need to educate people on the dangers and the treatments available,” says Marna Acker, an Occupational Therapist at Akeso Clinic Nelspruit. “South Africa has no regular representative surveys on substance abuse, which makes it difficult to understand the full extent of the problem. The stats are available only for people admitted for treatment. But we do know that the South African Community Epidemiology Network on Drug Use (SACENDU) project, which is an alcohol and other drug (AOD) sentinel surveillance  system, and is operational in nine provinces, shows that there was an increase in the number of people admitted for treatment – from 8 787 in 2016, to 10 047 in 2017, across 80 centres.”

What drives people to abuse substances?

Certain people are more at risk for substance abuse and for developing addiction disorders than others. “There are many factors that may make people vulnerable, including genetics, family background, mental health issues, work stress, financial pressure, and relationship problems,” says Acker.

“These factors can make the person at risk value substance abuse as a coping mechanism, even though it is against their interest in the long term. There are also other factors involved, such as peer pressure – particularly when substance use is a norm; boredom, and the feeling of not having a sense of purpose can also be contributing factors, as can feelings of depression, anxiety, and lack of control.

Long-term effects of substance abuse

The longer an addiction lasts, the more stress and strain it puts on the individual and, while different substances have different effects, depression, anxiety and paranoia are among the most common long-term results of substance abuse.

“Cannabis users, for example, may experience poor attention span, as well as memory and learning loss,” says Acker. “Poor performance, permanent cognitive impairment, lack of motivation, immunosuppression, and cardiac and lung complications are all common effects.

“In addition, cannabis-induced psychosis may occur. Several studies have linked marijuana use to increased risk for psychiatric disorders, including schizophrenia, depression, anxiety, and substance use disorders, although whether and to what extent it actually causes these conditions is not always easy to determine. On top of all these possible outcomes, sustained cannabis use can also have a negative impact on interpersonal relationships, work performance, financial management, and more. The list is endless.’

An added complication is that all substance abuse can lead to impulsive behaviour and poor judgement. Alcohol abuse contributes to risky sexual behaviour, increasing the chances of contracting HIV and other sexually transmitted diseases, as well as liver diseases, neurological disorders, and chronic memory disorders, while opioids, such as morphine and the illegal drug heroin, can result in accidental overdose. Sometimes, drug abuse can actually increase a user's risk of developing a mental disorder.

“Long-term drug abuse can also affect the physical health of the user, especially the kidneys, liver, heart and lungs,” Acker adds. “Increased tolerance is dangerous as it causes the individual to use more and more of a drug to achieve the desired euphoric or stimulated state. This increases the person’s risk for overdose and even death.”

Signs and symptoms to look out for

If you or someone you love is addicted to drugs or alcohol, they may exhibit some or all of the following physical, psychological and social signs and symptoms:

  • Weight loss, skin colour change, skin outbreaks
  • Intense urges or cravings as the addiction develops
  • Withdrawal symptoms leading to suboptimal performance and physical craving
  • Isolation, depression, anxiety and paranoia
  • Unhealthy friendships with people who have similar habits
  • Financial difficulties due to large amounts of money being spent on drugs or alcohol
  • Neglecting responsibilities, such as work or personal obligations
  • Poor judgement, including risky behaviours such as stealing, lying, engaging in unsafe sex, selling drugs, or crimes that could land the person in jail

What types of treatment are available?

Outpatient programmes are offered by organisations like the South African National Council on Alcoholism and Drug Dependences (SANCA), Alcoholics Anonymous (AA), and Narcotics Anonymous (NA). Short-term inpatient programs – 21 to 30 days – including detoxification, and longer-term in-patient programs -- 90 days to a year or more – are offered by addiction clinics throughout the country. For example, Akeso Clinics offers an inpatient programme which focuses on addictions and other psychiatric issues (dual diagnosis), with a multi-disciplinary team approach.

“The recovery process is life-long, there is no recipe for success, and relapse is very common, says Acker. “That’s why it is extremely important for people with addictions to have ongoing counselling and therapy, to belong to support groups, and to have an accountability partner.”

If you believe a friend or family member has an addiction, encourage them to seek help from a professional. Do not try to be that professional yourself. Be supportive and remember that substance use disorder is an illness. Put up boundaries, be careful of manipulation and do not do anything that enables the disorder. Make sure that you also have support sessions for the family as this can be helpful and informative.

Fact box

  • It’s estimated that up to 60% of crimes committed involve the use of substances
  • The rate of foetal alcohol syndrome in South Africa is five times that of the US
  • 80% of male youth deaths are alcohol-related
  • Drug consumption in South Africa is estimated to be twice the world norm
  • According to the South African Community Epidemiology Network on Drug Use (SACENDU), cannabis and alcohol are the substances most likely to be abused
  • Males over the age of 20 are the biggest abusers of alcohol
  • Male youths are the main abusers of cannabis

References:

  • https://www.recoverydirect.co.za/commonly-abused-substances-south-africa/
  • http://www.samrc.ac.za/sites/default/files/attachments/2018-05-09/SACENDUFullReportPhase42.pdf
  • http://www.mrc.ac.za/sites/default/files/attachments/2018-03-02/SACENDUupdateJan2018.pdf
  • https://www.drugabuse.gov/publications/research-reports/marijuana/letter-director

- Ends -            
Notes to the Editor
About the Akeso Group:
Akeso Clinics is a group of private in-patient psychiatric clinics that prides itself on providing individual, integrated and family-oriented treatment for a range of psychiatric, psychological and addictive conditions. Akeso Clinics offer specialised in-patient treatment facilities.
Please visitwww.akeso.co.za, email info@akeso.co.za, or contact us on 011 447 0268 for further information.
In the event of a psychological crisis, please call 0861 4357 87 for assistance.
Media contact - For further information contact:
Tranica Gurcharan
Bespoke Communications
072 230 8863
tranica@bespokecomms.co.za

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World-class robotic-assisted prostate surgery a welcome option for Eastern Cape men

PE urologists accredited in precision keyhole radical prostatectomy with da Vinci system

Wednesday, June 20 2018

A man who fainted in a Port Elizabeth urologist’s office when he received the news that he had prostate cancer has recounted his relief at learning that there was a minimally-invasive, high-precision robotic-assisted surgical option for the removal of the cancerous gland.

“It all began when I noticed my urine flow weakening last year. I had some tests, and a biopsy was taken from my prostate gland,” explains 54-year-old Christiaan Brits of Cradock in the Eastern Cape.

When Mr Brits and his wife went for a consultation with urologist, Dr Johannes Brummer, at his Netcare Greenacres Hospital practice, he received the unwelcome news that the tests had detected localised prostate cancer. “It was a huge shock; I passed out in Dr Brummer’s office when he told us the diagnosis,” he recalls.

“Dr Brummer explained the various treatment options available to me and recommended that the diseased prostate gland be surgically removed as the cancer was localised to my prostate, and that a radical prostatectomy would limit the risk of it spreading beyond the prostate gland,” says Mr Brits.

Pic: Urologists Dr Johannes Brummer and Dr Johan Coetzee have been accredited as da Vinci robotic surgeons to perform radical prostatectomies, the surgical removal of the prostate gland to treat prostate cancer. Together the two have completed 72 such robotic-assisted procedures at Netcare Greenacres Hospital in Port Elizabeth.;

He also informed Mr Brits that operating on the prostate poses certain risks, including possible loss of erectile function and reduced urinary control, but that a new surgical option associated with reduced risks was available.

“The doctor told me that one of the options was a new robotic-assisted surgical technique, for which he had to have special training overseas. I was very interested to hear that this world-class technology is available here in the Eastern Cape, and immediately I felt reassured,” Mr Brits says.

Robotic-assisted technology is recognised as the gold standard for the surgical treatment of localised prostate cancer in Europe and the United States.

Both Dr Brummer and fellow urologist, Dr Johan Coetzee, who also practises at the hospital, have been accredited as da Vinci robotic surgeons to perform radical prostatectomies, which is the surgical removal of the prostate gland. Together they have already completed 72 da Vinci robotic-assisted prostatectomy procedures at Netcare Greenacres Hospital since the technology was introduced at the hospital in August 2017.

“We are performing da Vinci prostatectomies routinely now. This highly advanced surgical system offers incredible high definition three-dimensional visualisation capabilities, which allows us as surgeons to see the nerves and tissues at a magnification that is 10 times greater than the human eye. The robotic arms and wristed instruments furthermore allow more freedom of movement than the human hand, which enhances surgical precision, and improves preservation of the nerves which control urinary continence as well as erectile function,” Dr Brummer explains.

“This is of considerable assistance in our efforts to spare the nerves associated with urinary continence and erectile function when performing prostatectomies. In terms of quality of life, this is an important consideration for our patients, particularly for the younger men we treat.”

Dr Coetzee adds that patients generally tend to recover more rapidly after surgeries performed with the da Vinci system compared with traditional surgery. “There is far less post-operative pain because da Vinci procedures are minimally invasive, and most patients spend only two nights in hospital after this type of surgery, versus four to five nights for open surgery,” he says.

“Patients are also mobile and able to return to work much sooner, on average. The length of time that the patient is required to use a catheter to assist them in passing urine, is much less compared to open surgery, and our patients appreciate this.”

Mr Brits says that he was pleasantly surprised that he experienced no pain, and had only slight discomfort in the days after the procedure. “There were six tiny punctures in my skin, but they soon healed. I was most impressed with Dr Brummer and his team, and the care I received at the hospital was first-rate.

“Ten days later, I had to go for scans and tests. Fortunately, these detected no signs of cancer, so there was no need for me to have further treatment. I have a follow-up appointment in August to monitor my progress since the procedure,” he says.

“I would recommend the da Vinci surgery at Netcare Greenacres Hospital 110% to any man who is faced with similar problems. I was concerned about the type of things men do worry about when confronted with the need for prostate surgery, but it has fortunately not impacted my quality of life,” Mr Brits asserts.

Dr Brummer says that it is gratifying to be able to offer this world-class minimally-invasive surgical option for suitable patients living in Port Elizabeth and surrounding communities as far afield as Knysna, George and East London along the coast, as well as the inland regions of the Eastern Cape, the southern region of the Free State, the eastern region of the Northern Cape and the north-eastern region of the Western Cape.


Christiaan Brits, 54, of Cradock in the Eastern Cape, is one of the more than 70 men who have already undergone robotic-assisted surgery at Netcare Greenacres Hospital after being diagnosed with prostate cancer.

“We have undertaken extensive training to bring international trends in robotic-assisted surgery to our province. With more than 4 000 men, some as young as 40, being diagnosed with prostate cancer in South Africa every year, it is extremely important that every effort is made to preserve urinary control and sexual function,” he says.

“The da Vinci robotic-assisted surgery has shown excellent results in terms of cancer control and survival rates. In most cases, there is less need for blood transfusion and reduced risk of complications, and the patient recovery experience is considerably better as it is quicker and more comfortable than traditional open surgery,” Dr Brummer concludes.

Ends

Issued by:    Martina Nicholson Associates (MNA) on behalf of Netcare Greenacres Hospital
Contact:      Martina Nicholson, Graeme Swinney, Meggan Saville or Estene Lotriet-Voster
Telephone:   (011) 469 3016
Email:    martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za,or estene@mnapr.co.za

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New chemotherapy unit opened at Netcare Milpark Hospital

Iconic Johannesburg hospital strengthens cancer care offering

Monday, June 18 2018

A new chemotherapy unit has been established at the iconic Netcare Milpark Hospital in Parktown, Johannesburg, offering convenient access to chemotherapy for individuals in the surrounding communities requiring this service.

“The modern chemotherapy unit is a welcome addition to the healthcare services available at our Hospital, and bolsters the person-centred health and care we are able to provide for those requiring cancer treatment,” says Dr Justin Gavanescu, general manager of Netcare Milpark Hospital.

The hospital is renowned for its range of highly specialised healthcare services, including being one of only two private hospitals in South Africa with a Level 1 accredited trauma centre, and the internationally accredited Netcare Milpark Breast Care Centre of Excellence, among others.
“The new chemotherapy unit has been designed to provide a tranquil setting for patients who need chemotherapy infusions. In common with all such facilities at Netcare hospitals, treatment is provided in accordance with the South African Oncology Consortium’s protocols,” Dr Gavanescu notes.

According to Noeleen Phillipson, Netcare’s executive responsible for cancer care, the chemotherapy services offered at Netcare Milpark Hospital are backed with evidence-based protocols and a caring, dedicated multidisciplinary team of specialists, nurses and other healthcare professionals.

“We recognise that each cancer diagnosis is unique. A multidisciplinary team works together to identify the optimal approach for each individual treatment journey to ensure quality physical care and psychological support is provided,” she explains. 

“A patient navigator assists in coordinating each individual’s treatment, guiding and supporting them through diagnosis, treatment and follow-up care. Not only does the patient navigator assist the person undergoing treatment through the various medical disciplines and healthcare providers, they also help to streamline the process so that the individual can focus on their recovery.”

Medical oncologists, who are specialists in antineoplastic drug management and form an integral part of the multidisciplinary team, have consulting facilities at Netcare Milpark Hospital and provide patients with chemotherapy in the new unit. Oncology pharmacists are responsible for carefully mixing the required chemotherapy drugs in a biosafety cabinet.

“Specially trained nursing staff members administer the therapeutic chemotherapy infusions in accordance with the South African Oncology Consortium (SAOC) guidelines, policies and treatment regimes. The infusions take place in a spacious treatment area, where family or friends can stay with patients or where patients can choose to chat to each other,” Phillipson says.

“The unit has been designed in such a way as to also offer privacy during treatment for patients who prefer this. Each of the 18 comfortable treatment stations are equipped with a flat screen TV for those who prefer entertainment during infusion sessions, while WiFi access is also available.

“As in all our facilities, infection prevention is a high priority. Chemotherapy infusions are provided in a hygienic clinical environment for the safety of our patients, while the look and feel of the unit was designed with comfort and tranquillity in mind.”

Additional services, including counselling, advice on coping with the illness, nutritional guidance and physiotherapy for patients suffering with lymphedema, provide further value-adding support for patients.

According to Phillipson, Netcare’s approach to cancer care services is underpinned by the appropriate use of high-end treatment technology and collaboration with independent oncologists embracing best practice in cancer care, so that patients are assured of clinical excellence.

“We strive to provide each person with continuous emotional support while being respectful of each one’s deeply personal journey. We recognise that everyone will have their own way of coping, and our approach is to offer world-class clinical treatments, together with caring, professional guidance that is empathetic of each individual’s specific needs. We ensure that no one fights cancer alone,” Phillipson says.

The facility is also home to Gamma Knife South Africa, the only centre in South Africa to provide highly advanced cranial radiosurgery with applications for malignant and benign tumours of the head and neck among other conditions. Intraoperative radiation therapy for treatment of breast cancer is also provided at Netcare Milpark Hospital.
“The new chemotherapy unit adds to the spectrum of cancer care services that are available at Netcare Milpark Hospital. We anticipate that this new chapter in the hospital’s unfolding history will assist a great many people with life-saving treatment and value-adding support services in the years to come,” Dr Gavanescu concluded.

Ends

Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare Milpark Hospital
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville or Estene Lotriet-Voster
Telephone: (011) 469 3016
Email: martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za, or estene@mnapr.co.za

 

 

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‘Take fainting to heart’ this World Heart Rhythm Week

Inherited heart rhythm disorders a challenge requiring urgent attention in SA

Thursday, June 14 2018

It is well known that heart rhythm disorders (arrhythmias) occur in adults, but few are aware that it is a significant problem among many South African children as well. Children may be born with a heart disorder that causes electrical and functional problems in the heart and remain unaware into adulthood that they have a potentially dangerous health problem.

“There needs to be much greater awareness of heart rhythm disorders and congenital heart disease, which is a common birth defect occurring in children and can cause problems with the efficient functioning of the heart,” says Dr Adele Greyling, a paediatric cardiologist who practises at Netcare Greenacres Hospital in Port Elizabeth. She was speaking during World Heart Rhythm Week, which runs from 4 to 10 June 2018.

Pic: Dr Adele Greyling, an Eastern Cape paediatric cardiologist and heart rhythm specialist who practises at Netcare Greenacres Hospital in Port Elizabeth. She believes there needs to be greater awareness of heart rhythm disorders and congenital heart disease, which is a common birth defect occurring in children and can cause problems with the efficient functioning of the heart

Dr Greyling, who is the only paediatric cardiologist in the country to have been specifically trained in electrophysiology − the study of electrical problems of the heart and heart rhythm disorders – says that many children with congenital heart defects go undiagnosed and take these conditions into adulthood. She says that untreated congenital heart defects and arrhythmias may be detrimental to health and in some cases even result in heart failure.

“It has been estimated that about four out of every 1 000 babies are born with inherited heart defects, which provides some idea of the extent of the challenge posed by this condition within the Eastern Cape and nationally,” adds Dr Greyling.

“World Heart Rhythm Week provides a good opportunity to improve knowledge of the problem among all sectors of the population including patients, parents and primary healthcare providers. We need to equip people with the necessary knowledge to be able to identify inherited heart problems and heart rhythm disorders, and to know when and where to obtain help.”

The theme of World Heart Rhythm Week 2018 is ‘Take Fainting to Heart’, as fainting can be an indication that one is suffering from a heart rhythm disorder, and should not be ignored. Dr Greyling says that other symptoms may include heart palpitations, dizziness, light-headedness, discomfort in the chest, or general weakness. A child with an inherited heart rhythm disorder may fail to thrive.

“It has been suggested that some 55 children out of every 100 000 suffer from heart rhythm disorders internationally, and our incidence here in South Africa is likely to echo this. The most common of these are supraventricular tachycardias, which is an electrical problem in the upper chambers of the heart,” notes Dr Greyling, who is accredited as an electrophysiologist by the Cardiac Arrhythmia Society of South Africa.

“Heart damage and rhythm disorders may be caused by a number factors including certain infections and rheumatic heart disease, but heart rhythm problems are particularly common among those born with a complex congenital, or inherited, heart defect.

“A child may, for example, be born with an inherited defect such as a hole in the heart that may cause the heart to function improperly, or with an extra electrical pathway in their heart that might cause heart rhythm disturbances,” she explains.

“Tragically, although many of these inherited heart defects can be relatively easily corrected with a minimally invasive catheter procedure, even in the very youngest of babies, the condition often goes undetected for years.

“We are finding that in the Eastern Cape, as well as nationally, there is a growing population of patients with inherited heart conditions surviving to adulthood due to improved surgical care, which poses unique challenges and a higher incidence of arrhythmias.”

Dr Greyling, who also practises in the state sector in addition to Netcare Greenacres Hospital, says that while the catheters and devices such as pacemakers often need to be smaller for children, the principles and physiology of treating heart rhythm disorders in children are similar to those in adults.

Therefore, cardiologists who have specialised in electrophysiology for adults can and do treat children with rhythm disorders, and likewise Dr Greyling, as a paediatric cardiologist who has super-specialised in heart rhythm disorders, also sometimes treats adults with inherited heart defects and arrhythmia.

Dr Greyling and her team perform interventions to repair structural heart defects, electrophysiology procedures such as cardiac ablations, which involve correcting electrical heart problems and structural abnormalities, and also implant pacemakers and defibrillators.

According to Dr Greyling, each patient is completely different and treatment depends entirely on the nature of their specific problem. “At Netcare Greenacres Hospital we are fortunate to have a team of cardiologists and cardiothoracic surgeons who work together to resolve complex heart problems in children and adults. Sometimes we may need to repair structural defects before addressing the rhythm disorder, at other times a simple ablation procedure can resolve an electrical problem. Having experience in congenital heart disease is thus most useful when dealing with heart rhythm disorders in patients with inherited heart disease.”

Asked if the fields of paediatric cardiology and heart rhythm disorders receive sufficient attention in South Africa, she said that the short answer was “no”. “We do not have enough paediatric cardiologists, adult cardiologists or electrophysiologists, let alone paediatric and congenital electrophysiologists for the patient burden. Many towns in South Africa have no cardiologists at all and Netcare Greenacres Hospital is the only private unit in the Eastern Cape to offer both paediatric cardiology and electrophysiology services.”

Initially working as a paediatrician at Netcare Greenacres Hospital, Dr Greying qualified as paediatric cardiologist in 2014. She realised there was great need for specialists trained in electrophysiology and completed a fellowship in electrophysiology in Belgium. She has trained extensively abroad and under well-known Bay paediatric cardiologist, Dr Lungile Pepeta, who also has rooms at Netcare Greenacres Hospital. Also part of the heart rhythm team at the hospital is cardiologist and cardiac electrophysiologist Dr Neil Hendricks, who has been practising there since 2014.

Netcare Greenacres Hospital general manager, André Bothma, says that Dr Greyling makes an invaluable contribution not only to the multidisciplinary cardiac team at the hospital, but also to heart medicine in the Eastern Cape province. “South Africa’s first ever paediatric cardiologist to also specialise in heart rhythm disorders, and the country’s first woman electrophysiologist, Dr Greyling’s skills and wonderful passion for medicine have benefitted many patients.

“Dr Greyling is an inspirational cardiologist who is determined to contribute to tackling the twin problems of congenital heart disorders and rhythm disorders in the Nelson Mandela Bay area and Eastern Cape province. Netcare Greenacres Hospital cardiac centre is most grateful to offer her services and those of the other cardiac specialists practising at the hospital,” concludes Bothma.

 

Ends

Issued by:         MNA on behalf of Netcare Greenacres Hospital
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone: (011) 469 3016
Email: martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

 

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New artificial urinary sphincter used for the first time in South Africa

Latest generation device offer better outcomes for men with severe urinary incontinence

Thursday, June 14 2018

A new type of artificial urinary sphincter has been used for the first time in South Africa at a private hospital in Pretoria to treat men with severe urinary incontinence, the loss of bladder control.

The device, a Victo adjustable artificial urinary sphincter, has been surgically implanted in a minimally invasive procedure by a team led by urologist, Dr Johan Venter at Netcare Pretoria East Hospital, announced Jacques du Plessis, managing director of the Netcare hospital division, today.

According to Du Plessis, this latest generation artificial sphincter was especially sent to South Africa from abroad at the request of Dr Venter. Dr Venter urgently requested the technology from local distributors in order to treat a Krugersdorp man who suffered stress incontinence problems, which is when bladder control is lost during a cough, sneeze or activity such as lifting.

“An artificial urinary sphincter is widely considered the gold standard of treatment for complete urinary incontinence in men who have suffered irreparable damage to the urinary sphincter,” explains Dr Venter.

“We were, however, particularly impressed by this new-generation artificial urinary sphincter option, our investigations revealing that it was the best new alternative available globally for cases such as this one. Some of the advantages it offers include that it is easy for patients to use and it does not require further invasive surgeries should it require adjustment in future.”

“The first procedure in South Africa using this new technology was completed successfully two weeks ago. The patient is doing well, having been discharged a day after their procedure. The artificial sphincter is activated after approximately six weeks after implantation, once we are sure the patients have fully healed and accepted the device,” adds Dr Venter.

“We will be performing a further procedure using this compact artificial sphincter on a Pretoria man with severe urinary stress incontinence soon, and will now be offering it as a standard urinary sphincter replacement option at Netcare Pretoria East Hospital,” he observes.

Du Plessis thanked Dr Venter and his team at the hospital for introducing the new technology in South Africa, which was designed to overcome shortcomings identified with older generation devices. 

“Dr Venter has always shown himself to be a pioneering and highly talented urology specialist. He has once again broken new ground by introducing this new artificial urinary sphincter option, which I understand is being rolled out now and is increasingly used around the world, particularly in Europe, because of the advantages it offers over other similar technologies,” notes Du Plessis.

plains that the Victo device has a pump that is palpated by the patient when he needs to urinate. This is made of soft silicone that is easy for the patient to operate and serves to deactivate the cuff of the sphincter so the patient can pass urine normally.

“The entire device is implanted and it is compact, limiting the size of the foreign object within the body. Among the other characteristics of the technology that we appreciate is that it offers two configurations, the Victo and Victo+, and four cuff sizes are available for each to provide a better fit for each patient’s anatomy, which can vary considerably.

“These cuffs should be less likely to go on to leak in the longer term, and while we have yet to have the benefit of longer term medical studies, it should offer a more sustainable solution to severe urinary stress incontinence in men with damaged than other previous types of artificial sphincters,” points out Dr Venter.

The Victo+ has a stress relief balloon added to provide occlusion, or pressure, automatically if there are increases in abdominal pressure.

Dr Venter says various factors can potentially cause damage to the urinary sphincter and pelvic floor in men, including on-going bladder or bowel problems, constipation, heavy lifting and can occasionally be a complication of prostatectomy, the surgical removal of the prostate gland to treat cancer.

Dr Erich Bock, director of Netcare’s North East region, says that the new implant is an important development for urinary medicine, enabling improved outcomes for male patients who suffer severe urinary stress incontinence caused by a damaged urinary sphincter.

“This brand new device was only introduced to the international market late in 2016 and by all indications it will be the most sustainable and practical solution, offering appropriate patients a substantially improved quality of life,” adds Dr Bock.

“We congratulate Dr Venter and Netcare Pretoria East Hospital for introducing this advanced technology to the benefit of our patients in the region,” he concludes.

Ends

Issued by:      MNA on behalf of Netcare Pretoria East Hospital
Contact:        Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone:     (011) 469 3016
Email:           martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

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Winter illnesses and your child: when should you be concerned?

How to distinguish between many winter ailments with the same common symptoms

Monday, June 11 2018

It is winter and along with the cold weather comes the usual bout of childhood illnesses. The season can prove especially challenging for parents of babies and young children who are more vulnerable when it comes to typical winter ailments. With so many of these illnesses sharing common symptoms, it can be hard to determine what illness your child has.

Dr Omolemo Percy Kitchin, a paediatric pulmonologist practising at Netcare Waterfall City Hospital, says understanding the basics when it comes to the different types of common winter ailments can go a long way towards assisting parents in navigating typical winter ailments. These basics include the common signs and symptoms, management, prevention, control and when it is advisable to see a doctor.  

According to Dr Kitchin the most common winter illnesses among children include:

  • Coryza: inflammation of the lining of the nasal cavity, better known as the “common cold’. It is derived from Greek word Ko’ruza, meaning nasal mucus.
  • Influenza: an infectious disease caused by the influenza virus, and is commonly referred to as flu.
  • Allergic rhinitis: inflammation of the nose, sometimes referred to as hay fever.
  • Bronchiolitis: inflammation of the bronchioles (small airways).
  • Asthma: chronic inflammation of the bronchi (larger airways).

One of the key factors that Dr Kitchin highlights is the overuse of antibiotics for the treatment of illnesses. Many parents automatically expect a prescription for antibiotics to treat colds and other viral infections. Not only will antibiotics not have the desired effect, it can have dangerous side effects and adds to the worldwide problem of antibiotic resistance.

“Common colds, influenza and bronchiolitis are caused by viruses and therefore do not require antibiotics to treat them. Parents and caregivers tend to think that an antibiotic will solve the problem. However, antibiotics are only effective in treating bacteria and not viruses.

“Influenza is potentially the most dangerous of the three conditions, specifically when it results in secondary complications such as pneumonia, which if very severe might require admission to the hospital and or the intensive care unit. This is more common in individuals with compromised immune systems. Compromised individuals should have a yearly flu vaccination which should limit the severity of the condition,” Dr Kitchin says.

According to Dr Kitchin, the public often confuses coryza and influenza. “Generally, when people say they have flu, they are actually referring to coryza or the common cold caused by the rhino virus. Symptoms include a sore throat, cough, runny and/or blocked nose, and possibly fever.”

“Influenza has similar symptoms to the common cold, but could also include painful muscles, rigours, a general feeling of being unwell accompanied by a severe lack of energy. Influenza can result in secondary complications such as pneumonia, ear infections and sepsis. Unfortunately, coryza and influenza have to work its way out of the body,” Dr Kitchin adds.

“Children under the age of two are frequently susceptible to bronchiolitis. It presents with a cough, fast breathing, difficulty in breathing, chest in-drawing and fever, and is commonly triggered by the respiratory syncytial virus (RSV) in 90% of cases. Para-influenza and other viruses causing a common cold and influenza, may also be involved,” notes Dr Kitchin.

Allergic rhinitis or hay fever, as it is commonly known, often originates from seasons when there is a lot of pollen in the air. It may also be caused by allergic reactions to other substances.

“Patients present with a cough, especially at night, an itchy and runny nose with clear secretions that can be greenish in colour, watery and itchy eyes, and sometimes swelling of the eyelids. Patients can, in addition, present with dark discolouration under the eyelids,” Dr Kitchin explains.

Asthma may present with a cough that is worse at night, a tight chest and wheezing. Dr Kitchin says, “Approximately 40% of patients with asthma have allergic rhinitis, so these conditions often co-exist and form part of what we refer to as a united airway. Taking a good history of asthma is very important, as the chest is usually clear on examination by a medical practitioner, unless the patient has acute symptoms. Asthma is consequently often missed.”

How are these illnesses managed?

Dr Kitchin explains that a common cold or flu is treated symptomatically with nasal decongestants, fever control, nutritious meals and quality sleep. The virus will work itself out of the system, over time.

“Allergic rhinitis may be treated with nasal cortisone spray and a non-sedating antihistamine. For bronchiolitis, which is firstly treated symptomatically, patients might benefit from admission to hospital and oxygen via a nasal tube if the respiratory distress becomes severe. Asthma should be treated with controller pump inhalation steroids through a spacer in young children, and a reliever in case of emergencies,” he adds.

“Asthma can be well controlled by using inhaled steroids, and hay fever through intranasal steroids,” Dr Kitchin explains.

To limit the risk of bronchiolitis, which cannot be prevented by itself, national guidelines recommend the use of prophylaxis before the respiratory syncytial virus (RSV) season starts for high-risk patients.

“High-risk children can be defined as premature babies and children with congenital cyanotic heart disease. Such children are born with an abnormally developed heart and blood vessels, resulting in low oxygen supply to the organs,” he says.

There are many simple ways in which you can control the spread of illnesses. “Teaching and implementing regular hand washing routines, ensuring your children receive good nutrition and establishing a healthy environment, will go a long way in preventing illnesses common in winter. Avoiding environmental risk factors and tobacco smoke, ensuring that your child's vaccinations are up to date, and getting a flu shot before the start of the winter season, are also advisable,” concludes Dr Kitchin.

Ends

 

Recommended further reading:

https://pdfs.semanticscholar.org/1ea3/0340baab1415966266b2061c748e346f00b3.pdf

Issued by:            Martina Nicholson Associates (MNA) on behalf of Netcare Waterfall City Hospital

Contact:              Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster

Telephone:          (011) 469 3016

Email:                   martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

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Competition Tribunal approves Netcare’s acquisition of Lakeview Hospital

Lakeview Hospital provides a range of multidisciplinary healthcare services

Wednesday, June 6 2018

Private healthcare group Netcare today announced that the Competition Tribunal has approved its acquisition of Lakeview Hospital.

“We are continuously exploring ways to improve our service offering to patients, and  are excited that the acquisition of Lakeview Hospital augurs well for the future of both Netcare and Lakeview, as the hospital is ideally positioned to enhance Netcare’s service offering to our patients in the greater East Rand,” said Jacques du Plessis, managing director of Netcare’s hospital division.

The previously privately owned Lakeview Hospital is a 94-bed facility, conveniently located in Benoni next to the N12 Highway and in close proximity to the Tom Jones off-ramp. The hospital, which opened in 2010, primarily serves the East Rand communities of Benoni, Brakpan, Boksburg and Springs.

“Lakeview Hospital provides a range of multidisciplinary healthcare services, and is particularly well-known for its state-of-the-art 20-bed mother and child unit and six-bed neonatal ICU. Advanced orthopaedic surgery is another focus area and the hospital is at present looking to establish an orthopaedic and spinal centre of excellence,” added Du Plessis.

Other facilities at Lakeview Hospital include an eight-bed adult intensive care unit, medical and surgical wards, a paediatric unit as well as a day surgical facility. The hospital also has four theatres, one of which is equipped with laminar flow technology, a 24-hour emergency department, radiology and pathology services, as well as a pharmacy.

Du Plessis concluded by saying that Lakeview Hospital ideally complements the other Netcare hospitals in the greater East Rand. “We look forward to growing our combined healthcare service offering together with the Lakeview team in the coming years in order to ensure greater accessibility to private healthcare services in the region.”

Ends.

Notes to journalists

About Netcare  

Netcare (JSE: NTC) operates the largest private hospital, primary healthcare, emergency medical services and renal care networks in South Africa. In addition to its world-class acute private hospital services in SA, Netcare provides:

  • cancer services including radiosurgery, radiotherapy, chemotherapy, bone marrow transplant and robotic-assisted surgery;
  • primary healthcare services through Medicross;
  • emergency medical services through Netcare 911;
  • occupational health and employee wellness services through Netcare Occupational Health;
  • mental health and psychiatric services through Akeso; and
  • renal dialysis through National Renal Care (NRC).

 

Netcare also has the distinction of being a leading private trainer of emergency medical and nursing personnel in the country.

Netcare’s core value is care. From this value flow four others, namely dignity, participation, truth and passion. We work hard to entrench these values in every action, decision and intervention we take with our patients, their families, our colleagues and communities.

For more information visit www.netcare.co.za.

Issued by:     Martina Nicholson Associates (MNA) on behalf of Netcare
Contact:        Martina Nicholson, Graeme Swinney, Meggan Saville or Estene Lotriet-Vorster
Telephone:    (011) 469 3016
Email:           martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

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Laparoscopic workshop keeps SA surgeons up to date with latest techniques

Minimally invasive approach increasingly used to treat colorectal cancer

Wednesday, June 6 2018

An educational laparoscopic colorectal cancer workshop which involved live procedures to demonstrate the latest in surgical techniques, was held at Netcare Pretoria East Hospital recently.
 
A total of 55 surgeons and interventional specialists from the private and public sectors in South Africa attended the workshop hosted by the hospital and highly experienced local laparoscopic surgeon, Dr Michael Heyns. The specialists were provided with the opportunity to participate in an interactive discussion during two live procedures.

According to Dr Heyns, who has participated in a number of advanced laparoscopic training courses in Europe and locally, minimally invasive laparoscopic procedures are increasingly being used to excise and treat colorectal cancers, and new approaches and imaging technologies are continuously being introduced to assist in improving outcomes.

He said the workshop, which was CPD (Continuing Professional Development) accredited, largely aimed to demonstrate how advanced new imaging and visualisation techniques and technologies assist in the diagnosis and guidance of laparoscopic colorectal procedures.

It focused in particular on the clinical applications of indocyanine green (ICG) enhanced fluorescence in this type of surgery. Specialists had the opportunity to ask questions and share their knowledge and expertise during this interactive forum.

“The ICG fluorescence imaging system is proving safe and adding significant value in diagnosing, planning and decision-making in colorectal laparoscopic procedures, and is increasingly being used in appropriate cases internationally.

“As a result of the advantages it offers, including enhanced visualisation of blood supply, this approach may well become a standard for appropriate cases in the near future,” added Dr Heyns.

Dr Heyns, who offers regular laparoscopic colorectal cancer workshops at Netcare Pretoria East Hospital for specialists across South Africa, said that such workshops were a way for him to “give something back” to his profession, by imparting skills he had learned during his many years as a laparoscopic surgeon.

According to the general manager of Netcare Pretoria East Hospital, Rolien Kuhne, the hospital had received much positive feedback from the participants attending the workshop.

“Dr Heyns is a key member of the surgical team at the hospital, performing a range of procedures including breast cancer, endocrine and hernia repair surgeries, among others. He has a special interest in laparoscopic colorectal surgery and has performed hundreds of procedures within this area of expertise,” she added.

“We are most grateful to him for organising these educational events and for sharing his extensive knowledge and experience with his colleagues and the wider medical fraternity in South Africa,” she concluded.

Ends

Issued by:   MNA on behalf of Netcare Pretoria East Hospital
Contact:    Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone:  (011) 469 3016
Email:    martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.
za

 

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New laser treatment for enlarged prostate now offered in South Africa

Laser procedure used to resolve urine blockage problems in older men

Monday, June 4 2018

A laser procedure to treat enlarged prostate, the most common non-cancerous prostate medical condition to develop in men by the time they reach their 60s, has been introduced to South Africa for the first time at Netcare Parklands Hospital in Durban.

The procedure, the holmium laser enucleation of the prostate (HoLEP), was recently successfully performed for the first time in the country by urologist, Dr Amit Kalpee, and his team on a Durban man with a severely enlarged prostate, a condition known as benign prostatic hyperplasia (BPH).

“A severely enlarged prostate causes uncomfortable urinary symptoms. HoLEP involves using a special high-powered laser to remove the gland and any tissue that causes obstruction of the urethra, through which the urine drains,” explains Dr Kalpee, who completed the European HoLEP Masterclass and is the first HoLEP surgeon in South Africa.

“This resolves symptoms such as urine blockage, which can in turn cause bladder and urinary tract infections and potentially serious kidney complications if left untreated,” he adds.

“The procedure is done under anaesthetic with the assistance of a tiny camera which together with the laser instrument is mounted on a fine telescopic rod that is inserted into the urethra via the penis.”

Dr Kalpee says HoLEP is a modern alternative to the standard procedure known as transurethral resection of the prostate procedure (TURP) for bladder outflow obstruction due to enlarged prostate. HoLEP requires specialist training and takes slightly longer to complete than a TURP, but it is less invasive and has a number of advantages over this standard procedure.

“There is less bleeding than after a TURP, and patients are often ready to be discharged from hospital the day after the procedure, much sooner than if a TURP was performed. Because enucleation is a much more precise procedure with the entire gland removed, recurrence of the problem does not occur. With HoLEP there is also no size limit of the prostate that can be treated,” explains Dr Kalpee, who has to date performed more than a dozen of these procedures.

Mr Dhanapalan Pillay, a patient who recently underwent HoLEP at Netcare Parklands Hospital, says that he is most grateful to have had the benefit offered by the new procedure. The 74-year-old from Durban admitted that prior to the procedure he was “quite scared, as I really didn’t know what to expect”.

“I have previously had two TURP procedures to assist with bladder flow obstruction, both of which were quite uncomfortable and took quite some time to recover from,” added Mr Pillay.

“I was therefore most pleasantly surprised by my experience with HoLEP. I had very little pain and bleeding after the operation and was up and about the afternoon following the operation, which was way beyond my expectations.”

“Now my symptoms have largely been resolved, my life is back to normal and I am walking every morning. I am most grateful to Dr Kalpee and his team at Netcare Parklands Hospital for performing this procedure, which has made a great difference to my life.”

According to Dr Kalpee, it is normal for a man’s prostate to enlarge with age, as the cells of the prostate begin to swell. It is estimated that half of men over the age of 50 will suffer from at least some BPH symptoms. Medication is usually used initially to treat these symptoms but unfortunately has limitations.

In some cases the prostate becomes large enough to occlude, or obstruct, the urethra, making it difficult to pass urine, as occurred in Mr Pillay’s case. It may cause weak urine flow and prevent the individual from emptying their bladder completely, resulting in the need to go to the toilet much more often.

“HoLEP is particularly indicated in men with large non-cancerous prostates where medication is either proving ineffective or causes side-effects. It is also safe for older men on blood thinning medication such as warfarin, aspirin or clopidogrel,” points out Dr Kalpee.

“It is normal to have some blood in the urine after the HoLEP procedure, so it is advisable to drink plenty of water for a few days while it clears. A catheter [a tube which drains the bladder] is inserted for between 12 to 24 hours until the urine clears. Prostate fragments are sent for laboratory analysis to ensure that they are not cancerous.

“The procedure does not generally affect erectile function or continence, although the possible urinary symptoms may take a few weeks to settle down afterwards. Patients are advised to take it easy and to avoid straining or heavy lifting for four weeks after the procedure.”

Netcare coastal region director, Craig Murphy, says that the introduction of HoLEP at Netcare Parklands Hospital is a welcome development in urology and private medicine in KwaZulu-Natal.

“This procedure brings hope to those large numbers of older men who are looking for relief from debilitating BPH symptoms, and Dr Kalpee and his team at Netcare Parklands Hospital are to be congratulated for introducing it to the benefit of our patients,” he concluded. 

Ends

Issued by:         MNA on behalf of Netcare Parklands Hospital
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone: (011) 469 3016
Email: martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

 

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Port Alfred Hospital placed on divert

Emergency department at Port Alfred Hospital will be on divert

Thursday, May 31 2018

Members of the public are advised that the emergency department at Port Alfred Hospital will be on divert from Wednesday, 13 June 2018 until further notice.

“People requiring urgent medical attention are advised to either contact their family doctor or go to the emergency department at Settlers Hospital in Grahamstown for assistance.

The province’s Department of Health (DoH) and Nalithemba are jointly responsible for staffing of Port Alfred Hospital’s emergency department, which serves both private and public sector patients. The temporary closure of the facility is due to industrial action by the DoH staff members, and unfortunately beyond Nalithemba management’s control,” says Marianne Stiglingh, clinical services manager of the public private partnership facility.

“Emergency medical services providers, doctors, Settlers Hospital and other relevant stakeholders have been notified that Port Alfred Hospital is on divert to Settlers Hospital until further notice,” adds Stiglingh.

“From our side, we have to place the emergency department on divert until the staff members return to work unconditionally, in order not to compromise clinical patient care or patient safety,” Stiglingh concluded.

 

Ends
 

Issued by: MNA on behalf of Nalithemba
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet
Telephone: (011) 469 3016
Email: martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

 

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