Paul G Williams | University of the Witwatersrand (original) (raw)

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Papers by Paul G Williams

Research paper thumbnail of Illicit intravenous drug use in Johannesburg--medical complications and prevalence of HIV infection

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1997

To describe the magnitude of the problem of abuse by self-injection of dipianone HCl/cyclizine HC... more To describe the magnitude of the problem of abuse by self-injection of dipianone HCl/cyclizine HCl (Wellconal) and to document the associated morbidity, mortality and prevalence of HIV infection. We conducted a retrospective analysis of 121 admissions of 86 patients who were current intravenous Wellconal abusers and presented to Johannesburg and J G Strijdom Hospitals over an 18-month period. Case records were analysed in respect of age, sex, median hospital stay, complications, HIV antibody status and eventual outcome. Age, sex, median hospital stay, complications, HIV antibody status and eventual outcome. Complications of Wellconal abuse occurred in young adults (median age 24 years) with an approximately equal gender distribution. Opiate overdose was the most frequent presenting diagnosis (32%), followed by right-sided endocarditis (20%) and deep-vein thrombosis (12%). A wide variety of complications accounted for the remaining 36%. A 2% HIV antibody positivity rate was found, wh...

Research paper thumbnail of Lung transplantation in South Africa: Indications, outcomes and disease-specific referral guidelines

African Journal of Thoracic and Critical Care Medicine, 2018

Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients ... more Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients extended and good-quality survival. In South Africa (SA), patients have historically had limited access to this therapy, particularly if unfunded. LT has been used as a successful therapeutic intervention for a wide variety of end-stage pulmonary parenchymal and vascular diseases, but the most common diseases that lead to LT are chronic obstructive pulmonary disease, interstitial lung disease, cystic fibrosis, alpha-1-antitrypsin deficiency and pulmonary arterial hypertension. Timing of referral for LT can be challenging and is disease specific, influenced by the rate of progression of the disease, the development of associated comorbidities, and access and response to advanced therapies. Advances in recipient and donor selection, surgical technique and postoperative management have improved early survival, but mortality remains higher than for other solid organ transplants. Rejection an...

Research paper thumbnail of Recommendations for the diagnosis and management of vaccine-induced immune thrombotic thrombocytopenia

There have recently been safety concerns regarding an increased risk of vaccine-induced immune th... more There have recently been safety concerns regarding an increased risk of vaccine-induced immune thrombotic thrombocytopenia (VITT) following administration of SARS-CoV-2 adenoviral vector vaccines. The Southern African Society of Thrombosis and Haemostasis reviewed the emerging literature on this idiosyncratic complication. A draft document was produced and revised by consensus agreement by a panel of professionals from various specialties. The recommendations were adjudicated by independent international experts to avoid local bias. We present concise, practical guidelines for the clinical management of VITT.

Research paper thumbnail of Management of pulmonary hypertension

South African Medical Journal, 2015

Research paper thumbnail of Haemodynamic definitions and updated clinical classification of pulmonary hypertension

European Respiratory Journal

Since the 1st World Symposium on Pulmonary Hypertension (WSPH) in 1973, pulmonary hypertension (P... more Since the 1st World Symposium on Pulmonary Hypertension (WSPH) in 1973, pulmonary hypertension (PH) has been arbitrarily defined as mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest, measured by right heart catheterisation. Recent data from normal subjects has shown that normal mPAP was 14.0±3.3 mmHg. Two standard deviations above this mean value would suggest mPAP >20 mmHg as above the upper limit of normal (above the 97.5th percentile). This definition is no longer arbitrary, but based on a scientific approach. However, this abnormal elevation of mPAP is not sufficient to define pulmonary vascular disease as it can be due to an increase in cardiac output or pulmonary arterial wedge pressure. Thus, this 6th WSPH Task Force proposes to include pulmonary vascular resistance ≥3 Wood Units in the definition of all forms of pre-capillary PH associated with mPAP >20 mmHg. Prospective trials are required to determine whether this PH population might benefit from specific mana...

Research paper thumbnail of Illicit intravenous drug use in Johannesburg: medical complications and prevalence of HIV infection

Research paper thumbnail of PAH position statement SAMJ

Research paper thumbnail of Lung Transplantation in South Africa;

AJRCCM

Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients ... more Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients extended and good-quality survival. In South Africa (SA), patients have historically had limited access to this therapy, particularly if unfunded. LT has been used as a successful therapeutic intervention for a wide variety of end-stage pulmonary parenchymal and vascular diseases, but the most common diseases that lead to LT are chronic obstructive pulmonary disease, interstitial lung disease, cystic fibrosis, alpha-1-antitrypsin deficiency and pulmonary arterial hypertension. Timing of referral for LT can be challenging and is disease specific, influenced by the rate of progression of the disease, the development of associated comorbidities, and access and response to advanced therapies. Advances in recipient and donor selection, surgical technique and postoperative management have improved early survival, but mortality remains higher than for other solid organ transplants. Rejection and infection remain major causes of early posttransplant death, while chronic rejection is the major cause of death after the first year. Survival is heavily influenced by the underlying lung disease. In this review, we summarise the indications and contraindications for LT, remind pulmonologists of the availability of this therapy in SA and offer guidelines for the timely referral of suitable candidates.

Research paper thumbnail of -Management of pulmonary hypertension

Research paper thumbnail of Lung transplantation in South Africa: Indications, outcomes and disease-specific referral guidelines

Afr J Thoracic Cri Care Med, 2018

Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients ... more Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients extended and good-quality survival. In South Africa (SA), patients have historically had limited access to this therapy, particularly if unfunded. LT has been used as a successful therapeutic intervention for a wide variety of end-stage pulmonary parenchymal and vascular diseases, but the most common diseases that lead to LT are chronic obstructive pulmonary disease, interstitial lung disease, cystic fibrosis, alpha-1-antitrypsin deficiency and pulmonary arterial hypertension. Timing of referral for LT can be challenging and is disease specific, influenced by the rate of progression of the disease, the development of associated comorbidities, and access and response to advanced therapies. Advances in recipient and donor selection, surgical technique and postoperative management have improved early survival, but mortality remains higher than for other solid organ transplants. Rejection and infection remain major causes of early posttransplant death, while chronic rejection is the major cause of death after the first year. Survival is heavily influenced by the underlying lung disease. In this review, we summarise the indications and contraindications for LT, remind pulmonologists of the availability of this therapy in SA and offer guidelines for the timely referral of suitable candidates.

Research paper thumbnail of CV P G Williams

Research paper thumbnail of Haemodynamic definitions and updated clinical classification of pulmonary hypertension Number 4 in the series "Proceedings of the 6th World Symposium on Pulmonary Hypertension" Edited by N

@ERSpublications State of the art and research perspectives of haemodynamic definitions and clini... more @ERSpublications State of the art and research perspectives of haemodynamic definitions and clinical classification of pulmonary hypertension http://ow.ly/TJeR30mgWKj Cite this article as: Simonneau G, Montani D, Celermajer DS, et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respir J 2018; in press [https://doi.

Research paper thumbnail of Illicit intravenous drug use in Johannesburg--medical complications and prevalence of HIV infection

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1997

To describe the magnitude of the problem of abuse by self-injection of dipianone HCl/cyclizine HC... more To describe the magnitude of the problem of abuse by self-injection of dipianone HCl/cyclizine HCl (Wellconal) and to document the associated morbidity, mortality and prevalence of HIV infection. We conducted a retrospective analysis of 121 admissions of 86 patients who were current intravenous Wellconal abusers and presented to Johannesburg and J G Strijdom Hospitals over an 18-month period. Case records were analysed in respect of age, sex, median hospital stay, complications, HIV antibody status and eventual outcome. Age, sex, median hospital stay, complications, HIV antibody status and eventual outcome. Complications of Wellconal abuse occurred in young adults (median age 24 years) with an approximately equal gender distribution. Opiate overdose was the most frequent presenting diagnosis (32%), followed by right-sided endocarditis (20%) and deep-vein thrombosis (12%). A wide variety of complications accounted for the remaining 36%. A 2% HIV antibody positivity rate was found, wh...

Research paper thumbnail of Lung transplantation in South Africa: Indications, outcomes and disease-specific referral guidelines

African Journal of Thoracic and Critical Care Medicine, 2018

Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients ... more Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients extended and good-quality survival. In South Africa (SA), patients have historically had limited access to this therapy, particularly if unfunded. LT has been used as a successful therapeutic intervention for a wide variety of end-stage pulmonary parenchymal and vascular diseases, but the most common diseases that lead to LT are chronic obstructive pulmonary disease, interstitial lung disease, cystic fibrosis, alpha-1-antitrypsin deficiency and pulmonary arterial hypertension. Timing of referral for LT can be challenging and is disease specific, influenced by the rate of progression of the disease, the development of associated comorbidities, and access and response to advanced therapies. Advances in recipient and donor selection, surgical technique and postoperative management have improved early survival, but mortality remains higher than for other solid organ transplants. Rejection an...

Research paper thumbnail of Recommendations for the diagnosis and management of vaccine-induced immune thrombotic thrombocytopenia

There have recently been safety concerns regarding an increased risk of vaccine-induced immune th... more There have recently been safety concerns regarding an increased risk of vaccine-induced immune thrombotic thrombocytopenia (VITT) following administration of SARS-CoV-2 adenoviral vector vaccines. The Southern African Society of Thrombosis and Haemostasis reviewed the emerging literature on this idiosyncratic complication. A draft document was produced and revised by consensus agreement by a panel of professionals from various specialties. The recommendations were adjudicated by independent international experts to avoid local bias. We present concise, practical guidelines for the clinical management of VITT.

Research paper thumbnail of Management of pulmonary hypertension

South African Medical Journal, 2015

Research paper thumbnail of Haemodynamic definitions and updated clinical classification of pulmonary hypertension

European Respiratory Journal

Since the 1st World Symposium on Pulmonary Hypertension (WSPH) in 1973, pulmonary hypertension (P... more Since the 1st World Symposium on Pulmonary Hypertension (WSPH) in 1973, pulmonary hypertension (PH) has been arbitrarily defined as mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest, measured by right heart catheterisation. Recent data from normal subjects has shown that normal mPAP was 14.0±3.3 mmHg. Two standard deviations above this mean value would suggest mPAP >20 mmHg as above the upper limit of normal (above the 97.5th percentile). This definition is no longer arbitrary, but based on a scientific approach. However, this abnormal elevation of mPAP is not sufficient to define pulmonary vascular disease as it can be due to an increase in cardiac output or pulmonary arterial wedge pressure. Thus, this 6th WSPH Task Force proposes to include pulmonary vascular resistance ≥3 Wood Units in the definition of all forms of pre-capillary PH associated with mPAP >20 mmHg. Prospective trials are required to determine whether this PH population might benefit from specific mana...

Research paper thumbnail of Illicit intravenous drug use in Johannesburg: medical complications and prevalence of HIV infection

Research paper thumbnail of PAH position statement SAMJ

Research paper thumbnail of Lung Transplantation in South Africa;

AJRCCM

Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients ... more Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients extended and good-quality survival. In South Africa (SA), patients have historically had limited access to this therapy, particularly if unfunded. LT has been used as a successful therapeutic intervention for a wide variety of end-stage pulmonary parenchymal and vascular diseases, but the most common diseases that lead to LT are chronic obstructive pulmonary disease, interstitial lung disease, cystic fibrosis, alpha-1-antitrypsin deficiency and pulmonary arterial hypertension. Timing of referral for LT can be challenging and is disease specific, influenced by the rate of progression of the disease, the development of associated comorbidities, and access and response to advanced therapies. Advances in recipient and donor selection, surgical technique and postoperative management have improved early survival, but mortality remains higher than for other solid organ transplants. Rejection and infection remain major causes of early posttransplant death, while chronic rejection is the major cause of death after the first year. Survival is heavily influenced by the underlying lung disease. In this review, we summarise the indications and contraindications for LT, remind pulmonologists of the availability of this therapy in SA and offer guidelines for the timely referral of suitable candidates.

Research paper thumbnail of -Management of pulmonary hypertension

Research paper thumbnail of Lung transplantation in South Africa: Indications, outcomes and disease-specific referral guidelines

Afr J Thoracic Cri Care Med, 2018

Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients ... more Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients extended and good-quality survival. In South Africa (SA), patients have historically had limited access to this therapy, particularly if unfunded. LT has been used as a successful therapeutic intervention for a wide variety of end-stage pulmonary parenchymal and vascular diseases, but the most common diseases that lead to LT are chronic obstructive pulmonary disease, interstitial lung disease, cystic fibrosis, alpha-1-antitrypsin deficiency and pulmonary arterial hypertension. Timing of referral for LT can be challenging and is disease specific, influenced by the rate of progression of the disease, the development of associated comorbidities, and access and response to advanced therapies. Advances in recipient and donor selection, surgical technique and postoperative management have improved early survival, but mortality remains higher than for other solid organ transplants. Rejection and infection remain major causes of early posttransplant death, while chronic rejection is the major cause of death after the first year. Survival is heavily influenced by the underlying lung disease. In this review, we summarise the indications and contraindications for LT, remind pulmonologists of the availability of this therapy in SA and offer guidelines for the timely referral of suitable candidates.

Research paper thumbnail of CV P G Williams

Research paper thumbnail of Haemodynamic definitions and updated clinical classification of pulmonary hypertension Number 4 in the series "Proceedings of the 6th World Symposium on Pulmonary Hypertension" Edited by N

@ERSpublications State of the art and research perspectives of haemodynamic definitions and clini... more @ERSpublications State of the art and research perspectives of haemodynamic definitions and clinical classification of pulmonary hypertension http://ow.ly/TJeR30mgWKj Cite this article as: Simonneau G, Montani D, Celermajer DS, et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respir J 2018; in press [https://doi.