
William H LambCounty Durham and Darlington NHS Foundation Trust · Child Health
William H Lamb
MB BS, MD, FRCP, FRCPCH
About
47
Publications
1,937
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
1,496
Citations
Introduction
Education
September 1971 - June 1976
Publications
Publications (47)
Introduction
It is important to understand patterns in the epidemiology of type 1 diabetes because they may provide insight into its etiology. We examined the incidence of type 1 diabetes in children aged 0–14 years, and patient demographics and clinical parameters at presentation, over the period 2012–2020 using the North East and North Cumbria Yo...
The incidence of type 1 diabetes and type 2 diabetes in children and adolescents is rising. The associated public health burden is substantial with major implications for those involved in planning health care provision at all levels. The aetiology of diabetes in this age group is poorly understood, although both genetic and environmental factors a...
Given the enormous changes in physiology and neurobiology prevalent during adolescence, it is hardly surprising that this is also the time when metabolic control of diabetes is at its worst. Clinical teams are constantly looking for ways to improve diabetes control in youth and exploiting the perceived fascination of adolescents for new technology...
The aim of the study reported here was to determine whether kidney scarring after urinary tract infections (UTI) in children can be prevented and to identify the risk factors for developing scars. We identified children in the Northern health region of the UK who had been seen to develop scars, identified as new defects on dimercapto-succinic acid...
Objective To assess the quality of perinatal autopsy.
Design Review of all reports of post mortem examinations carried out following perinatal deaths from January 1994 to June 1994.
Population Former Northern Region of England.
Methods Assessment of post mortem reports concerning their content and interpretation, the assessment carried out by panel...
A girl with failure to thrive and a haemoglobin of 140 g/l at 1.3 years died from a brain haemorrhage 2.5 years later. Renal artery stenosis had caused severe, chronic hypertension and increased erythropoietin secretion (haemoglobin 182 g/l). Blood pressure should be measured in all unwell children, including those failing to thrive.
To assess the quality of perinatal autopsy.
Review of all reports of post mortem examinations carried out following perinatal deaths from January 1994 to June 1994.
Former Northern Region of England.
Assessment of post mortem reports concerning their content and interpretation, the assessment carried out by panel comprising a pathologist, obstetric...
A patient with sideroblastic anaemia, development delay, and trichothiodystrophy is presented. Trichothiodystrophy is a feature of several autosomal recessive diseases. Photosensitivity, failure to thrive, and developmental delay are commonly observed in affected cases. X linked inheritance accounts for the bulk of cases with sideroblastic anaemia....
There has been a quiet revolution in the care of children with diabetes over the last decade. The establishment of child-centred teams together with advances in management help the child achieve a normal lifestyle while avoiding both the long- and short-term complications of diabetes.
Data from the 1984-1985 epidemic of measles in Keneba, a Gambian village, have been reanalysed in order to test the effect of same sex vs. opposite sex transmission of measles on the severity of infection. A person infected by someone of the opposite sex was more likely to have severe infection with pulmonary complications than a person infected by...
An infant of 31 weeks' gestation presented with refractory neonatal hypoglycaemia secondary to islet cell dysregulation. Treatment was started with somatostatin analogue and his glycaemic control improved initially. Tolerance developed, however, in that the dose required to maintain control increased by a factor of 40. The infant subsequently under...
Serologic markers of hepatitis B virus (HBV) infection were measured in children from Manduar and Keneba, two adjacent villages
in The Gambia, in 1980 and in 1984. The rate of HBV infection over the 4 years differed markedly: in Manduar 71% of children
who were <5 years of age in 1980 became infected, whereas in Keneba only 37% became infected. Mal...
Two babies are described with oesophageal atresia, a tracheo-oesophageal fistula and severe subglottic tracheal stenosis. A third baby, who did not survive, had a tracheal agenesis associated with bronchi arising from the oesophagus. A review of the types of tracheal stenosis and agenesis associated with various forms of tracheo-oesophageal fistula...
A measles epidemic occurred in a rural West African village, despite documented immunization in 90% of the <10-year age group.
In contrast to previous epidemics, this outbreak caused no associated deaths among the 54 cases diagnosed. Immunization protected
against infection - only 3.6% of immunized children developed measles, whereas 30.1% of those...
Birthweight data from 197 rural Gambian women who received an energy-dense prenatal dietary supplement over a 4-y period (net intake = 430 kcal/d) was compared with data from 182 women from 4 baseline years. Preintervention birthweights averaged 2944 +/- 43 (SEM) g when women were in positive energy balance during the dry harvest season (pregnancy...
Three trials of intradermal hepatitis B virus (HBV) vaccines were made in Gambian children. In the first trial HBV vaccine (1 microgram) was given to neonates in the same syringe with BCG followed by two further does of 1.0 microgram of intradermal HBV vaccine. The trial was a failure, for 19 of 32 subjects had an HBV surface antibody response of l...
The effect of a combined supplement of iron, thiamine, riboflavin and vitamin C on malarial incidence in 5 to 14-year-old children was tested in a malnourished rural community in a region of The Gambia noted for high prevalence of malaria during the rainy season. 190 children, divided into 2 matched groups, received either the supplement or a match...
Forty boys and girls between 11 and 14.5 years with evidence of subclinical vitamin deficiencies were allocated to two groups to receive, twice weekly, either a placebo or a multivitamin and iron supplement. Prior to supplementation and on two subsequent occasions about 5 weeks apart, the children performed an exercise regimen on a treadmill during...
We have investigated infant-caregiver interactions in an isolated African subsistence farming community where women perform arduous agricultural tasks in addition to their normal domestic duties which include child care. 49 babies aged 3-18 months were studied on one or two occasions. Detailed observations were made of the level of care and of posi...
Eighty-one pregnant or lactating women living in a village in The Gambia were allocated to treatment groups to receive a daily placebo, riboflavin, ferrous sulphate or ferrous sulphate plus riboflavin. At the beginning of the study and at 3 and 6 weeks thereafter women were examined clinically and blood samples collected for haematological and bioc...
Mastitis was found to be a sizeable clinical problem in a group of lactating Gambian mothers. The mean monthly incidence was
2·6% and repeated episodes of mastitis were common. The role of milk antimicrobial factors in the local defence of the breast
against mastitis was investigated by analysis of IgA, IgG, IgM, C3, C4, lactoferrin and lysozyme in...
Five different vaccination schedules were used to immunise Gambian infants aged 4-6 months against measles with the attenuated Edmonston-Zagreb strain of virus, which has a history of passage in human diploid cells. Vaccine aerosol given either by mask in a dose of 3500 or 7000 plaque-forming units (PFU) or from a plastic bag at a dose of 7000 PFU...
As an adjunct to the general nutrition research programme, the MRC Dunn Nutrition Unit has provided for the past 10 years a continuous medical service to three adjacent rural Gambian villages. There have been substantial reductions in annual childhood mortality rates. Perinatal mortality fell from 109.6 to 45.5 per 1000 births, infant mortality fro...
A major assumption in current dietary advice for pregnancy is that the amount of energy expended on tissue maintenance increases by 36 000 kcal over the whole gestation period. In a group of rural Gambian women engaged in subsistence farming, the increase was much smaller and depended on maternal dietary status. In women having the customarily low...
1. The effects of dehydration on mechanisms of water balance and milk synthesis were investigated in ten lactating Gambian women who were fasting during Ramadan. Ten non-pregnant, non-lactating women acted as controls. Fasting consisted of total water abstention from 05.00 hours to 19.30 hours and was accompanied by high insensible water losses.
2....
Adult males and children between 4 and 12 years in a subsistence farming community in The Gambia were screened for haematological status. 80 men and 80 children with initially poor status were identified and allocated to three treatment groups comprising: a placebo, ferrous sulphate, and ferrous sulphate with riboflavin. Over a period of 6 weeks of...
Thirty-seven women living in two rural Gambian villages, who were either pregnant or lactating at the outset of the study, received a tablet containing 15 mg riboflavin, or a placebo, at fortnightly intervals for 10 weeks at a time of year when riboflavin status was deteriorating. Clinical assessments were carried out once a week, with particular a...
The prevalence and severity of gingivitis was studied in 204 children living in a rural West African community. Seasonal prevalence varied from 38.6% to 9.5%. The lowest prevalence coincided with the seasonal consumption of citrus fruits and mangoes. Prevalence increased with age. Of the children, 13.7% required treatment with a standard antibiotic...
In studies in a rural West African village it was observed that all lactating women and 90 per cent of pregnant women fasted throughout the period of Ramadan. The metabolic consequences of this fasting were studied by measuring serum glucose, free fatty acid, triglyceride, beta-hydroxybutyrate, alanine, insulin, glucagon and T3 levels at 0700 h and...
Gambian women, who show marked seasonal fluctuations in energy balance, were offered a dietary supplement during pregnancy. This resulted in a net energy increment of 431 kcal/day. In the wet season, when the women were normally in marked negative energy balance due to food shortages and a high agricultural work load, the supplementation improved b...
A study of vitamin C requirements was undertaken in the village of Keneba, The Gambia, during the rainy season, when the intake of vitamin C-rich foods is very low. The effect of four supplementary levels of vitamin C (0, 24, 47 and 60 mg/day), together with a milk and biscuit food supplement which provided 34 mg vitamin C/day, was studied for a fi...
204 children between the ages of 1·5 and 6·5 years living in a West African village where the incidence of gingivitis and
bleeding gums is about 40% of the population at the end of the rainy season, were given vitamin C or a placebo for 69 days,
followed by a multivitamin supplement or placebo for 47 days. The condition of their gums was continuous...