Peter Helms

University of Aberdeen | ABDN · Institute of Medical Sciences

Objectives UK primary care databases (PCDs) are used by researchers worldwide to inform clinical practice. These databases have been primarily tied to single clinical computer systems, but little is known about the adoption of these systems by primary care practices or their geographical representativeness. We explore the spatial distribution of cl...

OBJECTIVES: UK primary care databases (PCDs) are used by researchers worldwide to inform clinical practice. These databases have been primarily tied to single clinical computer systems, but little is known about the adoption of these systems by primary care practices or their geographical representativeness. We explore the spatial distribution of c...

Objectives The aim was to explore the views of professional stakeholders and healthcare professionals (HCPs) on the linkage of UK National Health Service (NHS) data for paediatric pharmacovigilance purposes and to make recommendations for such a system. Methods A mixed methods approach including a literature review, interviews, focus groups and a...

Adverse drug events are a major cause of patient safety incidents. Current systems of pharmacovigilance under-report adverse drug reactions (ADRs), especially in children, leading to delays in their identification. This is of particular concern, as children especially have an increased vulnerability to ADRs. The objective was to seek consensus amon...

Airway epithelial cells (AEC) are key contributors to immune function in the lungs but little is known about their role and function in children. Having previously established that nasal AEC mediator release correlates with that of bronchial AEC, we assessed AEC responses in children with and without a history of wheeze. Nasal AEC cultures were est...

AimsA systematic review of the literature published in English over 10 years was undertaken in order to describe the use of electronic healthcare data in the identification of potential adverse drug reactions (ADRs) in children.MethodsMEDLINE and EMBASE were searched using MESH headings and text words. Titles, key words and abstracts were checked f...

Pharmakovigilanz (PV) setzt sich mit der Erkennung, Erfassung und dem Verstehen unerwünschter Arzneimittelwirkungen (UAW) auseinander. Im Rahmen einer umfassenden Studie in Schottland sollten ambulant und stationär erhobene Daten zur Früherkennung von UAW bei Kindern elektronisch vernetzt werden. Dazu wurde vorab in einer qualitativen Studie mit He...

Are maternal vitamin D and E intakes during pregnancy associated with asthma in 10-year-old children? In a longitudinal study of 1924 children born to women recruited during pregnancy, maternal vitamin D intake during pregnancy was assessed by the Food Frequency Questionnaire (FFQ) and vitamin E by FFQ and plasma α-tocopherol; respiratory questionn...

Background and aims Engaging and involving young people in clinical research has many benefits including greater understanding of young people’s perspectives and improvements in study design and the quality of clinical research.1 The nature and extent of support for the engagement of young people in research in Europe is unclear. Methods A survey w...

A new intravenous formulation containing paracetamol is now available and widely used in chil-dren, but with limited paediatric pharmacokinetic data. This study was aimed at determining the effects of age on the pharmacokinetics (PK) of this formulation of paracetamol in children. Blood samples were obtained from 24 children at 0, 15, 30 minutes, t...

AimsThe aim of this study was to assess opinions of frontline healthcare professionals on the linking of routinely collected national (Scottish) paediatric data for the purpose of identifying earlier signals of adverse drug reactions. Methods Stratified purposive sampling led to profession-specific focus groups with pharmacists, nurses and medical...

Because of relatively small treatment numbers together with low adverse drug reaction (ADR) reporting rates the timely identification of ADRs affecting children and young people is problematic. The primary objective of this study was to assess the utility of unplanned medication discontinuation as a signal for possible ADRs in children and young pe...

The inclusion of the Community Health Index in the recording of National Health Service (NHS) contacts in Scotland facilitates national linkage of data such as prescribing and healthcare utilisation. This linkage could be the basis for identification of adverse drug reactions. The aim of this article is to report the views of healthcare professiona...

Ketorolac, a potent nonsteroidal anti-inflammatory drug used for pain control in children, exists as a racemate of inactive R (+) and active S (-) enantiomers. To develop a microsampling assay for the enantioselective analysis of ketorolac in children. Ketorolac enantiomers were extracted from 50 μl of plasma by liquid–liquid extraction and separat...

Objective To review the literature on the views of healthcare professionals to the linkage of healthcare data and to identify any potential barriers and/or facilitators to participation in a data linkage system. Methods Published papers describing the views of healthcare professionals (HCPs) to data sharing and linkage were identified by searches...

Although research in children can be challenging for investigators, children and their families, it is only through well-designed and ethical studies that improvements in diagnosis, disease prevention and disease management can be made. The Scottish Children’s Research Network (ScotCRN), which was established in 2006 with core funding from the Scot...

Drug switching is a common medical practice. It indicates continuation of treatment regardless of the reason why the original therapy was stopped and switched. Therefore, the aims of this study were to develop a novel method for determining drug switching from routinely acquired NHS health data and to explore the aspect of continuation of care for...

The role of asthma controller medication adherence and the level of asthma control in children is poorly defined. To assess the association between asthma controller medication adherence and asthma control in children using routinely acquired prescribing data. A retrospective observational study of children aged 0-18 years prescribed inhaled cortic...

To determine the pharmacokinetics (PK) of a new i.v. formulation of paracetamol (Perfalgan) in children ≤15 yr of age. After obtaining written informed consent, children under 16 yr of age were recruited to this study. Blood samples were obtained at 0, 15, 30 min, 1, 2, 4, 6, and 8 h after administration of a weight-dependent dose of i.v. paracetam...

The CHRNA 3 and 5 genes on chromosome 15 encode the alpha subunits of the nicotinic acetylcholine receptor, mediating airway cholinergic activity. Polymorphisms are associated with cigarette smoking, chronic obstructive pulmonary disease, and lung cancer. To determine possible associations between CHRNA 3/5 SNP rs8034191 and asthma or lung function...

Conducting clinical trials in the paediatric population is difficult for a host of reasons that include logistical, methodological, financial and ethical problems. Indeed for many paediatric conditions, their low prevalence means that multicentre studies performed on an international scale often represent the only possibility to gather a sufficient...

Greater early fetal size is associated with reduced asthma risk and improved lung function in early childhood. To test the hypothesis that associations between early fetal size, asthma symptoms, and lung function persist into later childhood. In a longitudinal study, first- and second-trimester fetal measurements were recorded. At 10 years of age a...

Little is known about the impact of British asthma management guideline revisions. Concerns about the use of high dose inhaled corticosteroids (ICS) in children have resulted in the promotion of add-on therapy. To assess prescribing patterns of asthma medication in children in the primary care setting. Retrospective observational study of asthma pr...

To assess the level of paracetamol off label prescribing in the community and the potential for paracetamol under or overdosing. The Scottish Practice Team Information (PTI) database containing prescribing data for approximately 35,839 children aged (0-12 years) was analysed for paracetamol prescriptions for the year 2006. Off label prescribing was...

The development of systems to ensure appropriate and informed use of medicines in children is a global priority. Current pharmacovigilance systems, such as the UK Yellow Card Scheme, are limited by opportunistic reporting of adverse drug reactions (ADRs), lack of a denominator and lower than expected reporting rates. To develop a pharmacovigilance...

In the UK, adverse drug reactions (ADRs) are responsible for over 6.5% of all hospital admissions, representing a significant morbidity and cost burden to the health service. We aimed to develop an ADR monitoring system capable of identifying the reasons for patient discontinuation of drug therapy within 6 months of the index prescription. Patients...

Maternal D intakes during pregnancy are associated with childhood asthma at 10 years of age - Volume 70 Issue OCE1 - K. Allan, L. C. A. Craig, G. McNeill, S. W. Turner, N. Prabhu, R. Cutts, P. J. Helms, A. Seaton, G. Devereux

Maternal vitamins E and D intakes during pregnancy are associated with childhood asthma up to the age of 10 years - Volume 70 Issue OCE3 - K. Allan, L. C. A. Craig, G. McNeill, S. W. Turner, N. Prabhu, R. Cutts, P. J. Helms, A. Seaton, G. Devereux

Background Although audits of prescribing practice referenced to the British asthma management guidelines have been reported little is known on the impact of guideline revisions. Concerns about the use of high dose inhaled corticosteroids (ICS) in children, implicit in earlier adult oriented guidelines, has resulted in the promotion of add on thera...

Data on the efficacy and safety of long-acting β2-agonists (LABA) in children are limited, and current guidelines recommend that LABA always be used with inhaled corticosteroids (ICS). To compare asthma control, assessed by rescue medications use, in children prescribed LABA and ICS as a fixed-dose combination (LABA/ICS) or concurrently via separat...

BACKGROUND: Susceptibility to asthma is influenced by genes and environment; implicated genes may indicate pathways for therapeutic intervention. Genetic risk factors may be useful in identifying subtypes of asthma and determining whether intermediate phenotypes, such as elevation of the total serum IgE level, are causally linked to disease. METH...

This is a commentary on a Cochrane review, published in this issue of EBCH, first published as: Cates CJ, Lasserson TJ, Jaeschke R. Regular treatment with formoterol and inhaled steroids for chronic asthma: serious adverse events. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD006924. DOI: 10.1002/14 651 858.CD006924.pub2. Furth...

Unlabelled: WHAT IS ALREADY KNOWN ABOUT THE SUBJECT: Finger-prick blood samples are increasingly used for the clinical and biomedical measurement of drugs and endogenous substance concentration. The use of different sampling sites can give rise to different drug concentration measurements. What this study adds: During the absorption phase, the p...

Asthma guidelines recommend the use of long-acting 2-agonists (LABAs) as the preferred add-on therapy for adults and children over 5 years of age when asthma is inadequately controlled by inhaled corticosteroids alone. It has been suggested that LABA use may be associated with an increased risk of morbidity and mortality; however, this view is cont...

BACKGROUND The origins of respiratory disease might be traced back to exposures during fetal life. The aim of the present study was to explore whether there was a relationship between fetal size and respiratory outcomes at 5 years of age in the context of fetal exposure to vitamin E. METHODS A longitudinal birth cohort study was recruited (n=1924)....

Current pharmacovigilance systems are limited by spontaneous reporting of adverse drug reactions (ADRs), lack of a denominator, and lower than expected reporting rates. The aim of our study was to undertake a formal pilot evaluation of a community pharmacy-led ADR monitoring system. The setting was community pharmacies in five Health Boards areas o...

Maternal smoking in pregnancy is associated with reduced birth weight and childhood lung function. This study determined when maternal smoking first influences fetal growth and how this relates to childhood respiratory outcomes. A longitudinal cohort of 1924 pregnant women was recruited. Fetal ultrasound measurements at 11 weeks (crown-rump length,...

To explore the experiences and views of community pharmacists and parents participating in a prospective paediatric pharmacovigilance study. Twenty-five pharmacists and 32 parents were approached for telephone interview. Interviews were audio-recorded, transcribed and analysed thematically to identify recurring issues and themes. Seventeen pharmaci...

Surveys of primary schools children in Aberdeen carried out in 1964, 1989, 1994 and 1999 suggested a slowing of the increase in parent-reported wheeze between 1994 and 1999. To assess whether this pattern had continued, questionnaires were distributed to 5712 children aged 7-12 years in the same schools in 2004. A total of 3271 (57.3%) completed qu...

Specific language impairment (SLI) is a common developmental disorder characterized by difficulties in language acquisition despite otherwise normal development and in the absence of any obvious explanatory factors. We performed a high-density screen of SLI1, a region of chromosome 16q that shows highly significant and consistent linkage to nonword...

Studies show that 65-85% of mothers cradle their infants to the left side of their body, but that this bias changes with maternal mood and stress. The present study examines the hypothesis that maternal stress and depression status will influence the cradling bias differentially. As part of a larger study on mother-infant interaction, mothers (N =...

We invited 232 General Practice Trainees to complete an on-line questionnaire to assess how they rated their training for the task of paediatric prescribing and therapeutics in the community. Of the 166 (71%) respondents who completed the questionnaire, 26.5% recalled specific teaching about paediatric prescribing and 59.6% covering one or more rel...

Although wheezing illness is at its most prevalent in infancy and early childhood, its self-limiting nature in the majority poses considerable challenges in offering a long-term prognosis and in initiating long-term prophylaxis. Many of the established treatments in adults have not been adequately assessed in children. Evidence is also emerging for...

Exercise induced broncho-constriction (EIB) is a cardinal feature of asthma and with its greatest impact on children, active adults and elite athletes. Although its patho-physiology has been extensively studied, the relative contributions of airway cooling and water loss, reflex broncho-constriction and mediator release remain uncertain. Objective...

Climate change will affect individuals with pre-existing respiratory disease, but the extent of the effect remains unclear. The present position statement was developed on behalf of the European Respiratory Society in order to identify areas of concern arising from climate change for individuals with respiratory disease, healthcare workers in the r...

Specific language impairment (SLI) is a common developmental disorder characterized by difficulties in language acquisition despite otherwise normal development and in the absence of any obvious explanatory factors. We performed a high-density screen of SLI1, a region of chromosome 16q that shows highly significant and consistent linkage to nonword...

Although the notion that childhood wheezing illnesses, particularly those presenting in infancy and early childhood (children less than 5 yrs), may have different causes is not new, studies in recent years have revealed and rediscovered a number of distinct wheezing conditions in this early phase of life [1] (Table 1). The highest prevalence of rec...

Asthma is a common condition characterised by wheeze. Many different respiratory sounds are interpreted by parents as "wheeze" in young children. To relate different respiratory sounds reported as wheeze in 2-year-olds to asthma outcomes at age 5 years. As part of a longitudinal cohort study, parents completed respiratory questionnaires for their c...

The nose is an attractive source of airway epithelial cells, particularly in populations in which bronchoscopy may not be possible. However, substituting nasal cells for bronchial epithelial cells in the study of airway inflammation depends upon comparability of responses, and evidence for this is lacking. Our objective was to determine whether nas...

The interleukin 18 receptor (IL18R1) gene is a strong candidate gene for asthma. It has been implicated in the pathophysiology of asthma and maps to an asthma susceptibility locus on chromosome 2q12. The possibility of association between polymorphisms in IL18R1 and asthma was examined by genotyping seven SNPs in 294, 342 and 100 families from Denm...

To gather detailed data on the incidence of phrenic nerve damage (PND) following cardiac surgery in children, the risk factors for its development, its effect on morbidity and its prognosis. Prospective electrophysiological measurement of phrenic nerve latency in 310 children before and after cardiac surgery. Tertiary paediatric cardiac surgical ce...

Asthma is a clinically heterogeneous disease caused by a complex interaction between genetic susceptibility and diverse environmental factors. In common with other complex diseases the lack of a standardized scheme to evaluate the phenotypic variability poses challenges in identifying the contribution of genes and environments to disease expression...

To compare risk factors for wheezy bronchitis (WB) and multi-trigger wheeze (MTW) in pre-pubertal children along the spectrum of disease severity. Cross-sectional survey of children aged 7-12 yr in Aberdeen city primary schools in 2004 using parent-completed questionnaires as used in surveys in 1964, 1989, 1994, and 1999. Children were grouped into...

The aim of this study was to assess change in the number of adolescent females prescribed hormonal contraception in primary care following the publication in the United Kingdom of the Social Exclusion Unit report on Teenage Pregnancy. We conducted a retrospective observational study of 320 primary care practices in Scotland. Hormonal contraceptive...

Asthma is the leading chronic disease among children in most industrialized countries. However, the evidence base on specific aspects of pediatric asthma, including therapeutic strategies, is limited and no recent international guidelines have focused exclusively on pediatric asthma. As a result, the European Academy of Allergy and Clinical Immunol...

Endothelin-1 (EDN1) has been reported to be implicated in the pathophysiology of asthma. Literature results on the genetic association of EDN1 in asthma are inconsistent. Eleven single nucleotide polymorphisms in EDN1 were genotyped in 342 and 100 families from UK and Norway, respectively. Asthma, bronchial hyperreactivity (BHR) and atopic asthma p...

Postnatal depression has detrimental effects on the child's cognitive and emotional development. To assess the benefits of treating postnatal depression for mother-infant interaction and child development. A systematic search was made of 12 electronic bibliographic databases for randomised controlled trials and controlled clinical trials on treatme...

Spirometry is more frequently measured in younger children. Our primary aim was to validate 2005 ATS-ERS Task Force standards for spirometry in adults and older children among a population of 5-year-old children. Our secondary aim was to relate spirometry to asthma symptoms. Children were participants in a longitudinal cohort study where asthma sym...

Associations between maternal vitamin E, vitamin D and zinc intakes during pregnancy and asthma, wheeze and eczema in 5-year-old children have previously been reported. A study was undertaken to investigate whether maternal intake of specific foods during pregnancy is associated with asthma and allergic outcomes in the same children. A longitudinal...

Biomarkers associated with asthma aetiology and exacerbation have been sought to shed light on this multifactorial disease. One candidate is the serum concentration of the Clara cell secretory protein (CC16, sometimes referred to as CC10 or uteroglobin). In this review, we examine serum CC16's relation to asthma aetiology and exacerbation. There is...

Reduced dietary selenium intake has been linked to the development of asthma. We have investigated whether childhood wheezing symptoms, and asthma up to the age of 5 years are associated with plasma selenium and erythrocyte glutathione peroxidase (GPx) concentrations in pregnant mothers and neonates. Two thousand pregnant women were recruited and t...

To identify community pharmacist experiences of, and attitudes towards paediatric off-label prescribing. A prospective questionnaire-based study, with a 21-item questionnaire issued to 1500 randomly selected community pharmacies throughout the UK during 2005 on three separate occasions. Four hundred and eighty-two (32.1%) completed questionnaires w...