Bernardo Pinho

Bio: Bernardo Pinho is an academic researcher from University of Porto. The author has contributed to research in topics: Microphone & Smart device. The author has an hindex of 2, co-authored 6 publications receiving 10 citations.

Quality assessment and feedback of Smart Device Microphone Spirometry executed by children

Abstract: Smart device microphone spirometry, based on the audio recording of forced expiratory maneuver (FEM), can be a simple, ubiquitous and easy tool for patients to self-monitor their asthma. Automatic validity assessment is crucial to guarantee that the global effort of the FEM fulfil the admissible minimum or if the maneuver needs to be repeated. In this work an automatic method to classify the sounds from FEM with respect to global effort was developed and evaluated using data from 54 children (5-10 years). The method proposed was able to correctly classify the microphone spirometry with respect to admissible minimum of effort with an accuracy of 86% (specificity 87% and sensitivity 86%). This method can be used to provide immediate feedback of the correct execution of the maneuver, improving the clinical value and utility of this self-monitoring tool.

FRASIS - Monitorização da função respiratória na asma utilizando os sensores integrados do smartphone

Abstract: The FRASIS project aims to develop, integrate and validate a set of information and communication technologies (ICT) of mobile health (mHealth) for remote monitoring of respiratory function in asthma, using only the smartphone and their embedded sensors. Current tools for asthma self -monitoring and self -managing are complex, unattractive, not individualized and require laborious analysis by health professionals, discouraging their use in healthcare. There is an opportunity for cost -effective and easy -to -disseminate advanced technological solutions directed to patients and attractive to the different stakeholders. The strategy of FRASIS is to develop and integrate self -monitoring and self -managing tools, making use of the smartphones presence in everyday life and their future integration with environmental sensors in smart cities. It is expected that FRASIS results may have a large impact on the innovation of asthma care, with increased patient empowerment, providing quality prospective information for better clinical decisions and making healthcare more efficient and sustainable.

Automatic Quality Assessment of a Forced Expiratory Manoeuvre Acquired with the Tablet Microphone

Abstract: Evaluation of lung function is central to the management of chronic obstructive respiratory diseases. It is typically evaluated with a spirometer by a specialized health professional, who ensures the correct execution of a forced expiratory manoeuvre (FEM). Audio recording of a FEM using a smart device embedded microphone can be used to self-monitor lung function between clinical visits. The challenge of microphone spirometry is to ensure the validity and reliability of the FEM, in the absence of a health professional. In particular, the absence of a mouthpiece may allow excessive mouth closure, leading to an incorrect manoeuvre. In this work, a strategy to automatically assess the correct execution of the FEM is proposed and validated. Using 498 FEM recordings, both specificity and sensitivity attained were above 90%. This method provides immediate feedback to the user, by grading the manoeuvre in a visual scale, promoting the repetition of the FEM when needed.

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

Abstract: Objective We aimed to compare patient’s and physician’s ratings of inhaled medication adherence and to identify predictors of patient-physician discordance. Design Baseline data from two prospective multicentre observational studies. Setting 29 allergy, pulmonology and paediatric secondary care outpatient clinics in Portugal. Participants 395 patients (≥13 years old) with persistent asthma. Measures Data on demographics, patient-physician relationship, upper airway control, asthma control, asthma treatment, forced expiratory volume in one second (FEV1) and healthcare use were collected. Patients and physicians independently assessed adherence to inhaled controller medication during the previous week using a 100 mm Visual Analogue Scale (VAS). Discordance was defined as classification in distinct VAS categories (low 0–50; medium 51–80; high 81–100) or as an absolute difference in VAS scores ≥10 mm. Correlation between patients’ and physicians’ VAS scores/categories was explored. A multinomial logistic regression identified the predictors of physician overestimation and underestimation. Results High inhaler adherence was reported both by patients (median (percentile 25 to percentile 75) 85 (65–95) mm; 53% VAS>80) and by physicians (84 (68–95) mm; 53% VAS>80). Correlation between patient and physician VAS scores was moderate (rs=0.580; p Conclusion Although both patients and physicians report high inhaler adherence, discordance occurred in half of cases. Implementation of objective adherence measures and effective communication are needed to improve patient-physician agreement.

Validation of App and Phone Versions of the Control of Allergic Rhinitis and Asthma Test (CARAT).

Abstract: Jácome C1,2, Pereira AM2,3, Almeida R1,2, Amaral R1,4, Correia MA3, Mendes S1, Vieira-Marques P1, Ferreira JA5, Lopes I5, Gomes J5, Vidal C6, López Freire S6, Méndez Brea P6, Arrobas A7, Valério M7, Chaves Loureiro C7, Santos LM7, Couto M3, Araujo L3, Todo Bom A8, Azevedo JP9, Cardoso J10, Emiliano M10, Gerardo R10, Lozoya C11, Pinto PL12, Castro Neves A12, Pinto N12, Palhinha A12, Teixeira F13, Ferreira-Magalhães M13, Alves C14, Coelho D14, Santos N15, Menezes F16, Gomes R16, Cidrais Rodrigues JC17, Oliveira G17, Carvalho J17, Rodrigues Alves R18, Moreira AS18, Costa A19, Abreu C20, Silva R20, Morête A21, Falcão H22, Marques ML22, Câmara R23, Cálix MJ24, Bordalo D25, Silva D26, Vasconcelos MJ26, Fernandes RM27,28, Ferreira R27,29, Freitas P30, Lopes F31, Almeida Fonseca J1,2,3,31, INSPIRERS group 1Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal 2Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal 3Allergy Unit, Instituto and Hospital CUF, Porto, Portugal 4Dept. of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal 5Serviço de Imunoalergologia, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal 6Servicio de Alergia, Complejo Hospitalario Universitario de Santiago, Santiago De Compostela, Spain 7Serviço de Pneumologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal 8Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal 9Imunoalergologia, Centro Hospitalar de Leiria, Leiria, Portugal 10Serviço de Pneumologia, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal 11Serviço de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal 12Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal 13Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal 14Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal 15Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, Portimão, Portugal 16Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal 17Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal 18Serviço de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal 19Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal 20Serviço de Imunoalergologia, Hospital São Pedro de Vila Real, Centro Hospitalar De Trás-Os-Montes E Alto Douro, Vila Real, Portugal 21Serviço de Imunoalergologia, Hospital Infante D. Pedro, Centro Hospitalar Baixo Vouga, Aveiro, Portugal 22Serviço de Imunoalergologia, Centro Hospitalar Universitário do Porto, Porto, Portugal in asthmatic patients with sputum eosinophilia. J Allergy Clin Immunol. 2013;132(5):1086-96. 8. Ramakrishnan S, Camp JR, Vijayakumar B, Harding FM, Downs ML, Russell REK, et al. The Use of Benralizumab in the Treatment of Near Fatal Asthma: A New Approach [published online ahead of print, 2020 Feb 5]. Am J Respir Crit Care Med. 2020;10.1164/rccm.202001-0093LE. 9. Tello K, Hoffmann A, Beutel B, Greulich T, Vogelmeier CF, Richter MJ, et al. Anti-interleukin-5 therapy (mepolizumab) in life-threatening asthma attack: A case-based discussion. Respir Med Case Rep. 2019;28:100927. 10. Ryman JT, Meibohm B. Pharmacokinetics of monoclonal antibodies. CPT Pharmacometrics Syst Pharmacol. 2017;6(9):576-88.

Profiling Persistent Asthma Phenotypes in Adolescents: A Longitudinal Diagnostic Evaluation from the INSPIRERS Studies

Abstract: We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13–17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.

A Definition of a Coaching Plan to Guide Patients with Chronic Obstructive Respiratory Diseases

Abstract: With such a noticeable increase in the number of people with chronic obstructive respiratory diseases the effectiveness of traditional healthcare systems has worsened significantly over the last years. There is an opportunity to develop low cost and personalized solutions that can empower patients to self-manage and self-monitor their health condition. In this context, the PHE project is present whose main goal is to develop coaching solutions for remote monitoring of patients and that can be provided through the exclusive use of the smartphone. In this work we explore how patients with chronic obstructive respiratory diseases can adopt healthier behaviors by following personalized healthcare coaching plans used throughout their daily lives. We explain how a coaching plan can be defined to guide the patient and explore the mechanisms necessary to operate automatically and adapt itself according to the interactions between the patient and the system. As a result, we believe to be possible to enhance user experience and engagement with the developed system and consequentially improve his/her health condition.

Adult-Onset Sheep's Milk Allergy in a Patient Without Cow's Milk Allergy.

Abstract: Most childhood-onset sheep and goat’s milk allergies cooccur with cow’s milk allergy because of the high sequence homology between the corresponding proteins [1]. Alvarez et al [2] reported adult-onset sheep and goat’s milk allergies without cow’s milk allergy. Sensitization in food allergy is traditionally considered to occur via the intestinal tract; therefore, sheep’s milk allergy is mainly reported from countries with a higher consumption of goat and sheep’s milk products [3]. In 2013, >2000 cases of wheat allergy in Japan were induced after sensitization by a facial soap that contained hydrolyzed wheat protein [4]. Shimojo et al [5] reported the case of a patient with fish allergy induced via percutaneous sensitization. Therefore, percutaneous sensitization is a route through which food allergies develop. In Japan, people regularly consume cow’s milk products but not sheep or goat’s milk products. We report a Japanese case of adult-onset sheep’s milk allergy without cow’s milk allergy that was possibly induced by occupational percutaneous sensitization to sheep’s milk cheese. A 25-year-old woman with moderately severe atopic dermatitis and asthma had 3 anaphylactic episodes that were managed with injectable antihistamines and systemic corticosteroids. The patient had previously received topical corticosteroids for atopic dermatitis at a private clinic. Before the first occurrence of allergic symptoms at 21 years of age, the patient had worked regularly (6 days per week) at her part-time job for 1 year. The atopic dermatitis lesions on her hands were aggravated because she washed dishes without gloves at her workplace. Moreover, she occasionally handled pecorino cheese (made from sheep’s milk) without gloves during her work. Her first anaphylactic episode occurred at 21 years of age and was associated with hand numbness, laryngeal swelling, diarrhea, and vomiting after eating pasta and bread at her workplace. At 22 years of age, the symptoms recurred after eating pasta in Italy. At age 23 years, the patient experienced sneezing, rhinorrhea, Manuscript received June 20, 2020; accepted for publication August 20, 2020.