Percorrer por autor "Vaz, P."
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- Down syndrome: otolaryngological effects of rapid maxillary expansionPublication . Moura, C. Pinto de; Andrade, D.; Cunha, L. M.; Tavares, M. J.; Gonçalves, Maria João; Vaz, P.; Barros, H.; Pueschel, S. M.; Clemente, M. PaisPhenotypical Down syndrome includes pharyngeal and maxillary hypoplasia and, frequently, constricted maxillary arch with nasal obstruction. This clinical trial assessed the effects of rapid maxillary expansion on ENT disorders in 24 children with Down syndrome randomly allocated to receive either rapid maxillary expansion or not. Each group received ENT and speech therapy assessments before expansion and after the device had been removed. In the rapid maxillary expansion group, the yearly ENT infection rate was reduced when assessed after device removal (p < 0.01). The parents of rapid maxillary expansion children reported a reduction in respiratory obstruction symptoms. Audiological assessment revealed improvements in the rapid maxillary expansion group (p < 0.01). Cephalometry showed increased maxillary width in the rapid maxillary expansion group. Rapid maxillary expansion resulted in a reduction in hearing loss, yearly rate of ENT infections and parentally assessed symptoms of upper airway obstruction, compared with no treatment. These findings are probably related to expanded oronasal space, due to rapid maxillary expansion.
- Real-time dosimetry, organs dose and risk assessment for CBCT thorax protocols in IGRT proceduresPublication . Campos, A.; Sá, Ana Cravo; Romanets, Y.; Vaz, P.; Di Maria, S.Cone Beam Computed Tomography (CBCT) is essential in Image-Guided Radiation Therapy (IGRT), enabling more accurate treatments but increasing patients exposure to radiation. Despite advancements in dose reduction acquisition methods, routine daily CBCT imaging can still result in a considerable cumulative radiation dose to the patient, which should be considered and assessed. This study aimed at estimating the radiation doses absorbed with MOSFET detectors of some radiosensitive organs (e.g. lung, stomach, liver) during thoracic CBCT examination and calculates the risk of cancer incidence and mortality with adult thorax physical phantom. The absorbed doses in the aforementioned organs ranged between 3 mGy and 8 mGy per fraction, close to the isocenter. Over 33 fractions, the cumulative absorbed dose reached approximately 260 mGy. The analysis of cancer incidence and mortality risk through BEIR VII model revealed that the lungs have the highest number of cases for each age considered (20–80 years interval). Comparing dose assessment obtained using several methods (Monte Carlo, TLDs and MOSFETs), with the same irradiation protocol, lung dose varies among 2.08 mGy and 7.60 mGy, whereas the heart varies among 4.9 Gy and 10 mGy. Although surrogate dose-index methods are often used, organ absorbed doses assessment should be the preferred method to assess the magnitude of realistic organ radiation risk of populations undergoing examinations with ionizing radiation. Implications for practice: Promoting experimental dosimetry phantom studies in a more harmonized way would increase the accuracy of organ absorbed dose assessment and consequently would improve the risk communication and decision-making for better CBCT protocols choice in clinical settings.