Получение полуизолирующего кремния для высоковольтных приборов

Исследовано влияние условий осаждения на структуру и электрофизические свойства пленок поликристаллического кремния, легированного кислородом. Результаты использованы при изготовлении изделий силовой электроники

Hypospadias. From aetiology to prognosis of clinical and patient-related outcomes after surgical repair

Contains fulltext : 201211.pdf (publisher's version ) (Open Access)Radboud University, 22 maart 2019Promotor : Feitz, W.F.J. Co-promotores : Rooij, I.A.L.M. van, Roeleveld, N

Satisfaction Comparison Study After Hypospadia Reconstruction A comparison of the clinical outcome with post-operative patient and physician satisfaction: :

Introduction: Although hypospadia is a common congenital defect which is reconstructed in about 80% of the cases, there is still debate about outcome measurement. In this study clinical outcomes were compared with post-operative patient and physician satisfaction. In order to create more insight in the results of the reconstructions, the factors severity of the original hypospadia, current age, type and timing of reconstruction, re-operations and complications were analysed for their influence on clinical outcome as well as satisfaction. Material & Methods: Of all the patients who had a hypospadias reconstruction in the Medical Centre of Leeuwarden (MCL) between 1996 and 2010, 60 patients participated in this retrospective study. Clinical outcome measured with the Hypospadias Objective Scoring Evaluation (HOSE) system (maximum score = 16) was compared to the post-operative patient and physician satisfaction measured with the satisfaction questionnaire from Mureau (maximum score = 32). Results: Overall physician satisfaction (30.6, sd 1.83) was significantly higher than overall patient satisfaction (26.3, sd 5.28). (p = 0.009) The correlation between physician satisfaction and patient satisfaction was low. (0.35, p < 0.001) Mean total HOSE score was 15.3 (sd 1.02). 60% of the patients had an optimal HOSE score. These patients had a significantly higher patient and physician satisfaction (27.6, sd 4.44 and 31.3, sd 1.19) compared to patients with a sub-optimal HOSE score (24.3, sd 5.91 and 29.5, sd 2.11). (p = 0.018 and p = 0.001) The correlation between HOSE score and physician satisfaction (0.49, p < 0.001) was higher than between HOSE score and patient satisfaction (0.28, p = 0.035). Conclusion: Physician satisfaction was higher and more correlated to clinical outcome than patient satisfaction. Clinical outcome was not influenced by severity of the original hypospadia, current age, timing and type of the reconstruction or re-operations. However, complications had a negative influence on the clinical outcome. Patient satisfaction was influenced by the original severity of the hypospadia, the type of reconstruction and the clinical outcome. Surgery after the age of 4 had a negative influence on patient satisfaction. Physician satisfaction was influenced by current age, the type of reconstruction, re-operations, complications and the HOSE subquestions ‘meatal location’, ‘erection’ and ‘fistula’.

Patient Satisfaction with Surgical Outcome after Hypospadias Correction

Item does not contain fulltextBackground: Hypospadias is a congenital malformation in which surgical correction is indicated in most cases. Postoperative patient satisfaction is important because of its influence on the child's psychological development. Objective: To evaluate patient satisfaction with surgical outcome after hypospadias correction, comparison with physician satisfaction, and the influence of patient and treatment characteristics on satisfaction. Design, setting, and participants: Seventy-four patients who had hypospadias surgery between 1996 and 2010 in Medical Centre Leeuwarden participated in the study. Measurements: Patient/parent and physician satisfaction scores were measured using a standardised hypospadias satisfaction questionnaire (maximum score 32), and clinical outcome using the Hypospadias Objective Scoring Evaluation (HOSE; maximum score 16). Patient and treatment characteristics recorded were: preoperative meatal location, preoperative chordee, number of planned surgeries, reconstructive type and timing, patient age during the study, complications, and repeat operations. Results and limitations: Patients (mean age 10.5 yr) had a lower overall satisfaction score (27.1) than the physicians (30.6). Patients were least satisfied with overall genital appearance (3.1), penile length (3.3), and scars (3.3), whereas physician satisfaction was lowest for scars (3.5). The mean HOSE was 15.4 (standard deviation 0.9). Patients with acceptable HOSE (85%) had higher patient and physician satisfaction compared to patients with unacceptable HOSE. Patient satisfaction was lower among patients with a preoperative proximal meatal location or chordee, and with correction techniques other than the Mathieu approach. Physician satisfaction decreased with increasing patient age and was lower for patients with preoperative chordee, postoperative complications, or repeat operations. Conclusions: Overall patient and physician satisfaction and clinical outcome scores were relatively high. Patient satisfaction was lower and based on different factors compared to physician satisfaction. Patient satisfaction seems more influenced by aesthetic appearance, but both patients and physicians appear to incorporate clinical characteristics and outcome in their opinion on satisfaction. Patient summary: Different factors seem to influence patient and physician satisfaction with hypospadias correction, and there is only low correlation between the two. Therefore, patient satisfaction should be evaluated properly instead of making assumptions based on physician satisfaction or clinical outcome only. (C) 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved

Level of agreement on postoperative complications after one-stage hypospadias correction comparing medical records and parent reports

Item does not contain fulltextPURPOSE: To analyze agreement on postoperative complications after hypospadias surgery according to medical records and parents' reports. MATERIALS & METHODS: In this retrospective cohort study, data were collected from 409 children who received an initial one-stage hypospadias correction in the Radboudumc, The Netherlands. Postoperative complications according to medical records were compared with parent-reported complications in an online questionnaire. Main complications studied were wound-related complications, urinary tract infections, fistulas, stenosis, and prepuce-related complications. Agreement was determined by Cohen's kappa coefficient. RESULTS: Slightly less complications were mentioned in medical records (37%) compared to parents' reports (42%). Overall agreement was moderate (kappa=0.50, 95% confidence interval (CI):0.41-0.59), but poor for some specific complications. Agreement was higher for complications that needed reoperation compared to when no reoperation was performed (kappa=0.53, 95% CI: 0.43-0.62 and kappa=0.18, 95% CI: 0.06-0.31) and for patients with recent surgery (<5years before questionnaire completion) compared to less recent surgeries (kappa=0.69, 95% CI: 0.55-0.84 and kappa=0.43, 95% CI: 0.33-0.54). CONCLUSIONS: Agreement on complications according to medical records and parents' reports was poor to moderate, but better after reoperation and more recent surgery. Some complications mentioned in medical records were missing from parents' reports and the other way around. Better agreement will give physicians and parents a more reliable view on postoperative outcome after hypospadias surgery. TYPE OF STUDY: Diagnostic test. LEVEL OF EVIDENCE: Level III

Interaction between MTHFR 677C>T and periconceptional folic acid supplementation in the risk of Hypospadias

BACKGROUND: Hypospadias is a congenital malformation with both environmental factors and genetic predisposition involved in the pathogenesis. The role of maternal periconceptional folic acid supplement use in the development of hypospadias is unclear. As folate levels may also be influenced by the C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene, we hypothesize that a gene-environment interaction between this polymorphism and folic acid use is involved in the etiology of hypospadias. METHODS: We conducted a case-control study among 855 hypospadias cases and 713 population-based controls from the AGORA data- and biobank. Folic acid supplement use was derived from maternal questionnaires and infant and maternal DNA was used to determine the MTHFR C677T polymorphism using Taqman assays. We performed separate analyses for different hypospadias phenotypes (anterior/middle/posterior). RESULTS: Hypospadias was neither associated with folic acid use or the MTHFR C677T polymorphism, nor with their interaction. However, we did find an association with middle hypospadias when no supplements were used (odds ratio = 1.6; 95% confidence interval, 1.1-2.4), especially in infants carrying the CT/TT genotype (odds ratio = 2.5; 95% confidence interval, 1.4-4.7). In addition, more infants with these genotypes seemed to have posterior hypospadias, regardless of folic acid use. CONCLUSION: Our study does not suggest a major role for folic acid supplements or the MTHFR C677T polymorphism in the etiology of hypospadias in general, but not using folic acid and/or carrying the MTHFR C677T polymorphism may be associated with middle and posterior hypospadias. Therefore, we stress the importance of studying gene-environment interactions preferably in stratified analyses for different hypospadias phenotypes. Birth Defects Research (Part A) 106:275-284, 2016. (c) 2016 Wiley Periodicals, Inc

Preoperative Illnesses in Children Do Not Increase the Risk of Complications After Hypospadias Repair

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