Severe malnutrition after bariatric surgery and clinic manifestations of infection.

This report describes the post-bariatric-surgery evolution of an obese patient who had low adherence to the diet and micronutrient supplementation. Four years after two bariatric surgeries, the patient was admitted due to transient loss of consciousness, slow thinking, anasarca, severe hypoalbuminemia, in addition to vitamin and mineral deficiencies. She had subcutaneous foot abscess but did not present fever. Received antibiotics, vitamins A, D, B12, thiamine, calcium, and parenteral nutrition. After hospitalization (twenty-eight days), there was a significant body weight reduction probably due to the disappearance of clinical anasarca. Parenteral nutrition was suspended after twenty-five days, and the oral diet was kept fractional. After hospitalization (weekly outpatient care), there was a gradual laboratory data improvement, which was now close to the reference values. Such outcome shows the need for specialized care in preventing and treating nutritional complications after bariatric surgeries as well as clinical manifestations of infection in previously undernourished patients.

Severe malnutrition after bariatric surgery and clinic manifestations of infection

SUMMARY This report describes the post-bariatric-surgery evolution of an obese patient who had low adherence to the diet and micronutrient supplementation. Four years after two bariatric surgeries, the patient was admitted due to transient loss of consciousness, slow thinking, anasarca, severe hypoalbuminemia, in addition to vitamin and mineral deficiencies. She had subcutaneous foot abscess but did not present fever. Received antibiotics, vitamins A, D, B12, thiamine, calcium, and parenteral nutrition. After hospitalization (twenty-eight days), there was a significant body weight reduction probably due to the disappearance of clinical anasarca. Parenteral nutrition was suspended after twenty-five days, and the oral diet was kept fractional. After hospitalization (weekly outpatient care), there was a gradual laboratory data improvement, which was now close to the reference values. Such outcome shows the need for specialized care in preventing and treating nutritional complications after bariatric surgeries as well as clinical manifestations of infection in previously undernourished patients.

RESUMO Este relato descreve a evolução pós-cirurgia bariátrica de uma paciente obesa que apresentou baixa adesão à dieta e suplementação de micronutrientes. Quatro anos após duas cirurgias bariátricas, a paciente foi internada por perda transitória de consciência, raciocínio lento, anasarca, hipoalbuminemia grave, além de deficiências vitamínicas e minerais. Apresentava abscesso subcutâneo no pé, mas não apresentava febre. Recebeu antibióticos, vitaminas A, D, B12, tiamina, cálcio e nutrição parenteral. Após a internação (28 dias) houve redução significativa do peso corporal, provavelmente devido ao desaparecimento clínico da anasarca. A nutrição parenteral foi suspensa após 25 dias e a dieta oral foi mantida fracionada. Após a internação (atendimento ambulatorial semanal) houve uma melhora gradativa dos dados laboratoriais, que estavam próximos dos valores de referência. Tal desfecho mostra a necessidade de cuidados especializados na prevenção e tratamento de complicações nutricionais após cirurgias bariátricas, bem como manifestações clínicas de infecção em pacientes previamente desnutridos.

Highly Efficient Hybrid Polymer and Amorphous Silicon Multijunction Solar Cells with Effective Optical Management.

Highly efficient hybrid multijunction solar cells are constructed with a wide-bandgap amorphous silicon for the front subcell and a low-bandgap polymer for the back subcell. Power conversion efficiencies of 11.6% and 13.2% are achieved in tandem and triple-junction configurations, respectively. The high efficiencies are enabled by deploying effective optical management and by using photoactive materials with complementary absorption.

Wide-Bandgap Benzodithiophene-Benzothiadiazole Copolymers for Highly Efficient Multijunction Polymer Solar Cells.

Novel wide-bandgap semiconducting polymers are designed and synthesized for multijunction polymer solar cell (PSC) applications. In single-junction PSCs, BDT-FBT-2T exhibits efficiencies exceeding 6.5% for active layer thicknesses between 90 and 250 nm, with the highest efficiency of 7.7% at 100 and 250 nm. This enables tandem PSCs to be created with an efficiency of 8.9%.

A regioregular terpolymer comprising two electron-deficient and one electron-rich unit for ultra small band gap solar cells.

A regioregular terpolymer that combines electron-deficient diketopyrrolopyrrole and benzothiadiazole units with an electron-rich dithienopyrrole unit is presented. In solar cells, the terpolymer affords an open circuit voltage of 0.52 V and a power conversion efficiency of 3.7% with a spectral response up to 1050 nm.

High quantum efficiencies in polymer solar cells at energy losses below 0.6 eV.

Diketopyrrolopyrrole-based conjugated polymers bridged with thiazole units and different donors have been designed for polymer solar cells. Quantum efficiencies above 50% have been achieved with energy loss between optical band gap and open-circuit voltage below 0.6 eV.

Wide band gap diketopyrrolopyrrole-based conjugated polymers incorporating biphenyl units applied in polymer solar cells.

Incorporating biphenyls as co-monomers in electron-deficient diketopyrrolopyrrole (DPP) conjugated polymers enables widening the optical band gap to 1.70 eV. Power conversion efficiencies of 3.7-5.7% and high open-circuit voltages of 0.80-0.93 V are obtained in solar cells based on these wide band gap DPP polymers.

Effect of the fibrillar microstructure on the efficiency of high molecular weight diketopyrrolopyrrole-based polymer solar cells.

The nature of the solubilizing alkyl side chains has a strong effect on the performance of semiconducting diketopyrrolopyrrole polymers in organic solar cells with fullerene acceptors. The effect relates to the width of semicrystalline polymer fibrils that form in these blends. If the width of the fibril is wider than the exciton diffusion length, fewer charges form and the efficiency drops.

Universal correlation between fibril width and quantum efficiency in diketopyrrolopyrrole-based polymer solar cells.

For a series of six diketopyrrolopyrrole (DPP)-based conjugated polymers, we establish a direct correlation between their external quantum efficiencies (EQE) in organic solar cells and the fibrillar microstructure in the blend. The polymers consist of electron-deficient DPP units, carrying long branched 2'-decyltetradecyl (DT) side chains for solubility, that alternate along the main chain with electron-rich aromatic segments comprising benzene, thiophene, or fused aromatic rings. The high molecular weight DT-DPP polymers were incorporated in bulk heterojunction solar cells with [6,6]-phenyl-C71-butyric acid methyl ester ([70]PCBM) as acceptor. The morphology of the DT-DPP:[70]PCBM blends is characterized by a semicrystalline fibrillar microstructure with fibril widths between 4.5 and 30 nm as evidenced from transmission electron microscopy. A clear correlation is found between the widths of the fibrils and the EQE for photon to electron conversion. The highest EQEs (60%) and power conversion efficiencies (7.1%) are obtained for polymers with fibril widths less than 12 nm. For blends with fibrils wider than 12 nm, the EQE is low because exciton diffusion becomes limiting for charge generation. Interestingly, the correlation found here matches with previous data on related DPP-based polymers. This suggests that for this class of materials the relation between fiber width and EQE is universal. The fiber width is largely correlated with the solubility of the polymers, with less soluble DPP-based polymers giving narrower fibrils.

Efficient tandem and triple-junction polymer solar cells.

We demonstrate tandem and triple-junction polymer solar cells with power conversion efficiencies of 8.9% and 9.6% that use a newly designed, high molecular weight, small band gap semiconducting polymer and a matching wide band gap polymer.

Solution processed polymer tandem solar cell using efficient small and wide bandgap polymer:fullerene blends.

Solution processed polymer tandem solar cells that combine wide and small bandgap absorber layers reach a power conversion efficiency of 7% in a series configuration. This represents a 20% increase compared to the best single junction cells made with the individual active layers and shows that the tandem configuration reduces transmission and thermalization losses in converting sunlight.