Emerging Complexity and the Need for Advanced Drug Delivery in Targeting Candida Species.

BACKGROUND: Candida species are the important etiologic agents for candidiasis, the most prevalent cause of opportunistic fungal infections. Candida invasion results in mucosal to systemic infections through immune dysfunction and helps in further invasion and proliferation at several sites in the host. The host defence system utilizes a wide array of the cells, proteins and chemical signals that are distributed in blood and tissues which further constitute the innate and adaptive immune system. The lack of antifungal agents and their limited therapeutic effects have led to high mortality and morbidity related to such infections. METHODS: The necessary information collated on this review has been gathered from various literature published from 1995 to 2019. RESULTS: This article sheds light on novel drug delivery approaches to target the immunological axis for several Candida species (C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, C. krusei, C. rugose, C. hemulonii, etc.). CONCLUSION: It is clear that the novel drug delivery approaches include vaccines, adoptive transfer of primed immune cells, recombinant cytokines, therapeutic antibodies, and nanoparticles, which have immunomodulatory effects. Such advancements in targeting various underpinning mechanisms using the concept of novel drug delivery will provide a new dimension to the fungal infection clinic particularly due to Candida species with improved patient compliance and lesser side effects. This advancement in knowledge can also be extended to target various other similar microbial species and infections.

Factors associated with chest wall toxicity after accelerated partial breast irradiation using high-dose-rate brachytherapy.

PURPOSE: The purpose of this analysis was to evaluate dose-volume relationships associated with a higher probability for developing chest wall toxicity (pain) after accelerated partial breast irradiation (APBI) by using both single-lumen and multilumen brachytherapy. METHODS AND MATERIALS: Rib dose data were available for 89 patients treated with APBI and were correlated with the development of chest wall/rib pain at any point after treatment. Ribs were contoured on computed tomography planning scans, and rib dose-volume histograms (DVH) along with histograms for other structures were constructed. Rib DVH data for all patients were sampled at all volumes ≥0.008 cubic centimeter (cc) (for maximum dose related to pain) and at volumes of 0.5, 1, 2, and 3 cc for analysis. Rib pain was evaluated at each follow-up visit. Patient responses were marked as yes or no. No attempt was made to grade responses. Eighty-nine responses were available for this analysis. RESULTS: Nineteen patients (21.3%) complained of transient chest wall/rib pain at any point in follow-up. Analysis showed a direct correlation between total dose received and volume of rib irradiated with the probability of developing rib/chest wall pain at any point after follow-up. The median maximum dose at volumes ≥0.008 cc of rib in patients who experienced chest wall pain was 132% of the prescribed dose versus 95% of the prescribed dose in those patients who did not experience pain (p = 0.0035). CONCLUSIONS: Although the incidence of chest wall/rib pain is quite low with APBI brachytherapy, attempts should be made to keep the volume of rib irradiated at a minimum and the maximum dose received by the chest wall as low as reasonably achievable.

Influence of debittered, defatted fenugreek seed powder and flaxseed powder on the rheological characteristics of dough and quality of cookies.

A functional ingredient mix (FIM) comprising debittered and defatted fenugreek seed powder (70%) and flaxseed powder (30%) was used in cookies. Ash, fat and protein, dough development time, resistance to extension and peak viscosity values increased as the level of FIM increased from 10 to 30% in the blend. Beyond 20% of FIM substitution, the quality characteristics of cookies were adversely affected. Use of soya lecithin produced a significant improvement in the overall quality of the cookies with 20% FIM. Linolenic acid and total dietary fiber content of the cookies with 20% FIM and lecithin contained four times the amount of linolenic acid (2.3%) and double the amount of dietary fiber (13.04%) when compared with the control cookies (0.5% and 6.22%) respectively. Surface scanning electron microscopy of cookies with different levels of FIM from 10 to 30% showed that there was a disruption in the matrix.