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Aspergillus endocarditis is a rare infection that may affect immunocompetent patients following heart valve replacement or heart surgery. We report the case of a 39 year old woman with a history of intravenous drug use who developed endocarditis with direct examination of the resected valve and vegetation showing the presence of mycelia. Cultures were positive for an Aspergillus of section Nigri, which was subsequently identified as Aspergillus tubingensis by sequencing. The clinical course was favorable following surgery and prolonged antifungal therapy (8 months in total). Antifungal susceptibility testing showed good in vitro activity of amphotericin B, voriconazole and echinocandins against planktonic cells of this A. tubingensis isolate. However, only amphotericin B displayed significant activity against biofilms. In vitro combinations of voriconazole or amphotericin B with echinocandins did not meet the criteria of synergism. Our review of the literature identified 17 other cases of endocarditis attributed to Aspergillus of section Nigri with an overall mortality rate of 57% (100% in the absence of surgery). Endocarditis caused by Aspergillus niger and related cryptic species are rare events, for which surgical management appears to be crucial for outcome. While amphotericin B was the only antifungal drug displaying significant anti-biofilm activity, the type and duration of antifungal therapy remain to be determined.

The 3D reconstruction of upper limb anatomy plays a significant role in many biomedical fields such as ergonomics, motion rehabilitation, and prosthesis design. In the last few years, the technical advancement of consumer-grade depth cameras has supported the development of portable and low-cost optical 3D body scanners for healthcare applications. The real-time scanning of human body parts, however, still represents a complex task due to the non-stationary nature of the scanning target. This issue imposes that the scanning time must be reduced as much as possible to minimize scanning artifacts. In this regard, depth cameras can capture geometrical information at video frame rates, thus guaranteeing fast acquisition times. Furthermore, the simultaneous use of multiple sensors would minimize undercut geometries, which impair the 3D reconstruction’s completeness. In this work, a portable 3D optical scanner has been developed by rigidly assembling three Intel® RealSense™ D415 depth cameras on a lightweight circular frame. The three sensors are mutually calibrated, by using a 3D printed calibration specimen, to simultaneously align acquisitions from the three different camera viewpoints for each scanner pose. The system’s effectiveness has been assessed by acquiring the geometry of both a plaster hand and a human hand and comparing the results with those obtained by a high-end stationary structured light scanner. The developed system represents a low-cost handheld alternative to existing body scanners for collecting and storing 3D anatomical data, which can be used in the design process of bespoke medical devices.

HoloLens is the most recent and advanced forms of wearable Mixed Reality (MR) technology. It enables the user wearing a head-mounted device to experience 3D holographic objects “inside” the visualization of the real environment where he or she is located. Existing HoloLens applications have been developed in domains such as data visualization, entertainment, industrial training, education, and tourism, but the use of this technology in the arena of mental health is largely unexplored. The paper presents a HoloLens-based system called MemHolo that addresses persons with mild Alzheimer’s Disease (AD). AD is associated to a chronic progressive neurodegenerative process that severely affects cognitive functioning (especially memory) and some motor functions. MemHolo is intended to be used as a cognitive training tool to practice short-term and spatial memory in a safe and controlled virtual environment, and to mitigate the effects of mental decline. The paper discusses the design process of MemHolo, and describes three evaluation studies on progressive prototypes. To our knowledge, MemHolo is the first HoloLens application designed natively for persons with AD. Our empirical work sheds a light on how these people experience HoloLens applications, highlights some challenges and potential benefits of using MR technology in the AD arena, and may pave the ground towards new forms of treatment.

The allergic risk in sport is an emerging issue of relevance for public health. Several natural and synthetic allergens are present in indoor and outdoor sport environments. Epidemiological data show the widespread high incidence of allergies in the population. Elite athletes have been observed to have a high prevalence of allergic reactions and exposure to allergens during training and competitions is a concern for environmental occupational medicine. The connection between exercise-induced bronchoconstriction, genetics and environment is still debated. In recent decades, interest in this field has been growing as shown by the increasing number of ISI/PubMed publications. The main allergens present in the sport and physical activity environments are classified and reported here.

The multiple drug intolerance syndrome is a clinical entity characterized by adverse drug reactions to at least three drugs, chemically, pharmacologically and immunogenically unrelated, manifested upon three different occasions, and with negative allergy testing. Symptoms referred by the patients are often subjective, of neurovegetative origin. The aim of the study is to characterize patients suffering from the multiple drug intolerance syndrome from a psychological point of view, and to compare them to healthy subjects. We studied 30 women suffering from the multiple drug intolerance syndrome. All subjects underwent the following psychodiagnostic tests: (1) the State Trait Anxiety Inventory-Form Y, (2) the Zung Self-rating Anxiety Scale, (3) the Zung Self-rating Depression Scale, (4) the Quality of life enjoyment and satisfaction questionnaire, (5) the Minnesota Multiphasic Inventory-2, (6) the Toronto Alexithymia Scale. The study group was compared to 30 healthy women. When compared with the control group, our patients showed: a higher anxiety, a higher grade of depression, this difference was statistically significant (p < 0.01); a high difference (p < 0.01) between the two groups as regards somatic symptoms; a higher grade of alexithymia (p < 0.01); and a worse quality of life, in all the analyzed ambits. These findings clearly demonstrate the importance of psychological symptoms in patients with the multiple drug intolerance syndrome, and show that a complex allergy and psychological work-up is mandatory in the management of these patients.