Metabolic crisis in maple syrup urine disease: an unusual complication of a rare disease: a case report.

A 19-year-old woman with known maple syrup urine disease presented to hospital with metabolic crisis in the setting of influenza type A infection and intractable vomiting, rapidly progressing to acute cerebral oedema manifesting as refractory seizures and decreased level of consciousness needing emergency intubation and mechanical ventilation, continuous veno-venous haemodiafiltration and thiopentone coma. A computed tomography scan and magnetic resonance imaging of the brain demonstrated classic signs of cerebral oedema secondary to a metabolic crisis from the metabolic disorder. Her management posed multiple challenges to all teams involved due to lack of familiarity and experience in managing this clinical scenario in the adult intensive care setting.

Internal Chain of Correlation of Sagittal Cervical Alignment in Asymptomatic Subjects.

Study Design: Cross-sectional observational study in a prospective cohort.

Objective: To analyze the cervical alignment characteristics and their chain of correlation in a sample of asymptomatic individuals.

Methods: Asymptomatic adults who had full spinal radiographs performed.

Normal values for sagittal spinal alignment: a study of Brazilian subjects.

Objectives: The purpose of this study is to investigate the normal values of and chain of correlations between spinopelvic parameters in a Brazilian population.

Methods: This is a prospective observational study including asymptomatic adult subjects who had full spinal radiographs performed. The subjects were stratified by age into 3 groups (18-39 years old, 40-59 years old, and >60 years old), and radiographic parameters were compared across age groups and gender using ANOVA and Student's t-test, respectively.