Guillain-Barre Syndrome With Concomitant Severe Preeclampsia: A Case Report.

With an estimated 100,000 new cases yearly worldwide, Guillain-Barre syndrome (GBS) is the most common cause of flaccid paralysis. GBS is exceedingly rare in pregnancy and carries high maternal and fetal risk. We report a case of a 38-year-old essential primigravida who presented at 38 weeks six days gestational age with ascending paraplegia progressing to dysarthria, dysphagia, and facial weakness. A clinical diagnosis of GBS was made in an outside institution, supported by elevated protein on lumbar puncture. During the antepartum period, a diagnosis of gestational hypertension progressed to preeclampsia with severe features when a sudden rise in liver function tests occurred. The patient underwent an uneventful planned cesarean delivery but could not be extubated due to respiratory failure. After a 20-day critical care admission, she was extubated and had an improvement in neurologic status to near her baseline.

Effect of short bouts of high intensity activity on glucose among adults with prediabetes: A pilot randomized crossover study.

AIM: Few data exist on the effects of vigorous-intensity activity on blood glucose. The study aim was to determine the effects of 2-min and 4-min bouts of vigorous-intensity stair climbing on glucose levels. METHODS: Nine overweight/obese adults with prediabetes (40-64 years, HbA1C 5.7%-6.4%) participated in a randomized cross-over design with three conditions on consecutive days: control; 2-min bouts of stair climbing once per hour for 8 h; and 4-min bouts of stair climbing once every 2 h for 8 h, with the two activity days randomized in order. Continuous glucose monitoring estimated five-minute average interstitial glucose values. RESULTS: Total physical activity and 12-h AUC did not differ significantly by condition. The 4-min bout caused a significant decrease in glucose after 30 min (Cohen's d = -0.91) compared to the control condition, while the 2-min bout did not (Cohen's d = -0.13). Post-exercise change in glucose varied by pre-exercise glucose and by condition. No significant change in post-exercise glucose with stair climbing was found when pre-exercise glucose was <90 mg/dl, but when pre-exercise glucose was ≥90 mg/dl, the 4-min condition caused significant reductions in glucose. CONCLUSIONS: These results suggest short, intermittent bouts of vigorous-intensity exercise can be substituted for an equivalent volume of lower-intensity lifestyle activity when glucose is over 90 mg/dl. TRIAL REGISTRATION: Clinical Trials NCT02827383.