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This was associated with decreased neutrophil mobilisation from bone marrow, though produced no improvement but rather some exacerbation in pulmonary permeability.
We found that the proportions of individuals with some exacerbation episodes were similar in the three groups, in agreement with previous studies [ 35, 36], while a recent PR primary care program found a reduction in exacerbation rate after a community PR program [ 17].
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Some exacerbations are severe enough to require an ER visit or hospital admission.
The reasons why patients report some exacerbations to a health care professional and not others have been unclear and approximately 50% of exacerbations are unreported [ 4, 31].
It is possible that some exacerbations were unreported or self-managed at home with rescue packs of antibiotics and/or oral corticosteroids.
Avoidance of trigger factors such as allergens, non-steroidal anti-inflammatory agents or occupational agents in sensitive individuals, as well as exposure to environmental irritants such as passive smoke, is likely to prevent some exacerbations [ 1].
Although little is known on how early early detection should be, we believe that for obvious reasons it remains preferable to detect (some) exacerbations with a 6-day delay instead of not detecting/treating.
Moreover, the model is usually monophasic, although in some cases exacerbation could be induced by booster immunization [ 26].
In low-income countries, where the time lag is greatest, delays in diagnosis lead to suboptimal treatment, delayed identification of preventable diseases, and, in some instances, exacerbation of outbreaks.
ADAM9 also plays a pivotal role in some signaling pathways, wherein transmission of information might induce some inconvertible exacerbations of disease [ 29].
It is possible that reflux and aspiration maybe a precipitant or even a causal event in the pathogenesis of some pulmonary exacerbations.
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