Jama copd exacerbation steroids

Results   Of the 100 enrolled participants, 26 participants were randomized to exercise; 24 to diet; 25 to exercise + diet; 25 to control. Of these, 92 participants completed the trial. Exercise attendance was 84% (SD, 14%) and diet adherence was 99% (SD, 1%). By main effects analysis, peak V̇ o 2 was increased significantly by both interventions: exercise, mL/kg body mass/min (95% CI, to ), P  < .001; diet, mL/kg body mass/min (95% CI, to ), P  < .001. The combination of exercise + diet was additive (complementary) for peak V̇ o 2 (joint effect, mL/kg/min). There was no statistically significant change in MLHF total score with exercise and with diet (main effect: exercise, −1 unit [95% CI, −8 to 5], P  = .70; diet, −6 units [95% CI, −12 to 1], P  = .08). The change in peak V̇ o 2 was positively correlated with the change in percent lean body mass ( r  = ; P  = .003) and the change in thigh muscle:intermuscular fat ratio ( r  = ; P  = .02). There were no study-related serious adverse events. Body weight decreased by 7% (7 kg [SD, 1]) in the diet group, 3% (4 kg [SD, 1]) in the exercise group, 10% (11 kg [SD, 1] in the exercise + diet group, and 1% (1 kg [SD, 1]) in the control group.

Genetics play a role in the development of COPD. [9] It is more common among relatives of those with COPD who smoke than unrelated smokers. [9] Currently, the only clearly inherited risk factor is alpha 1-antitrypsin deficiency (AAT). [46] This risk is particularly high if someone deficient in alpha 1-antitrypsin also smokes. [46] It is responsible for about 1–5% of cases [46] [47] and the condition is present in about 3–4 in 10,000 people. [16] Other genetic factors are being investigated, [46] of which there are likely to be many. [11]

Symptom severity is assessed using the CAT or mMRC ( table 7 ) [ 103 ]. Lung function in addition to the number of exacerbations and hospitalizations for exacerbations in the previous 12 months can be used to predict future risk. A history of zero or one exacerbation in the past 12 months and GOLD 1 or 2 spirometric level suggests a low future risk of exacerbations, while two or more exacerbations or a hospitalized exacerbation or GOLD 3 or 4 spirometric level suggest a high future risk [ 8 ]. These components are combined into four groups as follows:

Jama copd exacerbation steroids

jama copd exacerbation steroids


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