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In the recent Rome Proposal, a COPD exacerbation was described as an event characterised by an acute burst of airways inflammation due to stimuli (e.g., bacteria, viruses, or environmental pollutants) that is coupled with worsening of existing airflow limitation, leading to worsening symptoms (dyspnoea and/or cough and sputum), which may be accompanied by tachypnea and/or tachycardia [4]

it knocked the pain down significantly about 30 minutes or so

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