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Respiratory causes such as asthma or chronic obstructive pulmonary disease are treated with short- or long-term bronchodilators, escalating the use of steroids and adjuncts based on clinical discretion

What is meant by ‘escalating’ in this sentence? it doesn't look like a cause and effect sentence? it has a passive structure but I didn't understand it exactly. if you can help me, I would appreciate i

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    escalating the use of steroids and adjuncts means causing the use of steroids and adjuncts to increase. And what's causing that effect is [treatment using] short- or long-term bronchodilators. Commented Jun 9 at 10:38
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    ...But it's causes within causes within causes, given that the entire paragraph is about "causes of tachypnea!. Anyway, the structure of "[comma] escalating..." is semantically equivalent to starting a new sentence there with "This escalates..." Commented Jun 9 at 10:44
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    @TimR then this sentence is a series of consecutive events. Yeah, that makes the most sense.
    – emilywenly
    Commented Jun 9 at 12:05
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    I'm no medic, but I asked Google Gemini is asthma more likely to be treated with steroids first, then with bronchodilators if steroids don't effect a cure, or with bronchodilators first, then steroids if necessary? It replied with Asthma is more likely to be treated with inhaled corticosteroids (steroids) first, then with bronchodilators if needed. Here's why... Which may all be rubbish, and it's a bit irrelevant here, since all we're concerned with is what the actual cited text means, not the medical truth of the matter, or what kind of typos might be involved. Commented Jun 9 at 15:12
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    ...and I really don't think "a cause-effect sentence" is a useful concept here, given that the starting point is asthma and chronic obstructive pulmonary disease are two possible causes of tachypnea (where the treatment of those diseases my cause further things to happen). Commented Jun 9 at 15:20

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[Respiratory causes such as asthma or chronic obstructive pulmonary disease are treated with short- or long-term bronchodilators], escalating the use of steroids and adjuncts based on clinical discretion.

This construction has similar meaning as one using a relative clause:

[Respiratory causes such as asthma or chronic obstructive pulmonary disease are treated with short- or long-term bronchodilators], which escalates the use of steroids and adjuncts based on clinical discretion.

where the relative pronoun has the entire precedent clause as antecedent.

Here escalate takes the usual meaning of increase or intensify.

The use of gerund-participles as in this case

allows us to say the same thing as a relative clause, starting with who, which or that, but with fewer words.

BBC

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    We can also say the same thing by starting a new sentence without a wh- word: This [treatment] escalates the use of steroids... Commented Jun 9 at 10:53
  • then we can say that this sentence is a cause-effect sentence, right?
    – emilywenly
    Commented Jun 9 at 10:58
  • How does the use of bronchodilators increase steroidal use? That is what transitive escalate would mean there. I'm pretty sure what is needed there is the intransitive formulation, "escalating to", which could be paraphrased as "including more drastic therapies if the clinical situation warrants them".
    – TimR
    Commented Jun 9 at 11:46
  • Thanks, @FumbleFingers. Agreed. The main clause is rather long, and splitting the sentence may be a good idea. Commented Jun 9 at 12:26
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It means this:

“Respiratory causes such as asthma or chronic obstructive pulmonary disease are treated with short- or long-term bronchodilators, and by escalating the use of steroids and adjuncts based on clinical discretion.”

This is a poorly constructed sentence, but this is the correct reading, because bronchodilators are not steroids. Rather, steroids are added to the bronchodilator treatment as needed.

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