الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
Chronic obstructive pulmonary disease (COPD) is the most frequent chronic lung disease in developed countries and is an important cause of hospital admission and doctor office visits. Because of the increase prevalence and mortality of COPD, and its high medical costs, it is important to identify patients and to treat them before they reach the symptomatic costly stages of the disease.
Acute exacerbations occur commonly in patients with COPD and can be defined as a sustained worsening of the patient’s condition from stable state and beyond normal day -to- day variations, that is acute in onset and necessitates a change in regular medication in a patient with underlying COPD.
Exacerbations mostly of an infectious etiology, are frequent cause of morbidity in COPD patients.
The present study was focused on investigating whether the degree of functional impairment measured by forced expiratory volume in the first second (FEV1) can provide an orientation to the infectious etiology of COPD exacerbations.
The present study was conducted in El-Mina University and Chest Hospitals in the period between September 2002 and March 2003, and this study included 70 patients with acute exacerbation of chronic obstructive pulmonary disease who were selected from the attendants of the chest out-patient clinic and emergency room.
The range of age was 45-74 years, the mean age was 55.81+11.3 years, and all patients are smokers
All patients were subjected to the following:
1- Through history taking.
2- Careful clinical examination.
3- Plain chest x-ray: (postero-anterior and lateral views).
4- ECG, Echocardiography (when needed).
5- Routine laboratory investigations.
6- Ventilatory pulmonary function tests.
7- Microbiological sputum analysis: where samples of spontaneous sputum were collected for mocrobiological isolation and identification of isolates by their cultural characters and biochemical reactions.
Then. The results will be statistically analyzed, tabulated and discussed to show the relationship between bacterial flora in sputum and pulmonary functional impairment in acute exacerbation of chronic obstructive pulmonary disease.
The following results are obtained:
As regards to the clinical symptoms and signs, there was worsening of dyspnea in 100% of cases, increased sputum volume in 91.5% of cases, and increased purulence of sputum in 85.7% of cases; these are the major clinical symptoms required to diagnose acute exacerbation of chronic obstructive pulmonary disease. But, there was increased chest wheezes in 81.42% of cases, increased respiratory rate in 100% of cases, increased heart rate in 81.42% of cases and fever in 74.24% of cases.