sarcoidosis is an inflammatory disease that may affect many different parts of the body. small round spots, called granulomas, form in various organs. the spots hinder normal functioning of those organs. the lungs are the most commonly affected organs. granulomas in the lung leave less space for the air exchange that needs to take place. this can cause the lungs to stiffen. other commonly affected organs are the skin, eyes, liver, and lymph nodes. rarely, the brain may be affected. scientists do not know what causes sarcoidosis. it seems to be related to malfunctioning of the immune system. the disease may possibly be triggered by an infection or exposure to a toxin in the environment. some people may be more susceptible to sarcoidosis due to genetic or environmental factors. a risk factor is something that increases your chance of getting a disease or condition. risk factors for sarcoidosis include : - age : 20 to 40 - sex : female - ethnic descent : african - american, northern european, scandinavian, and irish symptoms vary and can occur in different parts of the body, depending on where the granulomas form. most symptoms develop in the lungs, skin, eyes, and liver. multiple body systems may be affected. symptoms may come and go. this disease is often acute, but in some patients it is chronic, waxing and waning. symptoms may include : - shortness of breath - chest pain - rash ( may or may not be raised ) - pain or irritation of eyes - fatigue, especially with exertion - muscle weakness - night sweats - loss of appetite - weight loss - swollen lymph nodes - difficulty hearing - blurred vision or blindness - poor coordination - trouble walking - irregular heart rate - pain, swelling, and stiffness in the joints facial paralysis ( copyright © nucleus medical media, inc. the doctor will ask about your symptoms and medical history, and perform a physical exam. there is no specific lab test that confirms a diagnosis of sarcoidosis. instead, the diagnosis is made by noting a cluster of symptoms and a number of medical tests that are usually positive in patients with this condition. in some cases there may not be any symptoms. the disease may sometimes be suspected based on the appearance of a routine tests may include : blood tests — to check for a variety of factors : a complete blood count to check for - liver function tests to check for liver abnormalities - increased calcium levels, which can occur with sarcoidosis - elevated levels


of a routine tests may include : blood tests — to check for a variety of factors : a complete blood count to check for - liver function tests to check for liver abnormalities - increased calcium levels, which can occur with sarcoidosis - elevated levels of angiotensin - converting enzyme ( ace ), which is often released by the granulomas - urine test — 24 - hour urine test to check for elevated levels of calcium in the urine - x - rays — a test that uses radiation to take a picture of structures inside the body — removal of a sample of the affected tissue for testing - electrocardiogram ( ecg, ekg ) — a test that records the electrical activity of the heart - pulmonary function tests ( pfts ) — tests to determine how well you can breathe — the insertion of a lighted tube into the lungs to look at the tissue and obtain a sample for biopsy. the doctor may also do a bronchoalveolar lavage. this involves flushing the lungs with fluid and collecting the fluid for analysis. - gallium scan — the injection of radioactive material into the body. the material collects in areas with sarcoidosis. a machine later scans the body and identifies areas with higher concentrations of the injected material. - ct scan — a type of x - ray that uses a computer to make pictures of the inside of the body - eye exam — done with a special lighted instrument that allows the doctor to look inside the eye treatment aims to ease symptoms and minimize permanent problems. treatment may include : you need regular medical and eye exams to monitor for symptoms and complications of sarcoidosis. drugs that may be prescribed include the following : ( the main treatment ) is an oral steroid used to decrease inflammation. may be used for patients who do not respond to steroids. may be used to treat skin problems. - nonsteroidal anti - inflammatory agents may be used to treat musculoskeletal symptoms. - pulmonary rehabilitation programs may help improve lung function. - topical steroids may be advised for rashes. - eye drops may be used for mild eye problems. to help minimize your symptoms, follow these guidelines : if you smoke, - avoid exposure to dust and chemicals. - notify your doctor at once if any symptoms develop or worsen. although doctors do not know the exact cause of sarcoidosis, they believe infections or exposure to chemicals may bring on the disease. steps for prevention may include : - don ' t smoke. if you smoke, quit. -


or worsen. although doctors do not know the exact cause of sarcoidosis, they believe infections or exposure to chemicals may bring on the disease. steps for prevention may include : - don ' t smoke. if you smoke, quit. - avoid exposure to chemicals and toxins. - to prevent infection, wash your hands before eating or preparing food and after using the bathroom. american academy of family physicians website. available at :. accessed july 22, 2009. goldman l, ausiello da. cecil textbook of medicine. 23rd ed. philadelphia, pa : wb saunders ; 2007. rakel re, bope et, conn hf. conn ' s current therapy. 59th ed. philadelphia, pa : wb saunders co ; 2007. griffith ' s 5 - minute clinical consult. 16th ed. philadelphia, pa : lippincott, williams, and wilkins ; 2008. harris ed, ruddy s, kelley wn, et al. kelley ' s textbook of rheumatology. 7th ed. philadelphia, pa : wb saunders co ; 2005. goroll ah, mulley ag. primary care medicine. 4th ed. philadelphia, pa : lippincott, williams, and wilkins ; 2000. last reviewed november 2012 by igor puzanov, md please be aware that this information is provided to supplement the care provided by your physician. it is neither intended nor implied to be a substitute for professional medical advice. call your healthcare provider immediately if you think you may have a medical emergency. always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. copyright © ebsco publishing. all rights reserved.


accessmylibrary provides free access to millions of articles from top publications available through your library. in southwestern wisconsin, close to the southern limit of its range, eastern white pine ( pinus strobus l. ) grows in isolated stands on steep slopes of exposed ordovician st. peter sandstone and cambrian sandstone of the tunnel city group. on a larger geographic scale, white pine is associated with a humid, cool climate, which is typical of the northern two - thirds of the state of wisconsin, where the species grows best on deep loams or sandy loams ( curtis, 1959 ). in southwestern wisconsin, south of its typical range, white pine also grows from cracks in sandstone cliffs ( curtis, 1959 ). on sandstone outcrops, the establishment of hardwood competitors is impeded by low water retention of the weakly developed soils ( wilson and mcquilkin, 1965 ). thus, white pine located on steep sandstone bluffs in southwestern wisconsin has an advantage over species with less tolerance of xeric sites with minimal soil horizon development. fossil pollen studies show that white pine has been regionally abundant in southwestern wisconsin since at least 10, 480 [ + or - ] 100 radiocarbon years ago ( davis, 1977 ), when vegetation zones were located s of where they are today due to the cooler climate ( hansen, 1939 ; curtis, 1958, 1959 ; davis, 1977 ; webb et al., 1983 ). although palynological evidence that these pine relicts have persisted in the driftless area of southwestern wisconsin from the late pleistocene through the holocene indicates successful adaptation of the species to the local environment, several authors have documented the different degrees to which white pine is maintaining itself. curtis ( 1959 ) reported that " although these relic stands are considerably removed from the area of their climatic optimum, there is no indication that they are in a retreating or moribund condition " ( p. 216 ). in a study of the forest vegetation of the driftless area in ne iowa, cahayla - wynne and glenn - lewin ( 1978 ) observed that white pine grows in relict communities primarily on the drier sites, but that white pine seedlings were not a significant component of the herb layer, suggesting that the species was not reproducing well. in 1948, mcintosh completed a taxonomic survey of species composition of 22 sites in six counties in southwestern wisconsin where white pine, red pine ( pinus resinosa ait. ) or jack pine ( pinus banksiana lamb. ), all species with northern af


, mcintosh completed a taxonomic survey of species composition of 22 sites in six counties in southwestern wisconsin where white pine, red pine ( pinus resinosa ait. ) or jack pine ( pinus banksiana lamb. ), all species with northern affinities, were abundant. he found representatives of diverse plant communities, including numerous species characteristic of northern pine stands. mcintosh ( 1948, 1950 ) concluded that in a few of these stands white pine was reproducing enough to persist in this area. his study also indicated that in several other stands white pine was not reproducing well, as marked by the absence of seedlings and saplings, with a trend toward local extinction. species distributions change constantly over long and short time scales in response to changing environmental conditions ( hengeveld, 1990 ) and interactions with other plant species ( vale, 1982 ). the potential for population growth of a given species is greatest in the center of its geographic range ( hengeveld, 1990 ) ; vigor in plant growth and reproduction decreases toward the margins of the range. species are more vulnerable to environmental change and competition with other species at the limits of their range. northern conifer species, in general, are limited at the southern margin of their distribution not by minimum temperature, but by competitive interactions with hardwood species ( woodward, 1987 ). one might expect, then, that white pine at the southern extent of its range would grow better than hardwood species on sites where the soils are drought - prone and nutrient - poor ( wendel and smith, 1990 ). davis ( 1977 ) noted that the mosaic character of the prairie - deciduous forest ecotone in the upper midwest corresponds with topographic variation, and that relicts of past climatic conditions persist in favorable habitats. i hypothesized, therefore, that local site conditions are important in determining where stands of white pine are located and are regenerating at the southern margin of its range in southwestern wisconsin. i predicted that white pine reproduces best on exposed slopes of steep sandstone cliffs, less vigorously on upper slopes of intermediate steepness and least successfully on the slopes of ravines, where better - developed soils would likely support fewer conifers and more hardwoods ( vankat, 1979 ). this study investigates the contemporary dynamics of white pine in a selection of the stands studied by mcintosh ( 1948, 1950 ) more than 45 yr ago. the approach is two - tiered. first, by comparison with mcintosh ' s results, it evaluates qualitatively how stand dynamics have changed in


- residential market - light commercial market - commercial market - indoor air quality - components & accessories - residential controls - commercial controls - testing, monitoring, tools - services, apps & software - standards & legislation - extra edition the initiative ’ s goal is to address preventable hazards associated with the home. the strategy for action encourages federal agencies to take preemptive actions that will help reduce the number of american homes with health and safety hazards. according to the government, people in the united states spend about 70 percent of their time in a home. currently, millions of u. s. homes have moderate to severe physical housing problems, including roofing problems ; hvac, plumbing, and electrical deficiencies ; water leaks and intrusion ; high radon gas levels ; and more. these conditions are associated with a wide range of health issues, including unintentional injuries, respiratory illnesses like asthma and radon - induced lung cancer, and they result in lost school days for children, as well as lost productivity in the labor force. the health and economic burdens from preventable hazards associated with the home are considerable, and cost billions of dollars. the strategy for action unifies, for the first time, federal action to advance healthy housing, demonstrating the connection between housing conditions and residents ’ health. it also promotes strategies and methods intended to reduce in - home health hazards in a cost - effective manner. “ it is clear that unhealthy and unsafe housing has an impact on the health of millions of people in the united states, which is why we must do everything we can to ensure that individuals and families have a healthy place to call home, ” said donovan. “ energy efficiency and healthy homes are inextricably linked, ” said poneman. “ we cannot, in good conscience, pursue one in the absence of the other. doe is committed to ensuring that our efforts towards creating an efficient national housing stock also strive to maximize the health and safety of the families we serve. ” the overall vision for the strategy is to reduce the number of american homes with residential health and safety hazards, achieved through five goals : 1. establish healthy homes recommendations. 2. encourage adoption of healthy homes recommendations. 3. create and support training and workforce development to address health hazards in housing. 4. educate the public about healthy homes. 5. support research that informs and advances healthy housing in a cost - effective manner. for more on the strategy for action, visit http : / / healthyhomes. hud. gov. publication date : 2 / 11 /


as a sports lover, you know that injuries come with the territory. you know that injuries, whether caused by repetitive motion, imbalances in your biomechanics or both, can be painful, frustrating, and limiting. yoga is a great tool for preventing injuries. through a combination of active and passive stretching, yoga can be helpful to keep you injury - free. more : yoga poses to prevent the top sports injuries one of the most common injuries for athletes is plantar fasciitis. to prevent plantar fasciitis, practice these two yoga poses on days you train or workout. if you are recovering and your injury is acute, rest until the inflammation subsides. when you feel better, practice these two poses. more : what is plantar fasciitis? reclined leg stretch what it does : reclined leg stretch provides a safe stretch for the hamstrings and the tissue that runs along the back of the hip, thigh and calf, which tugs on the sole of the foot when it gets tight. how to practice : lie on your back, legs together. strongly extend through the heels. keep the left leg pressed on the ground as you bend the right knee to the chest. place a strap around the arch of the right foot and hold the strap loosely in both hands. more : easy yoga poses to stretch out stiff ankles exhale and extend the right leg straight up. walk your hands up the strap until the elbows are fully extended. keep your neck relaxed and make sure you are not throwing your head back. lengthen the back of the leg between the buttock bone and heel. try not to be overly enthusiastic about pulling your leg toward your chest. instead, emphasize the grounding of your left leg as you draw your arms back into their sockets and lift your collarbones. hold for 30 seconds to one minute. breathe evenly and then slowly release. repeat on the left side. more : prevent injuries with proper foot alignment


learn about nutrition become an informed food consumer, rather then a grazer who eats without thinking. research on weight loss shows that dieters who understand the importance of good nutrition are more likely to lose weight, and less likely to regain it. understand that crash diets or weight loss gimmicks often produce a boomerang effect that can leave you weighing more than you did when you started. try to see your weight loss as part of a larger plan to improve your overall physical and mental health. a sustained weight change requires sustained changes in both your diet and your behavior. are you really willing to live on nothing but grapefruit and poached eggs for the rest of your life? if not — and who would? — then you need eat balanced meals and make changes in your diet that you can maintain over time. track your progress hang up a calendar, and mark an x on the days you exercise. keep it simple - no need to mark workout time, reps, laps, heart rate, and so on. once a month, review what you ' ve accomplished to get a sense of your progress. try writing down everything you consume during the day. you may want to include the number of calories or carbohydrates that each item contains, but don ' t get hung up on numbers. instead think of these numbers as point totals in a game that you intend to win. pick out some clothes that are only one size smaller than your current size and use them as a short - term goal. you ' ll feel encouraged by your progress and motivated to continue on toward your ultimate goal. weight loss is easier with a partner to keep you on track and share in your pain and progress so recruit friends to go on your weight loss journey. you may even want to make things interesting with a bet for who will hit his / her target weight first. money is a great motivator, and even the " loser " wins by losing weight. friends can also help when you need a boost. many adults with adhd start an exercise program with tremendous enthusiasm, only to lose interest within a few weeks. if that sounds like you, write yourself a letter of encouragement. give it to a friend at the start of your exercise program, and ask her to " deliver " it back to you when your enthusiasm starts to flag. it ' s hard to develop regular exercise habits if a voice inside you keeps saying, " why not skip today ' s workout and do it tomorrow instead? " and with adders, there '