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Sarcoidosis causes increased inflammation in your body creating flu-like symptoms in the first stage. In the second stage granulomas - masses of inflamed tissue - can form in the body. The granulomas are the immune system attempting to isolate foreign particles that the body has trouble fighting. Third stage pulmonary sarcoidosis is when scar tissue can develop in your lungs impairing breathing.  In extreme cases, the granulomas can form in the heart provoking abnormal heart rhythms. When granulomas form it makes it harder to breathe. This slows down the oxygen getting into your lungs and makes the oxygen exchange slower and makes the body oxygen deprived as a result. The body then has not enough oxygen so diffusion of oxygen can’t happen. In the event that the oxygen levels lower it can cause Hypoxemia. Hypoxemia symptoms are life-affecting including shortness of breath headaches and fatigue. (Sarcoidosis News, N.D. ) This is a change in the body's normal state and homeostasis is not maintained.

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Since sarcoidosis is a disease that does not fix itself, and needs medical attention there is no feedback loop that the body goes through to return to homeostasis. If there was one, unmedicated,  it would be ending in a worse place than it started. For example,
Stimulus: Inflammation
Receptor: Nerve cells
Control Center: Brain
Effector: Granuloma
Response: Organ damage, shortness of breath
In a medicated example, the body can return back to homeostasis, because this would not be natural it doesn't count as a feedback loop.
Stimulus:  Inflammation
Receptor: Nerve cells
Control Center: Brain
Effector:  Immunosuppressive drug
Response:  Granulomas don't form since the Immunosuppressive drug restricts the formation of inflammatory cells, which are part of the immune system

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The sleep disturbance was measured by the general sleep disturbance scale that compared the sarcoidosis patients and the healthy control patients. It was a 21 question survey that scored from 0 (never) to 7  (every day). There 84 sarcoidosis patients and 30 healthy controls (Benn, 2018) The standard error for sarcoidosis patients was less than the healthy controls. Additionally, the bars didn't overlap indicating a significant difference between the two groups. The average sleep disturbance for sarcoidosis patients was approximately 45 and the average for the healthy controls was approximately 30. This is a difference of 15. Sarcoidosis patients experience a higher percentage of frequent and occasionally sleep disturbances in comparison to healthy controls. 54 percent of sarcoidosis patience experience frequent and occasional sleep disturbance while only 17 percent of the controls experienced sleep disturbance. The P-Value is 0.001 (Benn, 2018) meaning that there is less than 1 in 10,000 chance of being incorrect. (StatsDirence, N.D.)

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(Benn, 2018)

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Sarcoidosis makes it harder for your body to create CO2 to release because the granulomas hinder the transfer of oxygen (cellular respiration). In a negative feedback loop, which will come as a side effect of having sarcoidosis, when there is a high CO2 or low O2 in the body it activates the chemoreceptors/aorta/carotid artery/medulla oblongata, which then notifies the brain and reflexes involving somatic nerves. Then the respiratory muscles or lungs have an increased rate and depth of breathing. The levels of CO2 and O2 then return back to normal. (IBES,2021)

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A complication associated with Sarcoidosis is Pulmonary Hypertension. It is challenging to identify sarcoidosis patients. Pulmonary Hypertension exists in all stages of sarcoidosis and is known as Sarcoidosis Associated Pulmonary Hypertension or SAPH. (Huitema, 2016) There have been increased levels of endothelin (ET)-1 in sarcoidosis patients and it may be driving pulmonary fibrosis as well as SAPH. (Baughman, 2007)

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African Americans are three times more likely to be diagnosed and tend to have more severe cases of sarcoidosis as opposed to Caucasians. The causes are unknown but seem to have a genetic and environmental component. Sarcoidosis is more common in women and people between 20 to 40 years of age. Some common symptoms are Fatigue, swollen lymph nodes, fever, pain, and swelling in joints, and just common flu symptoms. Some may not experience symptoms and largely depend on what part of the body is affected. Some people can have granulomas form without any symptoms.  (ALA, 2021)

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Sarcoidosis commonly affects the lungs as well as the lymph nodes. On top of that the nervous system, eyes, skin, and heart can also be affected. Sarcoidosis is quite rare as there are fewer than 200,000 cases each year in the US. Sarcoidosis can also progress into heart disease or severe lung disease. (ALA, 2021)

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In a study from 1999-2010 assessing sarcoidosis patients in the United States, 1999 to 2010. In the 14 causes of death in the diagram, 11/14 causes kill more African Americans than caucasians. Not only are African Americans more susceptible to sarcoidosis, but it is more fatal to them(Baughman, 2007).

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Multiple cause of death in Caucasians and African Americans with sarcoidosis in the United States, 1999 to 2010.

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Multiple cause of death in Caucasians and African Americans with sarcoidosis in the United States, 1999 to 2010.

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https://www.webmd.com/asthma/guide/hypoxia-hypoxemia (WebMD, N.D.)

https://www.scientificamerican.com/article/how-do-we-breathe/#:~:text=All%20cells%20in%20our%20body,by%20breathing%20out%20stale%20air.&text=The%20blood%20transports%20oxygen%20to%20almost%20every%20part%20of%20the%20body. (Brabandere, 2019)

https://consultqd.clevelandclinic.org/socioeconomic-disparities-and-outcomes-in-patients-with-sarcoidosis/ (Cleveland Clinic, 2020)

https://www.lung.org/lung-health-diseases/lung-disease-lookup/sarcoidosis/learn-about-sarcoidosis (ALA, 2021)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4887307/ (Huitema, 2016)
https://arthritis-research.biomedcentral.com/articles/10.1186/ar2192 (Baughman, 2007)
https://drive.google.com/file/d/10l7ndb8F4uKarvga-_Edh2eKhp717jjp/view (Benn, N.D.)

https://www.statsdirect.com/help/basics/p_values.htm  (StatsDirect, N.D.)

https://www.mayoclinic.org/diseases-conditions/sarcoidosis/symptoms-causes/syc-20350358?utm_source=Google&utm_medium=abstract&utm_content=Sarcoidosis&utm_campaign=Knowledge-panel (MayoClinic, 2019)

https://www.commonwealthfund.org/blog/2018/healthy-low-income-people-greater-health-risks (Cunningham, 2018)

https://my.clevelandclinic.org/health/articles/21205-respiratory-system#:~:text=The%20respiratory%20system%20is%20the,waste%20gases%20like%20carbon%20dioxide. (Cleveland Clinic, 2020)

https://sarcoidosisnews.com/oxygen-therapy/#:~:text=Diseases%20affecting%20the%20lungs%2C%20such,breath%2C%20headaches%2C%20and%20fatigue. (Sarcoi

https://kidshealth.org/en/kids/lungs.html (KidsHealth, N.D.)

https://biologydictionary.net/how-does-the-respiratory-system-maintain-homeostasis/#:~:text=One%20of%20the%20main%20homeostatic,and%20out%20of%20the%20blood. (BD Editors, 2018)

https://flexbooks.ck12.org/cbook/ck-12-middle-school-life-science-2.0/section/2.17/primary/lesson/connecting-cellular-respiration-and-photosynthesis-ms-ls#:~:text=The%20products%20of%20one%20process,6CO2%20%2B%206H2O  (CK-12, 2018)

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How does it affect the Respiratory system and homeostasis?

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How does it affect the Respiratory system and homeostasis?

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Sarcoidosis healthy affects the lungs. As stated previously, sarcoidosis is an anti-inflammatory disease. Small lumps called granulomas to form. They are a cluster of anti-inflammatory cells in the body that can cause organ damage. In this case, the lungs are affected. If these granulomas form on the lungs or on the trachea, it can become difficult to breathe(MayoClinic, 2018). Homeostasis is the body's ability to maintain stable conditions that are best suited for survival. Lungs are necessary for homeostasis because gas exchange occurs within the alveoli. This is crucial to keep the body oxygenated and remove unnecessary CO2(BD Editors, 2018)).

Granulomas can form in the lungs as well as other parts of the body, If they do form in the lungs, there will be less space to breathe in air. This causes shortness of breath. As a result, one will be oxygen-deprived. Diffusion occurs and oxygen goes from a high concentration in the lungs to a low concentration in the body cells. If there is less oxygen present, cells will be oxygen-deprived. Deprivation of O2 would harm homeostasis. This could cause the body to have a rapid heart rate, rapid breathing, sweating, and wheezing(inogen). Additionally, O2 helps the body create energy efficiently(SA). O2 is a reactant in cellular respiration, which the body undergoes to produce energy(ALA, 2021).

6O2 + C6H12O6 --> 6CO2 + 6H2O + ATP

More simply put, the equation is:

oxygen+glucose/sugar-->carbon dioxide+water+energy in the form of ATP  (CK-12, 2018).

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Sarcoidosis is a type of anti inflammatory disease. Granulomas are clumps of inflammatory cells around the body. The cause of these lumps is the immune system going into overdrive. In turn, this can cause organ damage (MayoClinic, 2018)

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Sarcoidosis is a Respiratory Disease that can lead to organ damage and affects those of lower socioeconomic status more.

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The respiratory system is one of the eleven main body systems. The Respiratory system allows you to breathe. It oxygenates cells and excretes unneeded carbon dioxide(Cleveland  Clinic, 2020). This process is known as gas exchange. Molecules of CO2 and O2 move through the plasma membrane from an area of high concentration to an area of low concentration. This is known as diffusion, which is a type of passive transport, and it doesn't require energy(Brabandere, 2019). Air enters through the nasal or oral cavity, travels through the trachea/windpipe, proceeds to go through either of the 2 bronchi(which leads into the lungs), then through the bronchioles, and finally to the alveoli, where gas exchange occur(Cleveland  Clinic, 2020)s.

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1. What were some of my most powerful learning moments and what made them so?

1. Sarcoidosis is a condition that I have never previously heard of before, as it affects a tiny part of the population. It was interesting to learn about this disease which affects the respiratory system because I was able to carry my knowledge from the respiratory system here. I especially enjoyed the part where we listed ways in which sarcoidosis affects respiratory system processes. Learning moments like these are caused by getting new and surprising information. Discussing them with Maryam was also great because we shared our thoughts.

2. How well did I and my team communicate overall?

1. Maryam and I took advantage of class time in which we added to our padlet. We also worked on it separately and communicated changes we made. We divided work evenly and overall it was great working with her.

3. How can I better support and encourage my teammates on this unit 2 padlet and future projects?

1. I can be a better team member by collectively discussing what I am writing so that we are all on the same page. Sometimes, partners write on a project, but you are unaware of what the meaning of it is.

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What were some of my most powerful learning moments and what made them so?
I think one of my most powerful learning moments was when I made an organized plan of exactly what was going to be done and it made it easy for me and my partner to get through the work and do it efficiently. 
How well did I and my team communicate overall?
I think there was limited communication, however the work did get done well and both of us did what we were supposed to do and it was pretty equal. 
How can I better support and encourage my teammates on this unit 2 padlet and future projects?
I think I can communicate more with my partner, maybe even set up a time to zoom and talk about the work if we need to. 

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Socioeconomic Struggles with Sarcoidosis Patients  

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Socioeconomic Struggles with Sarcoidosis Patients  

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In many Sarcoidosis patients, recovery is quick and usually straightforward. For some patients, it can be more troublesome often because of multiorgan involvement  (Cleveland Clinic, 2020). In many cases, income correlates to the disease outcome. Income was hypothesized to play a big role in the outcome (Cleveland Clinic, 2020), and for many people, there were other comorbidities involved in worsening the effects of sarcoidosis. The main aspects to worse outcomes, says Logan J. Harper, MD, is less access to care, less ability to take medicines, and trouble interaction with providers (Cleveland Clinic, 2020). Some medications for sarcoidosis can cause depression or chronic fatigue syndrome, which actually worsen the outcomes of sarcoidosis. Where comorbidities and income connect is where there is a significant relationship between comorbidities and income. Lower-income patients had higher rates of steroid-related comorbidities, associating lower-income with worse outcomes. Increased attention should be paid to those patients with lower income as well as comorbidities.
Link- Cleveland Clinic, 2020

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Voter who grilled Trump: I broke down and cried after

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Racial Difference in Sarcoidosis Mortality in the United States

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Racial Difference in Sarcoidosis Mortality in the United States

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Though Sarcoidosis affects fewer than 200,000 individuals in the US per year, racial and gender inequities are present(MayoClinic, 2018). Data from this survey supports this claim and the numbers help readers visualize the disparities that come. In a previous article I read in the cardiovascular system unit about coronary artery disease, patients from African American households are more likely to go to a hospital with less quality care, while caucasians are more likely to receive higher-quality care. This is in part due to financial means and the fact that African Americans on average live near lower quality hospitals, and therefore receive lower quality care. These hospitals don’t have access to the resources and means to treat these patients, in both sarcoidosis and CAD, as well as a multitude of other diseases. This opens readers eyes to the disparity and a solution to not only help African American sarcoidosis patients, but patients with different diseases or conditions would be to provide more prominent donations. This would give hospitals the means to treat these patients with higher care. This in turn could reduce the mortality rate and hopefully improve quality of life (Baughman, 2007).

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Megan - Pink
Maryam - Green
Together - Blue