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Topic: Writing the abstract to accompany your research paper
Objective: To develop a working abstract (i.e. descriptive summaries that precede scholarly journal articles or can be found standing alone in periodical databases in order to help a reader quickly understand the paper’s purpose) for your research paper
You have already completed Assignment 2: The Annotated Bibliography. To further help prepare you for Assignment 4: The Research Paper you will first submit an abstract of the main points of what you will be covering in your paper.
Your Abstract should contain the following parts that are listed below.
Topic Sentence: your abstract must contain one sentence that clearly and concisely introduces the topic of the profile paper.
Content Sentences: your abstract must mention the following five main topics of the profile: Statistics/Epidemiology, Financial Costs, Anatomy & Physiology/ Etiology, Diagnosis/Treatments/ Prognosis, Conclusions and Findings. This is challenging to write! These sentences should not be too specific, but reflect broad strokes summaries of each of these main topics.
Conclusion Sentence: Abstract contains one sentence that mentions key conclusions and/or findings.
Advice on writing abstracts:
Please make note of the following tips and tricks:
We understand that this is a rough draft and as your research and writing continues over the next few weeks your abstract conclusion may change. Be sure to update this abstract if that happens when you submit Assignment 4.
Please review the rubric! The rubric is a very detailed template that I will use to assess your performance. It also will help you understand what is expected from you as you prepare your assignment.
Your abstract should be clear and concise and contain approximately five to seven well written sentences.
Be sure to avoid first person.
from Harvard Medical School Health Topics A-Z
View article on Credo
What Is It?
Scleroderma is a poorly understood illness that causes widespread hardening of the skin, especially on
the hands and face. It also can damage the lungs, heart, kidneys, digestive tract, muscles and joints. It is
a long-lasting (chronic) autoimmune disorder, an illness in which the body’s immune defenses mistakenly
attack the body’s own cells rather than protecting them from outside invaders. Scleroderma also is
called progressive systemic sclerosis.
There are two types of scleroderma. In thelimited form, also called limited systemic sclerosis, the skin
is the primary target. In thediffuse form (diffuse systemic sclerosis), the damage not only affects the
skin, but also can affect the lungs, kidneys and other internal organs.
In people with scleroderma, scientists have identified abnormal immune proteins called autoantibodies,
which are programmed to attack specific components of body cells. They also have found abnormal
accumulations of protective T cells (white blood cells that are part of the immune system) in the skin and
Although scientists don’t understand exactly what happens, they believe that the immune system,
perhaps involving these autoantibodies or T cells, somehow damages the body’s smallest arteries,
called arterioles. These damaged arterioles leak fluid, which causes swelling. They also release
chemical factors that stimulate cells called fibroblasts to produce too much collagen, a fibrous protein
involved in forming scar tissue.
In the skin, this leads to thickening, hardening and tightness. Elsewhere in the body, the autoimmune
attack of scleroderma can damage the digestive tract, the linings of joints, the outside sheaths of
tendons, muscles (including the heart muscle), portions of the heart that regulate heart rhythm, the small
blood vessels and the kidney.
Scleroderma is rare, affecting about 14 in every 1 million people worldwide. It is most common in women
aged 35 to 54. The cause is unknown. For some reason, cells called fibroblasts make too much scartype
tissue in the skin and in organs throughout the body.
A number of theories have been proposed to explain this, including abnormalities in blood vessel
function, abnormal proteins and antibodies in the circulation, and abnormal amounts of chemical
messengers instructing fibroblasts to become overly active. Because scleroderma is more common in
women during the childbearing years, researchers have looked for a pregnancy-related factor to
explain why scleroderma develops. One theory suggests that leftover fetal cells can still be circulating in
the mother’s bloodstream decades after pregnancy, and may play some role in triggering the
autoimmune changes behind scleroderma. Genetic factors and infectious triggers have also been
Older studies have linked scleroderma to exposure to certain chemicals, including vinyl chloride, epoxy
resins, aromatic hydrocarbons and ingestion of rapeseed oil adulterated with aniline. Some people who
took tryptophan, an amino acid that used to be sold as a dietary supplement, developed a condition
similar to scleroderma called eosinophilia myalgia syndrome. Since tryptophan was removed from the
market, no further cases of eosinophilia myalgia syndrome have been reported. But the clear link
between tryptophan and eosinophilia myalgia syndrome and the scleroderma-like disease associated
with contaminated rapeseed oil ingestion raise the possibility that exposure to something in the
environment could trigger scleroderma.
The symptoms of scleroderma vary from person to person and can include:
Raynaud’s phenomenon. In people with this condition, blood vessels in the fingers or toes, and
sometimes in the tips of the nose and ears, suddenly constrict. The area turns white or blue and
becomes cold and numb. This is followed by a flush of redness as the area warms up again, often
together with pain or tingling. Raynaud’s phenomenon can be triggered by exposure to cold or
vibration or by emotional stress.
Skin symptoms. There can be swelling of the fingers, hands, forearms and face and sometimes
the feet and lower legs. This is followed by a skin thickening and tightness that can limit body
movement. There also can be:
Skin that is lighter or darker than usual
Loss of hair
Abnormal skin dryness, including vaginal dryness
Calcium deposits in the skin (subcutaneous calcinosis)
Small red spots caused by localized swelling of tiny blood vessels (telangiectasias)
Joints. Joints can swell and become painful and stiff.
Muscles. Muscles can become weak, and tendons can become abnormally thick, causing pain
and limited joint motion.
Digestive system. When scleroderma involves the esophagus, it can cause a feeling of fullness
or burning pain (heartburn) in the upper abdomen or behind the breastbone, together with
difficulty swallowing or keeping food down. Other digestive symptoms include bloating,
constipation, lower abdominal pain or difficulty controlling bowel movements.
Lungs. Symptoms can include shortness of breath, especially when you exercise, and a dry
cough that doesn’t bring up sputum or mucus.
Heart. Problems can include chest pain, abnormal heart rhythms and heart failure.
Kidneys. Kidney damage can lead to high blood pressure, headache, seizures and too little urine
Other symptoms. Other symptoms can include dry eyes and mouth, sudden episodes of severe
facial pain (trigeminal neuralgia), and impotence.
More than 95% of people with scleroderma have both Raynaud’s phenomenon and skin thickening (also
called sclerodactyly when the fingers are involved). In addition, those with limited scleroderma tend to
have telangiectasias, a collection of dilated blood vessels under the skin (85% of patients); digestive
problems involving the esophagus (80%); and calcinosis (50%), often called CREST syndrome
(calcinosis, Raynaud’s, esophageal disease, sclerodactyly and telangiectasia). High pressure in the
blood vessels around the lung (a serious condition called pulmonary hypertension) develops in about
15% of people with limited scleroderma.
Besides having Raynaud’s phenomenon and skin thickening, people with the diffuse form of
scleroderma can have digestive symptoms involving the esophagus (80%), joint symptoms (70%), muscle
weakness (50%), lung symptoms (40%) and heart failure (30%).
Your doctor will ask about your symptoms and will examine your skin, especially on your fingers, hands
and face. If your doctor suspects you have scleroderma, he or she may want to order blood and urine
tests. Occasionally, a skin biopsy may be recommended during which a small sample of skin is removed
and examined in a laboratory. If scleroderma affects internal organs such as the heart, lungs or
digestive organs, a chest X-ray and other tests may be necessary.
Scleroderma is a chronic (long-lasting) disease. Although symptoms may come and go over time, the
various forms of this disease usually last a lifetime. The skin swelling that happens first can last for a few
weeks or months. This is followed by a gradual thickening of the skin and other skin changes. In the
diffuse form of the disease, skin symptoms tend to peak within three years, then stabilize or even
improve. If skin changes occur more rapidly, there is often a greater risk that internal organs are being
damaged as well. In limited scleroderma, skin symptoms tend to worsen very slowly over a period of
There is no way to prevent scleroderma.
There is currently no treatment for scleroderma that is reliably effective. A host of drugs have been
tried or are in development for the treatment of scleroderma. Among the most commonly prescribed
drugs for scleroderma are:
Cyclophosphamide (Cytoxan, Neosar) also decreases the activity of the immune system, and
has been shown to improve lung function slightly when used along with corticosteroids in people
with inflammation in the lungs. The risks associated with this powerful medication (including
infection, bleeding from the bladder and an increased risk of cancer) require that its use be highly
selective and closely monitored.
Glucocorticoids can be used to relieve inflammation of the membrane surrounding the heart
(pericarditis), arthritis and inflammation of the muscles (myositis). However, these drugs also can
have serious side effects, including the possibility that they may increase blood pressure and
worsen kidney function in people with scleroderma.
Non-steroidal anti-inflammatory drugs (NSAIDs) may be useful for joint and tendon
D-penicillamine (Cuprimine) decreases the activity of the immune system, and is thought to
interfere with collagen production. Some studies suggest that D-penicillamine may reduce skin
thickening and prevent organ damage in some patients, but its overall success rate is not high. It
also can cause serious side effects that harm the kidneys and blood cells. It is being used much
less now than in the past to treat scleroderma.
Diuretics encourage the body to release excess fluid as urine. They are used to relieve swelling
of the hands and feet.
Omeprazole (Prilosec) or related medications may be quite effective for the heartburn related
to esophageal disease.
Bosentan (Tracleer) or epoprostenol (Flolan) may be effective for pulmonary hypertension.
These drugs also may improve symptoms of Raynaud’s phenomenon.
Angiotensin converting enzyme (ACE) inhibitors, such as enalapril (Vasotec), lisinopril
(Prinivil or Zestril) or captopril (Capoten), lower blood pressure and may protect the kidney in
people with scleroderma.
Other immune suppressing medications, including methotrexate or mycophenolate are sometimes
recommended. A promising experimental therapy for severe disease is high dose immunosuppression
with stem cell treatment.
Many patients find relief from Raynaud’s phenomenon by limiting their exposure to cold and by wearing
warm clothing, especially mittens and socks. Others find that regular exercise, physical therapy, skin
massage and moisturizing ointments help skin symptoms. If dry skin becomes ulcerated and infected,
antibiotics may be needed.
For more severe cases, medications may be necessary. These include calcium channel blockers such
as amlodipine (Norvasc), nifedipine (Procardia, Adalat) or diltiazem (Cardizem), hydralazine (Apresoline),
prazosin (Minipress), losartan (Cozaar), sildenafil (Viagra) or tadalafil (Cialis). Each of these medications
may have side effects that limit their use.
As an alternative to medication, some patients choose biofeedback or injections called nerve blocks.
These injections are given under local anesthesia near the neck, armpit or hand and usually are done
only after other approaches have not worked. The injections temporarily or permanently interrupt nerve
signals to blood vessels. By removing the nerve signals that tell an artery to constrict, arteries can dilate
and improve blood flow.
Patients also are urged not to smoke and to avoid street drugs and certain prescription drugs including
beta-blockers, amphetamines, cocaine and ergotamine (Gynergen and other brand names).
When To Call a Professional
Call your doctor if you think that you are experiencing episodes of Raynaud’s phenomenon or other
symptoms of scleroderma, especially if you are a woman of childbearing age.
While many people with scleroderma live long, full lives, the death rate is increased by up to eight times
for diffuse disease and two times for limited disease. Pulmonary hypertension and diffuse skin disease
are risk factors for poor prognosis. However, longevity in this illness seems to be improving over time.
Its rarity and variability make it difficult to accurately predict the prognosis in an individual with
American College of Rheumatology
1800 Century Place
Atlanta, GA 30345-4300
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Insitutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
12 Kent Way
Byfield, MA 01922
Scleroderma Research Foundation
220 Montgomery Street
San Francisco, CA 94104
Medical content created by the Faculty of the Harvard Medical School. Copyright by Harvard
University. Selected illustrations copyright Harvard University, Krames, and the StayWell Company.
Content Licensing by Belvoir Media Group. All rights reserved
The information contained in this Harvard Health Publication may not be considered current medical
content and should only be used for research and reference purposes. As new scientific information
becomes available, recommended protocols and treatments may undergo changes. Any practice
described in this publication should be applied by the reader in accordance with professional
standards of care used in regard to the unique circumstances that may apply in each situation and
should not be used as a substitute for a medical professional’s judgment.
Shmerling, Robert H. M.D. (HMFP – Rheumatology)
Copyright 2016 Harvard Health Publications
Shmerling, R. H. (2017). Scleroderma. In Harvard Medical School (Ed.), Health reference series: Harvard
Medical School health topics A-Z. Boston, MA: Harvard Health Publications. Retrieved from
Shmerling, Robert H. “Scleroderma.” In Harvard Medical School Health Topics A-Z, edited by Harvard
Medical School. Harvard Health Publications, 2017. http://ezproxy.apus.edu/login?
Shmerling, R.H. (2017). Scleroderma. In Harvard Medical School (Ed.), Health reference series: Harvard
Medical School health topics A-Z. [Online]. Boston: Harvard Health Publications. Available from:
[Accessed 23 March 2018].
Shmerling, Robert H. “Scleroderma.” Harvard Medical School Health Topics A-Z, edited by Harvard
Medical School, Harvard Health Publications, 2017. Credo Reference, http://ezproxy.apus.edu/login?
Accessed 23 Mar 2018.