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Common Health Conditions

Here you’ll find background information on our most common areas of study and what types of studies take place for each indication.

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What forms of birth control are currently available?

Simple sexual abstinence has always been an effective method of birth control, while coitus interruptus (the withdrawal method) and fertility awareness methods have been much less effective. Male condoms have been used for centuries, and have the added benefit of preventing sexually transmitted diseases. Other barrier methods now available include diaphragms, cervical caps, contraceptive sponges and female condoms.

Intra-uterine devices (IUDs) prevent fertilization and uterine implantation of a fertilized egg. Introduced in the early 1920s, they have become a safe and reliable form of birth control for millions of women. In the United States. There are two types of IUDs available: the Mirena®, which continuously releases hormones for up to five years, and the ParaGard Copper T 380A IUD, which can be worn for up to ten or twelve years. IUD's are effective as soon as they are inserted. They do not protect against sexually transmitted diseases.

In 1962, the first hormonal contraception was licensed. Known simply as ‘the pill’, these combination pills of progesterone and estrogen that prevent ovulation are over 99% effective when taken as directed. Progesterone-only pills, nicknamed ‘mini-pills’, are also available, as are extended-cycle combination pills such as Seasonique®. Currently, over 100 million women worldwide rely on oral contraceptive pills (OCPs) as their form of birth control. Rochester Clinical Research has contributed to the testing and development of more than a dozen of today’s most utilized brands of birth control pills.

Since the development of the hormonal implant product Norplant® in the early 1990’s, many new delivery systems of hormonal therapies have been devised. Current hormonal therapies range from implants (Implanon®), to long-acting injections (Depo-Provera®, Lunelle®), to hormonal patches (Ortho-Evra®), to vaginal contraceptive rings (NuvaRing®). Rochester Clinical Research conducted a study of the once-monthly injection Lunelle® and performed some of the early clinical testing of the Ortho-Evra® hormonal patches that have become a convenient and popular form of birth control.

What types of studies are being conducted on birth control methods?

Medical researchers are creating new oral contraceptives that provide greatly flexibility of dosing. Pills that extend the interval between menstrual cycles are being developed, as are pills with lower hormone dosages. There is research being conducted to look at the secondary benefits of OCPs, such as decreased symptoms of pre-menstrual syndrome (PMS) or decreased facial acne. At Rochester Clinical Research, we have been conducting a number of studies on extended-cycle birth control pills, and we expect to be involved in studies exploring the full gamut of hormonal delivery systems such as pill, patch, implant, injection or vaginal ring.

For more information on birth control:

Planned Parenthood: Birth Control
Mayo Clinic: Birth Control Pills FAQs
MedlinePlus: Birth Control

Family Doctor: Birth Control Options

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What causes cold sores?

The herpes simplex virus causes cold sores. While there are eight types of herpes viruses, it is mostly type 1 and occasionally type 2 that cause cold sores, which are also known as fever blisters, oral herpes, or herpes labialis. Recurrent cold sores are usually caused by the type 1 virus.

Why do some people get cold sores so frequently?

The majority of people are exposed to the type 1 herpes simplex virus by direct contact with someone with cold sores before they are 10 years old. Most will develop a mild case of one or two cold sores. Some will have a more severe infection called “gingivostomatitis” that is characterized by dozens of painful cold sores on the tongue, gums and lips, and often is accompanied by fever and sore throat. In severe cases of gingivostomatitis, children are hospitalized because of dehydration.

After the initial infection, whether mild or severe, the herpes virus that causes cold sores remains dormant, or latent, in the nerve root connected to the lips. Essentially, the virus “hides and waits.” Unrelated to the severity of the first episode of cold sores, and for unknown reasons, about 25% of exposed individuals will go on to have recurrent cold sores for the rest of their lives. Generally, the virus will be reactivated and cause cold sores as a response to stress, tiredness, illness, sunlight, fever, diet, menstruation or pregnancy. The frequency of outbreaks decreases after age 35.

What cold sore treatments are available?

There is no available cure for recurrent cold sores. Treatments that decrease pain and speed healing include the topical creams acyclovir (Zovirax®), docosanol (Abreva®) or penciclovir (Denavir®). Oral medications include oral acyclovir (Zovirax®), oral famciclovir (Famvir®), and oral valacyclovir (Valtrex®).

What new cold sore treatments are being studied?

New antiviral medications are being developed, as are new routes of administration of existing medications. In one study conducted at Rochester Clinical Research, the medication acyclovir (Zovirax®) was administered in a tablet that adheres to the patient’s upper gum and gets slowly absorbed, targeting the release of the medication to the area of the body affected by the herpes simplex virus.

For information on the herpes simplex virus:

Wikipedia: Herpes simplex
For more information on cold sores:
eMedicineHealth.com: Cold Sores
MayoClinic.com: Cold Sores

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What is COPD?

A chronic and progressively worsening pulmonary disease, COPD is characterized by inflammation and damage to the lungs that obstructs the flow of air. It is the fourth leading cause of death in the U.S.

COPD is actually a classification of three distinct but often overlapping pulmonary disorders: emphysema, chronic bronchitis and severe, chronic asthma that never fully resolves. Each of these chronic entities causes obstruction of the airways and provokes a productive cough and shortness of breath, which is why they have come to be grouped together under the common name of COPD. They are also treated with the same medications.

While COPD results from the interplay of one’s genetic make-up and their exposure to noxious gases, dust and chemicals, the diagnosis of emphysema is most closely associated with a history of smoking cigarettes. Cigarette smoke damages the small air sacs in the lungs (the alveoli), thereby decreasing the smoker’s overall lung capacity, leading to the coughing and shortness of breath of COPD.

Chronic bronchitis results when the bronchial tubes are irritated and inflamed, most often from long-term cigarette smoking, which leads to a persistent productive cough. The criterion for diagnosis is having a cough with mucus on most days for at least three months a year and two years in a row (without another cause).

Asthma results when the airways get inflamed with increased mucus production and bronchospasms that result in wheezing and coughing. Most asthmatics do not have COPD because their symptoms resolve with treatment. Those who go on to develop COPD have chronic airway inflammation that never fully goes away despite treatment.

What are the symptoms of COPD?

Because many patients are able to ignore a nagging cough or a little bit of shortness of breath, COPD is under-diagnosed and under-treated, which is unfortunate as early treatment can provide symptom relief and slow the advance of the disease. “It’s just my smoker’s hack” is the common refrain of denial.

Diagnosis is best made by performing a simple Pulmonary Function Test with a spirometer that measures a patient’s airflow and lung capacity. It is a simple and easy test, which only requires breathing into a machine. Chest x-rays are useful to rule out other underlying diseases, and CT scans of the lungs can provide additional diagnostic data.

What treatments are available for COPD?

The mainstays of treatments are inhalers that help to decrease lung inflammation and bronchospasm. Short and long-acting bronchodilators, anticholinergics and inhaled corticosteroids are all useful treatments, and come in a number of different combinations. For the most severe cases, lung surgery or continuous oxygen therapy is required.

What are the research opportunities for someone with COPD? At Rochester Clinical Research, we routinely perform clinical trials on new and promising therapies for COPD. One of the benefits of being enrolled in a COPD study is to have close monitoring of your lung function through regular pulmonary testing at our office. We also perform clinical studies on therapies to help people to quit smoking.

For more information on COPD:

Mayo Clinic: COPD
WebMD: COPD

COPD Foundation The National Heart, Lung & Blood Institute

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What is diabetes?

Normally, the glucose we eat in the form of sugars and starches provides energy for our muscles and our brain cells. The glucose in our blood stream relies on the hormone insulin (produced in the pancreas) to get into the cells, where it can be utilized by the body. If the pancreas does not produce enough insulin, or if the insulin is being absorbed by abdominal fat cells (insulin resistance), then blood sugars levels will rise. By definition, diabetes is indicated by a fasting blood sugar (FBS) level greater than 126. The normal range is an FBS level of less than 100. Those with an FBS level of 100-126 are said to have “impaired fasting glucose,” a precursor to diabetes.

What are the symptoms of diabetes?

When blood sugars rise, the body tries to get rid of the excess sugar by diluting it. Patients will note increased thirst and urination. Typically, the first sign of diabetes is increased urination at night. Fatigue, blurred vision or increased appetite with weight loss can also occur.

What are the different types of diabetes?

In some instances, the pancreas will stop working, and the individual will have to rely on insulin shots to regulate their glucose levels. This is known as type 1 diabetes. Much more common in our society is type 2 diabetes, which is generally caused by obesity. Being overweight makes the pancreas work harder until it can no longer keep up with the increased demand, resulting in slowly rising blood sugars. Generally, type 2 diabetes is controlled by weight loss, diet and oral medications, though some type 2 diabetics will require insulin for blood sugar control.

What are the risks and complications of diabetes?

Unfortunately, uncontrolled diabetes can have severe consequences. Diabetes is the third leading cause of death after heart disease and cancer. Diabetics are at increased risk for heart attacks and strokes. The small blood vessels in the eyes, kidneys and nerves can also be damaged, leading to retinopathy, nephropathy and diabetic neuropathy.

What types of studies are available for diabetics at Rochester Clinical Research?

Exciting new treatments are being developed for diabetes and for the symptoms of diabetic neuropathy (burning nerve pain, tingling, numbness or weakness, usually starting in the feet and legs). The highly effective injectable diabetes medication Byetta (exenatide) was studied here at Rochester Clinical Research, as was the new oral medication Januvia (sitagliptin). We are expecting to do more studies for similar oral medications. For diabetic neuropathy, we have conducted several studies, including a new medication that not only treats the nerve pain of neuropathy, but also actually helps to regenerate small nerve fibers.

For more information on diabetes:

Mayo Clinic: Diabetes
Joslin Diabetes Center

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What is gout?

Gout is an acute form of arthritis caused by the deposition of uric acid crystals in a joint, tendon or soft tissues. Gout has been with humanity for thousands of years. It is the most common form of inflammatory joint disease in men over the age of 40. It is estimated to affect 0.5–2.8% of men, with a lower rate of occurrence among women. The elevated uric acid levels that lead to gout can also lead to kidney stones.

What are the symptoms of gout?

A classic attack of gout is to wake up one morning with a red, swollen, hot and acutely painful big toe. While the base of the big toe is the most common target, the ankle, instep, knee or wrist could also be involved. There are a couple of ways to diagnose gout. If the person has a painful big toe, where it is often difficult to obtain joint fluid, a diagnosis can be made by the presence of a high blood uric acid level.

What causes gout?

Purines in foods that we eat are metabolized by the body into uric acid. Normally, uric acid levels in the blood are maintained at levels that will not lead to gout. If an individual has a genetic predisposition or a diet high in purines, their body produces too much uric acid, or their kidneys do not excrete enough of it, it can build up in the blood, increasing the risk of urate crystals forming and causing an acute attack of gouty arthritis.

What treatments are available?

For those with a propensity for gouty arthritis, some dietary changes can help:

  • Avoid alcohol, anchovies, sardines, oils, herring, organ meat (liver, kidney and sweetbreads), legumes (dried beans and peas), gravies, mushrooms, spinach, asparagus and cauliflower.
  • Limit how much meat you eat.
  • Avoid fatty foods such as salad dressings, ice cream, pizza and fried foods.
  • If you are losing weight, lose it slowly. Quick weight loss may cause uric acid kidney stones to form.

Medications that help with gout are anti-inflammatories such as colchicine, ibuprofen, naproxen, etc. To avoid gouty arthritic attacks, medicines like allopurinol and/or probenecid can help.

What research is being done to help gout sufferers?

At Rochester Clinical Research, we routinely perform clinical trials on novel therapies to decrease the frequency and severity of gout attacks. Some of the newer research involves the use of human monoclonal antibodies.

For more information on gout:

Mayo Clinic: Gout
WebMD: Gout
National Institutes for Health: Gout

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What is a healthy volunteer study?

When a company makes a new laboratory machine to analyze blood, blood samples from a wide range of people are needed to calibrate it. Similarly, when scientists develop a new blood testing methodology many blood samples are required to set standards for “normal” versus “abnormal.”

The healthy volunteer studies conducted at Rochester Clinical Research typically involve drawing several tubes of blood, for which the volunteer receives a small monetary stipend and the satisfaction of helping others by advancing medical science.

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What is cholesterol?

Cholesterol is a lipid that is produced in the liver, and circulates in the bloodstream. It is important to the function of cell membranes, and contributes to the formation of many of the body’s hormones. The body synthesizes some cholesterol; we ingest some in our diets.

Why are high cholesterol levels dangerous?

High levels of total cholesterol and LDL (low-density lipoprotein) contribute to the formation of atherosclerotic plaque build-up on the inside walls of blood vessels. If the build-up blocks an artery, or breaks loose and forms a clot “downstream” in a smaller blood vessel, the result can be a heart attack or a stroke.

There is a direct and exponential relationship between elevated cholesterol levels and the incidence of coronary heart disease. Coronary heart disease is the leading cause of death for both men and women of all races and ethnicities in the United States. In the U.S., more people die of heart attacks every year than die of all the forms of cancers combined.

How often should I be tested?

It is recommended by the American Heart Association to test cholesterol every five years for people aged 20 years or older. It is recommended to have cholesterol tested more frequently than five years if a person has total cholesterol of 200 or more, is a man over age 45 or a woman over age 50, has HDL (good) cholesterol less than 40, or other risk factors for heart disease and stroke.

What are the recommended levels of cholesterol?

The acceptable levels will vary from individual to individual depending upon age and other risk factors. As a rule, total cholesterol should be less than 200 and triglyceride levels less than 150. LDL (“bad” cholesterol) levels are optimally less than 100. Near optimal is 100 to 129, borderline high is 130 to 159, high is greater than 160, and very high is over 190. High-density lipoprotein (HDL or “good” cholesterol) should be greater than 40 in men and 50 in women.

What treatments are available?

A low-cholesterol, low-fat diet is the most important intervention. Regular aerobic exercise can help to raise HDL levels. Over-the-counter supplements such as flax seed, fish oil capsules and red yeast rice tablets have been shown to be beneficial.

For those requiring medications, there are several families of medicines: statins such as simvastatin (Zocor®) or atorvastatin (Lipitor®); cholesterol absorption inhibitors such as ezetimibe (Zetia®); bile acid sequestrants such as cholestyramine (Questran®); Nicotinic acid such as Niacin (immediate, sustained, and extended release, Niaspan®); and the fibrates such as gemfibrozil (Lopid®) or fenofibrate (Tricor®).

What new therapies are being tested?

Newer medications that work by inhibiting cholesterol absorption or production are being developed. If you have high cholesterol and would like to participate in a study, please contact us. If you do not know your cholesterol levels, Rochester Clinical Research offers a free cholesterol-screening visit that only requires a drop of blood from the fingertip.

For additional, general information on cholesterol:

MedlinePlus: Cholesterol
NIH National Heart, Lung, and Blood Institute: High Cholesterol
American Heart Association: Cholesterol

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What are hot flashes?

As most menopausal women know, hot flashes are an uncomfortable and sudden sensation of heat accompanied by flushing of the skin. They generally affect the upper chest, neck and face before affecting the entire body. Hot flashes can cause profuse sweating or heart palpitations, they typically last two-4 minutes and they are often followed by a cold chill.

Three out of four menopausal women will experience hot flashes with an average age of onset of 51. The frequency and severity of hot flashes are quite variable and unpredictable, and they can stop and start without rhyme or reason. On average, hot flashes continue for 3-5 years, but 10-15% of menopausal women will suffer from persistent hot flashes for many years. Women who smoke, are overweight, or do not get enough exercise are at increased risk for hot flashes.

What causes hot flashes?

While the cause is not fully understood, it is generally accepted that a “thermoregulatory disorder” at the level of the hypothalamus (the part of the brain that regulates body temperature) occurs in response to falling blood estrogen levels. Estrogen levels decrease during menopause because the ovaries slow down and no longer produce eggs. If the hypothalamus erroneously senses that the body is too warm, it attempts to dissipate the excess heat by dilating (enlarging) the blood vessels in the skin, resulting in a "hot flash."

Do hot flashes cause other problems?

Yes. Because hot flashes are typically more common at night, they can interfere with sleep, and the resulting sleeplessness can in turn cause daytime fatigue, irritability, difficulty concentrating, mood swings and short-term memory loss.

What can be done for hot flashes?

For mild hot flashes, several lifestyle modifications might be sufficient to help control symptoms; dress in multiple layers (removing outer layers if feeling too warm), avoid hot flash triggers (such as hot or spicy foods, caffeinated or alcoholic beverages), or at the onset of a hot flash take deep, slow, abdominal breaths for several minutes. For moderate to severe hot flashes, hormonal therapies with estrogen, progesterone, or a combination of the two are the most effective treatments. Estrogen should not be taken by women with a history of breast cancer, heart disease, stroke or blood clots. Women who have not had a hysterectomy need to take estrogen combined with progesterone to limit the risk of uterine cancer. Hormonal therapies are available in pills, patches or injections. Some non-hormonal prescriptions medications can be effective for hot flashes; selective serotonin reuptake inhibitors (Prozac®, Paxil®, Zoloft®, etc.), serotonin-norepinephrine reuptake inhibitors (Effexor®), the nerve pain medicine gabapentin (Neurontin®), and the blood pressure medication Clonidine (Catapres®).

Plant-derived estrogens have been marketed as a "natural" or "safer" alternative to hormones for women with menopausal symptoms, but there is little to no evidence that such "phytoestrogens" are effective. Other alternative treatments, including black cohosh, ginseng, dong quai, evening primrose oil, wild yam and progesterone creams have also been studied. There has not been consistent scientific data to support their effectiveness in reducing hot flashes.

What research opportunities are there for hot flashes?

At Rochester Clinical Research, we have performed a number of clinical trials on hormonal therapies. A promising new approach to controlling hot flash frequency and severity is to use low dosages of medications that increase levels of serotonin, the SSRIs (selective serotonin re-uptake inhibitors). Newer, alternative medications are also being developed.

For more information on hot flashes:

Mayo Clinic: Hot Flashes
WebMD: Hot Flashes
North American Menopause Society

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

How is insomnia defined?

Insomnia is a symptom or syndrome rather than a disease that results in decreased quantity or quality of sleep. It is characterized by difficulty falling asleep, staying asleep or simply having “unrefreshing” sleep. It is a very common problem, more so in women than men.

Insomnia can be of transient, short, or chronic duration. For many people, insomnia is related to an underlying problem such as situational stress, anxiety, grief or depression, or to a medical problem such as sleep apnea or restless legs syndrome. Circadian rhythm disorders related to shift work or jet lag also contribute to insomnia. People with insomnia can experience daytime fatigue or sleepiness, inability to concentrate, irritability, anxiety, depression, or forgetfulness.

If you suffer from insomnia, you should consult your doctor, as there may be an underlying disorder causing your problem.

What do sleep experts recommend for insomnia?
  • Go to bed and wake up at the same time every day, including weekends.
  • Establish a relaxing bedtime routine: take a bath, read a book or do something calming before bed.
  • Make sure your sleep environment is dark, quiet, cool and comfortable.
  • Avoid or limit your use of stimulants like caffeine (coffee, tea, sodas, chocolate), decongestants or tobacco before bed.
  • Avoid or limit your intake of alcohol before going to sleep. Alcohol’s depressant effect helps people fall asleep, but not to stay asleep.
  • Exercise regularly, but avoid exercise within a few hours before going to bed.
  • Learn to reduce or manage the stress in your life.
  • Avoid daytime naps.
  • Use the bed only for sleep and sex; keep the bedroom free from distractions like television, computers and work. Remember that the multispectral light of TV stimulates the central nervous system.
  • Avoid going to sleep hungry, but also avoid eating just before bedtime, as this not only adversely effects sleep, but can also cause gastro esophageal reflux disease (GERD).
  • Get out of bed if you can’t fall asleep within 15–20 minutes. Read under a dim lamp until you are drowsy. Only spend time in bed when you are actually sleepy or sleeping.
  • Don’t watch the clock—it can cause anxiety about sleep.
  • Keep a journal or sleep log to record both good and poor nights' sleep. This can help you recognize patterns and expose activities that trigger sleeplessness.
What treatments are available?

Medications that currently are available by prescription are known to improve sleep by reducing the amount of time it takes to fall asleep, increasing sleep duration, and/or reducing the number of awakenings during sleep. There are several types of prescription sleeping pills, such as the benzodiazepines like temazepam (Restoril). There are also the newer medications such as zolpidem (Ambien®), zaleplon (Sonata®), and eszopiclone (Lunesta®).

Over-the-counter medications that are available for the treatment of insomnia are mainly sedating antihistamines, such as diphenhydramine (Benadryl®).

What new treatments are being studied?

Rochester Clinical Research has performed clinical trials on medication for those individuals who have difficulty staying asleep, and suffer from frequent awakenings in the night.

For more information on insomnia:

Mayo Clinic: Insomnia
WebMD: Insomnia
Sleep Association: Insomnia
Family Doctor: Insomnia

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What is a migraine headache?

The pain of a migraine headache usually begins gradually, intensifies over minutes to one or more hours and resolves gradually at the end of the attack. The headache is typically dull, deep and steady when mild to moderate in severity; it becomes throbbing or pulsatile when severe. Migraine headaches are worsened with moving the head rapidly, light, sneezing, straining, constant motion or physical exertion; many migraine sufferers try to get relief by lying down in a darkened, quiet room. In 60 to 70 percent of people, the pain occurs on only one side of the head. In adults, a migraine headache usually lasts a few hours, but can last from four to 72 hours.

Migraine headaches are often accompanied by nausea and vomiting as well as sensitivity to light and noise. Between 10 and 20 percent of people with migraine, also experience nasal stuffiness and runny nose, tearing, or changes in skin tone or body temperature. The symptoms of a migraine attack may be severe and alarming but in most cases, there are no lasting health effects when the attack ends.

Migraine is the most common cause of disabling headache, affecting 35 million Americans. About 15 percent of women and six percent of men experience migraine. The condition is often hereditary; if you have migraines, it is very likely that another family member suffers from them too.

Migraine is characterized by recurrent attacks, with pain often on one side of the head that may be throbbing or pounding, accompanied by other symptoms such as nausea, vomiting and sensitivity to light, sound and head movement. Although migraine can occur at any time of day or night, they tend to affect people in the morning.

Episodes can last from several hours to several days and often are disabling. During the attack, pain may travel from one part of the head to another and may radiate down the neck into the shoulder. Scalp tenderness occurs in the majority of patients during or after an attack. Signs and symptoms of migraine headaches include:

  • Throbbing or pounding pain
  • Nausea and vomiting
  • Scalp tenderness
  • Sensitivity to light or sound
  • Worsening of pain with movement
  • Visual disturbances, such as flashes of light or blind spots in your vision
  • Abnormal body sensations, called paresthesias, such as tingling, numbing or prickling
  • Diarrhea
  • Dizziness or vertigo

Migraines can be triggered by stress, worry, menstrual periods, birth control pills, physical exertion, fatigue, lack of sleep, hunger, head trauma, and certain foods or drinks that contain chemicals such as nitrites, glutamate, aspartate, or tyramine.

Certain medications and chemicals can also trigger a migraine, including nitroglycerin (used to treat chest pain), estrogens, hydralazine (used to treat high blood pressure), perfumes, smoke and organic solvents with a strong odor.

For more information on migraines:

Mayo Clinic: Migraines
WebMD: Migraines

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What is osteoarthritis?

Osteoarthritis (OA) is the most common type of arthritis and is characterized by a gradual loss of cartilage from the joints. As osteoarthritis advances, it causes increasing pain and loss of movement as bone begins to rub against bone. Although OA can affect almost any joint, it most often affects the hands, knees, hips and spine. Common symptoms include pain, stiffness, some loss of joint motion, and changes in the shape of affected joints.

OA is strongly associated with the wear and tear on joints during a lifetime, but it is no longer considered a normal part of aging. Studies suggest that the risk of OA is also influenced by other factors, including heredity, obesity, and occupation. A chronic condition, it gradually worsens over time. Osteoarthritis treatments can, however, relieve pain and help you remain active. Taking steps to actively manage your osteoarthritis may help you gain control over your osteoarthritis pain.

What are the risk factors for getting osteoarthritis?
  • Age: Becomes more common in those over 40.
  • Heredity: Familial genetic make-up can increase likelihood of developing OA.
  • Gender: For unknown reasons, women are more likely than men to develop osteoarthritis.
  • Occupation: Repetitive overuse of individual joints increases risk, as does a history of previous injury or trauma.
  • Weight: Carrying extra weight increases risk, and is the most important modifiable risk factor.
  • Sedentary Lifestyle: The lack of physical activity increases risk.
What treatments are available?

Current medical therapies include the use of pain medication such as acetaminophen (Tylenol®) or anti-inflammatory medications such as ibuprofen (Advil®) or naprosyn (Aleve®). Topical capsaicin cream (Zostrix®) is beneficial in some patients. The dietary supplements glucosamine and chondroitin have been shown in some studies to benefit those with moderate to severe OA of the knee. Weight loss can dramatically help the pain and alter the course of OA. Rest, exercise, physical therapy, and heat or cold treatments can be beneficial. Alternative therapies like acupuncture, Tai chi or yoga may help. Some patients will benefit from joint injections, of either cortisone or artificial joint lubricants such as Synvisc®, but the most severe cases may require surgical joint replacements.

What osteoarthritis research studies are being done at RCR?

Two areas of primary focus of current research are on medications that prevent cartilage breakdown and on those that relieve the painful symptoms of osteoarthritis. There are some exciting new options and novel approaches for controlling pain and swelling, increasing joint range of motion, and slowing the progression of osteoarthritis. Rochester Clinical Research is conducting research on some of these new therapies for osteoarthritis; please contact us if you would like more information.

For more information on osteoarthritis:

The Arthritis Foundation: Osteoarthritis
Mayo Clinic: Osteoarthritis

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What is the plague?

Plague is an infectious disease caused by bacteria called Yersinia pestis. These bacteria are found mainly in rodents, particularly rats, and in the fleas that feed on them. Other animals and humans usually contract the bacteria from rodent or fleabites.

Wasn’t the plague a disease of the Dark Ages?

The first recorded case of plague was in China in 224 B.C. There have been three major plague epidemics; the first plague epidemic spanned from the Middle East to the Mediterranean basin during the 5th and 6th centuries, killing about half the population of those areas. In the 1300s, the "Black Death," as it was called, killed approximately one-third (25 million) of Europe's population. The third pandemic started in 1855 in China and spread to every major continent, killing an estimated 12 million people.

Is it still around?

Yes. Because there are about 30 species of fleas that carry the bacteria, and because they infect more than 200 mammalian species, the plague is virtually impossible to eradicate. Rodents are the most important hosts to transmit the disease, particularly rats. In the U.S., the animals most likely to transmit plague are squirrels, rabbits and prairie dogs.

Are people still being infected with plague?

Yes. Between 1987 and 2001, over 36,000 cases were reported to the World Health Organization. Globally, the WHO reports 1,000 to 3,000 cases of plague every year. The 1994 outbreaks in Malawi, Mozambique and India raised concerns that the disease might reemerge as a significant worldwide public health hazard.

Is it in the U.S.?

Approximately 10 to 20 people develop plague each year from flea or rodent bite–primarily from infected prairie dogs in rural areas of the southwestern United States. In 2006, 13 human plague cases were reported among residents of four states: New Mexico, Colorado, California and Texas; two cases were fatal. The rate of plague in the United States is low, probably because the affected areas are rural and largely uninhabited.

How can plague be prevented?

Reducing exposure is the best preventive measure. In known endemic areas, avoidance of handling dead rodent carcasses, use of insect repellents, and flea and rodent control can play an important role in prevention efforts. For those who have been in face-to-face contact with someone with known or suspected plague, preventive antibiotic therapy can be utilized.

Are there vaccines available?

A killed whole-cell vaccine has been developed but is no longer commercially available in the United States. The effectiveness of the vaccine has been difficult to evaluate. Much of the experience has been with vaccination of military personnel deployed to areas where plague is common, such as Vietnam. The vaccine does appear to provide some protection. The concern about plague as a bioterrorism agent has led to the development of a number of newer vaccines, some of which are undergoing clinical testing.

For more information on plague:

Mayo Clinic: Plague
WebMD: Bubonic Plague
Center for Disease Control: Plague
World Health Organization: Plague

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What are the risks of smoking?

Simply stated, smoking is the single most avoidable cause of disease, disability and death in the United States. About half of the people who smoke will die of smoking-related problems. Smoking directly contributes to more than 440,000 deaths per year in the US. In addition to causing almost 90% of all lung cancers, smoking also increases the risk of cancers of the head & neck, esophagus, pancreas and bladder. Smoking also doubles an individual’s risk of developing coronary artery disease and dying of a heart attack.

Smoking is the number one cause of emphysema, chronic bronchitis and chronic obstructive pulmonary disease. Asthma and sudden infant death syndrome (SIDS) are more common among children exposed to second-hand smoke. Exposure to second-hand smoke leads to the deaths of an additional 35,000 people a year by coronary artery disease.

Smoking increases the risk of peptic ulcer disease as well as the risks of osteoporosis and hip fractures in women. It causes premature skin wrinkling and increases the risk of sexual dysfunction (impotence).

What are the benefits of quitting smoking?

Smoking cessation has major and immediate health benefits for men and women of all ages. The earlier a person quits, the greater the benefits. People who quit smoking before age 50 reduce their risk of dying over the next 15 years by one-half, as compared to those who continue to smoke. The risk of dying from coronary heart disease is reduced by about half one-year after stopping smoking, and then continues to decline with time. Smoking cessation reduces the risk of lung cancer within five years of stopping, although former smokers still have a higher risk of lung cancer than those who have never smoked. The risks of peptic ulcer disease, osteoporosis and hip fractures all decrease with quitting.

There is a secondary benefit to quitting: saving money. With cigarettes averaging more than $5 a pack, a two pack per day smoker will save $3,650 dollars a year.

Are there any risks to quitting smoking?

Yes. The process of quitting can lead to withdrawal symptoms from nicotine that includes irritability, anxiety, insomnia or depression. Some people experience intense cravings for cigarettes. The oral medications to help people quit can decrease these symptoms and cravings.

Also, weight gain can result from quitting smoking, as many smokers replace smoking with eating. An exercise program and eating a reasonable diet can minimize such weight gain. It must be emphasized that the benefits of quitting smoking are much greater than the risks of gaining weight.

What is available to help me quit smoking?

Nicotine replacement products can help relieve withdrawal symptoms people experience when they quit smoking. Nicotine patches, nicotine gum and nicotine lozenges are available over-the-counter, and a nicotine nasal spray and inhaler are currently available by prescription. Nicotine replacement therapies are helpful in quitting when combined with a behavior change program such as the American Lung Association's Freedom from Smoking online program (available atwww.lungusa.org) which addresses psychological and behavioral addictions to smoking and strategies for coping with urges to smoke.

The oral medication bupropion (Zyban®, Wellbutrin®) is an anti-depressant that can decrease cravings and help people to quit. Bupropion may be more effective than nicotine replacement therapy, and combining the two may be even more effective. More effective still is varenicline (Chantix®) that works in the brain to reduce nicotine withdrawal symptoms and cigarette cravings, but patients need to be monitored for mood or behavioral changes.

What new treatments to help smokers quit are being studied?

New therapies to help smokers quit are currently being developed. Rochester Clinical Research has performed clinical trials on an extended-release form of varenicline (Chantix®), as well as an exciting new vaccine to help smokers quit. For more information on this or other studies at Rochester Clinical Research, please contact us.

For more information on smoking, and to get help with quitting:

Mayo Clinic: Quit Smoking
WebMD: Quitting Smoking
American Lung Association: Stop Smoking
American Cancer Association: Guide to Quitting Smoking

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

What are vaccines?

Vaccines are immunizations that generally come in the form of shots, and help our bodies to defend against a number of infectious diseases. Vaccines typically contain a killed or much weakened virus or protein that stimulates our body to produce antibodies against a specific disease.

How many vaccines are there?

Currently, there are 27 licensed vaccines in the U.S. to help prevent diseases like tetanus, polio, influenza, measles, mumps, hepatitis and HPV/cervical cancer.

Can a vaccine cause the disease it is supposed to prevent?

Most of our current vaccines are inactivated (killed), so that they cannot cause disease. A few vaccines use weakened or attenuated viruses, so they could theoretically cause disease, but generally do not.

What kinds of vaccines need to be studied?

There are several vaccines in development for treating diseases like bird flu, anthrax, tuberculosis and malaria. The hope is to find a bird flu vaccine that doesn’t depend on chicken embryos for its manufacturing, so that hundreds of millions of doses could be quickly produced in the event of a global outbreak of bird flu. We call our volunteers “everyday heroes” because they help to come up with solutions to some of the world’s biggest problems, such as the threat of pandemic bird flu.

For more information on vaccines:

Mayo Clinic: Top 5 Myths about Vaccines
WebMD: Immunizations
About the Flu
Vaccinations

Please consult with your medical professional about the applicability of this information to your own situation. The content below includes links to external sites, which will open in a new browser window.

Am I overweight?

For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the “body mass index” (BMI). BMI is used because, for most people, it correlates with their amount of body fat.

  • An adult who has a BMI between 25 and 29.9 is considered overweight.
  • An adult who has a BMI of 30 or higher is considered obese.
  • The CDC offers an online body-mass index calculator.
What are the risks of being overweight?

Currently, two-thirds of the adult U.S. population is considered overweight or obese, with experts calling the problem an “epidemic.” Both genetic and environmental factors play a role, with overeating and sedentary lifestyles contributing to the problem. Being overweight can cause a number of other medical problems, including diabetes, hypertension, high cholesterol, heart disease, sleep apnea, osteoarthritis and/or depression.

What are the benefits of participating in a weight loss study?

Volunteers in weight loss studies at Rochester Clinical Research have access to new therapies for weight loss before they become available to the public. Studies vary between three months to several years in length and typically involve a decreased calorie diet and an exercise program.

The accountability of regular office visits, coupled with routine educational visits with our registered dietician, enable our volunteers to be successful with their weight loss goals, regardless of whether they are on study drug or placebo.

For more information on weight loss:

Mayo Clinic: Weight Loss Basics
WebMD: How to Lose Weight Fast and Safely