According to an article published in the British Medical Journal (2008;336:1287-1290), a study was performed to examine whether doctors’ global assessments of treatment effects agree with patients’ global assessments. The study was designed as a survey of trials included in systematic reviews of treatments for diverse conditions. The data source included the Cochrane database of systematic reviews. For the study, data were extracted on patients’ global assessments and on doctors’ global assessment for the same treatment against the same comparator. The main outcome measures were the relative odds ratio of 1) global improvement with the experimental intervention versus control according to doctors compared with patients, and 2) improvement rates according to doctors and patients. Doctors’ global assessments were compared with patients’ global assessments for 63 different treatment comparisons (240 trials) in 18 conditions. Results showed that the summary relative odds ratio across the comparisons was not statistically significant. In 62 of the 63 comparisons, the effects of treatment rated by patients and by doctors did not differ beyond chance, but for single comparisons the confidence intervals were large. Rates of improvement on average did not differ between doctors’ assessments and patients’ assessments. According to the authors, doctors’ global assessments of the effects of treatments are on average similar to those of patients.

Topical applications of a naturally occurring fat 1) ___ has the potential to slow down skin aging, whether through natural causes or damage. Through both the normal aging process and external factors like UV 2) ___, smooth, young skin inevitably becomes coarse and wrinkled. The basis of this wrinkling is that time and damage both lower the production of new collagen while increasing the levels of 3) ___ called MMPs that chew up existing collagen. Covering up, slowing down, or even stopping the wrinkling process has become a big business, and as part of this research endeavor, Jin Ho Chung and colleagues who tested seven naturally occurring lipids (greasy molecules that play many important biological roles) in their ability to reduce skin 4) ___. In samples of skin cells, three of the lipids could prevent UV-radiation from both reducing collagen expression and increasing the levels of MMPs; they even increased 5) ___ in undamaged skin cells. Of these three, the molecule phosphatidylserine (PS) seemed the most promising, so it was tested on human skin. They applied a 2% PS solution to small areas of the buttocks in both young and old volunteers. The young skin was subsequently given a dose of UV-radiation to simulate sun damage. In both natural and UV-induced aging, PS treatment prevented collagen 6) ___ and an increase in MMPs when compared to no treatment. While larger and longer trials are needed to confirm any therapeutic benefits, these initial findings suggest 7) ___ PS application might be a simple and natural way to slow down the biological elements underlying wrinkling. (published in the Journal of Lipid Research, 2008;49:1235-1245)

ANSWERS: 1) molecule; 2) damage; 3) enzymes; 4) aging; 5) collagen; 6) reduction; 7) topical