Temporal relationships

Flori and le Vaillant (2004) studied the temporal relationship between the uptake of the more aggressive antiretroviral therapy and the use and cost of hospital treatment for HIV-infected patients in France from 1995 to 2000 from a hospital perspective. The authors found that during this period the proportion of patients on ARV treatment increased from 69.5% to 97%, with a large rise in the use of polytherapy. This increase was most notable for patients with CD4 cell counts above 500. ART expenditures per patient increased between the study years by 220%, reaching US 1,886 in 2000. Unlike that, inpatient hospitalization fell by 60% and average length of stay declined. Thus hospital costs (excluding ART) decreased to US 2,137 in 2000. 

Temporal Relationships of Adverse Events. The temporal relationship between duration of product exposure and development of an adverse event is important in assessing causality. But how can data on temporal relationships be systematically summarized in a database containing thousands or even hundreds of thousands of subjects Temporal relationships cannot be clearly elicited if only frequencies of adverse events between treatment and control groups are compared. There can be many disparities in the subjects time of exposure or time at risk. Toxic manifestations of drugs may not occur until several months or even years after the initial exposure to the drug. How do we systematically assess delayed toxicity of a previously prescribed drug from the effect of a newly prescribed drug Such a scenario occurred with reported cases of pancreatitis associated with valproic acid therapy, in which some cases appeared several years after therapy [2]. 

The phenotype and clinical presentation of antiretroviral toxic neuropathy (ATN) are similar to those of HIV-associated DSP. However, ATN is more likely to be painful, and has an abrupt onset and rapid progression. The main diagnostic clue is the temporal relationship of peripheral neuropathy to the start of NRTI therapy and stabilization, or at least the partial resolution when therapy is interrupted (Moyle and Sadler 1998). ATN most often develops after a mean of 16 to 20 weeks of treatment, unless there are other conditions that lower the threshold. Symptomatic improvement over weeks to months has been reported in two thirds of patients after discontinuation of the offending drug, but may be preceded by an initial period of worsening symptoms, also known as coasting (Berger et al. 1993). Despite the improvement, most patients do not return to a completely asymptomatic state (Hoke and Comblath 2004). 

Zhang J, De Koninck Y (2006) Spatial and temporal relationship between monocyte chemoattractant protein-1 expression and spinal glial activation following peripheral nerve injury. J Neurochem 97 772-783... 

Zeolite minerals (wairakite, laumontite etc.), mixed-layer clay minerals and sme-cite occur in the upper part of the propylitically altered rocks (e.g., Seigoshi, Fuke, Kushikino), but they are sometimes poor in amounts. Generally carbonates are more abundant in the mine area as in the Toyoha district. Temporal relationship between the formation of high temperature propylitic alteration minerals (epidote, actinolite, prehnite) and low temperature propylitic alteration minerals) (wairakite, laumontite, chlorite/smectite, smectite) in these areas (Seigoshi, Fuke, Kushikino) is uncertain. 

Thick sedimentary pile from middle Miocene to late Pliocene is exposed in the Oga Peninsula, northern Honshu, Japan (Fig. 1.153). Age of the sedimentary rocks has been determined by microfossil data. Thus, the sedimentary rocks in the Oga Peninsula where type localities of Miocene sedimentary rocks in northern Japan are well exposed have been studied to elucidate the paleoenvironmental change of the Japan Sea (Watanabe et al., 1994a,b). Kimura (1998) obtained geochemical features of these rocks (isotopic and chemical compositions) and found that regional tectonics (uplift of Himalayan and Tibetan region) affect paleo-oceanic environment (oxidation-reduction condition, biogenic productivity). However, in their studies, no detailed discussions on the causes for the intensity and periodicity of hydrothermal activity, and temporal relationship between hydrothermal activity, volcanism and tectonics in the Japan Sea area were discussed. They considered only the time range from ca. 14 Ma to ca. 5 Ma. 

This belief was further supported by the evidence of a correlation between the clinical response and REM sleep suppression as well as a temporal relationship between the onset of clinical response and REM sleep suppression. However, some of the later studies suggested that REM sleep suppression is not necessary for the antidepressant action (Gillin 1983). For example, some studies show evidence of no change or even an increase in REM sleep with the treatment of depression (Gillin et al. 2001). Recently, Landolt Gillin (Landolt and Gillin 2002) have also demonstrated that the antidepressant response to phenelzine treatment does not depend on elimination of REM sleep or inhibition of slow wave activity in non-REM sleep. However, the generalization of some of these studies is limited because of their small sample size. 

Scholey AB, Moss MC and Wesnes KA (1998). Oxygen and cognitive performance The temporal relationship between hyperoxia and enhanced memory. Psychopharmacology, 140, 123-126. 

FIGURE 10-7 The delay between Ca2+ influx into the nerve terminal and the postsynaptic response is brief. The temporal relationships between the Ca2+ current and the action potential in the nerve terminal and the postsynaptic response in the squid giant synapse are shown. The rapid depolarization (a) and repolarization (b) phases of the action potential are drawn. A major fraction of the synaptic delay results from the slow-opening, voltage-sensitive Ca2+ channels. There is a further delay of approximately 200 is between Ca2+ influx and the postsynaptic response. (With permission from reference [20].)... 

The duration of the skin condition should be determined, and the temporal relationship with any new medications should be established. 

Bryant, H.U., Bemton, E.W., and Holaday, J.W., Morphine pellet-induced immunomodula-tion in mice Temporal relationships, J. Pharmacol. Exp. Then, 245, 913, 1988. 

Levin L.I., et al., Temporal relationship between elevation of Epstein-Barr virus antibody titers and initial onset of neurologic symptoms in multiple sclerosis, JAMA, 293, 2496, 2005. 

The Na-Ca and K-Fe-(Ca) alteration assemblage hosting iron-oxide, copper and gold mineralization and spatial and temporal relationship between mineralization and alteration, as well as the oxide and sulfide mineralogy at amli (Balikesir) suggest that it has characteristics more akin to Fe-oxide-Cu-Au systems. 

Strada, S. J., Sanders-Bush, E., and Sulser, F. (1970) Parachloroamphetamine Temporal relationship between psychomotor stimulation and the metabolism of brain norepinephrine. Biochem. Pharmacol., 19 2621-2626. 

KikuyamaM, TazawaM. Temporal relationship between action potential and Ca2+ transient in Characean cells. Plant Cell Physiol 1998 39 1359-1366. 

Thompson, N. T., Tateson, J. E., Randall, R. W., Spacey, G. D., Bonser, R. W., Garland, L. G. (1990). The temporal relationship between phospholipase activation, diradyl-glycerol formation and superoxide production in the human neutrophil. Biochem. J. 271, 209-13. 

Hewitt LA, Caille G, Plaa GL. 1986b. Temporal relationships between biotransformation, detoxication, and chlordecone potentiation of chloroform-induced hepatotoxicity. Can J Physiol Pharmacol 64(4) 477-482. 

The entire basis of medicine is, quite properly, moving from the art of medicine to the science of medicine, and the reporting of clinical events observed while a patient is receiving a drug should reflect this change of attitude. At the time of observation, apart possibly from a temporal relationship between the administration of a drug and the event, there may be no other evidence on which to base an attribution of causality. In these circumstances, it would be correct to term the observation an event and not a reaction, the latter term being strictly reserved for the situation in which a causal relationship has been reasonably established. The vast majority of spontaneous reports, apart from those... 

Unlikely A clinical event, including laboratory test abnormality, with a temporal relationship to drug administration which makes a causal relationship improbable, and in which other drugs, chemicals or underlying disease provide plausible explanations. 

The judicious use of biological monitoring entails the scheduled administration of the test within the context of the exposure history. The usefulness of urinary concentrations of heavy metals, such as uranium, can be highly dependent upon the time between the collection of the specimen and the last exposure (12). The assessment of blood cholinesterase levels is similarly dependent upon the temporal relationship between the administration of the test and the exposure (13). The designation of an exposure or medical parameter as normal or abnormal can be made in relationship to the individuals baseline status 0,J ) or in reference to results from a statistically generated reference group (14,15). 

It is these interests, based on alternative rewards and motivated by their temporal relationships to act upon one another, that would be the choice-making agents in a picoeconomic approach. I will argue that the moves they are motivated to make can be expected to generate the... 

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