RESUMO
OBJECTIVES: To review the clinical and social benefits of a pain management programme in Hong Kong. DESIGN: Prospective cohort study. SETTING: Tertiary out-patient clinic, Hong Kong. PARTICIPANTS: Patients with chronic non-cancer pain and prolonged (mean, 46 months) psychosocial disability who joined the Comprehensive Outpatient Pain Engagement programme between 2002 and 2012. INTERVENTION: A structured 6-week out-patient pain rehabilitation course designed to improve function and reduce disability, regardless of the cause or severity of pain. MAIN OUTCOME MEASURES: Social outcomes included return-to-work rate, hospital admissions, and out-patient visits. Physical outcomes included tolerance to sitting and standing. Psychological constructs such as mood, catastrophisation, self-efficacy, quality of life, and perceived performances were used. Each measure was taken before and 1 year after the programme. RESULTS: There was significant increase in return-to-work rate 1 year after commencement of the programme (35% after vs 17% before the programme; odds ratio=3.01), reduction in medical utilisation, and improvement in all physical and psychological measures. Pain intensity, psychological distress, and history of work-related injuries were not related to the likelihood of return to work. Shorter duration of pain and higher physical functioning score in 36-Item Short-Form Health Survey were prognostic indicators. CONCLUSIONS: Patients with chronic pain who joined the Comprehensive Outpatient Pain Engagement programme showed significant functional improvement despite the long history of pain.
Assuntos
Dor Crônica/reabilitação , Avaliação da Deficiência , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Manejo da Dor/métodos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Adulto , Povo Asiático , Dor Crônica/psicologia , Feminino , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Visita a Consultório Médico/estatística & dados numéricos , Pacientes Ambulatoriais/psicologia , Pacientes Ambulatoriais/estatística & dados numéricos , Manejo da Dor/estatística & dados numéricos , Medição da Dor/psicologia , Medição da Dor/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Estudos Prospectivos , Qualidade de Vida , Retorno ao Trabalho/estatística & dados numéricos , Adulto JovemRESUMO
The mTOR alpha4 phosphoprotein is a prolactin (PRL)-downregulated gene product that is found in the nucleus of PRL-dependent rat Nb2 lymphoma cells. Alpha4 lacks a nuclear localization signal (NLS) and the mechanism of its nuclear targeting is unknown. Post-translational modification by O-linked beta-N-acetylglucosamine (O-GlcNAc) moieties has been implicated in the nuclear transport of some proteins, including transcription factor Sp1. The nucleocytoplasmic enzymes O-beta-N-acetylglucosaminyltransferase (OGT) and O-beta-N-acetylglucosaminidase (O-GlcNAcase) adds or remove O-GlcNAc moieties, respectively. If O-GlcNac moieties contribute to the nuclear targeting of alpha4, a decrease in O-GlcNAcylation (e.g., by inhibition of OGT) may redistribute alpha4 to the cytosol. The present study showed that alpha4 and Sp1 were both O-GlcNAcylated in quiescent and PRL-treated Nb2 cells. PRL alone or PRL + streptozotocin (STZ; an O-GlcNAcase inhibitor) significantly (P Assuntos
Acetilglucosamina/química
, Acetilglucosamina/metabolismo
, Linfoma/metabolismo
, Fosfoproteínas/metabolismo
, Fator de Transcrição Sp1/química
, Fator de Transcrição Sp1/metabolismo
, Acetilglucosaminidase/genética
, Acetilglucosaminidase/metabolismo
, Aloxano/metabolismo
, Animais
, Linhagem Celular Tumoral
, Inativação Gênica
, Isoenzimas/química
, Isoenzimas/metabolismo
, Fosfoproteínas Fosfatases/química
, Fosfoproteínas Fosfatases/metabolismo
, Fosfoproteínas/química
, Prolactina/metabolismo
, Processamento de Proteína Pós-Traducional
, RNA Interferente Pequeno/genética
, RNA Interferente Pequeno/metabolismo
, Ratos
, Estreptozocina/metabolismo