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Purpose: Opioid misuse is increasingly recognized as a relevant problem among patients with cancer. However, the applicability of these concerns for patients with metastatic disease is complicated by shorter prognoses and greater symptom burden. This study aimed to investigate whether nonmedical opioid use (NMOU) was identified as contributing to opioid-related healthcare encounters among patients with metastatic cancer receiving long-term prescribing. Methods: The study included patients with stage IV cancer diagnosed from 2004–2017 in Alberta, Canada who 1) received long-term opioid prescribing and 2) experienced ≥ 1 hospitalization or emergency department visit relating to opioid overdose or use disorder. Records from visits to cancer centres and opioid-related hospital encounters were reviewed to identify any documentation of NMOU. Patient characteristics were compared between those with and without documented NMOU. Results: Charts of 46 patients were reviewed. Although NMOU contributed to opioid-related encounters, these events were often related to poorly controlled pain, declining functional status, and disease progression. NMOU behaviors were documented for 16 (35%) patients. The most common NMOU behaviour was overuse of prescribed medications, which was documented for 12 patients. For 7 patients, there were indications of use of opioids for psychological coping, including 3 encounters caused by intentional overdoses with suicidal intent. Patients with NMOU were significantly more likely to have a history of substance use and limited social support. Conclusion: Approximately 1-in-3 patients experiencing opioid-related hospitalizations/emergency department visits had indications of NMOU. Further psychosocial care and interdisciplinary pain management are warranted to improve safe prescribing for these patients. [ABSTRACT FROM AUTHOR]

In a hip joint environment, the bone-metal implant interface of an implant is exposed to the combined effect of wear and corrosion (tribocorrosion). This may create mechanical instability and cause early failure of the implants. The aim of this work was to investigate the tribocorrosion behavior of Ti6Al4V alloys in the presence of bone-forming cells cultured on its surface (cell-metal interface), using an electrochemical and tribological approach. The results showed that at a cathodic potential (−0.9 V), the presence of osteoblast-like cells and serum proteins in the media might induce a higher passivation rate of the oxide film, enhancing the corrosion resistance. However, when the surface is in steady state (0.7 V) they show a lower resistant to corrosion, increasing the susceptibility to corrosion. [ABSTRACT FROM AUTHOR]