Current opinion in pulmonary medicine
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In various studies, it has been postulated that pharyngeal collapse occurring during sleep in obstructive sleep apnea may be alleviated by stimulating the genioglossus muscle. Basic experiments have demonstrated that neuromuscular stimulation applied intraorally via electrodes or by direct neural stimulation of the hypoglossal nerve might improve upper airway and respiratory function. ⋯ An impairment of sleep quality during electric stimulation has been excluded simultaneously. Considering clinical aspects, anatomical properties and long-term experience in electric stimulation it might be possible to develop full implantable devices as an alternative treatment for patients with obstructive sleep apnea.
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Despite significant progress in therapy for cystic fibrosis (CF), most patients with the disease still die before the age of 30 years. Published discussions and descriptions of end-of-life care of patients with CF have been few, but interest in these issues is increasing. ⋯ Advanced care planning offers an opportunity for persons with CF to actively influence the type of care they will receive. Still, more empiric research and ethical discussion is needed to facilitate optimal end-of-life care of patients with CF.