Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Asymptomatic intradialytic hypotension: the need for pre-emptive intervention

Intradialytic hypotension (IDH) remains the most common severe side effect of hemodialysis despite numerous technological advancements. Recent evidence emphasises the significance of asymptomatic hypotensive episodes, as well as the hypoperfusive consequences of both relative blood pressure drops and repetitive, symptomatic events. This article reviews the physiological importance of rapid blood pressure decrease during hemodialysis, and highlights the pathological consequences of repeated asymptomatic and symptomatic hypoperfusive episodes. In proposing a view concerned with asymptomatic IDH, a practicalpre-emptive intervention is offered to improve the long-term outcomes of patients on hemodialysis. Ongoing monitoring of individual patient\u27s mean arterial pressure (MAP) throughout the dialysis treatment can facilitate the identification of an asymptomatic hypotensive episode. A brief pause in ultrafiltration enables vascular refill and subsequent increase in MAP, allowing resumption of safe fluid removal. Such enhanced assessment results in a reduction off patient risk, allowing safe and optimal fluid removal

Intradialytic hypotension prevention and management knowledge and practices: Results from a survey of Australian and New Zealand nephrology nurses

Intradialytic hypotension (IDH) remains the most frequent serious side effect of hemodialysis, increasing morbidity in patients on hemodialysis. Nephrology nurses have a critical role in the prevention and management of IDH. The aim of this study was to investigate nephrology nurse knowledge and practice habits in the prevention and management of IDH. This was an explorative cross-sectional design, web-based survey of Australian and New Zealand nephrology nurses (n = 173). IDH definitions, blood pressureinterpretation, and IDH interventions were inconsistent and not always evidencebased.Demographic characteristics had little impact on the variation in responses. A universal definition for IDH may improve early recognition of the problem. Formal guidelines in considering individualized interventional strategies for asymptomaticepisodes prior symptomatic IDH occurrence may improve outcomes for patients on hemodialysi