Carbon dioxide conversion via reverse water-gas shift reaction: Reactor design.

The reverse water gas shift (RWGS) reaction converts carbon dioxide (CO2) and hydrogen (H2) to syngas, which is used to produce various high-added-value chemicals. This process has attracted great interest from researchers as a way of mitigating the potential environmental impacts of this greenhouse gas, with emphasis on global warming. This work aims to model and simulate an industrial catalytic reactor using kinetic data for the RWGS reaction. The simulation was carried out in Aspen Plus® v10. The thermodynamic analysis showed that the appropriate conditions for the reaction are feed molar ratio (H2/CO2) of 0.8:1, 750 °C, and 20 bar. The RWGS process proceeds in a multi-tubular fixed bed reactor with 36.26% CO2 conversion and 96.41% CO selectivity, at residence times in the order of 2.7 s. These results are at near-equilibrium CO2 conversion with higher CO selectivity.

Avaliação Geriátrica Ampla (AGA) como ferramenta na condução de pacientes idosos anticoagulados / Comprehensive Geriatric Assessment (AGA) as a tool in the management of anticoagulated elderly patients

INTRODUÇÃO: A avaliação geriátrica ampla (AGA) é composta por diversos domínios e avalia a condição clínica, cognitiva, funcional, nutricional e social de pacientes idosos. Contribui para a predição de desfechos adversos e a decisão da melhor abordagem terapêutica. Pode-se considerá-la na avaliação de risco e condução de idosos portadores de fibrilação atrial (FA) com indicação de anticoagulação. Tanto no manejo da anticoagulação quanto na adequada aplicação da AGA, a equipe multiprofissional tem papel central. Este estudo tem como objetivo avaliar a importância da AGA como ferramenta de suporte na avaliação de idosos, portadores de FA e anticoagulados com varfarina. MÉTODOS: Estudo retrospectivo, descritivo e observacional, a partir de dados de prontuário, no período do primeiro semestre de 2021. Foram selecionados pacientes com 70 anos ou mais, portadores de FA e anticoagulados com varfarina, acompanhados em ambulatório de cardiogeriatria e para os quais a AGA havia sido aplicada durante avaliação de rotina. A AGA realizada incluía exame clínico, avaliação de comorbidades, fragilidade (escala de Frail), funcionalidade (escalas de Katz e Lawton), risco de depressão, função cognitiva, suporte social e estado nutricional. Para estratificação do risco tromboembólico foi usado o escore CHA2DS2VASc. As variáveis quantitativas foram apresentadas em forma de média e desvio padrão, com valores expressos em percentuais. RESULTADOS: Foram avaliados 119 pacientes portadores de FA e anticoagulados com varfarina. Observou-se idade média de 78,5 anos (+ 3,7) e predomínio do sexo feminino (52%). As comorbidades mais prevalentes, além da FA, foram hipertensão arterial sistêmica (80%) e diabetes melitos (40%). O CHA2DS2VASc médio foi de 4,6 (± 1,03). O RNI encontrava-se dentro da faixa preconizada (2,0 - 3,0) em 58,4 % das avaliações pelo método Rosendall. Fragilidade foi observada em 29%, funcionalidade comprometida em 78%, risco nutricional em 20%, humor deprimido em 40% e risco de quedas em 50%. Risco social não foi identificado. CONCLUSÃO: A AGA pode ser ferramenta adicional importante na avaliação clínica desses pacientes, contribuindo para ajuste na prescrição da anticoagulação, bem como para tomada de decisão referente a sua continuidade ou suspensão.

Avaliação Geriátrica Ampla (AGA) como instrumento na decisão terapêutica de pacientes idosos com estenose valvar aórtica grave / Comprehensive Geriatric Assessment (AGA) as a tool in the therapeutic decision of elderly patients with severe aortic valve stenosis

INTRODUÇÃO: A avaliação geriátrica ampla (AGA) otimiza a identificação de componentes cognitivos, psíquicos, funcionais, nutricionais e sociais que afetam a saúde do idoso, contribuindo para a predição de desfechos adversos e melhorando a decisão terapêutica. Sabe-se que, no perioperatório, a AGA é capaz de reduzir complicações pós-operatórias e tempo de internação. Assim, pode-se considerar seu uso como instrumento adicional na avaliação pré-operatória de cirurgias cardíacas, especialmente troca valvar aórtica. Este estudo tem como objetivo avaliar a importância da AGA como instrumento na indicação de cirurgias cardíacas eletivas em idosos. MÉTODOS: Estudo retrospectivo, descritivo e observacional, a partir de dados de prontuário, de outubro de 2018 a dezembro de 2021. Selecionados pacientes com 70 anos ou mais, estenose valvar aórtica (EAo) grave e indicação de intervenção, acompanhados em ambulatório e para os quais a AGA havia sido aplicada na pré-operatório. A AGA era composta por exame clínico, avaliação de comorbidades, fragilidade (Frail), funcionalidade (Katz e Lawton), risco de depressão, função cognitiva, suporte social e estado nutricional. Para estratificação do risco cirúrgico usou-se o EUROSCORE II. As variáveis quantitativas foram apresentadas em forma de média e desvio padrão, com valores expressos em percentuais. RESULTADOS: Foram avaliados 48 pacientes com EAo grave e indicação de intervenção. Observou-se idade média de 78,5 anos (+ 5,8), predomínio do sexo masculino (60%), área valvar média de 0,7cm² (+ 0,19) e classe funcional III em 28% dos casos. As comorbidades mais prevalentes foram hipertensão arterial sistêmica (80%) e diabetes melitos (42%). Polifarmácia identificada em 60% dos casos, fragilidade em 52%, funcionalidade comprometida em 28%, provável déficit cognitivo em 26%, risco nutricional em 33%, humor deprimido em 28% e risco de quedas em 36%. Risco social não identificado. EUROSCORE II de alto risco observado em 12% dos casos, apresentando relação positiva com fragilidade. Estes pacientes foram mantidos em tratamento clínico (50%) ou submetidos a procedimento percutâneo (TAVI - 50%). Os demais, de baixo ou intermediário risco, apresentaram fragilidade associada em 11% dos casos, sendo optado por tratamento clínico. Deste modo, observou-se que, na tomada de decisão, a avaliação de fragilidade prevaleceu em relação a avaliação de risco habitual. CONCLUSÃO: A AGA mostra-se como ferramenta auxiliar importante na avaliação pré-operatória de pacientes idosos com EAo grave, sendo determinante na escolha da melhor terapêutica.

Colorectal cancer in the young - outcomes following surgical management?

INTRODUCTION: Colorectal cancer (CRC) is the third most common cancer, accounting for approximately 10% of all cancer deaths. The incidence of CRC in young adults and the adolescent population is increasing. This study aims to highlight short-term outcomes for young patients with CRC. METHODS: Data were collected retrospectively for all patients aged less than 50 years diagnosed with CRC at a university teaching hospital between October 2012 and June 2018. The primary endpoints were disease-free survival (DFS) and overall survival (OS). RESULTS: A total of 120 patients (65 males, 55 females) with CRC aged under 50 years were initially included; 20 did not receive surgical treatment (12 metastatic adenocarcinoma, 5 metastatic squamous cell cancer (SCC), 3 neuroendocrine tumours (NET)), and 13 patients had insufficient data for analysis and were excluded. A total of 87 patients underwent surgical intervention and 66 with diagnosis of adenocarcinoma were included in survival analysis. Median age of patients was 42 years (19-49 years). Cancer recurrence was seen in 14 patients, 10 showing local, 3 liver and 1 lung metastasis. The median OS was 28 months (3-156 months). The median DFS was 13 months (3-85 months). Overall 5-year survival and DFS were 72% and 59%, respectively. Median survival in the group who did not undergo surgery was 4.5 months (1-15 months). CONCLUSIONS: CRC is often more advanced and aggressive in younger patients. Current guidelines can result in young patients being investigated/treated for other gastrointestinal conditions before referral for CRC investigation.

Pneumococcal pneumonia and carriage in Africa before and after introduction of pneumococcal conjugate vaccines, 2000-2019: protocol for systematic review.

INTRODUCTION: Africa harbours a high burden of pneumococcal disease, with associated high mortality rates. Despite 34 countries introducing the pneumococcal conjugate vaccine, which reduces the risk of pneumococcal carriage (a prerequisite for disease) of some of the most pathogenic pneumococcal serotypes, it remains uncertain whether they will achieve the sustained direct or indirect protection necessary to reduce pneumococcal carriage to levels sufficient to interrupt transmission and disease. We will therefore summarise the available data on the impact of the pneumococcal conjugate vaccine in reducing vaccine serotype carriage and pneumococcal pneumonia in Africa between 2000 and 2019. METHODS AND ANALYSIS: Using a predetermined search strategy, we will conduct a comprehensive search of PubMed, MEDLINE database, the Excerpta Medica Database, the ISI Web of Science (Science Citation Index), Scopus and the African Index Medicus to identify published studies reporting the prevalence of Streptococcus pneumoniae carriage (vaccine type and non-vaccine type), incidence rates of pneumococcal pneumonia and mortality among children, adults and HIV-infected (all-ages) pre-pneumococcal conjugate vaccine (PCV) and post-PCV introduction (published between 1st January 2000 and 31st December 2019) in African countries that have introduced PCVs (PCV7/PCV10/PCV13) in their routine national immunisation programme. The studies retained and data extracted will be assessed for bias using prevalidated tools and checklists. Heterogeneity across studies will be assessed using the χ2 test on Cochrane Q statistic. A random effect meta-analysis will be used to estimate the overall prevalence of pneumococcal carriage and incidence of pneumococcal pneumonia across studies with similar characteristics. Results will be reported in compliance with the Meta-Analysis Of Observational Studies in Epidemiology guidelines. The protocol has been prepared in accordance to the 2015 guidelines on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. ETHICS AND DISSEMINATION: This systematic review will not require ethical approval as we will be using already published data. The final manuscript will be submitted for publication in a peer-reviewed journal and presented at conferences. PROSPERO REGISTRATION NUMBER: CRD42019130976.

Prevalência de síndrome coronariana aguda em octogenários segundo sexo / Prevalence of Acute Coronary Syndrome in Octogenarians by sex

INTRODUÇÃO: A doença cardiovascular e, em particular, a doença arterial coronariana, são as principais causas de morbidade e mortalidade em pessoas muito idosas (> 80 anos) em todo o mundo. Esses pacientes representam uma coorte em rápido crescimento para intervenção coronária percutânea (ICP). Os pacientes, geralmente, apresentam doença coronariana complexa, avançada, com extensa calcificação, anatomia vascular tortuosa, múltiplas comorbidades e maior taxa de mortalidade que levam a uma menor indicação do procedimento neste subgrupo. OBJETIVO: Avaliar as diferenças em octogenários quanto à forma de apresentação de DAC em ambulatório de Cardiogeriatria. METODOLOGIA: Estudo retrospectivo, descritivo e observacional, realizado de janeiro de 2013 a abril de 2017. Variáveis quantitativas foram analisadas por média e desvio padrão, e variáveis qualitativas em valores absolutos e/ou percentuais. RESULTADOS: De 165 octogenários, 41% do sexo feminino e 59% masculino. Entre as mulheres, 69 pacientes, a idade média de 82,6 anos, AE em 22%, AI 12%, IAMSST 33%, IAMCST 7%, Clearance de creatinina médio de 52,2ml/min, Fração de Ejeção (FE) média= 59%, Lesão de tronco em 21% e óbitos = 4%. Entre os homens, 96 pacientes, a idade média de 83,09 anos, Angina Estável em 33%, Angina Instável 10%, Infarto Sem Supra de ST em 29%, Infarto com Supra de ST (IAMCST) em 17%, Clearance de creatinina médio de 54,3ml/min, FE média= 53%, Lesão de tronco em 40% e óbitos = 4%. CONCLUSÃO: Observou-se alta prevalência de DAC em octogenários, predominando IAMCST em homens, com tendência maior de lesão de tronco de coronária esquerda. Não houve diferença de mortalidade quanto do sexo. (AU)

On-site test to detect syphilis in pregnancy: a systematic review of test accuracy studies.

BACKGROUND: Syphilis in pregnancy can lead to fetal and neonatal death or congenital anomalies. Accurate on-site tests are an essential part of effective prevention of mother-to-child transmission of the disease. OBJECTIVE: This systematic review assessed the accuracy of on-site tests to detect infection with Treponema pallidum in pregnant women. SEARCH STRATEGY: Major databases were searched from inception to January 2016 using terms: 'pregnancy', 'antenatal', 'syphilis', 'Treponema pallidum' with their variations, and the search limit for the relevant study design. SELECTION CRITERIA: We included studies that used dual reference standard (non-treponemal and treponemal tests) to detected syphilis in pregnancy. DATA COLLECTION AND ANALYSIS: Extracted accuracy data were tabulated and pooled using hierarchical, bivariate random effects model. MAIN RESULTS: Seven studies (combined sample 17 546) reporting the accuracy of four on-site tests met the eligibility criteria. On average, Determine™ and SD BioLine Syphilis 3.0 had the highest sensitivity of all the evaluated tests: 0.83 (95% CI 0.58, 0.98) and 0.86 (95% CI 0.82, 0.89), respectively, with a high specificity 0.96 (95% CI 0.89, 1.00) and 0.99 (95% CI 0.94, 1.00), respectively. The Qualitative Rapid Plasma Reagin card commonly used in clinical practice had a pooled sensitivity of 0.70 (95% CI 0.54, 0.88) and specificity of 0.97 (95% CI 0.96, 0.99). CONCLUSION: Immunochromatographic tests such as Determine™ and SD BioLine Syphilis 3.0 seem to be acceptable options in antenatal testing for syphilis, especially in resource-limited settings. Future research should seek more evidence to strengthen this claim. TWEETABLE ABSTRACT: On-site test to detect syphilis-options during antenatal care.

Translation Hypersurfaces with Constant Sr Curvature in the Euclidean Space.

The main goal of this paper is to present a complete description of all translation hypersurfaces with constant r -curvature S r , in the Euclidean space ℝ n + 1 , where 3 ≤ r ≤ n - 1 .

Assessment of Central Corneal Thickness in Different Subtypes of Systemic Sclerosis.

PURPOSE: To compare central corneal thickness between patients with diffuse cutaneous systemic sclerosis and limited cutaneous systemic sclerosis. METHODS: A total of 53 consecutive patients with systemic sclerosis were enrolled in this study. All subjects were screened for age, gender, classification of disease subtype, autoantibody profile, duration of disease, organ involvement, current treatment, tear break-up time, Schirmer test, and measurement of the central corneal thickness with an ultrasonic pachymeter. RESULTS: No statistically significant differences were found in terms of age, sex, and duration of the disease, and dry eye evaluation between systemic sclerosis subsets. The mean central corneal thickness was 535.3 ± 37.6 µm (range, 471-619 µm) in diffuse cutaneous systemic sclerosis patients, and 539.3 ± 37.1 µm (range, 484-651 µm) in limited cutaneous systemic sclerosis (p = 0.71). CONCLUSIONS: Central corneal thickness in patients with diffuse cutaneous systemic sclerosis is not different from the one in limited cutaneous systemic sclerosis.

Silsesquioxane organofunctionalized with 4-amino-3-hydrazino-5-mercapto-1,2,4-triazole: Preparation and subsequent reaction with silver and potassium hexacyanoferrate(III) for detection of L-cysteine.

The octakis(3-chloropropyl)octasilsesquioxane (SS) was organofunctionalized with 4-amino-3-hydrazino-5-mercapto-1,2,4-triazole (Purpald). The functionalized silsesquioxane with Purpald (SP) was characterized by Fourier transform infrared spectroscopy (FT-IR), and nuclear magnetic resonance (NMR). After functionalized, silsesquioxane can interact with silver nitrate and subsequently with potassium hexacyanoferrate (III) (AgHSP). The novel hybrid composite formed (AgHSP) was characterized by Fourier transform infrared spectra, scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDX). AgHSP was electrochemically characterized by cyclic voltammetry (CV) using graphite paste electrode. The AgHSP incorporated into a graphite paste electrode (20% w/w) was tested for detection of l-cysteine. The modified electrode showed a linear response from 9.0 × 10(-5) to 5.0 × 10(-3)mol L(-1) with the corresponding equation Y(A)=0.01315+1.865 [l-cysteine], and a correlation coefficient of r(2)=0.9995. The method showed a detection limit of 1.76×10(-4)mol L(-1) with a relative standard deviation of ± 2% (n=3) and amperometric sensitivity of 1.865 A/mol L(-1).

Intraocular pressure in chronic users of low-dose oral corticosteroids for connective tissue disease.

OBJECTIVE: To investigate the mean intraocular pressure (IOP) of patients with connective tissue disease (CTD) on low-dose chronic systemic corticosteroid therapy and compare with control subjects. DESIGN: Cross-sectional comparative study. PARTICIPANTS: A total of 86 patients with CTD were grouped according to corticosteroid therapy. Group 1 (n = 27) was composed of patients with CTD receiving low-dose systemic corticosteroid therapy (<10 mg prednisone or its equivalent oral corticosteroid) for at least 6 months, and group 2 (n = 59) included patients with CTD without use of corticosteroid therapy. Group 3 (n = 20) was composed of healthy control subjects. METHODS: All patients underwent a complete ophthalmic evaluation by an experienced investigator and had their clinical records reviewed by another independent investigator. IOP was measured by Goldmann applanation tonometry. RESULTS: In all 3 groups, the IOPs were within the normal range. The mean IOP was 13.1 ± 2.7 mm Hg (range 8-19 mm Hg) in the CTD corticosteroid group (group 1), 13.7 ± 2.7 mm Hg (range 9-22 mm Hg) in CTD group without corticosteroid therapy (group 2), and 13.1 ± 1.6 mm Hg (range 10-16 mm Hg) in the control group (group 3). No significant differences in IOP were observed among the 3 groups (p = 0.50). CONCLUSIONS: Patients under chronic treatment with low-dose systemic corticosteroid therapy for CTD presented with IOP within the normal range, not clinically significant different from the IOP of patients with CTD without any steroid therapy or from healthy control subjects.

Preconcentration and determination of metal ions from fuel ethanol with a new 2,2'-dipyridylamine bonded silica.

A silica surface chemically modified with [3-(2,2'-dipyridylamine) propyl] groups was prepared, characterized, and evaluated for its metal ion preconcentration in fuel ethanol. To our knowledge, we are the first authors who have reported the present modification on silica gel surface. The material was characterized using infrared spectra, scanning electronic microscopy, and (13)C and (29)Si solid-state NMR spectra. Batch and column experiments were conducted to investigate for metal ion removal from fuel ethanol. The results showed that the Langmuir model describes the sorption equilibrium data of the metal ions in a satisfactory way. From the Langmuir isotherms, the following maximum adsorption capacities (in mmol g(-1)) were determined: 1.81 for Fe(III), 1.75 for Cr(III), 1.30 for Cu(II), 1.25 for Co(II), 1.15 for Pb(II), 0.95 for Ni(II), and 0.87 for Zn(II). Thermodynamic functions, the change of free energy (ΔG), enthalpy (ΔH), and entropy (ΔS) showed that the adsorption of metal ions onto Si-Pr-DPA was feasible, spontaneous, and endothermic. The sorption-desorption of the metal ions made possible the development of a preconcentration and quantification method of metal ions in fuel ethanol.

Study on soluble heavy metals with preconcentration by using a new modified oligosilsesquioxane sorbent.

In this work, a new modified oligosilsesquioxane was prepared, characterized and evaluated for its heavy metal adsorption characteristics from aqueous solution. The material was characterized using infrared spectroscopy, X-ray diffractometry, solid-state (29)Si and (13)C nuclear magnetic resonance. Batch and column experiments were conducted to investigate for Fe (III), Cr (III), Cu (II), Cd (II), Pb (II) and Ni (II) removal from dilute aqueous solution by sorption onto modified oligosilsesquioxane. The results obtained in the flow experiments, showed a recovery of ca. 100% of the metal ions adsorbed in a column packed with 2.0 g of nanomaterial, using 3 mL of 1.0 mol L(-1) HCl solution as eluent. The detection limits for Fe, Cr, Cu, Cd, Pb, and Ni were 0.26, 0.33, 0.38, 0.41, 0.47 and 0.55 µg L(-1), respectively. The relative standard deviation values (n=12) were <4.82% for Fe, <4.12% for Cr, <3.79% for Cu, <3.03% for Cd, <4.02% for Pb and <2.65% for Ni. The proposed method was successfully applied to the analysis of environmental samples.

The effects of increased testicular temperature on testis-specific isoform of Na+/K+ -ATPase in sperm and its role in spermatogenesis and sperm function.

Impaired testicular thermoregulation is commonly implicated in abnormal spermatogenesis and impaired sperm function in animals and humans, with outcomes ranging from subclinical infertility to sterility. Bovine testes must be maintained 4-5 °C below body-core temperature for normal spermatogenesis. The effects of elevated testicular temperature have been extensively studied in cattle using a scrotal insulation model, which results in abnormal spermatogenesis and impaired sperm morphology and function. Using this model and proteomic approaches, we compared normal and abnormal sperm (from the same bulls) to elucidate the molecular basis of impaired function. We identified a cohort of sperm functional proteins differentially expressed between normal vs abnormal sperm, including a testis-specific isoform of Na(+) /K(+) -ATPase. In addition to its role as a sodium pump regulating sperm motility, Na(+) /K(+) -ATPase is also involved as a signalling molecule during sperm capacitation. In conclusion, because of its involvement in regulation of sperm function, this protein has potential as a fertility marker. Furthermore, comparing normal vs abnormal sperm (induced by scrotal insulation) is a useful model for identifying proteins regulating sperm function.

Delays in treating endometrial cancer in the South West of England.

BACKGROUND: Poor cancer survival rates in the United Kingdom are often blamed on delayed medical care. A local audit of endometrial cancer revealed a variety of preventable delays. We surveyed practice in the South West of England to see if this was an isolated or widespread problem. METHODS: All 15 hospitals in the South West of England collected information prospectively from all women with endometrial cancer over 3 months in the spring of 2009. RESULTS: There were delays in all stages of the uterine cancer pathway. Excluding extraneous cases, 52% of women waited more than a month and 12% waited more than 6 months to see their GP from the onset of symptoms. Almost half the cases said they were unaware that abnormal bleeding was a symptom of cancer. Only a quarter of women had treatment within 31 days from the outpatient visit to first definitive treatment and 18% waited more than the target of 62 days for their treatment. CONCLUSIONS: Significant treatment delays occur because women do not report bleeding. If this is replicated throughout Britain, approximately 1000 women per year will delay presentation for at least 3 months and 600 will wait for more than 6 months.

Controlled release system for ametryn using polymer microspheres: preparation, characterization and release kinetics in water.

The purpose of this work was to develop a modified release system for the herbicide ametryn by encapsulating the active substance in biodegradable polymer microparticles produced using the polymers poly(hydroxybutyrate) (PHB) or poly(hydroxybutyrate-valerate) (PHBV), in order to both improve the herbicidal action and reduce environmental toxicity. PHB or PHBV microparticles containing ametryn were prepared and the efficiencies of herbicide association and loading were evaluated, presenting similar values of approximately 40%. The microparticles were characterized by scanning electron microscopy (SEM), which showed that the average sizes of the PHB and PHBV microparticles were 5.92±0.74 µm and 5.63±0.68 µm, respectively. The ametryn release profile was modified when it was encapsulated in the microparticles, with slower and more sustained release compared to the release profile of pure ametryn. When ametryn was associated with the PHB and PHBV microparticles, the amount of herbicide released in the same period of time was significantly reduced, declining to 75% and 87%, respectively. For both types of microparticle (PHB and PHBV) the release of ametryn was by diffusion processes due to anomalous transport (governed by diffusion and relaxation of the polymer chains), which did not follow Fick's laws of diffusion. The results presented in this paper are promising, in view of the successful encapsulation of ametryn in PHB or PHBV polymer microparticles, and indications that this system may help reduce the impacts caused by the herbicide, making it an environmentally safer alternative.

Takayasu's Arteritis: an important cause of stroke in younger patients.

Stroke in young patients is important and early diagnosis of Takayasu's Arteritis as the cause will assist in acute management. A retrospective notes review of six patients presenting with acute neurological symptoms secondary to TA was performed. Three male and three female patients (mean age of 32.2 years) were identified. Neurological presentations included four ischaemic strokes, one TIA, and one syncopal episode. Pulse loss, bruit, or a difference in brachial blood pressures was evident in five patients at presentation. 4 patients had a previous history of TIA, 3 had prior ischaemic limb symptoms and 1 had prodromal symptoms. A history of limb ischaemia, prodromal symptoms, absent pulses and asymmetric blood pressure should alert the clinician to possible TA.

Clinical practice recommendations for depression.

OBJECTIVE: To provide clinically relevant evidence-based recommendations for the management of depression in adults that are informative, easy to assimilate and facilitate clinical decision making. METHOD: A comprehensive literature review of over 500 articles was undertaken using electronic database search engines (e.g. MEDLINE, PsychINFO and Cochrane reviews). In addition articles, book chapters and other literature known to the authors were reviewed. The findings were then formulated into a set of recommendations that were developed by a multidisciplinary team of clinicians who routinely deal with mood disorders. The recommendations then underwent consultative review by a broader advisory panel that included experts in the field, clinical staff and patient representatives. RESULTS: The clinical practice recommendations for depression (Depression CPR) summarize evidence-based treatments and provide a synopsis of recommendations relating to each phase of the illness. They are designed for clinical use and have therefore been presented succinctly in an innovative and engaging manner that is clear and informative. CONCLUSION: These up-to-date recommendations provide an evidence-based framework that incorporates clinical wisdom and consideration of individual factors in the management of depression. Further, the novel style and practical approach should promote uptake and implementation.