Two new flavonol glycosides and a metabolite profile of Bryophyllum pinnatum, a phytotherapeutic used in obstetrics and gynaecology

Bryophyllum pinnatum is a succulent perennial plant native to Madagascar which is used in anthroposophical medicine to treat psychiatric disorders and as a tocolytic agent to prevent premature labour. We performed a metabolite profiling study in order to obtain a comprehensive picture of the constituents in B. pinnatum leaves and to identify chromatographic markers for quality control and safety assessment of medicinal preparations. Preliminary HPLC-PDA-ESIMS analyses revealed that flavonoid glycosides were the main UV-absorbing constituents in the MeOH extract of B. pinnatum. Two phenolic glucosides, syringic acid β-D-glucopyranosyl ester (1) and 4'-O-β-D-glucopyranosyl-cis-p-coumaric acid (2), as well as nine flavonoids (3-11) including kaempferol, quercetin, myricetin, acacetin, and diosmetin glycosides were unambiguously identified by 1H and 2D NMR analysis after isolation from a MeOH extract. The flavonol glycosides quercetin 3-O-α-L-arabinopyranosyl-(1 → 2)-α-L-rhamnopyranoside 7-O-β-D-glucopyranoside (3) and myricetin 3-O-α-L-arabinopyranosyl-(1 → 2)-α-L-rhamnopyranoside (4) were new natural products. With the aid of HPLC-PDA-APCIMS and authentic references isolated from the related species B. daigremontianum, the presence of four bufadienolides, bersaldegenin-1-acetate (12), bryophyllin A (13), bersaldegenin-3-acetate (14), and bersaldegenin-1,3,5-orthoacetate (15) was detected in B. pinnatum.

The Hamburg-Model of Integrated Care for Patients with Psychosis: Part 1

Objective: The "Hamburg model" designates an integrated care model for severely ill patients with psychotic disorders financed by the health insurance system in accordance with § 140 SGB V.Methods: It comprises comprehensive and long-term treatment within a regional network of the psychosis center of the University Medical Center Hamburg-Eppendorf (UKE) and private psychiatrists. The treatment model consists of therapeutic assertive community treatment (ACT) provided by a highly specialized treatment team and need-adapted in- and outpatient care.Results and conclusions: The present article summarizes the disease- and treatment-specific rationales for the model development as well as the model structure and treatment contents. The article further summarizes the effectiveness and efficiency results of a study comparing the Hamburg model and treatment as usual (without ACT) within a 12-month follow-up study (ACCESS trial).

The Hamburg-Model of Integrated Care for Patients with Psychosis: Part 2

Objective: Since the beginning of the integrated care model for severely ill patients with psychotic disorders ("Hamburg model") in 2007 different clinical parameters have been consecutively assessed within a naturalistic, observational, prospective study.Methods: Clinical outcome of the 2-year and 4-year follow-ups of n = 158 patients.Results: A significant and ongoing improvement of psychopathology, severity of illness, functional outcome, quality of life and satisfaction with care in this sample of severely ill and merely chronic patients with psychosis was shown. Moreover, medication adherence improved and quality and quantity of outpatient treatment increased.Conclusion: The ongoing psychosocial stabilisation of the patients most likely result from a combination of various factors: continuity of care, multimodal and individualized care, therapeutic specialisation and the multidisciplinary ACT team. Results provide clinical and scientific evidence for future implementations of the integrated care model "Hamburg Model" for the treatment of psychosis.

Biographien und Netzwerke im Kaffeehandel zwischen Deutschland und Zentralamerika, 1920-1959

Kaffee ist nicht nur ein beliebtes Getränk, sondern vernetzte auch unterschiedliche Welten: Der Kaffeehandel band Hamburg und Bremen in transnationale Netzwerke ein, die sich zwischen Europa und Lateinamerika erstreckten. Zentralamerika war für den globalen Kaffeehandel wichtig, weil die Region als erste die „nasse“ Form der Aufbereitung einführte. Die hohe Qualität dieser „gewaschenen“ Kaffees machte sie auf dem Weltmarkt begehrt. Deutsche Einwanderer prägten die Handelsverbindungen zwischen den zentralamerikanischen Kaffee-Anbauregionen und den norddeutschen Hafenstädten: Sie gründeten Exportfirmen, erwarben Kaffeeplantagen und beteiligten sich an der Vorfinanzierung der Ernten. Christiane Berth analysiert Biografien und Netzwerke deutscher Kaffee-Akteure in Guatemala, Costa Rica und Chiapas. Dabei zeigt sie, wie deren Handelsnetzwerke durch wirtschaftliche Krisen und neue außenpolitische Konstellationen brüchig wurden, im Nationalsozialismus unter Druck gerieten und während des Zweiten Weltkrieges zerbrachen. Trotzdem blieben auch in der Nachkriegszeit Handelsbeziehungen zwischen Nationalstaaten, Netzwerke in der Kaffeebranche und Biografien der Kaffee-Akteure eng miteinander verknüpft.

Kaffeewelten. Historische Perspektiven auf eine globale Ware im 20. Jahrhundert

Kaffee war im 20. Jahrhundert wichtige Handelsware und heißgeliebtes Konsumgut. Der Sammelband beleuchtet Zusammenhänge und Widersprüche entlang der globalen Warenkette von Produktion, Handel und Konsum. Indigene Erntearbeiter in Mexiko, costaricanische Kleinbauern, Hamburger Importhändler, Röster, Konsumenten und Fair-Trade-Aktivisten stehen als historische Akteure im Zentrum. Geographisch erstreckt sich die Reichweite von Zentralamerika über Hamburg und die beiden deutschen Staaten bis nach Indien, Äthiopien und Brasilien. Das internationale Autorenteam präsentiert neue Forschungsergebnisse zur Wirtschafts-, Sozial- und Kulturgeschichte des Kaffees.

Coxiella burnetii Infections in Small Ruminants and Humans in Switzerland

The recent Q fever epidemic in the Netherlands raised concerns about the potential risk of outbreaks in other European countries. In Switzerland, the prevalence of Q fever in animals and humans has not been studied in recent years. In this study, we describe the current situation with respect to Coxiella (C.) burnetii infections in small ruminants and humans in Switzerland, as a basis for future epidemiological investigations and public health risk assessments. Specific objectives of this cross-sectional study were to (i) estimate the seroprevalence of C. burnetii in sheep and goats, (ii) quantify the amount of bacteria shed during abortion and (iii) analyse temporal trends in human C. burnetii infections. The seroprevalence of C. burnetii in small ruminants was determined by commercial ELISA from a representative sample of 100 sheep flocks and 72 goat herds. Herd-level seroprevalence was 5.0% (95% CI: 1.6-11.3) for sheep and 11.1% (95% CI: 4.9-20.7) for goats. Animal-level seroprevalence was 1.8% (95% CI: 0.8-3.4) for sheep and 3.4% (95% CI: 1.7-6) for goats. The quantification of C. burnetii in 97 ovine and caprine abortion samples by real-time PCR indicated shedding of >10(4) bacteria/g in 13.4% of all samples tested. To our knowledge, this is the first study reporting C. burnetii quantities in a large number of small ruminant abortion samples. Annual human Q fever serology data were provided by five major Swiss laboratories. Overall, seroprevalence in humans ranged between 1.7% and 3.5% from 2007 to 2011, and no temporal trends were observed. Interestingly, the two laboratories with significantly higher seroprevalences are located in the regions with the largest goat populations as well as, for one laboratory, with the highest livestock density in Switzerland. However, a direct link between animal and human infection data could not be established in this study.