017. Comparison of the first to fourth quartile of TF antibodies resulted in hazard ratio (HR) = 1.82, 95% confidence interval 1.12-2.94, p = 0.015, adjusted for age, education, diabetes, daily smoking, and systolic blood pressure. Specificity comparing decile 1 to deciles 2-10 of TF predicting mortality was 92.3%. We found an increased HR by low levels of antibodies to the bacterium T. forsythia predicting CVD mortality in a 12 ½ years follow-up in persons who had experienced an MI but not among non-MI men.  https://www.selleckchem.com/products/DMXAA(ASA404).html  This novel finding constitutes a plausible causal link between oral infections and CVD mortality. Herein we describe for the first time a practical analytical method for determining the enantio-purity of L-α-glycerophosphocholine (L-α-GPC) by chiral derivatization. The use of a suitable chiral boronic acid allowed the formation of a mixture of two diastereomeric boronate esters whose ratio, carefully analyzed by 1HNMR spectroscopy, reflects L-α-GPC enantiomeric excesses. The determination of the enantiopurity of L-α-GPC furnishes convincing correlations with its manufacturing process. BACKGROUND The association of antiseizure medication (ASM) and bone density abnormalities has long been recognized; however, there remains a lack of consensus on efficacy and optimal vitamin D dosing in patients receiving enzyme inducing and non-inducing ASMs. The objective was to explore the relationship between ASMs and vitamin D supplementation requirements in a population of adult patients with epilepsy. METHODS Patients with a diagnosis of epilepsy receiving supplemental vitamin D were included in this retrospective chart review. All instances of 25-hydroxyvitamin D3 (25-OHD) measured among those patients were compared between patients taking an enzyme inducing antiseizure medication (EIASM) to patients receiving ASM regimens only containing non-enzyme inducing antiseizure medications (NIASM). ASM use, prescription and over the counter (OTC) vitamin D use, 25-OHD plasma concentration, presence of chronic kidney disease (CKD), age, gender, and ethnicity were collected. Multiple linear regression was used ower dose OTC requires closer monitoring of vitamin D status in patients with epilepsy, especially those on EIASMs, is warranted. vitamin D agent may not be adequate. OBJECTIVE To determine whether clinical outcomes are improved after repeat surgery for medically refractory epilepsy in children. METHODS This is a single-center retrospective cohort analysis of all patients who received repeat resective surgery for ongoing seizures from 2000-2017. From a total of 251 consecutive individual epilepsy surgical patients for focal resection, 53 patients met study inclusion criteria and had adequate follow-up documented. RESULTS Median age of seizure-onset was 2.0-years-old (IQR 0.3-5.5 years). The median age at first epilepsy surgery was 6.3-years-old (IQR 2.9-9.2 years) and at second epilepsy surgery was 8.4-years-old (IQR 4.7-12.6 years). Overall, 53 % (n = 28) of this series achieved Engel Class I (seizure freedom); with improved seizure control (Engel Class I-II) in 83 % (n = 44) of the cohort. 64 % (n = 34) had one reoperation; 26 % (n = 14) had two; and 9% (n = 5) had three. Pathology 58 % (n = 31) had focal cortical dysplasia; 13 % (n = 10) tumor; 9% (n = 5) encephalitis; 6% (n = 3) gliosis; 4% (n = 2) mesial temporal sclerosis; and 2% (n = 1) hemimegalencephaly. Tumor pathology was associated with increased chance (p = 0.01) for seizure freedom (90 % of tumor patients had Engel Class I outcome). MTS had worse outcome with both patients having ongoing seizures (Engel II-IV). There were 6 patients who developed post-operative hemiparesis; one was unplanned but resolved. SIGNIFICANCE Reoperation for pediatric epilepsy surgery can lead to seizure freedom in many cases and improved seizure control in most cases. Reoperation for brain tumor pathology is associated with a high rate of seizure freedom. OBJECTIVE Certain antiepileptic drugs (AEDs) may be more suitable for elderly patients with epilepsy (EWE) relative to others. However, little is known regarding which antiepileptic drugs (AEDs) are being used to treat EWE in the United States and how it has changed over time. METHODS We performed a serial cross-sectional study evaluating noninstitutionalized US adults aged 65 years or older with a diagnosis of epilepsy using data from the Medical Expenditure Panel Survey (MEPS) from 2004 through 2015. Trends in AEDs used among EWE were examined. Using each AED as a dependent variable, we determined the p-value for the trend by performing a linear regression with the time interval as the explanatory variable. RESULTS There was a weighted total of 399,801 EWE. Between the years 2004-2006 and 2013-2015 use of phenytoin, carbamazepine and phenobarbital decreased from 60.7% to 31.1% (p ≤ 0.001), 13.7 % to 5.22 % (p = 0.03) and 12.5 % to 5.91 % (p = 0.04), respectively. Use of levetiracetam concomitantly increased from 6.70 % to 43.1 % (p ≤ 0.001). Patients with more medical comorbidities as measured by the Charlson Comorbidity Index had higher odds of levetiracetam use (OR = 2.52, 95 % CI = 1.19-5.34) and lower odds of phenytoin use (OR = 0.46, 95 % CI = 0.24-0.88). CONCLUSIONS There have been significant changes in AED prescriptions to EWE between 2004-2015. However, potentially harmful AEDs (e.g. phenytoin, carbamazepine, phenobarbital, primidone and valproate) were still being prescribed to 42.9 % of all patients between 2013-2015. Increased work to educate providers regarding the use of more appropriate AEDs in this population is needed. The consensus of the current literature strongly supports the concept that brain neurotransmitters, and second messengers involved in the net release of dopamine in the mesolimbic region, especially the Nucleus Accumbens (NAc), is directly linked to motivation, anti-stress, incentive salience (wanting), and well-being. The role of dopamine in terms of alcohol withdrawal symptomology, cocaine craving behavior, dopamine -condensation products (TIQs), and more recently, the genetic aspects of drug-seeking and pro-dopamine regulation, provide compelling evidence of the relevant molecular neurological correlates of dopaminergic /endorphinergic mechanisms in reward circuitry due to genetic polymorphisms and epigenetic insults. In the face of an Americans opioid epidemic, the clinical consensus is to treat Opioid Use Disorder (OUD) with life-long opioid substitution therapy. However, the authors suggest a paradigm shift involving novel modalities like targeting the endorphinergic system linked to dopamine release at the NAc, in terms of the induction of required "dopamine homeostasis.