Long-Term Polyethylene (Bio)Degradation in Landfill: Environmental and Human Health Implications from Comprehensive Analysis.

This study investigates the process of long-term (bio)degradation of polyethylene (PE) in an old municipal waste landfill (MWL) and its implications for environmental and human health. Advanced techniques, such as ICP-ES/MS and IC-LC, were used to analyze heavy metals and anions/cations, demonstrating significant concentration deviations from control samples. The soil's chemical composition revealed numerous hazardous organic compounds, further indicating the migration of additives from PE to the soil. Toxicological assessments, including Phytotoxkit FTM, Microtox® bioassay, and Ostracodtoxkit®, demonstrated phytotoxicity, acute toxicity, and high mortality in living organisms (over 85% for Heterocypris Incongruens). An unusual concentration of contaminants in the MWL's middle layers, linked to Poland's economic changes during the 1980s and 1990s, suggests increased risks of pollutant migration, posing additional environmental and health threats. Moreover, the infiltration capability of microorganisms, including pathogens, into PE structures raises concerns about potential groundwater contamination through the landfill bottom. This research underscores the need for vigilant management and updated strategies to protect the environment and public health, particularly in older landfill sites.

Changes in Metabolism and Content of Chlorophyll in Common Duckweed (Lemna minor L.) Caused by Environmental Contamination with Fluorides.

The impact of fluorine on plants remains poorly understood. We examined duckweed growth in extracts of soil contaminated with fluorine leached from chicken manure. Additionally, fluorine levels were analyzed in fresh manure, outdoor-stored manure, and soil samples at varying distances from the manure pile. Fresh manure contained 37-48 mg F- × kg-1, while soil extracts contained 2.1 to 4.9 mg F- × kg-1. We evaluated the physiological effects of fluorine on duckweed cultured on soil extracts or in 50% Murashige-Skoog (MS) medium supplemented with fluorine concentrations matching those in soil samples (2.1 to 4.9 mg F- × L-1), as well as at 0, 4, and 210 mg × L-1. Duckweed exposed to fluorine displayed similar toxicity symptoms whether in soil extracts or supplemented medium. Fluoride at concentrations of 2.1 to 4.9 mg F- × L-1 reduced the intact chlorophyll content, binding the porphyrin ring at position 32 without affecting Mg2+. This reaction resulted in chlorophyll a absorption peak shifted towards shorter wavelengths and formation of a new band of the F--chlorophyll a complex at λ = 421 nm. Moreover, plants exposed to low concentrations of fluorine exhibited increased activities of aminolevulinic acid dehydratase and chlorophyllase, whereas the activities of both enzymes sharply declined when the fluoride concentration exceeded 4.9 mg × L-1. Consequently, fluorine damages chlorophyll a, disrupts the activity of chlorophyll-metabolizing enzymes, and diminishes the plant growth rate, even when the effects of these disruptions are too subtle to be discerned by the naked human eye.

The impact of global climate changes on trace and rare earth elements mobilization in emerging periglacial terrains: Insights from western shore of Admiralty Bay (King George Island, Antarctic).

In the rapidly changing climate, the biogeochemical behaviours of trace elements and Rare Earth Elements (REEs) in emerging periglacial environments assumes profound importance. This study provides pivotal insights into this dynamic by investigating the Antarctic's response to global climate change. The bedrock of King George Island is rich in REEs, with the presence of trace metals (TEs), with the highest concentrations of metals found in ornithogenic soil (∑REE 84.01-85.53 mg∙kg-1 dry weight). REEs in the studied soil, found mainly in igneous rocks, as is indicated by the positive correlation of these elements with sodium and calcium. The TEs released as a result of weathering are leached by water flowing down local watercourses to Admiralty Bay, as indicated by the decreasing results of ∑REE = 11.59 µg∙dm-3 in watercourse water, ∑REE = 1.62 µg∙dm-3 in watercourse pools and ∑REE = 0.66 µg∙dm-3 in the water of Admiralty Bay at the outlet of the watercourse. Water originating from the melting of snow on the glacier also carried REEs (∑REE = 0.14 µg∙dm-3), a fact which suggest the further influx of these elements from atmospheric deposition. The Prasiola crispa turned out to be the most susceptible to the accumulation of REEs (∑ 80.73 ± 5.05 µg g-1) and TEs, with the exception of chromium and zinc, whose concentrations were found to be at their highest in Deschampsia antarctica. In Usnea antarctica, Xanthoria candelaria, and Ceratodon purpureus and Politrichastrum alpinum, a dominant role in the accumulation of REEs was played by HREEs. The determined enrichment factor (EF) indicates that the soil cover is a source of REEs (EFAlgae for ∑REE = 5.07; EFLichen for ∑REE = 6.65; EFBryophyta for ∑REE = 5.04; EFVascular for ∑REE = 4.38), while Ni, As and Pb accumulated in plants may originate from other sources than the soil.

Production of pro-inflammatory mediators stimulated by exposure of poultry house workers to airborne dust particulates.

INTRODUCTION AND OBJECTIVE: Poultry house employees spend a significant part of their work shift being exposed to airborne particulate pollutants. The aim of this study was to assess their exposure at different stages of chicken production cycle, based on quantification of pro-inflammatory mediators (IL-1ß, IL-6, IL-8, and TNFα) in nasal lavage (NAL) samples. MATERIAL AND METHODS: The concentrations of airborne dust at 3 different stages of the production cycle (i.e. empty poultry house, with 7- and 42-day-old chickens) were stationary measured using Grimm spectrometer, as well as CIS and Button samplers. The dust collected by the latter 2 samplers was analyzed for endotoxin and (1→3)-ß-D-glucan content. NAL samples were collected from employees after their work shift to determine the pro-inflammatory mediator levels. RESULTS: The maximum particulate aerosol, endotoxin, and (1→3)-ß-D-glucan concentrations at workplaces reached the levels of 4.12 mg/m3, 45.21 ng/m3, and 56.54 ng/m3, respectively. The IL-1ß, IL-6, and IL-8 concentrations in NAL samples ranged between 0.62-18.12 pg/mL, <0.70-25.37 pg/mL, and <3.50-259.5 pg/mL, respectively. All TNFα levels were below 4 pg/mL. There were no significant differences between these cytokine concentrations in NAL samples collected at different stages of chicken breeding in either 'winter' or 'summer' seasons. CONCLUSIONS: Inhalation stimulation with poultry dust containing endotoxins and (1→3)-ß-D-glucans resulted in the production of pro-inflammatory mediators, which proves the course of immunological processes in the exposed employees that may lead to adverse effects. The use of nasal lavage fluid in the control of such exposure confirms that NAL analysis is a reliable laboratory tool for assessing the impact of poultry dust on exposed farm workers.

Poultry house as point source of intense bioaerosol emission.

INTRODUCTION AND OBJECTIVE: Intensive poultry farming is usually associated with massive exposure to organic dust, which is largely composed of microbiological origin particulates. The aim of the study is to assess occupational and environmental exposures to airborne bacteria, fungi, and Marek's disease virus emitted by a poultry house. MATERIAL AND METHODS: The concentrations of airborne microorganisms in a poultry house and its vicinity (250-500 m) at 3 different stages of the production cycle (i.e. empty poultry house, with 7-day-old and 42-day-old chickens) were stationary measured using Andersen and MAS impactors, as well as Coriolis and BioSampler impingers. The collected microbiota was taxonomically identified using molecular and biochemical techniques to characterize occupational exposure and its spatial dissemination. RESULTS: Although Marek's disease virus was not present in the tested air samples, the appearance of reared chickens in the poultry house resulted in an increase in airborne bacterial and fungal concentrations up to levels of 1.26 × 108 CFU/m3 and 3.77 × 104 CFU/m3, respectively. These pollutants spread around through the ventilation system, but their concentrations significantly decreased at a distance of 500 m from the chicken coop. A part of the identified microbiota was pathogens that were successfully isolated from the air by all 4 tested samplers. CONCLUSIONS: The poultry house employees were exposed to high concentrations of airborne microorganisms, including pathogens that may lead to adverse health outcomes. To protect them, highly efficient hygienic and technical measures regarding the poultry house interior and its ventilation, respectively, should be introduced to prevent both unwanted pollution and subsequent emission of microbial contaminants during intensive chicken breeding.

Intensive poultry farming: A review of the impact on the environment and human health.

Poultry farming is one of the most efficient animal husbandry methods and it provides nutritional security to a significant number of the world population. Using modern intensive farming techniques, global production has reached 133.4 mil. t in 2020, with a steady growth each year. Such intensive growth methods however lead to a significant environmental footprint. Waste materials such as poultry litter and manure can pose a serious threat to environmental and human health, and need to be managed properly. Poultry production and waste by-products are linked to NH3, N2O and CH4 emissions, and have an impact on global greenhouse gas emissions, as well as animal and human health. Litter and manure can contain pesticide residues, microorganisms, pathogens, pharmaceuticals (antibiotics), hormones, metals, macronutrients (at improper ratios) and other pollutants which can lead to air, soil and water contamination as well as formation of antimicrobial/multidrug resistant strains of pathogens. Dust emitted from intensive poultry production operations contains feather and skin fragments, faeces, feed particles, microorganisms and other pollutants, which can adversely impact poultry health as well as the health of farm workers and nearby inhabitants. Fastidious odours are another problem that can have an adverse impact on health and quality of life of workers and surrounding population. This study discusses the current knowledge on the impact of intensive poultry farming on environmental and human health, as well as taking a look at solutions for a sustainable future.

Difficulties in the Modeling of E. coli Spreading from Various Sources in a Coastal Marine Area.

Coastal and transitional waters are often used as bathing waters. In many regions, such activities play an important economic role. According to the European Union Bathing Water Directive (2006/7/EC) (BWD) the concentration of Escherichia coli in bathing water exceeding 500 CFU·100 mL-1 poses a high risk for bathers' health. In order to safeguard public health, microbiological environmental monitoring is carried out, which has recently been supported or replaced by mathematical models detailing the spread of sanitary contamination. This study focuses on the problems and limitations that can be encountered in the process of constructing a mathematical model describing the spread of biological contamination by E. coli bacteria in coastal seawater. This and other studies point to the following problems occurring during the process of building and validating a model: the lack of data on loads of sanitary contamination (often connected with multiple sources of biological contamination inflow) makes the model more complex; E. coli concentrations higher than 250 CFU·100 mL-1 (low hazard for health) are observed very rarely, and are associated with great uncertainty; the impossibility of predicting the time and intensity of precipitation as well as stronger winds and rougher sea, which may be a significant source of E. coli. However, there is universal agreement that such models will be useful in managing bathing water quality and protecting public health, especially during big failures of the wastewater network.

Raw Meat Contaminated with Cephalosporin-Resistant Enterobacterales as a Potential Source of Human Home Exposure to Multidrug-Resistant Bacteria.

The prevalence of cephalosporine-resistant (3GC-R) strains among United States community-related research samples ranged from 5.6 to 10.8%, while, in the European countries, it was 1.2% to 10.1%. Several studies suggest that meat of animal origin could be one of the reservoirs of 3GC-R bacteria. Here, 86 raw meat samples (turkey, pork, chicken and beef) were collected randomly and verified for the presence of 3GC-R bacteria. The 3GC-R bacteria were isolated, identified and characterized phenotypically (antibiotic resistance, motility and biofilm) and genotypically (repetitive-sequence-based rep-PCR) to elucidate any correlations with principal component analysis (PCA). From 28 3GC-R positive samples, 41 strains were isolated, from which the majority belonged to Serratia fonticola (39%), followed by Escherichia coli (19.5%), Enterobacter cloacae (17.1%) and Klebsiella pneumoniae (14.6%). The isolates of E. coli and S. fonticola presented diverse profiles in rep-PCR. Generally, 3GC-R strains were more resistant to antibiotics used in veterinary medicine than in human medicine. PCA derived from antibiotic resistance, motility and biofilm formation of S. fonticola and E. coli strains showed that resistance to beta-lactams was separated from the resistance to other antibiotic classes. Moreover, for the S. fonticola, E. coli and En. cloacae, the type of meat can create a specific tendency towards antibiotic resistance and phenotypic characteristics for S. fonticola, while these relationships were not found for other tested species.

Escherichia coli and Serratia fonticola ESBLs as a potential source of antibiotics resistance dissemination in the Tricity water reservoirs.

Despite the fact that cephalosporins are rarely used in medical or veterinary treatment, the presence of Enterobacterales strains resistant to this group of anti-bacterial drugs (ESBL) is an important issue that requires attention. Between 2019 and 2021, 14 retention reservoirs, 12 streams, 3 rivers and 1 lake situated in the Tricity area (in northern Poland) were sampled for the presence of ESBL strains. Out of 40 water samples, characteristic growth (E. coli and the KESC group) on Chromagar ESBL plates was observed for 33 samples. The average number of ESBL E. coli was 42±132 CFU/100 ml, while the KESC group was 73±147 CFU/100 ml. Out of 33 positive samples, 57 ESBL Enterobacterales strains were isolated, of which the most abundant species were E. coli (13 isolates) and S. fonticola (23 isolates). The E. coli ESBL isolates not only showed resistance to third generation cephalosporins but also to antibiotics from other groups, such as fluoroquinolones, aminoglycosides and sulfonamides. The S. fonticola ESBL isolates were also found to be mainly resistant to the third generation cephalosporins, with the exception of 5 imipenem and 2 ertapenem-resistant strains. These strains presented highly diverse fingerprinting profiles, as well as significant differences in phenotypic traits helpful for survival in the environment, such as biofilm formation and motility. Moreover, biofilm formation and the swimming ability were species and temperature dependent. We confirmed the presence of highly diverse ESBL strains with multiple drug resistance patterns in the Tricity water reservoirs. This could possibly pose a threat to human health and create a suitable ground for acquiring antibiotics resistance in the natural environment.

Determination of amino acids in human biological fluids by high-performance liquid chromatography: critical review.

The quantitation and qualification of amino acids are most commonly used in clinical and epidemiological studies, and provide an excellent way of monitoring compounds in human fluids which have not been monitored previously, to prevent some diseases. Because of this, it is not surprising that scientific interest in evaluating these compounds has resurfaced in recent years and has precipitated the development of a multitude of new analytical techniques. This review considers recent developments in HPLC analytics on the basis of publications from the last few years. It helps to update and systematize knowledge in this area. Particular attention is paid to the progress of analytical methods, pointing out the advantages and drawbacks of the various techniques used for the preparation, separation and determination of amino acids. Depending on the type of sample, the preparation conditions for HPLC analysis change. For this reason, the review has focused on three types of samples, namely urine, blood and cerebrospinal fluid. Despite time-consuming sample preparation before HPLC analysis, an additional derivatization technique should be used, depending on the detection technique used. There are proposals for columns that are specially modified for amino acid separation without derivatization, but the limit of detection of the substance is less beneficial. In view of the fact that amino acid analyses have been performed for years and new solutions may generate increased costs, it may turn out that older proposals are much more advantageous.

Polypropylene structure alterations after 5 years of natural degradation in a waste landfill.

Up to 25% of plastic waste in Europe is still disposed of in landfills, despite recycling efforts. The plastic waste in the landfill plot may be exposed both to abiotic and biotic degradation processes, although it is thought that most of the plastic materials tend to be resistant to biodegradation or biodeterioration even after a long time. To verify if polypropylene (PP) can undergo the process of short-term biodegradation and how this process is manifested in a municipal waste landfill, we collected a plastic sample from an already closed landfill plot estimating its age at approximately 5 years. Fourier-Transform Infrared Spectroscopy led to sample identification as PP as well as showed additional bands which are not specific to polymer structure but rather result from microbial metabolism. Differential Scanning Calorimetry was performed to examine the influence of the environmental degradation process on the degree of crystallisation of the tested PP. Moreover, significant changes on the surface of an old PP packaging were observed with Scanning Electron Microscopy (SEM) showing clear signs of PP delamination which resulted in microplastic particles formation (smaller than 5 µm in diameter). Additionally, several round and oval shaped structures were observed with SEM leading to the suspicion of biofilm formation on the PP surface. Indeed, the microorganisms were present in a vast amount on the old PP surface and possibly formed a viable biofilm as it was confirmed with fluorescence microscopy. These data show that plastic waste can be inhabited by microorganisms from the ambient environment which may probably lead to its faster degradation. However, this process should be investigated in more detail in order to shed light upon the possible risk factors of plastic biodegradation in waste landfills to the environment and human health. Even after five years, polypropylene can undergo deterioration/biodegradation in a waste landfill with viable microbial cells on its surface, possibly involved in its degradation.

Plasma free amino acid profiling as metabolomic diagnostic and prognostic biomarker in paediatric cancer patients: a follow-up study.

Amino acids (AAs) play a crucial role in cancer cell metabolism. Levels of 22 plasma AAs at the time of diagnosis and after treatment were established among 39 pediatric cancer patients and 33 healthy children. Glutamic acid levels decreased and tryptophan levels increased during treatment. Cancer patients presented significantly lower levels of glutamine and leucine post-treatment while levels of 12 other AAs were higher comparing to controls. Results suggest that plasma free AA profile may serve as a prognostic biomarker.

Poultry Farms as a Potential Source of Environmental Pollution by Pharmaceuticals.

Industrial poultry breeding is associated with the need to increase productivity while maintaining low meat prices. Little is known about its impact on the environment of soil pollution by pharmaceuticals. Breeders routinely use veterinary pharmaceuticals for therapeutic and preventive purposes. The aim of this work was to determine the influence of mass breeding of hens on the soil contamination with 26 pharmaceuticals and caffeine. During two seasons-winter and summer 2019-15 soil samples were collected. Liquid extraction was used to isolate analytes from samples. Extracts were analyzed using ultra-high performance liquid chromatography coupled with tandem mass spectrometry detection (UPLC-MS/MS). The results showed the seasonal changes in pharmaceutical presence in analyzed soil samples. Ten pharmaceuticals (metoclopramide, sulphanilamide, salicic acid, metoprolol, sulphamethazine, nimesulide, carbamazepine, trimethoprim, propranolol, and paracetamol) and caffeine were determined in soil samples collected in March, and five pharmaceuticals (metoclopramide, sulphanilamide, sulphamethazine, carbamazepine, sulfanilamid) in soil samples collected in July. The highest concentrations were observed for sulphanilamide, in a range from 746.57 ± 15.61 ng/g d.w to 3518.22 ± 146.05 ng/g d.w. The level of bacterial resistance to antibiotics did not differ between samples coming from intensive breeding farm surroundings and the reference area, based on antibiotic resistance of 85 random bacterial isolates.

The Influence of Ionic Liquids on the Effectiveness of Analytical Methods Used in the Monitoring of Human and Veterinary Pharmaceuticals in Biological and Environmental Samples-Trends and Perspectives.

Recent years have seen the increased utilization of ionic liquids (ILs) in the development and optimization of analytical methods. Their unique and eco-friendly properties and the ability to modify their structure allows them to be useful both at the sample preparation stage and at the separation stage of the analytes. The use of ILs for the analysis of pharmaceuticals seems particularly interesting because of their systematic delivery to the environment. Nowadays, they are commonly detected in many countries at very low concentration levels. However, due to their specific physiological activity, pharmaceuticals are responsible for bioaccumulation and toxic effects in aquatic and terrestrial ecosystems as well as possibly upsetting the body's equilibrium, leading to the dangerous phenomenon of drug resistance. This review will provide a comprehensive summary of the use of ILs in various sample preparation procedures and separation methods for the determination of pharmaceuticals in environmental and biological matrices based on liquid-based chromatography (LC, SFC, TLC), gas chromatography (GC) and electromigration techniques (e.g., capillary electrophoresis (CE)). Moreover, the advantages and disadvantages of ILs, which can appear during extraction and separation, will be presented and attention will be given to the criteria to be followed during the selection of ILs for specific applications.

Environmental Risk Assessment Resulting from Sediment Contamination with Perfluoroalkyl Substances.

Due to wide use of perfluoroalkyl substances (PFASs) (e.g., in metal-plating, in fire-fighting foam, lubricants) and their resistance to degradation, they occur widely in the environment. The aim of this study was to estimate the environmental risk resulting from the presence of PFASs in the Gulf of Gdansk. Therefore, 17 PFASs concentrations were determined using ultra performance liquid chromatography with tandem mass spectrometry detection (UPLC-MS/MS). Additionally, sediment ecotoxicity was investigated. The results of the chemical analysis were used to asses environmental risk of PFASs. In samples collected around discharge collectors from a wastewater treatment plant and the Vistula mouth, Σ17PFASs values were 0.00403 ÷ 40.6 and 0.509 ÷ 614 ng/g d.w., respectively. In samples collected around discharge collectors, PFHxA, PFPeA, PFHpA, and PFOA were dominating, while at the Vistula River mouth, PFHxS, PFDS, and PFBS were prevalent. For most sediments, no toxic effect was observed in the toxicity tests with Heterocypris inconguens and Aliivibrio ficsheri. There was no observed correlation between the PFASs level and their ecotoxicity. Generally, the results of environmental risk assessment indicate that the PFASs would not generate high impact on the aquatic life (five water samples have shown medium risk related to PFBS and PFDoA).

Micropollutants in treated wastewater.

Compounds such as pharmaceuticals, or personal care products are only partially removed in wastewater treatment processes. Large number of these compounds and their degradation products is out of any control. A small number of compounds are covered by legal regulations. Among the compounds non-regulated by law, the target compounds, as well as non-target compounds can be distinguished. In the scientific literature, number of reports on various target compounds' determination is increasingly growing. This paper provides an up-to-date review on micropollutants present in treated wastewater and their concentrations found in literature in the years 2015-2019. Because the obtained results of chemical analyses do not adequately reflect the risks to ecosystems and consequently humans, the results of chemical analyses have been supplemented by a review of ecotoxicological studies. In addition, legal issues linked to contamination of treated wastewater and research related to identification of non-target compounds in treated effluents have been discussed.

Pharmaceutical Household Waste Practices: Preliminary Findings from a Case Study in Poland.

Pharmaceutical consumption continues to grow constantly. Unused/expired pharmaceuticals are disposed of to the municipal sewage system or waste disposal. Consequently, many countries have implemented a system of collecting pharmaceutical waste, with pharmacies playing an important role. It is important to educate consumers on rational consumption and the appropriate disposal of unused/expired pharmaceuticals and to identify the level of public awareness. Two studies were conducted in Poland to estimate the problem of collection and disposal of expired/unused pharmaceuticals. The purpose of the Survey I was to identify the scale of pharmaceutical consumption and the way pharmaceuticals are disposed of by various social groups. The Survey II was aimed to identify patients' attitudes regarding expired/unused pharmaceuticals at home. Of the respondents who participated in in Survey I, almost 74% indicated that analgesics were among the over-the-counter drugs they purchased. Group of pharmaceuticals 65% of the respondents purchased were medicines for treating flu symptoms. Almost 68% of the respondents said they usually disposed of expired pharmaceuticals in their household waste or by flushing them down the toilet. In Survey II more than 35% reported that they disposed of pharmaceuticals in the same ways. Of all respondents, ~30% returned their expired pharmaceuticals to pharmacies. Most respondents (over 65%) who participated Survey I indicated that they were aware that pharmaceutical waste can be returned to pharmacies. It should be noted that local governments are currently not obliged by law to work with or compensate pharmacies in the collection and proper disposal of unused pharmaceuticals.

Advancement in Determination of Phthalate Metabolites by Gas Chromatography Eliminating Derivatization Step.

A gas chromatography-mass spectrometry (GC-MS) method to determine polar and thermally unstable phthalate metabolites [monomethyl phthalate-MMP, monoethyl phthalate-MEP, mono-n-butyl phthalate-MnBP, mono-(2-ethylhexyl) phthalate-MEHP] has been developed. This is the first report presenting the separation of monophthalates without derivatization step and any additional equipment or special injection port. Injection parameters (temperature, pressure, time, and volume of injection), chromatographic separation (retention gap, temperature program), and MS detection/identification (working parameters, ion selection) were investigated. Mechanisms and phenomena occurring under different conditions in the GC injector were evaluated and discussed. The limits of detection (LODs) of MMP, MEP, MnBP, MEHP in the protocol were 0.049, 0.036, 0.038, and 0.029 ng (per 2 µL of injection), respectively. The response of the monophthalates was found to be linear in the tested concentration range (for MMP: 0.15-100 ng, MEP and MnBP: 0.11-100 ng, MEHP: 0.087-100 ng per 2 µL) with the coefficient of determination higher than 0.9817 and inter-day precision in the range of 1.4-5.4%. The developed method is fast, easy and repeatable. Moreover, it allows for the elimination of derivatization agents, reduction of toxic waste production and simplification of analytical procedure.

Amino acid profile after oral nutritional supplementation in hemodialysis patients with protein-energy wasting.

OBJECTIVES: Protein-energy wasting (PEW) is highly prevalent in patients on hemodialysis (HD). Oral nutritional supplementation (ONS) is recommended for malnourished patients on HD. The aim of this study was to evaluate ONS on plasma amino acid in HD patients with PEW. METHODS: Thirty-two HD patients with a mean age 59.1 ± 9.5 y with PEW were enrolled into the study. Patients were prescribed ONS (125 mL twice a day for 3 mo) together with dietary advice. The nutritional status was evaluated by means of body mass index, Subjective Global Assessment, and serum albumin and prealbumin levels. The percentages of body fat and lean body mass were measured by means of the near-infrared method. The lean body mass-to-body weight ratios were calculated. Tumor necrosis factor, interleukin-6 and high-sensitivity C-reactive protein, were measured by the enzyme-linked immunosorbent assay method. Serum concentrations of amino acids were measured by the high-performance liquid chromatography method. RESULTS: After 3 mo of ONS, a significant increase of both serum prealbumin and albumin was observed. The concentration of most of the amino acids increased independently on inflammation. CONCLUSIONS: Dietary advice, combined with ONS, is effective in HD patients with PEW. Both dietary advice and ONS are needed to be sure that patients consume an adequate daily amount of calories and protein.