End-stage renal disease (ESRD) represents the final stage of chronic kidney disease and is characterized by progressive loss of renal function, metabolic instability, inflammation, and increased risk of protein-energy wasting. Although kidney transplantation improves survival, the early post-transplant period remains clinically complex due to surgical stress, immunosuppressive therapy, and fluctuating renal function. These factors significantly increase energy expenditure, promote protein catabolism, and predispose patients to electrolyte abnormalities, underscoring the critical role of evidence-based medical nutrition therapy (MNT). Current standards of care recommend comprehensive nutrition assessment by a registered dietitian (RD) within the first 90 days post-transplant and routine monitoring of anthropometrics, intake adequacy, and biochemical markers. For metabolically stable post-transplant patients, energy needs are estimated at 25–35 kcal/kg/day, with higher targets of 30–35 kcal/kg/day in the early post-operative period. Protein recommendations increase to 1.2–2.0 g/kg/day initially to counter negative nitrogen balance and support wound healing. Sodium intake is generally limited to <2.3 g/day for blood pressure and volume control, while potassium and phosphorus are adjusted based on laboratory trends. If oral intake is inadequate beyond several days, enteral nutrition (EN) is recommended when gastrointestinal function permits, with parenteral nutrition (PN) reserved for cases where oral and EN routes cannot meet needs. This case report illustrates the application of evidence-based MNT standards in a post–kidney transplant patient during inpatient rehabilitation and highlights the integral role of RD-led care in supporting metabolic stabilization and clinical recovery.

Acute pancreatitis (AP) is an inflammatory condition characterized by premature pancreatic enzyme activation leading to autodigestion, local tissue injury, and systemic inflammation. AP commonly causes abdominal pain, nausea, vomiting, and ileus, which can decrease oral intake and increase the risk of malnutrition. In clinical practice, patients with AP often present with comorbid conditions that further complicate feeding tolerance. Historically, bowel rest and delayed feeding were standard management strategies. However, growing evidence demonstrates that early nutrition intervention improves outcomes, including reduced infectious complications, shorter hospital length of stay, and preservation of gut mucosal integrity. Medical nutrition therapy in AP requires careful assessment of feeding tolerance, disease severity, and metabolic demands. Current evidence-based guidelines recommend early oral feeding in mild pancreatitis and initiation of enteral nutrition within 24–48 hours in moderate to severe cases, with parenteral nutrition reserved for patients unable to tolerate enteral intake or meet requirements. Recommended diet progression involves advancement to low-fat or regular diets as tolerated rather than routine use of restrictive liquid diets. Key interventions include early diet advancement, appropriate diet or formula selection based on tolerance, provision of approximately 25–35 kcal/kg/day and 1.2–1.5 g/kg/day protein, and close monitoring of fluid status and biochemical markers, with adjustments individualized to clinical status. This case report reviews current nutrition guidelines for AP and highlights the importance of implementing evidence-based nutrition strategies in a patient with complex clinical presentations and increased nutrition risk.

Non-occlusive mesenteric ischemia (NOMI) is a rare but highly fatal form of acute mesenteric ischemia, which is defined by a sudden interruption of blood supply to the intestines. NOMI occurs most commonly in critically ill, mechanically ventilated patients with hemodynamic instability presenting with low cardiac output and vasoconstriction. Mortality remains high due to diagnostic delays, rapid progression to bowel necrosis, and multisystem organ failure. While nutrition therapy is not a primary treatment for NOMI, it becomes essential following diagnosis due to repeated surgical interventions, sepsis, and increased metabolic demand, and the frequent interruption of feeding caused by hemodynamic instability. In critically ill patients, particularly with obesity, medical nutrition therapy (MNT) must balance the risks of underfeeding with the potential risks of enteral nutrition (EN) intolerance and bowel ischemia. Current evidence supports early nutrition intervention, prioritizing EN when hemodynamically stable, while initiating parenteral nutrition (PN) when EN is contraindicated or not feasible. Guidelines recommend hypocaloric, high protein feeding in obese critically ill patients to preserve lean mass and reduce the risks of complications of overfeeding. This case report highlights complexities of implementing evidence-based nutrition support in NOMI, and emphasizes the importance of individualized nutrition strategies, close monitoring, and interdisciplinary coordination to preserve nutritional status and support clinical outcomes.

Prebiotic sodas are marketed as healthy alternatives to traditional soda, but these claims have not yet been substantiated by research. This study evaluated the effects of fasted consumption of the prebiotic sodas Olipop and Poppi, compared with Diet Coke and Coca-Cola Original, on blood glucose, insulin, glucagon-like-peptide-1 (GLP-1), satiety, gastrointestinal symptoms, and beverage preference. A single-blind, repeated-measures design was employed with 10 participants. Participants completed four randomly assigned trials with a one-week washout period between each. During each visit, blood samples and satiety questionnaires were collected at baseline and throughout a two-hour trial. Beverage preference was assessed post-consumption, and gastrointestinal symptoms were evaluated using a follow-up questionnaire 24h post-intervention. The results from this study are expected to be completed by mid-April (by SRS).

The overall goal of our study is to understand how excess adiposity in women with and without
confounding cardiometabolic risk factors influences breast cancer cell growth and oxidative stress
signaling. I have already collected preliminary data indicating that activity of the antioxidant response
gene, NRF2, and expression of NRF2 targets are decreased in serum from obese subject, regardless of
phenotype. We investigated the functional consequences of these responses
by measuring and quantifying differences in reactive oxygen species (ROS) production. We also
investigated if these changes could lead to changes in breast cancer cell growth. To
investigate this, MCF7 breast cancer cells was grown in 6 distinct treatment groups reflecting varied
human metabolic health: CON (healthy control), NWO (normal weight obese), MUO (metabolically
unhealthy obese), and MHO (metabolically healthy obese), alongside the standard fetal bovine serum-
containing media a negative control. Reactive oxygen species production was assessed using a reagent
that fluoresces when it becomes oxidized by ROS. We expect cells grown in serum from obese subjects
will have higher levels of ROS production and increased invasive capacity. However, the results have yet
to be processed as of Mar 6. This research could demonstrate how total systemic metabolic health
influences oxidative stress responses and invasive potential, linking gene expression to real functional
outcomes. These insights could heavily inform medical assessments.

Congestive heart failure (CHF) is a highly prevalent form of heart disease in which the heart is unable to pump an adequate amount of blood to meet the body’s needs, with characteristic symptoms such as fluid overload, respiratory distress, and fatigue on exertion. Nutrition is an integral part of care for CHF with significant implications on health outcomes such as patient survival and quality of life. The primary goals of medical nutrition therapy (MNT) include preventing malnutrition, meeting patients’ nutritional needs, and managing signs and symptoms. CHF increases the risk of malnutrition. Evidence-based guidelines developed by the Heart Failure Society of America and the American College of Cardiology recommend weight loss for patients with overweight or obesity and weight gain for those with unintentional weight loss or cardiac cachexia, a condition involving fat loss and muscle wasting. The registered dietitian (RD), a key member of the interdisciplinary team, assesses patients’ nutritional needs and provides individualized nutrition care, including appropriate calorie recommendations and potential restrictions on sodium, fluid, and fat. Excessive sodium and fluid can contribute to volume overload, while the recommendations for fat intake address both the type and amount of fat to consume to control cholesterol levels. Despite established guidelines, implementing appropriate nutrition interventions can be complex, particularly in patients with numerous clinical needs. This case report discusses the challenges of balancing nutrition interventions with patient goals of care in a patient with CHF and malnutrition.

Patients with cancer who undergo ileostomy creation are at high risk for dehydration, electrolyte imbalance, malnutrition, and reduced quality of life due to increased gastrointestinal (GI) losses, impaired nutrient absorption, and the complex self-management and physiological demands associated with ostomy care. An ileostomy is an opening in the abdomen where the GI tract is brought to the surface, formed from the ileum. Evidence-based medical nutrition therapy (MNT) guidelines for ileostomy management emphasize a fiber-restricted diet in the early postoperative period (6-8 weeks), small, frequent meals, limitation of hypertonic and excessive hypotonic fluids, use of oral rehydration solutions, close monitoring of ostomy output, and sufficient protein intake to support wound healing. In contrast, evidence-based guidelines for severe chronic disease-related malnutrition prioritize adequate energy and protein provision, oral nutrition supplementation, weight stabilization or gain, correction of micronutrient deficiencies, and consideration of advanced nutrition support when oral intake remains inadequate. However, implementation of these standards becomes complex in the context of advanced malignancy, significant symptom burden, and evolving goals of care. This case report examines the application of evidence-based guidelines in an older adult with metastatic endometrial cancer, severe chronic disease-related malnutrition, and recent ileostomy following small bowel obstruction (SBO), illustrating the importance of individualizing MNT to the patient’s clinical trajectory and goals of care.

Oral health is an essential part of overall well-being, yet many children in underserved communities lack access to dental education and basic hygiene resources. Although cavities are completely preventable, they remain one of the most common chronic diseases affecting both children and adults. Early education is crucial for building lifelong habits and preventing future dental issues. The New Smiles initiative is a student-led outreach program focused on improving oral hygiene awareness and access to care among elementary students in the Fort Worth community.

Through interactive elementary school presentations, the program teaches proper brushing and flossing, healthy eating habits, and the importance of routine dental visits to kids. To reinforce these lessons, hygiene kits containing toothbrushes, toothpaste, floss, and educational materials were assembled in collaboration with Cook Children’s and distributed to participating students. Additionally, a brief survey was administered to assess students’ baseline knowledge of oral hygiene and evaluate the effectiveness of the educational presentation.

By combining hands-on education, community partnerships, and the distribution of essential hygiene supplies, the New Smiles program aims to promote preventive oral health practices at an early age. This initiative seeks to reduce oral health disparities while empowering children with the knowledge and resources needed to maintain lifelong dental health.

Women who are obese have a much higher risk of being diagnosed with breast cancer than women who maintain a healthy body weight. However, excess body fat, even in the absence of excess body weight, a condition referred to as normal weight obesity also increases breast cancer risk. The goal of our study is to determine how serum from human subjects with three distinct obesity phenotypes, metabolically healthy obese, metabolically unhealthy obese, and normal-weight obese, influences breast cancer cell growth and proliferation. We have already collected preliminary data indicating differences in cell viability via NADH measurement, yet metabolic activity alone does not definitively demonstrate growth or vitality because cells may be metabolically active without entering S-phase or replicating. To conclusively show DNA replication (and thus true proliferation/vitality), our plan is to quantitatively measure differences in DNA synthesis using the Click-iT EdU DNA-synthesis assay, which uses a thymidine analog incorporated into newly synthesized DNA which can be detected by the appearance of fluorescent conjugates. Based on our preliminary findings, we expect that the lower rates of metabolic activity in cells grown in serum from obese subjects are not due to reduced rates of cellular proliferation. These findings could be used to inform improved, targeted nutritional and chemotherapeutic strategies for individuals with distinct obesity phenotypes.

Viral stability, replication, and host-virus interactions are all significantly impacted by temperature. Numerous experimental studies have demonstrated that SARS-CoV-2 grows differently at different temperatures, but it is still unknown which specific infection processes are impacted. In this work, we used a mathematical modeling approach to quantify the effects of temperature on the kinetic parameters controlling SARS-CoV-2 replication. Results from previously published experiments were used to determine the viral load from in vitro infections of Vero E6 and human nasal epithelial (hNEC) cells at 33 and 37 C. We fit a mathematical model of viral infections to estimate model parameters at the two temperatures. Vero E6 cells showed evidence of temperature dependence when parameter distributions were compared; the infection rate, eclipse phase transition rate, and infected cell death rate varied between 33 and 37 C. The parameter estimates in hNEC cells, on the other hand, revealed no statistically significant differences and showed a significant overlap in parameter estimates between temperatures. These results imply that the cellular environment has a significant impact on how temperature affects SARS-CoV-2 replication dynamics. The measurement of temperature-dependent variations in viral kinetic parameters sheds light on SARS-CoV-2 replication and could enhance forecasts of infection dynamics under various environmental and physiological circumstances.