Professor, Urology and Pediatrics
Children's National Health System
I am currently Professor at Children’s National Health System in the Division of Urology and Department of Pediatrics, George Washington University School of Medicine and Health Sciences in Washington, DC. My research program is motivated by my interest in understanding the infectious etiologies for renal function loss in children. My earliest exposure to research on urinary tract infection (UTI) occurred during residency in Urology and has continued to the present – offering me also the opportunity to participate in conferences on a National and International stage, to collaborate on panels convened by the American Urological Association to develop clinical guidelines, and to join NIH-sponsored multi-institutional trials and PCORI-sponsored collaborations investigating UTIs. These efforts have taught us that: My Much of my research has sought to determine what information can be gleaned from various types of renal imaging to discriminate between children at low versus high risk for renal function loss, which is the critical determinant for whether surgical intervention should be offered. These investigations have taught us that: (1) DMSA-SPECT, Gadolinium-enhanced MRI, and Contrast-enhanced CT scan, are equally accurate for the detection of acute pyelonephritis (APN) based on an experimental porcine model of vesicoureteral reflux (VUR) (2) adjunctive corticosteroids reduce the incidence of renal scarring following APN in an experimental porcine model, (3) in children, the presence of dysfunctional fecal and urine elimination increases the risk for recurrent UTIs, decreases the likelihood of spontaneous resolution of UTI and is associated with a lesser surgical success following minimally invasive correction of VUR, and (4) a select subgroup of children with VUR do benefit from daily preventive antibiotics. While we have made significant progress in understanding bacterial phenotypes associated with uropathogenicity, much work can be done to better understand how these isolated phenotypes interact with features within the host (behavioral, anatomical and genetic) to determine the susceptibility and outcomes following UTI. My future work will focus on refining the current evaluation algorithms for children UTI, identifying novel adjunctive treatments for UTI in patients with chronic UTI and in promoting collaboration between clinicians and researchers studying UTI.
Friday, October 5
10:45 AM – 12:15 PM