Nasuhi Engin Aydin, MD

Nasuhi Engin Aydin,  M.D. a graduate of Hacettepe University Faculty of Medicine, Ankara with E.C.F.M.G. Certification. He started his academic career at Ankara University working on short-term carcinogenicity tests with his research cited in NCI, Bethesda Monograph 65. He has been working as a registered Anatomic Pathologist in Turkey since 1983. Main topics of interest are research on gynecologic pathology besides forensic and surgical pathology with manuscripts published internationally. 

Separation of epithelia and stroma components in endometriosis lesions yields remarkable molecular points - Ie-Ming Shih, MD, Ph.D.

The pathologies of adenomyosis and endometriosis are unique among non-malignant gynecological diseases and provide fertile research topics. Ectopic endometrial tissues may have distinct molecular changes distinct from eutopic endometria despite having similar morphology. In this regard, there are intriguing suggestions as peritoneal endometriosis and adenomyosis seem to be molecularly related. Research made on molecular aspects of eutopic and ectopic endometrium by separating epithelia from stroma has been rewarding. Whole-exome sequencing besides global methylation profiles utilizing this separation technique by laser-capture microdissection was…

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It is time for redefining endometriosis with our contemporary scientific knowledge - Philippe Koninckx, MD, Ph.D.

Endometriosis defined as endometrium-like tissue outside the uterus has a poorly understood natural history. It is a heterogeneous disease having genetic-epigenetic features with many biochemical changes in the lesions. The Sampson hypothesis of implanted endometrial cells following retrograde menstruation is not able to explain all observations. The property of genetic- and epigenetic features transmitted at birth may explain the hereditary aspects, the predisposition, and the endometriosis-associated changes in the endometrium, immunology, and placentation. However, the pathogenesis of cystic ovarian or deep…

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How to unveil the discrepancy regarding the effect of chemicals on the etiology of endometriosis

Kristen Upson from Michigan State University published a review article evaluating research papers on environmental factors effective in endometriosis from an epidemiological perspective in "Current Epidemiology Reports". Endometriosis is a multifactorial disease with anatomical, hormonal, immunological, estrogenic, genetic, epigenetic, and environmental factors operating. Exogenous chemicals, interfering with any aspect of the hormonal milieu (endocrine-disrupting chemicals) are suspected in yielding a risk in endometriosis. The list of environmental chemicals suspected having a role in endometriosis expanded tremendously and includes perfluoroalkyl substances,…

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Endometriosis and adenomyosis could be the “sides of the same coin”.

The two common gynecological disorders, namely adenomyosis, and endometriosis are not settled yet, whether they are representing two different entities or different phenotypes of the same ailment. Dr. Maruyama and colleagues from Nara, Japan searched PubMed and Google Scholar electronic databases published between January 2000 and April 2020 for keywords ‘adenomyosis’, ‘endometriosis’, ‘pathogenesis’, ‘classification’, ‘subtype’, ‘phenotype’, and ‘fibrosis’. The results of this search were published in the "European Journal of Obstetrics & Gynecology and Reproductive Biology" recently. Endometriosis has three…

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It is time for non-invasive tests for peritoneal endometriosis diagnosis

Maria Szubert with colleagues from Lodz Medical University, Poland, investigated the possibility of potential diagnostic biomarkers in the eutopic endometrial tissue from peritoneal endometriosis patients and published their results in the "Journal of Gynecology Obstetrics and Human Reproduction". Currently, diagnostic laparoscopy is the golden standard procedure to prove peritoneal endometriosis since it is not visible either on ultrasound or MRI. There is a need to have a contemporary non- or less-invasive diagnostic tool for patients with a presumptive diagnosis of…

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An animal model of endometriosis reveals stress related disturbed vitamin D - vitamin D receptor axis

Lopez and colleagues from academic institutions of Puerto Rico published their experimental endometriosis findings on female rats regarding the effect of stress on vitamin D-vitamin D receptor systems and recently published their findings in "Reproductive Sciences". The group previously showed the negative impact of stress in the same animal model of endometriosis.  Altered levels of vitamin D are noted in patients with endometriosis. Vitamin D signaling through the vitamin D receptor system is known to have anti-proliferative properties. Stress may alter adversely…

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Time for reassessment : Laparoscopic surgery and bowel endometriosis

Ferrero and associates from medical centers of Verona and Genoa, Italy, made a comprehensive review covering all aspects of the surgical approach to bowel endometriosis, published their results in "Best Practice & Research Clinical Obstetrics and Gynaecology". Bowel endometriosis is the presence of endometriotic glands and stroma infiltrating at least the main muscle layer of the intestinal wall and causing symptoms like dyschezia, abdominal bloating, constipation, or diarrhea worsening during the menstrual cycle, the passage of mucus in the stools, rectal…

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Endometrial polyps of patients with and without endometriosis

Endometrial polyps are benign local overgrowths comprising both glands and the stroma, and are quite common in gynecological practice. Endometriosis patients also commonly have polyps, which have yielded different features than those from patients without endometriosis.  Dr. Jiangand and associates from the Center of Reproductive Medicine, The First Affiliated Hospital of Guangxi Medical University, China, have made recent research on polyps from endometriosis patients comparing with those from non-endometriosis. The results have been published in a recent issue of  "The…

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Natural history of spontaneous endometriosis in crab-eating monkeys

Kaori Hayashi and associates from Shiga University of Medical Science, Japan, published their observations on spontaneously occurring endometriosis in crab-eating monkeys in "Tohoku Journal of Experimental Medicine"https://www.jstage.jst.go.jp/article/tjem/251/4/251_241/_pdf/-char/en. The presence of endometrial tissue outside the uterus, i.e., endometriosis is a progressive prevalent condition among women of reproductive age. Along with abdominal pain and infertility endometriosis severely affects the quality of life in young women. Animal models of human disease are quite valuable in medical research in revealing pathogenetic mechanisms and investigating the effects…

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The effects of nutrients on endometriosis-related symptoms

A recent literature review from the Netherlands by researchers Emma Huijs and Annamiek Nap, published in "Reproductive Biomedicine Online" puts light on the effects of some nutrients for endometriosis-related symptomatology.  Endometriosis has heterogeneous pathogenesis involving genetic, immunological, environmental, and hormonal components. Due to this complexity, current treatment methods are not completely successful, and women with endometriosis are trying to control their diseases individually. These women are in the search for remedies available in daily life. An Australian online survey showed…

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Suggested remedies for endometriosis patients during coronavirus pandemic

The pandemic of COVID-19 continues to have important effects on endometriosis patients worldwide. Many health care facilities stopped providing surgical management and outpatient appointments are canceled or postponed. Dr. Leonardi from Australia and associates from several countries published their proposals for this awkward situation in their recent paper at the open-access journal, "Human Reproduction". The authors proposed expert opinion-based self-management guidance for endometriosis patients in particular which may be applicable to others during crisis periods.  Unavailable surgeries postponed appointments to healthcare…

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International experts commentary for assisted fertility treatment facilities amidst COVID-19

A multinational and multi-institutional commentary led by Dr. Alviggi from Italy and Dr.Esteves from Brazil has addressed important issues on assisted reproductive technology treatment amid COVID-19 lockdown suggesting remedies in the journal of "Reproductive Biology and Endocrinology" May 2020 issue. Prolongation of lockdown in health services providing high tech fertility treatments has been advocated by most of the authorities, however, this situation is affecting adversely both the infertility patients and the whole society together. Restarting these services after the lockdown…

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Discrepancies between racial/ethnic groups and choice of hysterectomy procedures

Dr. Pollack and associates from Washington University, St.Louis, made multistate research regarding the patient profile in hysterectomies and published their results in the 2019 December issue of "The Journal of Minimally Invasive Gynecology". The most frequently performed nonobstetric surgery in women is hysterectomy, with more than 400 000 procedures for benign gynecologic conditions performed each year in the US. Minimally invasive surgery, i.e. vaginal, laparoscopic/robot-assisted hysterectomy is preferred over abdominal hysterectomy for benign conditions owing to a quick return to…

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Laparoscopic surgery for COVID-19 positive patients: A Dilemma

COVID-19 pandemic is the most important issue of our days. In this regard, it is crucial to keep health care providers (HCPs) safe and away from contamination. Doctors Without Borders reported that regardless of all preventive measurements, nearly eight percent of the total COVID-19 cases in Italy are HCPs making HCP the highest risk group, and the importance of protecting this group is clear. All HCP who are in direct contact with infectious secretions from a patient with COVID-19 at…

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Defective “ferroptosis”: a new pathogenetic explanation of endometriosis

Dr. Ng and associates from Tufts University School of Medicine, Boston, USA made a comprehensive review of the role of the iron element in the development of endometriotic lesions. Though iron element is essential for cell survival, and its deficiency is important in reproductive disorders, iron excess is equally harmful.  In endometriosis, eutopic endometrium has resistance to the process of iron-mediated programmed cell death, i.e., ferroptosis. As far as eutopic endometrial cells do not undergo programmed cell death by ferroptosis, the cells…

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Non-hormonal chemicals for endometriosis related pain reduction

Loi and colleagues conducted a clinical prospective study at the Department of Obstetrics and Gynecology, University of Cagliari, Italy, and published in the journal "International Journal of Women’s Health".  Formation of adhesions and/or interference with the reproductive process endometriosis, severe chronic pain results and may cause functional disability requiring treatment. Activated mast cells in these lesions especially in deep infiltrating lesions being proximal to nerves, may contribute to pain by a direct effect on nerve structures. Cytokines and growth factors secreted…

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All aspects of endometriosis reviewed with focus on modern management

Dr. Chapron and associates from academic centers in France published in Nature Review Endocrinology, a comprehensive review on endometriosis. The article is inclusive of all aspects of endometriosis but especially focuses on the management of the disease with its contemporary status.  Having a heterogeneous nature, endometriosis has a well- recognized subgroups namely, superficial peritoneal lesions, ovarian endometriomas, and deep infiltrating endometriosis. Additionally, endometriosis may be seen in extragenital locations, e.g. pleural, diaphragmatic or umbilical. Adenomyosis is a condition characterized by infiltrating endometrial tissue into…

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Leiomyomas have similar genetic background with endometriosis

This multicenter research conducted in institutions located in the USA and UK published in Nature Communications, October 2019 issue.  Leiomyomata of the uterus are hormone-dependent tumors with an estimated prevalence of about  20-77%. İn several publications. Research in uterine leiomyoma pathogenesis suggests overlapping genetic similarities with endometriosis, both of them affecting millions of women worldwide causing considerable morbidity.  Revealing similar pathogenic mechanisms for uterine leiomyomas and endometriosis may not only a result in deeper better understanding of the pathogenesis, but…

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Primary care physicians have a crucial role in the early diagnosis of endometriosis

Dr. Verket and associates from the University of Oslo, Norway, published their cross-sectional anonymous postal questionnaire study in "BMJ open". Diagnosing endometriosis is difficult because dysmenorrhea, dyspareunia, and infertility are also common among other diseases. The most accurate and reliable diagnosis of endometriosis is by confirmation of the histopathologic findings through surgically resected biopsies. Screening tool development in endometriosis has been confined to women in secondary and tertiary gynecological surgical units or infertility clinics that have sophisticated health facilities.  A prediction model…

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An important environmental contaminant dioxin has links to the pathogenesis of endometriosis

Giampaolinoa and associates from the University of Genoa, Italy published a review on environmental contaminant dioxin and its possible epigenetic role related to endometriosis development in "Gynecological Endocrinology". The authors made a narrative review, with the results of their search questions: “Does it really exist a relation between Dioxin and Endometriosis? Could it be explained through an epigenetic approach?”. The search string was applied to the electronic literature databases MEDLINE and WEB of SCIENCE.  There is increasing evidence of serious…

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