Nasuhi Engin Aydin, MD

Nasuhi Engin Aydin, MD is a graduate of Hacettepe University Faculty of Medicine, Ankara with ECFMG Certification. He started his academic career at Ankara University working on short-term carcinogenicity tests, supported by TUBITAK grant with his research cited in NCI, Bethesda Monograph 65. He has been working as a licensed Anatomic Pathologist in Turkey since 1983. Main topics of interest are anatomic and surgical pathology with published manuscripts mainly in gynecopath and forensics https://www.youtube.com/watch?v=cNq6VTWVk80

A novel contribution to patient management in endometriosis by immunohistochemistry

Dr. Tarumi and associates from the Kyoto Prefectural University of Medicine, Kyoto, Japan published their retrospective cohort study on the importance of progesterone receptors on recurring ovarian endometriosis in "The Journal of Clinical Endocrinology & Metabolism". Surgery for endometriosis is applied to a great number of patients and the postoperative recurrence rate of endometriosis is estimated to be from 21.5% up to 56.7% within 2 years of surgery. Unfortunately, recurrence following endometriosis surgery decreases the quality of life and increases pain…

Key Points Lay Summary

A revolutionary view on endometriosis related pain

Dr. Lydia Coxon and colleagues from Oxford University, UK, have recently published their cross-sectional study on the categorization of endometriosis-related pain in the journal "Frontiers in Pain Research". As a chronic inflammatory condition, endometriosis results in pelvic pain, dysmenorrhea, and dyspareunia not related to disease burden. In the current research, the prevalence of neuropathic-like pain in endometriosis using a questionnaire screening hypothesizes that endometriosis-associated pain would be classified as neuropathic in some women. Similar to other patients with neuropathic pain these…

Key Points Lay Summary

Non-invasive diagnostic tools for endometriosis revisited

Dr. Signorile and associates from the Italian Endometriosis Foundation have published the results of their retrospective study on a large cohort of endometriosis patients in a recent issue of the periodical, In Vivo. Endometriosis lacks precise scientific knowledge and this brings about an incredible underdiagnosis and undertreatment with a long interval of 8-12 years between the beginning of symptoms and the appropriate clinical diagnosis. Currently, there is not any non-invasive diagnostic tool for definitive diagnosis. The final diagnosis of endometriosis is…

Key Points Lay Summary

International Working Group's review on endometriosis classification systems

International Endometriosis Working Group including AAGL, ESHRE, ESGE, and WES published a comprehensive review on endometriosis classification, staging, and reporting systems in a recent issue of the journal named "Facts, Views & Vision in Obstetrics and Gynecology". Classification and staging systems have improved clinical management, especially in oncology, rheumatology, and Parkinson’s disease. Following the first suggestion for a classification system for endometriosis in 1973, various publications for endometriosis classification, staging, and reporting systems emerged, but there is still no international…

Key Points Lay Summary

An important enigmatic promoter of endometriosis: immune dendritic cells

Dr. Larinha and associates from a Brasilian academic center have published their comprehensive review on the role of immune dendritic cells in the pathogenesis of endometriosis in a recent issue of the "Journal of Reproductive Immunology". Antigen-presenting dendritic cells of the immune system present processed antigens to T cells to mediate between innate and adaptive immunity. Dendritic cells originate from bone marrow progenitors and are a heterogeneous group of immune cells with the ability to migrate from blood to lymphoid and…

Key Points Lay Summary

Immunotherapy in endometriosis: a challenging research topic

Dr. Maksym and associates from academic centers in Poland have published their comprehensive review on endometriosis emphasizing the immunological aspects of the disease in a recent issue of the "Journal of Clinical Medicine". Even though endometriosis is a multifactorial disease, it is well known that the appearance of ectopic endometrial implants in the peritoneal cavity is possible due to immunological defects allowing the survival of abnormal tissues which would otherwise be cleared. It is well known that endometriosis is characterized…

Key Points Lay Summary

A novel approach to a common lesion: mapping adenomyosis by imaging modalities

Dr. Habiba from Leicester, UK, and Dr. Benagiano from Rome, Italy, have published their overview on adenomyosis in an attempt to set light on a clinically important topic in a recent issue of the "International Journal of Environmental Research and Public Health". The common widely accepted definition of adenomyosis is the presence of endometrium, with both glandular and stromal components, in the uterine muscle layer. There is a wide variation in the incidence rates ranging from 5 to 70%. This…

Key Points Lay Summary

Diaphragmatic defects, liver herniations and catamenial pneumothorax

Dr. Arakawa and associates from The Jikei Katsushika Medical Center, Japan, have published their recent case of catamenial pneumothorax with diaphragmatic defect and liver herniation in the "Journal of Cardiothoracic Surgery". Catamenial pneumothorax is an uncommon condition with a reported incidence of less than 3–6% in women with spontaneous pneumothorax. The main clinical features include the repetitive onset of pneumothorax during pre and postmenstrual periods, right-sided onset, and pelvic endometriosis in reproductive age patients.  The patient presented here was a…

Key Points Lay Summary

Thoracic endometriosis: the most frequent endometriosis involvement outside abdominopelvic cavity

Six to ten percent of reproductive-age women are affected by endometriosis, and about 12% are estimated to be outside the abdominopelvic cavity - the most frequent location being the thorax. Endometriosis within the pulmonary parenchyma or on the diaphragm and pleural surfaces presents different manifestations, collectively known as thoracic endometriosis syndrome.  Besides classic theories of retrograde menstruation, coelomic metaplasia, lymphatic and hematogeneous dissemination in thoracic endometriosis syndrome, a unique prostaglandin theory is also acceptable, where prostaglandin F2α, a potent constrictor…

Key Points Lay Summary

Full understanding the role of nervous system in endometriosis could yield new gateways to novel therapeutic approaches

Dr. Velho and associates from Berlin, Germany have recently published their comprehensive review on the role of the nervous system in endometriosis in a recent issue of “International Journal of Molecular Sciences”. Understanding the role of the peripheral nervous system and its interactions with immune cells will reveal novel pathways and targets in endometriosis that could yield new therapeutic gateways. An increase in the levels of cytokines, chemokines, growth factors, and immune cells enhances the inflammatory environment present in the…

Key Points Lay Summary

A rare but important disease: "isolated" endometriosis of the sciatic nerve

Professor Marc Possover from Zurich, Switzerland has published his 16-year experience of surgical laparoscopic interventions on isolated endometriosis of the sciatic nerve in a recent issue of the official publication of the European Society for Gynecological Endoscopy; Facts, Views & Vision in ObGyn. Endometriosis is a problematic disease, both for the patients and physicians but endometriosis of the sciatic nerve (ESN) is even more enigmatic. Cyclical sciatic nerve pain in women may be a clue to potential endometriosis of the…

Key Points Lay Summary

The relevance of mitosis in endometriotic tissue biopsies

Dr. Wetzk and co-workers from the Technical University, Dresden, Germany have published a retrospective study on the diagnostic impact of mitotic activity in the endometriotic lesion biopsies in the recent issue of the journal “Geburtshilfe und Frauenheilkunde”. Guidelines highly recommend a microscopic assessment, i.e. sending biopsies to the pathology laboratory after surgical procedures to make a diagnosis of endometriosis precisely. However, the current guidelines do not have clear statements about the specific procedures for this histopathological evaluation. This retrospective study carried…

Key Points Lay Summary

A trial of exogenous melatonin on dysmenorrhea in women "without endometriosis"

In their recent article published in “European Journal of Clinical Pharmacology”,  Dr. Söderman and associates from Stockholm report the results of their randomized, double-blind, placebo-controlled trial on the effects of oral melatonin in women with dysmenorrhea -unrelated to endometriosis-. Melatonin is a hormone synthesized, and secreted mainly from the pineal gland in the brain and has pain-relieving effects when administered exogenously. Dysmenorrhea related to endometriosis is treated by non-steroid anti-inflammatory drugs and/or hormonal suppression, both having important complications. In 2013, Schwertner and associates showed…

Key Points Lay Summary

Intravascular adenomyomatosis: an important entity to be alert

Pathologists from Stanford University, USA have recently published four novel cases of intravascular adenomyomatosis co-existing with pelvic endometriosis in a recent issue of “Human Pathology”. Intravascular leiomyomatosis is characterized by the presence of smooth muscle in venous and lymphatic spaces of the uterine muscle layer, i.e. myometrium. This invasive intravascular tissue consists of typical smooth muscle. Following the first description of a variant coined as intravascular adenomyomatosis, which is the growth of intravascular smooth muscle also featuring endometrial glands and…

Key Points Lay Summary

Is breastfeeding beneficial to endometriosis pain?

Dr. Porta team from Italian academic centers have recently published their research in “International Journal of Environmental Research and Public Health” on breastfeeding mothers who were under follow-up for histologically proven endometriosis. The hormonal milieu is believed to have an important effect in the etiopathogenesis of endometriosis, suggesting that breastfeeding, may influence its course. WHO has recently published issues on the benefits of breastfeeding yielding advantages to mothers and their progeny. Breastfeeding may have healing effects on endometriosis and reduce its…

Key Points Lay Summary

A plea from pathologists: standardized protocols for adenomyosis and endometriosis  

Pathologist Drs. Camboni and Marbaix from Brussels, Belgium published their comprehensive review on adenomyosis and endometriosis titled “Ectopic endometrium: the pathologists’ perspective” in a recent issue of the International Journal of Molecular Sciences. Endometriosis and adenomyosis are well-known entities as the existence of ectopic endometrial tissues in myometrium and extra-uterine places respectively. As early as the beginning of the 20th century, world-renowned pathologists Rokitansky, Meyer, Cullen, and Frankl put forward views on ectopic endometrial tissues. However, only Sampson put forward…

Key Points Lay Summary

Inflammatory and genetical background of endometriosis may yield new therapeutic approaches

Elisa Giacomini and colleagues from medical centers in Milan, Italy have published their review manuscript on the inflammatory and genetical pathogenetic background of endometriosis in a recent issue of  “International Journal of Molecular Sciences”, suggesting also new therapeutic approaches. The inflammatory basis of endometriosis with research supporting local and systemic immune cell dysfunctions is a widely accepted opinion. The published data of endometriosis research groups yields local and systemic immune cell dysfunctions, and an inflammatory component in all kinds of endometriosis.…

Key Points Lay Summary

Phytoestrogens could have promising effects in endometriosis management

Dr. Bartiromo and associates from Milan, Italy published a systematic review on phytoestrogens and endometriosis in the periodical “Nutrients”. Endometriosis has features of chronic inflammation based on uncontrolled hormonal response and immune-mediated dysfunctions. Estrogens are endocrine and paracrine agents that could yield adverse effects locally, even with modest variations of estrogen production. From this point, local increase in estradiol and modifications of estrogen receptor expressions in ectopic endometrial tissues may activate a network of cell proliferation genes. Phytoestrogens consist of flavonoids (i.e.,…

Key Points Lay Summary

Etiopathogenesis of Endometriosis and Links with Endometrial Cancer

Professor Terzic and colleagues from the Medical School of Nazarbayev University, Kazakhstan published their review on the molecular aspects of endometriosis and endometrial cancer in “International Journal of Molecular Sciences”. The etiopathogenesis of endometriosis has remained controversial, with recent studies suggesting a pelvic inflammatory condition, i.e. “sterile peritonitis”. The peritoneal fluid has an increased concentration of activated macrophages besides an inflammatory profile in the cytokine/chemokine molecular status. There is also further evidence on hormonal and immune factors creating a pro-inflammatory…

Key Points Lay Summary

Lead and cadmium exposures of female workers should be reduced as much as possible

Min-Gi Kim and associates from Korea published their results on the possible effects of lead and cadmium exposure in endometriosis induction and severity in a recent issue of “International Journal of Environmental Research and Public Health”. Endometriosis is an illness with multiple causal factors and there is growing evidence on endocrine-disrupting chemicals like dioxin could be involved in the induction and severity of the disease. Trace metals like cadmium, lead, copper, chromium, and mercury have been shown to possess endocrine-disrupting…

Key Points Lay Summary