Eylül GÜN, MD

Dr Gun is a histopathologist who graduated from Aydin Adnan Menderes University and completed her surgical pathology training in Izmir Katip Celebi University Ataturk Training and Research Hospital in Turkey. She has presented her studies as a bursary awardee many times in the international congresses of the European Society of Pathology. She is a Diplomate of the Royal College of Pathologists, UK. She is interested in gynecological and urological pathology and has been doing research on these subjects. 

Gastrointestinal symptoms in colorectal deep endometriosis

The colon, particularly the recto-sigmoid is the most commonly involved area in deep endometriosis. These patients suffer from gastrointestinal symptoms almost as much as pelvic pain symptoms the most common being reported as frequent and painful defecation. Gastrointestinal symptoms may be seen in endometriosis patients without deep endometriosis as well owing to various mechanisms such as local irritation, anatomical impairments, inflammatory environment, and coexistence of irritable bowel syndrome.  Researchers from Austria and Belgium performed a prospective questionnaire-based study with colorectal deep…

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Creating a reliable indirect immunofluorescence protocol as a promising diagnostic tool for endometriosis

Owing to its inflammatory nature, endometriosis results in the overproduction of reactive oxygen species (ROS) which disrupt the cellular functions and eventually lead the cell to apoptosis and cell cycle arrest. Senescence, the natural state of irreversible cell cycle arrest, induces inflammation and production of ROS just like in endometriosis. The biomarkers that are used in evaluating cellular senescence are shown to be p16 and lamin B1 and the method used for this purpose is indirect immunofluorescence.  Palmieri et al.…

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 How accurate is ultrasonography in evaluating deep infiltrating endometriosis?

Deep infiltrating endometriosis (DIE) appears to be the most severe form of endometriosis comprising 15-30% of all endometriosis patients. The difference in the presentation of the lesions ranges from simple adhesions to infiltrative nodules. Even though there is no consensus on evaluating the severity of endometriosis, the American Society of Reproductive Medicine classification is widely used but it falls short of accurately capturing the traits of DIE. It is stated that pelvic ultrasonographic examination including transvaginal and rectal ultrasonography is…

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Which parameter is useful in predicting cardiovascular disease risk in perimenopausal endometriosis patients?

Cardiovascular disease is known to be the leading cause of death among women worldwide. Studies have shown that postmenopausal women are at a greater risk as well as women who undergo premature menopause proving the effect of hormonal imbalances on the development of cardiovascular events. The main contributor to cardiovascular disease is atherosclerosis. The assessment of vascular function is performed with arterial stiffness tests: cardio-ankle vascular index (CAVI) which shows arterial elasticity and ankle-brachial index (ABI) which is the ratio…

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Endometriosis Hospitalization Trends in Spain

According to the general assumption, one in every ten women is believed to have endometriosis. However, recent literature shows a big difference in the prevalence rates ranging from 1 to 5%, likely because most cases remain undiagnosed. The need for hospital admissions in endometriosis patients on the other hand has decreased in the latest years owing to the fact that outpatient care for these patients has increased. A group of researchers from Alicante, Spain, led by Dr. A. Queseda conducted…

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Anhedonia and its relation to endometriosis as a sole symptom

"Anhedonia may be defined as a broad category of hedonic function deficiencies, including diminished motivation or enjoyment capacity. It has been an area of interest for a long time in psychiatric disorders and has been crucial in some diagnoses such as being a major criteria component in the diagnosis of major depression. Recently, research on anhedonia has expanded beyond psychiatric illnesses, particularly in chronic health conditions. Upon the newly discovered findings of chronic pain sufferers having increased rates of anhedonia,…

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Epigenetic changes in endometriosis: A new target area for therapy

Epigenetics is the heritable genetic modifications and changes in chromosomes without alterations in the DNA sequence. Numerous mechanisms, like DNA methylation and RNA editing to mention a couple, have been discovered as epigenetic alterations that are triggered by environmental factors. Epigenetics play a role in maintaining the body's homeostasis, and any abnormalities in these mechanisms make way for certain diseases. In autoimmune diseases, the immune system attacks its own cells and many cells have roles in it as immune effectors.…

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Adenomyosis and the anti-mullerian hormone levels

The presence of endometrial glands and stroma in the myometrial layer of the uterus is called adenomyosis. It is considered a form of endometriosis and affects up to 35% of women with varying symptomatology, from asymptomatic to subfertility. For a long time, the diagnosis could only be made in the histological sections of the hysterectomy specimens. Nowadays, new technology and advances in radiological techniques may have made it possible to detect it via transvaginal ultrasound and magnetic resonance imaging. The…

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How beneficial is colorectal surgery for patients with deep endometriosis?

In cases of deep endometriosis, which causes more severe pain and gastrointestinal symptoms, the patient's quality of life and fertility outcomes are negatively affected. Surgical intervention is thought to be the optimal treatment method in colorectal deep endometriosis cases, however, there is controversy when it comes to the best surgical approach a segmental resection or the partial resection of the wall along with the endometriotic lesion - a discoid resection. Each technique has its own complications and advantages. The team…

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Rhein usage in endometriosis: A potential new therapeutic agent

The invasive nature of endometriosis has prompted scientists to find preventative and curative methods.  The progression and proliferation of endometriotic lesions are being studied extensively. As one of the agents used in Chinese herbal medicine for inflammatory disorders, rhein is an anthraquinone derivative found in the rhubarb root. It is known to have anti-proliferative, anti-oxidant, and pro-apoptotic effects and it has been shown to regulate its functions by targeting microRNAs (miRs) or long non-coding RNAs. The study performed by Dan…

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The dilemma of autophagy and its role in endometriosis

Autophagy is a mechanism for cell survival under metabolic stress that involves the degradation and recycling of intracellular components. Multiple genes actively control this process. Among these, the initiation stage of autophagosome formation is regulated by the gene Beclin-1 and Microtubule-associated protein light chain 3 (LC3) which is located on the membrane surface of autophagosomes has roles such as cell ingestion and antigen presentation and is used widely as a marker to detect autophagosomes. The autophagy pathway plays several functions…

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The Sex Life of Women With Endometriosis Improve After Laparoscopic Surgery

As one of the most common symptoms of endometriosis, dyspareunia affects the patient's quality of life in many aspects including sexual dysfunction and disorders. Among the treatment methods used in endometriosis, laparoscopic surgery is suggested to improve the symptoms of dyspareunia and the sexual quality of life. A group of researchers from Tehran, Iran conducted a cross-sectional study that aimed to assess the changes in sexual quality of life and sexual self-efficacy in patients with endometriosis after they underwent laparoscopic procedures. The study was published…

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How do the couples feel when dealing with endometriosis?

The effects of endometriosis on the patients' psychosocial well-being are well known. However, not many studies have investigated how it impacts the well-being of partners and couples. A few studies focused on the male perspective of the disease, whereas some of them investigated the sexual functioning of male partners. The burden endometriosis brings to a relationship is an important matter to explore and it has not been studied widely. With the aim of examining how partners affect each other in…

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Vitamin C as a possible therapeutic agent in endometriosis

A rather toxic environment is generated with the production of reactive oxygen species by the immune cells in endometriosis. The anti-oxidant metabolism is also altered which results in a state of oxidative stress. As a potent antioxidant, Vitamin C has many effective properties such as anti-inflammatory, anti-angiogenic, and immune stimulator and thus, it is thought to prevent the development of endometriotic lesions. With the increasing need for novel therapeutic agents, many studies have been focusing on non-hormonal methods in endometriosis…

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Fibrosis is not only a histological finding in endometriosis

Endometriosis remains to be an active subject of research with its complex pathophysiology and the indistinct mechanisms that cause the proliferation and progression of the lesions. Besides the already known characteristics of the disease, there is strong evidence to support fibrosis as a molecular hallmark of the disease, and Dr. Burney from Washington, USA has shared his reflections on the importance of fibrosis in endometriosis. The article was published in the July 2022 issue of the journal Fertility and Sterility.…

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An important matter to revise: Immune system changes in endometriosis

Endometriosis is a multifactorial disease with unclear and obscure pathogenetic mechanisms. In their review, Chopyak et al. revised the immunopathogenic pathways that are proven and/or thought to be responsible for disease development and progression. The article was published in the March 2022 issue of the Central European Journal of Immunology. Alterations in the functions of the immune cells play an important role in endometriosis pathogenesis. Systemic and local changes are observed in both innate and humoral immune cell levels which…

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The effects of resveratrol on endometriotic cells

The current treatment methods for endometriosis still carry recurrence risks and side effects from medications. Herbal medicine has been investigated and used as an additional alternative method. Derived from several plants and found in some dietary sources, resveratrol is a natural polyphenol. It has many features such as anti-carcinogenic, anti-inflammatory, antioxidant, and pro-apoptotic. The exact molecular mechanism however is yet to be known. Its role in inhibiting angiogenesis has also been a subject of cancer research and its use in…

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The best method for the diagnosis of endometriosis: SEE and BELIEVE

Deciding on the best diagnostic procedure for endometriosis patients has been a recent subject of debate. While some clinicians believe non-invasive methods such as imaging and symptom-based treatment should be the choice in the diagnosis, some believe the best method to detect the lesion is by seeing it via diagnostic laparoscopy. In the debate article written by Mak et al., it is argued that diagnostic laparoscopy is still a justified and useful diagnostic test in the diagnosis of endometriosis. The…

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Time has come to learn more about endometriosis and take action!

It has been a long time since endometriosis was defined. Extensive population studies have shown that around 10% of women suffer from this condition. Depending on its severity, it alters the various functions of the body and causes the patients to suffer. A perspective article by Ellis et al. attracts attention to the current knowledge and actions on endometriosis and was published in the May 2022 issue of the journal Frontiers in Global Women’s Health. The authors first detail the…

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Is it possible to reduce pain by diet in endometriosis?

Endometriosis-related pain is one of the most common symptoms of endometriosis that significantly affects the patient's quality of life. The peripheral and central sensitization, caused by chronic inflammation activation, may result in referred pain. The pain perception was shown to be decreased with dietary changes by some studies, including in patients with endometriosis. These changes include intake of Omega-3 polyunsaturated fatty acids (PUFAs), a low FODMAP diet, a Mediterranean diet, a gluten-free diet, and a low nickel diet. Researchers from…

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