Irem Onur, MD

Dr. Onur is an associate professor of pathology with subspecialty certification in cytopathology in Turkey. She is deeply interested in medical writing and conveying the latest scientific information to medical professionals as well as the public.

Preoperative serum CA 125 levels predict the severity of adhesions in endometriosis

Lee Y. et al., a group of researchers from Korea evaluated the correlation between preoperative serum markers and pelvic adhesions in endometriosis patients and explored the markers’ clinical value for outcome prediction. They have recently published their study in the Journal of Gynecology Obstetrics and Human Reproduction. The researchers retrospectively reviewed the medical records of patients aged 19 to 52 years who underwent laparoscopy for histologic confirmation of endometriosis from January 2015 to December 2017. A total of 152 patients…

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The prevalence and severity of endometriosis today

Ghiasi M. et al., a group of researchers from the USA, presented a comprehensive review of the prevalence, incidence, and stage of endometriosis worldwide as reported over the past 30 years. Researchers performed a search in four databases, including PubMed, Web of Science, EMBASE, and CINAHL for relevant manuscripts.  Search terminologies were “endometriosis” AND “prevalence” or “incidence” or “epidemiology”, or “frequency”, or “occurrence”, or “statistics.” A total of 69 cross-sectional and cohort studies were included for the qualitative synthesis between…

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A nonhormonal treatment of endometriosis: Dichloroacetate

In women with endometriosis, peritoneal mesothelial cells show higher glycolysis, lower mitochondrial respiration, decreased enzymatic activity of pyruvate dehydrogenase and increased production of lactate compared to women without the disease. Transforming growth factorβ1 and lactate are elevated in the peritoneal fluid of endometriosis patients. Lactate can stimulate cell migration and invasion, and immune escape during tumorigenesis, with the same processes implicated in the etiology of endometriosis. Increased lactate concentrations in the pelvic peritoneal fluid may facilitate the invasion of ectopic…

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MRI findings predicting the need for colorectal surgical treatment of deep infiltrating endometriosis

LAY SUMMARY: Brusic A. et al., a group of researchers from Australia, conducted a retrospective study to identify the features of deep infiltrating endometriosis on MRI which have an association with colorectal surgical bowel resection. They have recently published their study in the journal named European Journal of Radiology. One-hundred twenty-two MRIs were included in the analysis. The median age at the time of MRI was 35 years. Of 122 patient MRIs, 71 experienced dyschezia, and 18 patient MRIs experienced…

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Cannabis usage among Australian women with endometriosis

Sinclair J. et al., a group of researchers from Australia, conducted a cross-sectional online survey to determine the prevalence, tolerability, and self-reported effectiveness of cannabis in women with endometriosis. This study included 484 women with complete responses. Of all women, 76% reported using a self-management strategy in the past 6 months, and 13% of these women self-reported using cannabis for endometriosis symptom management. Respondents had a median age of 30 years (25−36) and were mainly from urban areas (79% urban…

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A rigorous literature review on endometriosis

Bulun SE. et al., from Feinberg School of Medicine, Northwestern University, Chicago, conducted a rigorous literature review on endometriosis. This outstanding review by Dr. Bulun et al. addresses the definition, remarkable medical features, clinically useful research findings, prevalence and distribution, histopathology and mechanisms of endometriosis as well as key biological processes in endometriosis. In addition, it provides innovations in the clinical management of endometriosis, management of endometriosis-related infertility and advanced or future cell-based treatments including induced pluripotent stem cells. This…

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Which surgical approach for bowel endometriosis?

A group of researchers from Spain, led by Dr. Alicia Hernández Gutiérrez, conducted a retrospective study to compare postoperative complications and recurrence of three surgical techniques: segmental bowel resection (group I), discoid excision (group II), and rectal nodule shaving (group III). They analyzed 143 patients who underwent surgical treatment for symptomatic bowel endometriosis. Endometriosis patients who underwent segmental resection revealed a higher rate of severe postoperative complications in comparison with discoid resection or shaving groups. The authors explained the higher…

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Perinatal risk factors for endometriosis

Gao M. et al., from Sweden analyzed the associations of maternal and birth characteristics with the risk of endometriosis among Swedish women of reproductive age. They have recently published their study in the "International Journal of Epidemiology". The authors conducted a total-population register-based cohort study consisted of more than 625000 singleton women born in Sweden between 1973 and 1987. These women were followed for diagnosed endometriosis from age 15 years until the end of 2012. Among them, 8262 were diagnosed…

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Analysis of childless women with endometriosis

Facchin F. et al., from Italy studied if the beliefs of childless women regarding motherhood, female identity, and infertility affected their psychological health. They have recently published their study in the Journal of Health Psychology. The data of this study were derived from the study of Nisenblat et al. which analyzed the psychological impact of endometriosis on 190 women with a surgical or current clinical diagnosis of endometriosis. The participants matched the inclusion criteria of the current study such as diagnosis…

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Not a malignancy, it is "polypoid endometriosis"

Ghafoor S. et al., from Memorial Sloan Kettering Cancer Center, NY, USA, has recently reported a case of a 60-year-old postmenopausal woman with an incidental pelvic mass mimicking a pelvic malignancy on ultrasound. Their paper has been published in the journal Abdominal Radiology.  The patient had a history of a remote supracervical hysterectomy for symptomatic leiomyomata and resection of benign breast cysts. She had no remarkable medical history. Of note, she had been on continuous hormonal replacement therapy for the…

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Mortality of 49956 midlife women with surgically verified endometriosis

Saavalainen L. et al., from Finland recently published a retrospective large cohort study in the journal Human Reproduction, where they retrospectively examined the data of surgically verified endometriosis patients to find out if all-cause and the cause-specific mortality rate is increased in endometriosis patients. All endometriosis-associated diagnoses 1987 to 2012 were identified from the Finnish Hospital Discharge Register to identify surgically diagnosed cases. Altogether 57713 endometriosis diagnoses were detected among 49956 women. The reference cohort (n =98824) was randomly drawn…

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Botox as a promising treatment for chronic pelvic pain in endometriosis

Botulinum toxin (Botox) for treating chronic pelvic pain specifically addressing women with endometriosis has been studied for the first time by Tandon et al., from Bethesda, Maryland, USA. Their paper has recently been published in the journal Regional Anesthesia & Pain Medicine. In this proof-of-concept case series, 13 women with surgically diagnosed endometriosis and chronic pelvic pain persisting despite optimal surgical and hormonal treatments and pelvic floor muscle spasm were included in the study. Patients were recruited nationally within the…

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Chronic Fatigue Syndrome and Endometriosis: Comorbid Conditions

In the study of Dr. Boneva et al., from Atlanta, GA, the United States which has recently been published in the journal Frontiers in Pediatrics evaluated the impact of endometriosis on the health of women with chronic fatigue syndrome (CFS). The authors compared selected health characteristics and laboratory parameters in women with CFS with and without endometriosis. Thirty-six women with CFS from a cross-sectional study of CFS conducted between 2002 and 2003 were included in the study. The health characteristics and laboratory parameters…

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Control on endometriosis progression by a "tyrosine kinase inhibitor"

B cells, which are important players of the immune system, are increased in the blood and peritoneal cavity of endometriosis patients. Activation of B cells and the presence of anti-endometrial autoantibodies have been also been described in women with endometriosis, but their exact role in the disease mechanism is not known. Ibrutinib is a tyrosine kinase inhibitor which is essential for development and function of B cells. In order to better characterize the role of B cells on endometriosis, Riccio…

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"Endometriosis", "Fibromyalgia" and "Autoimmune diseases"

Greenbaum et al. from Israel, investigated the prevalence of and the association between endometriosis, fibromyalgia and autoimmune diseases in a large population database and described healthcare resource utilization in affected women. Their study has been published in the "American Journal of Reproductive Immunology". The authors performed a retrospective cross-sectional study using the computerized database of Maccabi Healthcare Services which has over 2.1 million members in Israel. Women aged ≥15 years who were registered in Maccabi Healthcare Services on 31/12/2015, had…

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Urocortin: A biomarker deserving investigation for endometriosis patients

Urocortin is a neuropeptide in the corticotropin-releasing hormone family and is expressed by eutopic and ectopic human endometria. Since it has paracrine and immunomodulatory effects, urocortin is thought to contribute to the pathogenesis of endometriosis. Its expression has been thoroughly investigated in the field of endometriosis. To find out if urocortin may be used as a screening and/or prognostic biomarker of endometriosis, Pergialiotis V. et al. from Athens, Greece, reviewed the literature and published their results in the "International Journal of…

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The association of significant hemoperitoneum (blood in the abdominal cavity) and deep pelvic endometriosis

 Although there are several theories to explain the etiology of deep endometriosis, the cause is unknown and there are currently no effective strategies to prevent its development. Bean E. et al., from University College London Hospital, UK,  observed that some women in their gynecology clinic who were referred with symptoms of chronic pelvic pain following conservative management of hemoperitoneum developed deep endometriosis. Based on this observation, the authors conducted a prospective observational cohort study to test their hypothesis that the…

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The relationship between periodontal disease and endometriosis

Thomas et al. have recently studied the association between endometriosis and periodontal disease which may share a common pathogenesis, and have published it in the Journal of Human Reproductive Sciences. The authors screened a total of50 women; 25 with and 25 without endometriosis, for periodontal diseases. The periodontal parameters included plaque index, gingival index, probing pocket depth, and loss of attachment. Scores for plaque index, the measures for probing pocket and loss were similar among cases and controls. The proportion of…

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Vaginal Sexual Intercourse during Menstruation

Mazokopakis and Samonis from Greece examined and discussed the vaginal sexual intercourse during menstruation from a biblical as well as a modern medical point of view in their paper published in MAEDICA – a Journal of Clinical Medicine in September 2018. According to the Old Testament (Provisions of clean and unclean of the Mosaic Law), menstruating women were perceived as unclean for 7 days and must not be approached to have sexual intercourse by men. Otherwise, men will be regarded as…

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The association of endometriosis and peritoneal malignant mesothelioma

Endometriosis is well known to cause chronic inflammation of the serosa and incite mesothelial hyperplasia. Although multilocular peritoneal inclusion cysts and well-differentiated papillary mesothelioma were reported to be associated with endometriosis, the association of malignant mesothelioma has not been reported before. Butnor et al. reported 6 cases of peritoneal malignant mesothelioma arising in the setting of endometriosis. Their study which is the first report of malignant mesothelioma in women with endometriosis has recently been published in the Journal of Clinical Pathology in November…

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