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.

Fatigue from the viewpoint of patients with endometriosis

Fatigue, feeling spoonie, is documented as a significant symptom of endometriosis in many studies. Researchers from three different institutions dealing with reproductive health conducted individual interviews with patients reporting moderate to severe endometriosis-related pain to better understand endometriosis-related fatigue and its effect on patients. The study sample included 22 endometriosis patients who had a mean age of 38.6 years (range, 27-48 years). The research team found that symptoms reported by endometriosis patients were fatigue (100%), pain with periods (86.4%), heavy…

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Are endometriosis patients at higher risk of bipolar disorder?

Endometriosis patients are prone to develop certain psychiatric disorders, including depression and anxiety, as well as bipolar disorder, according to a nationwide population-based cohort study from Taiwan. Bipolar disorder formerly called manic-depression is a chronic mental disorder characterized by unusual changes in mood, energy, activity level, and ability to perform daily tasks and fatigue. Chen et al., researchers from Taiwan, investigated the risk of bipolar disorder development in women with endometriosis as well as the effect of endometriosis treatment on the…

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The efficacy of combined hormonal contraception on pelvic pain in endometriosis patients

Chronic pelvic pain, which is experienced by more than 33% of endometriosis patients, constitutes a significant challenge for patients and physicians. A new study that appears in the journal Human Reproduction Open has explored the prevalence of endometriosis patients with a history of combined hormonal contraception (CHC) ineffectiveness for pain or discontinuation due to side-effects. The researchers have also determined the association between CHC ineffectiveness or discontinuation due to side-effects and quality-of-life, psychological scores, and underlying pain conditions. Yong PJ et al.,…

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Long-term Pregnancy Results after Surgical Removal of Endometrioma

Sun et al., from China, investigated the pregnancy outcomes and the related factors in patients with endometrioma and stage III-IV endometriosis along with a long-term follow-up postoperatively. Their study has recently been published in the journal named "Advances in Therapy". Among 347 patients with ovarian endometriosis, 59 infertile patients with stage III-IV endometriosis who had a minimum of 5 years of postoperative follow-up after undergoing laparoscopic excision of ovarian endometriomas were included in the study. The mean age was 32…

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Kisspeptin and its Receptor in the Pathogenesis of Endometriosis

It is known that matrix metalloproteinases (MMP) may play a role in the pathogenesis of endometriosis. For example, the upregulation of MMP-2 and MMP-9 may enhance the degradation of extracellular matrix proteins, facilitating cell migration and invasion. Kisspeptin (KISS1, also known as metastin), a neuropeptide hormone, encoded by the KISS1 gene, may interact with MMPs in endometrial tissue. Abdelkareem et al. evaluated the immunoreactivity of KISS1 and its receptor in the eutopic endometrium of patients with and without endometriosis, in…

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The relationship of serum concentrations of neuropilin-1 (NRP-1) and endometriosis

Although many serum biomarkers or biomarker panels for endometriosis are evaluated, none of them is exact enough to be used in daily laboratory practice. In a recent study, which has been published in Scandinavian Journal Of Clinical and Laboratory Investigation, Barberic et al., researchers from Croatia, aimed to investigate the serum concentration of neuropilin-1 (NRP-1) in women with endometriosis and to evaluate the level of NRP-1 to preoperatively predict the diagnosis of endometriosis. NRP-1 is is a transmembrane glycoprotein that serves…

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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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