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1. Changes in environmental temperature may cause alterations in TSH secretion and in the serum concentration of thyroid hormones and their metabolism. For this reason, it is difficult to precisely classify all external and internal influences according to their mode of action. Stubblefield, MD Emeritus Professor of Obstetrics and Gynecology, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA. 2 Within a few years, the technique became widely practiced in Russia and Eastern Europe. This chapter reviews effects on the thyroid produced by changes in the external environment, chemicals and drugs. The overall effects of environmental temperature have been more obvious and easier to demonstrate in animals than in humans but differences in thermal regulation 1a may mean that findings in animal models may not apply to humans. Effects of the Environment, Chemicals and Drugs on Thyroid Function. INSTRUMENTS FOR VACUUM CURETTAGE Vacuum for uterine aspiration can be produced with either an electric pump or a hand-held syringe (manual vacuum). The in vitro effects of temperature on the firmness of binding of T4 to its transport serum proteins conceivably also play a role in vivo. The changes are probably mediated through the hypothalamus and the pituitary and by peripheral effects on the pathways and rates of thyroid hormone degradation and fecal losses and alterations in thyroid hormone action. D. Lynn Borgatta, MD, MPH Associate Professor of Obstetrics and Gynecology, Boston University School of Medicine, Boston, Massachusetts, USA. The thyroid is subject to a great number of exogenous and endogenous perturbations. The effects of the more important factors and chemical agents and drugs are discussed individually. The sensitive and tightly regulated feedback control system, thyroid gland autoregulation, and the large intrathyroidal and extrathyroidal storage pools of thyroid hormone serve to provide a constant supply of thyroid hormone to peripheral tissues in the face of perturbations imposed by the external environment, chemicals and drugs, and a variety of diseases processes.
David Sarne, M. Additionally, studies of individuals with prolonged residence in Arctic and Antarctic regions may be confounded by other alterations in daylight, activity levels, living conditions and sleep deprivation. The same agent may produce alterations in various aspects of thyroid hormone economy. Surgical techniques in the first trimester consist virtually exclusively of vacuum or suction techniques. The effects of non-thyroidal illness are reviewed in Chapter 5b. Abortion has been widely practiced since ancient times, and instruments for scraping the uterine cavity existed in Greek and Roman civilizations. Manual vacuum aspiration is the term commonly applied to uterine evacuation using a hand-held syringe as the source of the vacuum. In 1958, the Chinese Medical Journal published reports of abortion induced by vacuum curettage. Electric vacuum is used for most abortions in the United States, but manual vacuum is used for an increasing proportion. Kattan, MD, MPH Instructor, Obstetrics and Gynecology, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA. Medical Director, Endocrinology and Metabolism Clinics University of Chicago. There should be two vacuum bottles in series and a third bottle or trap with a one-way valve to protect the pump from any overflow of fluid. 1 Vacuum curettage techniques, however, are of more recent origin. A number of electrically powered uterine aspirators are sold in the United States. By the time abortion was legalized throughout the United States in 1973, the vacuum technique had largely replaced the older method of dilation and sharp uterine curettage.
