Peyote use during pregnancy.

Peyote is a substance with varied potential. Used properly it may be a spiritual aid but used in excess, it can be a hallucinogenic agent with teratogenic potential. There is a growing community of devout people who use it as part of their religious observance. The active ingredient, mescaline, has been linked to a specific group of fetal abnormalities when the substance is used inappropriately.

Supernumerary nipples and accessory breast tissue.

Supernumerary nipples and supernumerary breast tissue are often dismissed as cosmetic curiosities. These structures have the potential for pathologic degeneration and may be associated with significant congenital abnormalities. In a prospective comparison of 100 Native American women to 100 non-Native American women, these accessory organs were found much more commonly in Native American women. Careful attention should be given to thorough evaluation and long term follow-up of any patient in whom this anomaly is found.

An experience in missionary obstetrics and gynecology.

An extended visit at a small community hospital in Thailand provided an opportunity to observe and learn about rural health care in an emerging nation. Several aspects of gynecologic and obstetric care are compared.

Preparing faculty members for problem based, small group learning encounters.

In 1991, the University of South Dakota School of Medicine initiated the use of a problem based educational method for the junior students at the Yankton Campus. This program was innovative for both the students and the faculty. In order to prepare the faculty for their role in the management of the small group sessions, workshops were arranged. The students that made up the groups were chosen from the senior class at Yankton High School. Since these students needed appropriate prompting, the faculty gained experience in the management of a problem based small group learning session.

The Yankton Model Program.

Changes in medical education towards a student-centered, problem-based learning, with continuity care experience in ambulatory settings have been recommended. The University of South Dakota School of Medicine has developed such an educational model for third year medical students named the Yankton Model Program and is herein described.

Pregnancy complications in Sioux Indians.

The poor health status of Sioux Indians residing on reservations in South Dakota has been recognized for many years. The present report documents evidence of a high incidence of socioeconomic health-related disorders and pregnancy-related complications by comparing 342 pregnant white women and 405 pregnant Sioux Indian women. In collaboration with the Aberdeen Area Indian Health Service, beginning in 1976, a program was initiated to identify, assess risks, and provide patient management for pregnant Sioux Indians. This prenatal consultative program has proved effective in the reduction of fetal and infant mortality.

Postoperative pelvic gas collections mimicking abscesses or bowel injury.

Extraperitoneal gas collections were routinely found in the pelvic soft tissues following abdominal hysterectomies in 35 patients. These collections have the typical appearance of extraperitoneal gas, are absorbed gradually, and should not be confused with pelvic abscesses or bowel injury. There was no trapping of gas in the pelvic soft tissues following vaginal hysterectomies in 15 patients.

Postoperative pelvic gas collections simulating pelvic abscess.

Extraperitoneal gas collections are routinely found in pelvic soft tissues following abdominal hysterectomy. These collections have the typical appearance of extraperitoneal gas but should not be confused with pelvic infection or bowel injury. Similar collections are not routinely found following vaginal hysterectomy.