Multiseptate gallbladder presenting with biliary colic.

Common diagnoses associated with right upper quadrant and epigastric pain include cholecystitis, peptic ulcer disease (PUD), biliary colic, gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS). Multiseptate gallbladder is a rare congenital anomaly that can cause symptoms of biliary colic, however it may present with atypical symptoms, which can prolong definitive diagnosis and treatment. We present a case of multiseptate gallbladder in a 21-year-old female who initially presented with GERD and IBS.

Cost savings associated with the use of community health centers.

This study assesses the potential cost savings associated with the use of community health centers, based on econometric analyses of the 2006 Medical Expenditure Panel Survey. After controlling for health status, health insurance coverage, income, age, and other factors, this study finds that patients who receive a majority of their ambulatory care at community health centers have significantly lower annual overall medical expenditures (24%) and ambulatory expenditures (25%) than those who do not. These results are consistent with other studies indicating that, by providing good quality primary care, community health centers can reduce the utilization of other medical services.