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Isolated Macrodactyly

This well-formed, enlarged second digit on the right foot of a 2-day-old girl was noted at birth. All other digits were of normal size. The distal portion of the digit is deviated medially with a diminished triangular matrix unguis. No other musculoskeletal anomalies are apparent. There is no family history of congenital malformations or deformations.

A 15-year-old boy presented with a “string” protruding about 5 cm from his anus. He had had abdominal cramping that morning, prompting a bowel movement. After the stool, he passed a meter-long object that broke into the toilet. He attempted to remove the remaining “string,” but pulling on it induced left lower quadrant abdominal pain. He denied purposefully ingesting nonfood objects, choking, or chewing anything unusual. He also denied inserting anything or having anything inserted into his anus. He was otherwise healthy and had no significant medical or family history.

Contemporary Pediatrics asked its readers what they would say to President Obama regarding health care and pediatrics. No two responders hit the same points.