Macrocephaly diagnosed during well child visits.

BACKGROUND: The measurement of head circumference (HC) provides valuable anthropometric data for a child's growth during well child visits. There are few studies on the characteristics of macrocephaly (MC) diagnosed during well child visits. The aim of this study was to identify the characteristics of children with MC diagnosed during the well-child visits. METHODS: This descriptive clinical study was carried out in the well child unit of a medical faculty hospital. The health records of all children who were followed up between 2004 and 2014 were reviewed. The records of children with the diagnosis of MC were evaluated. All children with MC had cranial ultrasonography, measurement of parental HC, and biochemistry. The HC measurements were carried out until 3 years of age in the unit. RESULTS: Ninety of 9,758 children (0.9%) had the diagnosis of MC. Of these children, 61% were male. Mean age at diagnosis was 2.7 months. The majority of children (63.3%) had familial MC. The other leading findings were isolated MC and hydrocephalus: two of eight children with hydrocephalus had delayed neuromotor development. CONCLUSION: MC was not rare in the present well child unit population. The evaluation of parental HC and cranial ultrasonography might be important for the differential diagnosis.

Risk Factor Assessment and a Ten-Year Experience of DDH Screening in a Well-Child Population.

AIM: Risk based screening for developmental dysplasia of the hip (DDH) with ultrasound is common. However, risk factors vary from one country to the other since data are insufficient to give clear recommendations. We aimed to evaluate the risk factors for developmental dysplasia of the hip (DDH). METHODS: In this retrospective case-control study, the health records of all children, who were followed up between 2004 and 2014 at a well-child unit, were investigated for the diagnosis of DDH in Turkey. Of 9758 children, 57 children were found to have abnormal ultrasonographic findings (according to Graf classification) and these constituted the case group. As the control group, healthy 228 children who matched the case children in birth months were selected. Two groups were compared for the risk factors. RESULTS: A total of 19516 hips of 9758 children were examined for DDH. 97 hips of 57 children were found to have abnormal ultrasonographic findings. When the two groups were compared, breech presentation, multiple pregnancy, and torticollis were identified as risk factors. The female sex was also found to have a significantly high prevalence among the children in the case group. Limited hip abduction, positive Ortolani, and Barlow signs were important clinical findings in the case group. CONCLUSION: According to our findings, breech presentation, female sex, torticollis, and multiple pregnancy were found to be the risk factors of this disorder. Infants with these risk factors should be investigated carefully for DDH.

Epidemiology of under-five mortality in Istanbul: changes from 1988 to 2011.

BACKGROUND/AIM: Understanding the causes of under-five deaths is key to realizing sustainable developmental goals. The aim of this descriptive study was to investigate the causes of under-five mortality in Istanbul during 2011 and compare the findings to those of 1988 and 2000. MATERIALS AND METHODS: All burial records of Istanbul were evaluated, and cemetery records of 1494 children, who died at under five years of age and were buried in Istanbul Metropolitan Municipality Cemeteries between 1 January and 31 December 2011, were analyzed. Several sociodemographic characteristics and causes of death were compared with the results of studies carried out in 1988 and 2000 in Istanbul with similar methods. RESULTS: Under-five mortality rate was lower in 2011 than in 1988 and 2000. Of all deaths, 58.8% had occurred in the neonatal period and most were in the first day of life, similarly to those of 1988 and 2000. The proportion of deaths in the age group of 1-4 years was found to be increasing. Prematurity and perinatal causes remained the main cause of death under five years of age in Istanbul during the 23-year period. Unknown causes, due to misclassification, were still seen in a relatively high proportion. CONCLUSION: Under-five mortality rate and death due to infectious diseases decreased in Istanbul from 1988 to 2011. Our findings showed a need for more emphasis on perinatal events and better evaluation of causes of death in clinical practice.