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BACKGROUND AND OBJECTIVE: Late-onset sepsis frequently complicates prematurity, contributing to morbidity and mortality. Probiotics may reduce mortality and necrotizing enterocolitis (NEC) in preterm infants, with unclear effect on late-onset sepsis. This study aimed to determine the effect of administering a specific combination of probiotics to very preterm infants on culture-proven late-onset sepsis. METHODS: A prospective multicenter, double-blinded, placebo- controlled, randomized trial compared daily administration of a pro- biotic combination {Bifidobacterium infantis, Streptococcus thermophilus, and Bifidobacterium lactis, containing 1 x 109 total organisms) with placebo (maltodextrin) in infants born before 32 completed weeks' gestation weighing <1500 g. The primary outcome was at least 1 episode of definite late-onset sepsis. RESULTS: Between October 2007 and November 2011,1099 very preterm infants from Australia and New Zealand were randomized. Rates of definite late-onset sepsis (16.2%), NEC of Bell stage 2 or more (4.4%), and mortality (5.1%) were low in controls, with high breast milk feeding rates (96.9%). No significant difference in definite late-onset sepsis or all-cause mortality was found, but this probiotic combination reduced NEC of Bell stage 2 or more (2.0% versus 4.4%; relative risk 0.46, 95% confidence interval 0.23 to 0.93, P= .03; number needed to treat 43, 95% confidence interval 23 to 333). CONCLUSIONS: The probiotics B infantis, S thermophilus, and B lactis significantly reduced NEC of Bell stage 2 or more in very preterm infants, but not definite late-onset sepsis or mortality. Treatment with this combination of probiotics appears to be safe. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics which include the assessment of the long-term safety of inhaled ciclesonide on growth in children with asthma, effect of a community trial to promote judicious antibiotic use in Massachusetts and the clinical characteristics of New York City children who received tympanostomy tubes in 2002.

Presents abstracts of studies about pediatrics. "Who Receives a Diagnosis of Attention-Deficit/Hypersensitivity Disorders in the United States Elementary School Population?"; "Severe Pediatric Influenza in California, 2003-2005: Implications for Immunization Recommendations"; "Universal Newborn Hearing Screening and Postnatal Hearing Loss"; "Fathers and the Well-Child Visit."

This section presents abstracts of several articles about pediatrics. Late Neurologic and Cognitive Sequelae of Inflicted Traumatic Brain Injury in Infancy, Karen M. Barlow, Elaine Thomson, David Johnson and Robert A. Minns describes the long-term neurologic, behavioral and cognitive sequelae in infancy. Inflicted traumatic brain injury has a very poor prognosis and correlates with severity of injury. Extended follow-up is necessary so as not to underestimate problems such as specific learning difficulties and attentional and memory problems that may become apparent only once the child is in school. Ethnic Differences in Parent Preference to Be Present for Painful Medical Procedures, by Melissa Jones, Mohammed Qazi and Kelly D. Young examines ethnic differences between white, African American and Hispanic parents in their desire to remain present during their children's painful medical procedures. Association of Melanin Pigmentation in the Gingiva of Children With Parents Who Smoke, by Takashi Hanioka, Keiko Tanaka, Miki Ojima and Kazuo Yuuki establishes the association between gingival pigmentation and active smoking. This investigation is the first to address the relationship between gingival pigmentation in children and passive smoking.

Presents abstracts of several articles on pediatrics. "Utility of Rapid B-Type Natriuretic Peptide Assay for Diagnosis of Symptomatic Patent Ductus Arteriosus in Preterm Infants," by Byung Min Choi, Kee Hyoung Lee, Baik Lin Eun, Kee Hwan Yoo, Young Sook Hong, Chang Sung Son and Joo Won Lee; "Late-Onset Septicemia in a Norwegian National Cohort of Extremely Premature Infants Receiving Very Early Full Human Milk Feeding," by Arild Rønnestad, Tore G. Abrahamsen, Sverre Medbø, Hallvard Reigstad, Kristin Lossius, Per I. Kaaresen, Thore Egeland, Inger E. Engelund, Lorentz M. Irgens and Trond Markestad; "National Autism Prevalence Trends From United States Special Education Data," by Craig J. Newschaffer, Matthew D. Falb and James G. Gurney.