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The purpose of this study was to compare antipyretic activity and evaluate tolerability of ibuprofen and paracetamol suspension in the treatment of febrile children. It was designed as a double blind, parallel group, multiple dose study comparing ibuprofen (20 mg/kg/24 hours) with paracetamol (50 mg/kg/24 hours) given at six hourly intervals for a maximum of 12 doses. Children on paediatric wards between the ages of 0-2 and 12 years, with fever as defined by an axillary temperature ¢ 37 5°C, were included. The main outcome measures were: change in axillary temperature; palatability of medication; changes in irritability and clinical condition; overall efficacy at the end of treatment; and number and nature of adverse events.The mean temperature change from baseline at four hours was -1-8°C and -1 60C in ibuprofen and paracetamol groups respectively. In both groups: median palatability score was 'no reaction'; median irritability score at end point was 'not irritable'; median score for change in clinical condition was 'improved'; and median score for overall efficacy was 'good effect'. The proportion of patients experiencing adverse events was similar in both groups, the majority of events having doubtful or no relationship to therapy and being mild in severity.In conclusion, ibuprofen suspension was as effective and well tolerated as paracetamol in treatment of fever in young children.

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SUMMARY1. Transfer of fatty acids across the placenta was studied in anaesthetized rabbits at 28-days gestation by measuring umbilical venous-arterial differences, by injection of labelled palmitate into the mother and observing its appearance in the foetus, by injection of labelled palmitate into the foetus and measuring its appearance in the mother and the foetal clearance rate.2. The release of fatty acids and glycerol by foetal adipose tissues was investigated in vitro by measuring the effect of addition of noradrenaline to the incubation medium and in vivo by measuring the effect of noradrenaline infusion into the foetus on circulating glycerol and free fatty acid concentrations.3. In anaesthetized rabbits at 28-days gestation the maternal circulating free fatty acid concentrations were high and there was a positive umbilical venous-arterial difference. High maternal free fatty acid concentrations were associated with high umbilical venous-arterial differences.4. Label was present in the foetus in 2 min and reached a peak in 3 min after injection of labelled palmitate into the mother. Label appeared in the maternal circulation in 1 min after injection into the foetus. The half-life of labelled palmitate was of the order of 30-60 sec in both mother and foetus.5. Foetal white adipose tissue released both free fatty acids and glycerol into the medium and the rate of release increased four to five fold after addition of noradrenaline. Infusion of noradrenaline in the foetus led to a rise in glucose and glycerol concentrations, but the change in free fatty acid concentrations was not significant.6. It was concluded that (i) free fatty acids can cross the rabbit placenta in amounts sufficient to provide the fatty acid components of stored 30 M. C. ELPHICK, D. G. HUDSON AND D. HULL triglyceride and structural lipids; (ii) placental transport of free fatty acids depends in part on maternal blood concentration and on foetal uptake; (iii) foetal circulating free fatty acids are continually exchanging with fatty acid pools in the placenta and with the maternal circulating free fatty acids.

1. A direct method for measuring venous outflow from brown adipose tissue in anaesthetized new-born rabbits is described.2. During noradrenaline infusion the mean blood flow through brown adipose tissue increased from 87 to 360 ml./100 g tissue (wet wt.).min, and the mean rate of oxygen consumption of brown adipose tissue rose from 9.3 to 60 ml. O(2)/100 g tissue.min.3. During cold exposure the mean blood flow through brown adipose tissue increased from 90 to 304 ml./100 g tissue.min.4. The mean cardiac output was 266 ml./kg body weight.min; during noradrenaline infusion it was 405 ml./kg body weight.min. At rest about one tenth, and during noradrenaline infusion about one quarter of the cardiac output went to brown adipose tissue.5. It was calculated that most of the extra oxygen consumed during the metabolic response of the anaesthetized new-born rabbit to noradrenaline infusion or cold exposure was consumed by brown adipose tissue.6. Hypoxia (breathing 10% O(2) in N(2)) greatly reduced the increase in oxygen consumption but not the increase in blood flow in brown adipose tissue caused by noradrenaline infusion.

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