BACKGROUND: Teratology Information Services (TIS) educate the public and health professionals via telephone regarding the safety of drugs and other exposures during pregnancy and lactation. Currently TIS consultations are free, but funding is eroding. A cost-benefit analysis may inform resource allocation. It was hypothesized that an individual TIS consultation regarding anti-depressant use during pregnancy provides a positive net benefit compared to a family doctor (FD) consultation. METHODS: A survey of international TIS was conducted to gauge TIS costs. A discrete choice experiment (DCE) was designed to assess preferences and willingness-to-pay (WTP, an estimate of benefit) for teratology counseling. DCE respondents (local community volunteers) chose between potential counseling services following an anti-depressant exposure during pregnancy. Services were described by five service attributes and one cost attribute, which were generated in focus groups. Preferences and WTP were estimated using logit regression. Incremental benefits and costs of counseling by TIS and FD were compared in a probabilistic sensitivity analysis to obtain the incremental net benefit from both a societal (productivity costs included) and health system perspective. The FD consultation was costed through OHIP billing codes. The TIS consultation was micro-costed. RESULTS: Eighteen TIS in North America and 16 international TIS completed the survey. Most TIS are small (median two employees, median budget US$69,000). The DCE had 175 respondents. The most important attribute of counseling was receiving very helpful information; information delivery methods were less important. WTP for the TIS scenario was CDN$124 (SD $12); WTP for the FD scenario was CDN$79 (SD $8). Service costs were similar for TIS and FD (approximately $32/consultation); FD had higher productivity costs. Incremental TIS benefits were likely to outweigh costs under both the societal and health system perspectives (probability 99% and 97% respectively). CONCLUSIONS: An economic evaluation of a program that delivers pregnancy health information via telephone required a novel approach. While there are some methodological challenges to valuing benefits through willingness-to-pay, it may be appropriate for valuing counseling. TIS should emphasize their ability to provide high quality information. The benefits of an individual TIS consultation on anti-depressant use during pregnancy are likely greater than the costs.

Le monstre intrigue et fascine : il a été étudié, disséqué, et abondamment mis en scène dans des œuvres littéraires. Il reste pourtant mystérieux : nous retrouvons par exemple des monstres similaires dans des cultures éloignées sans aucun contact aussi bien temporellement que géographiquement. Mais si la tératologie est florissante dans de nombreux pays, cet engouement paraît être moins partagé lorsqu’il s’agit de la littérature mexicaine contemporaine car les monstres y sont moins analysés. Ils y sont pourtant présents et nombreux. Une grande partie de notre travail consiste à proposer une typologie des figures du monstre du folklore mexicain en regroupant ceux qui apparaissent dans des recueils de légendes ou des dictionnaires de créatures étranges. Cela permet de comprendre comment il est perçu dans la croyance populaire puis ensuite réutilisé par des auteurs d’œuvres fictionnelles.Le monstre est inscrit dans un imaginaire populaire collectif partagé d’abord oralement puis passé à l’écrit, et ainsi transmis en héritage aux générations futures. L’écriture littéraire s’inspire de cet héritage, ce qui crée une sorte d’hypertextualité entre l’imaginaire collectif présent dans les mythes et légendes, et l’imaginaire individuel de l’auteur par le biais de ses œuvres de fiction. Ce dernier réactive ces sources et même les modifie. L’intertextualité est aussi présente entre les fictions mexicaines et celles du reste du monde, ce qui nous invite à proposer une analyse littéraire comparatiste lorsque celle-ci est possible. Le but de ce travail est de déterminer à travers ces jeux d’écriture et ces inventions, les enjeux de ces figures du monstre dans la littérature mexicaine. / The monster intrigues and fascinates: he was studied, dissected, and abundantly staged in literary works. He remains nevertheless mysterious: we find for example similar monsters in distant cultures without any contact so temporarily as geographically. But if the teratology is prosperous in numerous countries, this craze appears to be less shared when it is the contemporary Mexican literature because monsters are less analyzed there. Nevertheless, they are present and numerous. A big part of our work consists in proposing a typology of the figures of the monster of the Mexican folklore by grouping those who appear in collections of legends or the dictionaries of strange creatures. It allows to understand how it is perceived in the popular belief and then reused by authors of fictional works.The monster is registered in a collective popular imagination, shared at first orally then passed to the paper, and transmitted in inheritance to the future generations. The literary writing is inspired by this inheritance, what creates a sort of hypertextuality between the present collective imagination in the myths and the legends, and the individual imagination of the author by means of its works of fiction. The latter revives these sources and even modifies them. The intertextuality is also present between the Mexican fictions and those besides of the world, what invites us to propose a comparative literary analysis when this one is possible. The purpose of this work is to determine through these sets of writing and these inventions, the stakes in these figures of the monster in the Mexican literature.

Maternal administration of a single dose of retinoic acid (vitamin A acid, 100 mg/kg) on either the 11 th, 11 1/2, 12th, 12 1/2, 13th or 13 1/2 day of gestation produced phocomelia or partial phocomelia in ICR/DUB fetuses. The results depended upon the time of treatment and two gradients of effect were produced: 1) cranio-caudal gradient, since forelimb defects resulted from treatment between days 11 and 13, while similar hindlimb abnormalities were produced by administration of retinoic acid 12 to 24 hours later: 2) proximo-distal gradient, due to the heterogenous sensitivity among individual bones of the limb. In the forelimb, early treatment (11th day) produced humero-ulnar defects and later treatment (12th day) ulnoradial defects. A similar proximo-distal gradient was observed in the hindlimb. The use of teratological studies as a tool to assist morphogenetic investigation is discussed.

Neonatal Sprague-Dawley rat pups were assigned to one of five groups. Three cocaine-treated groups were injected SC with either 40, 60, or 80 mg/kg/day of cocaine from postnatal day (PND) 4 through 9. Control groups were either injected with equivalent volumes of sterile dH2O (vehicle control) or received no injections (normal control) from PND 4 through 9. This early postnatal period, corresponding to the third trimester of pregnancy in humans, is characterized as a period of rapid development within the central nervous system (CNS), generally termed the brain growth spurt. The survival rate, somatic growth, and brain development in response to the various dosages of postnatal cocaine administration were assessed. There was a dose-dependent relationship between cocaine administration and survival rate. Furthermore, significantly reduced somatic growth, assessed in terms of body weight, was found in animals given 80 mg/kg cocaine daily, as compared with controls. With respect to brain weight, no significant differences were obtained among the various doses of cocaine-treated and control animals and there was no evidence of regional vulnerability (forebrain, cerebellum, or brainstem) to the cocaine insult. Additionally, neither an effect of gender, nor the interactions of gender with various doses of cocaine treatment was found on somatic growth and brain development. Taken together, the present results suggest that the brain exhibits a greater resistance to the cocaine insults than does somatic growth. Several possible explanations regarding the somatic growth retardation are discussed.

Les plantes à fleurs se caractérisent par une diversification rapide au cours de l’évolution des plantes à graines, en partie grâce à l'émergence de la structure florale. L’étude des phénotypes tératologiques se présente comme un outil important pour mieux comprendre l’apparition et le maintien des innovations florales. Le genre Delphinium L. appartient à la famille des Ranunculaceae, une des premières familles ayant divergé parmi les Eudicotylédones (clade le plus diversifié au sein des Angiospermes) et présentant une grande diversité florale.Dans un premier temps, nous avons réalisé une étude phylogénétique, morpho-anatomique et pollinique de l'espèce Delphinium turcicum (H.Duman, Vural, Aytac & Adiguzel) Espinosa, espèce endémique turque connue depuis plus de 20 ans dans la nature et présentant des déviations par rapport à la fleur typique du genre Delphinium. Cette étude nous a permis de comprendre l'organisation de la fleur de cette espèce ainsi que de mettre en évidence des modifications de symétrie, du type d'organes formant le périanthe, et du développement des éperons. Des anomalies dans le développement des organes floraux, potentiellement liées à des modifications dans l'expression des gènes responsables de l'établissement de l'identité florale, sont à l'origine de ce phénotype particulier. Dans un deuxième temps, nous avons réalisé une étude de la morpho-anatomie florale de cultivars, organismes présentant des variations florales importantes issues d’une sélection artificielle, des genres Delphinium L. et Aquilegia L. (ce dernier appartenant également aux Ranunculaceae et un des genres modèles pour les études évo-dévo). Cette étude nous a permis d'identifier les étapes cruciales du développement floral pendant lesquelles ces variations prennent place. Chez les deux genres nous avons trouvé que la symétrie florale et la phyllotaxie sont conservées, tandis que l'organisation florale et la vascularisation de la fleur sont modifiées par rapport à la morphologie des fleurs typiques. La plupart des déviations morphologiques et anatomiques se situent au niveau du périanthe, et concernent notamment le nombre et l'identité des organes qui le forment. Nous avons émis l'hypothèse que les phénotypes floraux des cultivars d'Aquilegia L. et Delphinium L. résultent d'altérations génétiques affectant la taille du méristème, les frontières entre les organes d'identité différente, l'organogenèse et le développement des structures nectarifères. Dans un troisième temps, une recherche historique sur la taxonomie du genre Delphinium L. a permis de mettre en évidence les possibles ambiguïtés induites par les variations florales au sein du genre. L'inclusion de l'espèce D. turcicum dans le genre Delphinium requiert d’amender la description du genre afin d'inclure les particularités florales de l'espèce.Cete thèse permet de mettre en évidence les étapes cruciales du développement pendant lesquelles les variations morphologiques prennent place, ainsi que de viser les gènes potentiellement à l'origine de ces variations chez une espèce sauvage et chez des variétés issues d’une sélection artificielle. Ces nouvelles informations permettront d'orienter des études en évo-dévo visant la compréhension de l'évolution florale au sein des Angiospermes. / In the evolution of seed plants, flowering plants are characterized by an especially rapid, partly due to the emergence of the floral structure. The study of teratological phenotypes is an interesting tool to better understand the origin and maintenance of floral innovations. The genus Delphinium L. belongs to the family Ranunculaceae, one of the earliest-diverging families among Eudicots and characterized by an outstanding floral.First, we carried out phylogenetic, morphological, anatomical and palynological studies of Delphinium turcicum (H.Duman, Vural, Aytac & Adiguzel) Espinosa, a Turkish endemic species known for more than 20 years in the wild and presenting unusual floral features. This study allowed us to understand the organization of the flower of this species, as well as to characterize the deviations to the typical morphology (modification of symmetry, of the type of organs composing the perianth and of the spur development). Changes in floral organ development, possibly related to changes in the expression of genes involved in floral identity, are responsible for this particular phenotype. Second, I carried out a morphological-anatomical study of cultivars (organisms with major floral variations resulting from artificial selection) of the genera Delphinium L. and Aquilegia L. (the latter belongs to Ranunculaceae and has been proposed as model genus for evo-devo studies). This study allowed me to identify the crucial stages of floral development where morphological variations take place. In both genera, floral symmetry and phyllotaxis were found to be conserved, while flower arrangement and vascularization were altered with respect to the typical flower morphology. Most morphological and anatomical deviations affect the perianth, especially on the number and identity of the organs. We hypothesized that the floral phenotypes of the cultivars of Delphinium L. and Aquilegia L. result from genetic alterations affecting meristem size, boundaries between sets of organs of different identity, organogenesis and development of nectariferous structures. Third, a historical research on the taxonomy of the genus Delphinium L. highlighted the taxonomical ambiguities induced by the floral morphological variations recorded within the genus. The inclusion of the species Delphinium turcicum implies amending the genus description in order to include the floral features of the species.This thesis, through the study of a wild species and of varieties undergoing artificial selection, allowed to highlight the crucial developmental stages during which the morphological floral variations take place, as well as to target the genes possibly responsible for these variations. These results will guide future evo-devo studies aiming at understanding floral evolution within angiosperms, and better understand the evolution of angiosperms as a whole.

Submitted by Adriana Martinez (amartinez@unoeste.br) on 2016-10-11T12:17:24Z No. of bitstreams: 1 Jaqueline Nascimento da Silva.pdf: 2368376 bytes, checksum: b34072cdd99331d11d5544ee10f94320 (MD5) / Made available in DSpace on 2016-10-11T12:17:24Z (GMT). No. of bitstreams: 1 Jaqueline Nascimento da Silva.pdf: 2368376 bytes, checksum: b34072cdd99331d11d5544ee10f94320 (MD5) Previous issue date: 2016-04-25 / Brazil produces approximately 1% of natural rubber derived from rubber tree (Hevea brasiliensis) in the world, and Sao Paulo state is the major producer. The plantation of rubber tree might be stricken by fungal diseases, specially Antracnose. This fact requires the necessity of agriculture defenders as Cerconil WP®, composed by thiophanate methyl and chlorothalonil, one of the most used. Facing the large exposure to these compounds of workers and population that live near plantations, it is extremely important evaluate its possible toxicity and health impacts. Once that, the present work had as objective identify potential teratogenic effects and maternal toxicity of exposure to Cerconil WP® fungicide in different doses, using rat as an experimental model. Moreover, the study also aimed to identify effects of this fungicide on the chemistry structure latex of rubber tree, via Raman Spectroscopy. Therefore, Winstar female rats, adults and pregnant were divided into 4 experimental groups, that received 0 (control), 400 (EA), 800 (EB) or 1200mg/kg/day (EC) of Cerconil WP®, via gavage, from 6º to 15º gestational day (GD). In GD20, pregnant rats were euthanized and submitted to laparotomy for collection of uterus and maternal organs. The fetuses were collect, processed to skeletal and visceral analysis. Rats that were exposure to the fungicide presented clinical signs of toxicity. Reduction in weight evidenced in all groups in comparison to the Control group in GD12. Weight of maternal liver was lower in group EC than Control and histopathologic analysis of hepatic tissue presented areas of focal necrosis, inflammatory infiltrate, picnotic nuclei in hepatocytes and microvesicular fat degeneration areas moderated in groups EB and EC. The percentage of fetuses with adequate weight for gestational age was lower in groups EA and EB, in relation to the Control and EC groups. Porcentage of little fetuses increased in group EA, in relation to the other experimental groups, and in group EB in comparison to Control. In addition, there was an increase of total incidence of skeletal anomalies in groups exposure in relation to the control. Skeletal alterations observed in higher frequency were: decrease in esternal centres, absence of xiphoid process and caudal vertebrae, malformation of suppra-occiptal and reduction on number of anterior and metatarsus phalanges. Measures of Raman Spectroscopy (laser island of 514,5 nm, 25 seconds of exposure and 3 to 5 accumulations) did not show significant chemistry alterations on the latex exposure in vitro to 2g/L of Cerconil WP®. Results demonstrated that the oral exposure of pregnant rats to Cerconil WP®, during organogenesis, might affect on the embrio-fetal development and cause low toxicity to general maternal health. However, the molecular structure of latex exposed to the fungicide was not affect on the experimental study conditions. / O Brasil produz aproximadamente 1% da borracha natural derivada de seringueira (Hevea brasiliensis) no mundo, sendo o estado de São Paulo o maior produtor. O plantio de seringueira pode ser acometido por doenças fúngicas, especialmente a Antracnose. Isto leva à necessidade do uso de defensivos agrícolas, sendo o Cerconil WP®, composto por tiofanato metílico e clorotalonil, um dos mais utilizados. Diante da ampla exposição de trabalhadores rurais e da população do entorno das plantações a estes compostos, torna-se extremamente importante avaliar a sua possível toxicidade e impactos à saúde. Assim, o presente trabalho teve como objetivo identificar os potenciais efeitos teratogênicos e de toxicidade materna da exposição ao fungicida Cerconil WP® em diferentes doses, utilizando o rato como modelo experimental. Além disso, o estudo também pretendeu identificar os efeitos deste composto sobre a estrutura química do látex de seringueira, via Espectroscopia de Espalhamento Raman. Para tanto, ratas Wistar adultas prenhes foram divididas em 4 grupos experimentais, que receberam 0 (controle), 400 (EA), 800 (EB) ou 1200mg/kg/dia (EC) de Cerconil WP®, via gavagem, do 6º ao 15º dia gestacional (DG). No DG20, as ratas prenhes foram mortas e submetidas à laparotomia para coleta do útero gravídico e órgãos maternos. Os fetos coletados foram processados para análise esquelética e visceral. Ratas expostas ao fungicida apresentaram sinais clínicos de toxicidade. Houve redução no peso das ratas no DG12 em todos os grupos expostos em relação ao grupo controle. O peso do fígado materno foi reduzido no grupo EC em relação ao controle e a análise histopatológica do tecido hepático apresentou áreas com necrose focal, infiltrado inflamatório, presença de hepatócitos com núcleo picnótico e área com formação de degeneração gordurosa microvesicular de moderada intensidade nos grupos EB e EC. A porcentagem de fetos com peso adequado para a idade gestacional foi menor nos grupos EA e EB, em relação aos grupos controle e EC. Além disso, a porcentagem de fetos pequenos aumentou no grupo EA, em relação aos demais grupos experimentais, e no grupo EB em relação ao controle. Foi observado um aumento na incidência total de anomalias esqueléticas nos grupos expostos em relação ao grupo controle. As alterações esqueléticas observadas em maior frequência foram: diminuição dos centros esternais, ausência de processo xifoide e vertebras caudais, malformação do supra-occipital e redução no número de falanges anteriores e metatarsos. As medidas de Espectroscopia de Espalhamento Raman (linha de laser de 514,5 nm, 25 segundos de exposição e 3 a 5 acumulações) não apresentaram alterações químicas significativas no látex exposto in vitro a 2g/L de Cerconil WP®. Os resultados demonstram que a exposição oral de ratas prenhes ao Cerconil WP®, durante a organogênese, pode afetar o desenvolvimento embrio-fetal e causar toxicidade leve sobre a saúde geral materna. No entanto, a estrutura molecular do látex exposto ao fungicida não foi afetada nas condições experimentais do estudo.

Orientadores: Wilma De Grava Kempinas, Jair de Campos Soares / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-16T17:23:07Z (GMT). No. of bitstreams: 1 Francia-Farje_LuisAlbertoDomingo_D.pdf: 5269408 bytes, checksum: 9fcbeacc2566c4c907be21de0f818627 (MD5) Previous issue date: 2010 / Resumo: A ação anorexígena e termogênica da sibutramina é bem conhecida e tem com efeitos colaterrais principalmente o aumento da pressão arterial e da frequência cardíaca. Entretanto, seus efeitos sobre a performance reprodutiva e sobre os fetos de mulheres que receberam sibutramina durante a gestação nõa é bem conhecido. Assim, os trabalhos mostrados nesta tese têm o bojetivo de avaliar os possíveis efeitos da sibutramina na pergormance reprodutiva de ratas prenhes, assim como seu possível efeito teratogêncio na prole de ratas tratadas durante a prenheze sua possível influência na morfofisiologia cardíaca das mães...Observação: O resumo, na íntegra poderá ser visualizado no texto completo da tese digital / Abstract: The anorexigenic and thermogenic action of sibutramine is well-knownand its side effects are mainly the increase of arterial pressure and cardiac frequency. However, its effects on the reproductive performance and on the fetuses of women who had sibutramine during pregnancy are not well known. Thus, the studies in this thesis aimed to evaluate possible effects of sibutramine on the reproductive performance of pregnant rats as well as its possible teratogenic effect on the pups of rats treated during pregnancy and its possible influence on the cardiac morpho physiology of the mothers...Note: The complete abstract is available with the full electronic digital thesis or dissertations / Doutorado / Anatomia / Doutor em Biologia Celular e Estrutural

Les centres d’information sur les tératogènes (CIT) fournissent aux professionnels de la santé ainsi qu’au public de l’information sur les risques et bienfaits associés à l’utilisation des médicaments durant la grossesse et l’allaitement. Le Centre IMAGe (Info-Médicaments en Allaitement et Grossesse) du CHU Sainte-Justine (Centre Hospitalier Universitaire Sainte-Justine) au Québec, est un CIT qui offre depuis 1997 un service téléphonique d’information gratuit aux professionnels de la santé. Deux études ont été réalisées à partir des appels reçus au Centre IMAGe. La première étude a été réalisée sur l’ensemble des appels reçus entre janvier 2004 et avril 2007 au sujet de femmes qui prenaient ou envisageaient prendre un médicament durant la grossesse ou l’allaitement. Les objectifs de cette étude visaient à déterminer les classes de médicaments les plus fréquentes ainsi que les indications d’utilisation et les déterminants d’un appel à leur sujet (caractéristiques maternelles associées). Les antidépresseurs, les anti-inflammatoires, les antibiotiques, les benzodiazépines et les antipsychotiques sont les classes de médicaments qui correspondaient aux plus grands nombres d’appels. Cela porte à croire que pour ces classes de médicaments, il existe chez les professionnels de la santé un besoin d’information en ce qui concerne les risques et bienfaits de leur utilisation durant la grossesse et l’allaitement. La dépression représentait une des trois indications les plus prévalentes chez les femmes qui prenaient ou désiraient prendre des antidépresseurs, des benzodiazépines ou des anti-psychotiques durant la grossesse ou l’allaitement. Le tabagisme était associé à l’utilisation des antidépresseurs et des anti-psychotiques durant la grossesse, ainsi qu’à un appel au sujet des anti-inflammatoires durant l’allaitement. La deuxième étude a été réalisée sur l’ensemble des appels reçus entre janvier 2003 et mars 2008. Cette étude visait à déterminer l’impact des avis émis par Santé Canada concernant les risques de l’exposition aux antidépresseurs durant la grossesse et celui concernant le retrait du rofécoxib, sur le nombre d’appels reçus à IMAGe. L’analyse des séries temporelles du nombre hebdomadaire d’appels reçus a révélé que l’avis de Santé Canada sur les risques de malformations cardiaques associés à l’utilisation de la paroxétine lors du premier trimestre de la grossesse a généré une augmentation statistiquement significative, soudaine et permanente du nombre d’appels reçus à IMAGe au sujet des antidépresseurs. Ces études permettent de mieux comprendre le besoin d’information des professionnels de la santé sur les risques et bienfaits de l’utilisation des médicaments durant la grossesse et l’allaitement. / Teratogen Information Services (TIS) are giving information on the risks and benefits associated with medication use during pregnancy and lactation, to the health care providers and the public. IMAGe Center at the CHU Sainte-Justine in Quebec is a TIS which providing since 1997 a free telephone information service to the health care providers. Two studies were conducted using the calls received at IMAGe Center. The first study included all the calls received between January 2004, and April 2007, concerning women who used or expected to use medication during pregnancy or lactation. The objectives of this study aimed to identify the most frequent medication classes, the indications of use, and the predictors of a call concerning them (associated maternal characteristics). Antidepressants, anti-inflammatory drugs, antibiotics, benzodiazepines, and anti-psychotics represented the medication classes with the greater amount of calls. These results rise to the possibility that more information about the risks and benefits associated with the use of these medication classes during pregnancy and lactation is needed by the health care providers. Depression was in the top three of the most prevalent indications of use for the antidepressants, benzodiazepines, and anti-psychotics. Smoking was associated with the use of antidepressants and anti-psychotics during pregnancy, and with a call concerning the anti-inflammatory drugs during lactation. The second study included all the calls received between January 2003, and March 2008. This study aimed to identify the impact of the Health Canada (HC) warnings, concerning the risks of antidepressant use during pregnancy, and related to the rofecoxib market withdrawal, on the number of calls received to IMAGe. Time series of the weekly number of calls received demonstrated that the Health Canada warning on the risk of cardiac malformations associated with paroxetine use during the first trimester of pregnancy generated a statistically significant abrupt and permanent increase of the calls received at IMAGe about the antidepressants. These studies ensure to better understand the information need of the health care providers concerning the risks and benefits of medication use during pregnancy and lactation.

L’objet de ce travail de thèse est l’analyse des monstruosités biologiques en tant qu’elles posent question quant à la nature même de la vie et quant à la puissance de la raison à pouvoir l’appréhender. En mettant l’accent sur le travail d’Étienne et d’Isidore Geoffroy Saint-Hilaire, nous nous sommes attachés à montrer en quoi la tératologie parvenait à intégrer les monstres dans des procédures rationnelles – ici celles des sciences biologiques. Mais cette intégration se fait au prix d’un oubli : la dimension nécessairement normative du concept de monstre. Nous nous sommes alors efforcés d’intégrer cette dimension normative et nous avons alors mis au jour la question de savoir ce qu’est la vie en elle-même pour qu’elle soit capable de produire des êtres vivants monstrueux. Cette question nous a amené à élaborer une métaphysique de la vie selon laquelle elle est, en son être même, errance vitale. Penser les monstres revient à devoir penser la vie comme puissance d’écart. / This thesis analyses the concept of biological monstrosity. This concept questions the nature of life and the power of reason. We study the teratology of E. and I. Geoffroy Saint-Hilaire in order to understand how they are successful to think monsters rationally. But both forget the normative dimension in the concept of monster. We try to take this normative dimension into consideration. What should be life to product monstrous beings ? This question leads to develop a metaphysic of life which puts forward the notion of “vital wandering” (“errance vitale”) and the notion of “variation” (“écart”)

Les centres d’information sur les tératogènes (CIT) fournissent aux professionnels de la santé ainsi qu’au public de l’information sur les risques et bienfaits associés à l’utilisation des médicaments durant la grossesse et l’allaitement. Le Centre IMAGe (Info-Médicaments en Allaitement et Grossesse) du CHU Sainte-Justine (Centre Hospitalier Universitaire Sainte-Justine) au Québec, est un CIT qui offre depuis 1997 un service téléphonique d’information gratuit aux professionnels de la santé. Deux études ont été réalisées à partir des appels reçus au Centre IMAGe. La première étude a été réalisée sur l’ensemble des appels reçus entre janvier 2004 et avril 2007 au sujet de femmes qui prenaient ou envisageaient prendre un médicament durant la grossesse ou l’allaitement. Les objectifs de cette étude visaient à déterminer les classes de médicaments les plus fréquentes ainsi que les indications d’utilisation et les déterminants d’un appel à leur sujet (caractéristiques maternelles associées). Les antidépresseurs, les anti-inflammatoires, les antibiotiques, les benzodiazépines et les antipsychotiques sont les classes de médicaments qui correspondaient aux plus grands nombres d’appels. Cela porte à croire que pour ces classes de médicaments, il existe chez les professionnels de la santé un besoin d’information en ce qui concerne les risques et bienfaits de leur utilisation durant la grossesse et l’allaitement. La dépression représentait une des trois indications les plus prévalentes chez les femmes qui prenaient ou désiraient prendre des antidépresseurs, des benzodiazépines ou des anti-psychotiques durant la grossesse ou l’allaitement. Le tabagisme était associé à l’utilisation des antidépresseurs et des anti-psychotiques durant la grossesse, ainsi qu’à un appel au sujet des anti-inflammatoires durant l’allaitement. La deuxième étude a été réalisée sur l’ensemble des appels reçus entre janvier 2003 et mars 2008. Cette étude visait à déterminer l’impact des avis émis par Santé Canada concernant les risques de l’exposition aux antidépresseurs durant la grossesse et celui concernant le retrait du rofécoxib, sur le nombre d’appels reçus à IMAGe. L’analyse des séries temporelles du nombre hebdomadaire d’appels reçus a révélé que l’avis de Santé Canada sur les risques de malformations cardiaques associés à l’utilisation de la paroxétine lors du premier trimestre de la grossesse a généré une augmentation statistiquement significative, soudaine et permanente du nombre d’appels reçus à IMAGe au sujet des antidépresseurs. Ces études permettent de mieux comprendre le besoin d’information des professionnels de la santé sur les risques et bienfaits de l’utilisation des médicaments durant la grossesse et l’allaitement. / Teratogen Information Services (TIS) are giving information on the risks and benefits associated with medication use during pregnancy and lactation, to the health care providers and the public. IMAGe Center at the CHU Sainte-Justine in Quebec is a TIS which providing since 1997 a free telephone information service to the health care providers. Two studies were conducted using the calls received at IMAGe Center. The first study included all the calls received between January 2004, and April 2007, concerning women who used or expected to use medication during pregnancy or lactation. The objectives of this study aimed to identify the most frequent medication classes, the indications of use, and the predictors of a call concerning them (associated maternal characteristics). Antidepressants, anti-inflammatory drugs, antibiotics, benzodiazepines, and anti-psychotics represented the medication classes with the greater amount of calls. These results rise to the possibility that more information about the risks and benefits associated with the use of these medication classes during pregnancy and lactation is needed by the health care providers. Depression was in the top three of the most prevalent indications of use for the antidepressants, benzodiazepines, and anti-psychotics. Smoking was associated with the use of antidepressants and anti-psychotics during pregnancy, and with a call concerning the anti-inflammatory drugs during lactation. The second study included all the calls received between January 2003, and March 2008. This study aimed to identify the impact of the Health Canada (HC) warnings, concerning the risks of antidepressant use during pregnancy, and related to the rofecoxib market withdrawal, on the number of calls received to IMAGe. Time series of the weekly number of calls received demonstrated that the Health Canada warning on the risk of cardiac malformations associated with paroxetine use during the first trimester of pregnancy generated a statistically significant abrupt and permanent increase of the calls received at IMAGe about the antidepressants. These studies ensure to better understand the information need of the health care providers concerning the risks and benefits of medication use during pregnancy and lactation.