A terapia fotodinâmica (TFD) é uma técnica não invasiva usada no tratamento de lesões de pele, como câncer basocelular, queratose actínica, e doença de Bowen, dentre outros. Basicamente, a combinação da administração de um fotossensibilizador (FS), com a irradiação de luz adequada e o oxigênio celular, gera uma série de reações oxidativas que provocam a morte do tecido. Contudo, o principal efeito colateral desta terapia é a fotossensibilidade prolongada ocasionada pela administração de fotossensibilizadores sistêmicos. Por outro lado, a via tópica não apresenta esta limitação, pois o tratamento é realizado no local da lesão através de pró-drogas. O ácido aminolevulínico, ALA, está entre as pró-drogas mais utilizadas para indução do acúmulo do agente fotossensível na pele, a protoporfirina IX, ou PpIX. Contudo, a via tópica não permite penetração suficiente e homogênea do creme para o tratamento de lesões espessas. Visando a melhoria da TFD, foram realizados estudos in vivo e in vitro. Nos estudos in vivo, técnicas mecânicas - rolos de microagulhas, tape stripping e injeção livre de agulhas foram estudadas buscando encontrar a mais eficiente nos quesitos de: promoção da penetração da pró-droga no tecido, distribuição homogênea e de indução do acúmulo de PpIX. Para isto, foi o utilizado o modelo porcino, in vivo, conhecido como o modelo que possui a pele mais similar à pele humana. Os resultados in vivo mostram que as técnicas têm resultados similares na produção de PpIX e na distribuição de porfirina mais homogênea na superfície. Além disso, todas as técnicas estudadas in vivo têm se destacado em promover uma entrega mais homogênea de ALA também na profundidade da pele quando comparadas ao grupo controle. Nos estudos in vitro, foram examinadas possíveis diferenças na capacidade de formação da PpIX e/ou de resistência de células ao tratamento por TFD entre células expressando diferentes características de transição epitélio-mesenquimal. Os resultados in vitro indicam que as células com características epitélio-mesenquimal mais acentuadas produzem mais PpIX e são mais responsivas à TFD. Estes resultados indicam que a TFD tem maior efetividade no tratamento de células mesenquimais, e os estudos in vivo mostram que no tecido normal há maior seletividade de produção na camada da epiderme e apêndices da pele sugerindo que a terapia pode ser utilizada com maior eficiência em lesões superficiais e, até mesmo diminuir as taxas de recorrência devido a heterogeneidade de distribuição do creme na pele quando umas das técnicas mecânicas são utilizadas. / Photodynamic therapy (PDT) is a noninvasive technique used to treat skin lesions, such as basal cell cancer, actinic keratosis and Bowen\'s disease. Basically, the administration of a photosensitizer (PS), combined with the illumination of adequate light and the cellular oxygen, generate a series of oxidative reactions that cause tissue death. However, the major side effect of the treatment is prolonged photosensitivity caused by the systemic administration of photosensitizers. On the other hand, the topical therapy does not show this limitation, and it is performed at the lesion site via prodrugs. The aminolevulinic acid, ALA, is the most popular pro-drug in topical PDT. This prodrug induces PpIX production that is a photosensitive porphyrin. However, when ALA is used topically, the cream does not provide enough or homogeneous penetration for the treatment of deep lesions. Therefore, with the aim of improving PDT therapy, studies in vivo and in vitro were performed. In the in vivo analysis, mechanical techniques - microneedle roller, tape stripping, and needle-free injection- were studied looking for the most effective regarding to improve the following purposes: promoting penetration of the prodrug into the tissue, homogeneous distribution, and at inducing PpIX accumulation. The evaluations were made by fluorescence spectroscopy, biopsy of skin, and fluorescence images, using the porcine model, in vivo, known as the most similar of human skin tissue. The in vivo results showed that all techniques have similar results in the production of PpIX, and perform a more homogeneous porphyrin distribution in the skin surface. Moreover, all the techniques have excelled in promoting a homogeneous distribution of PpIX in the deep of the skin when compared to the control group. In addition to the skin penetration, studies of PpIX production were performed in vitro in cells expressing different levels of epithelial-mesenchymal transition characteristics. The studies were made in regard to a possible difference in PpIX formation capacity and / or a resistance to the PDT treatment. The in vitro results showed that cells with more epithelial-mesenchymal characteristics produce more PpIX and are more responsive to the PDT therapy. These results indicate that PDT therapy may have a better effectiveness in the treatment of mesenchymal cells and also the results in vivo showed that the ALA-induced PpIX in normal tissue seems to be selective to epidermal and skin appendages, indicating that the topical therapy may be used with a higher efficiency in superficial injuries providing lower recurrence rates when they combine with one of the techniques studied.

Submitted by Fabiano Vassallo (fabianovassallo2127@gmail.com) on 2017-04-20T18:40:31Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação Luciana Cavalcante Matos de Mello.pdf: 1861283 bytes, checksum: 0040dbf72a9b98a66a9a078904a97051 (MD5) / Approved for entry into archive by Josimara Dias Brumatti (bcgdigital@ndc.uff.br) on 2017-04-25T14:59:41Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação Luciana Cavalcante Matos de Mello.pdf: 1861283 bytes, checksum: 0040dbf72a9b98a66a9a078904a97051 (MD5) / Made available in DSpace on 2017-04-25T14:59:41Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação Luciana Cavalcante Matos de Mello.pdf: 1861283 bytes, checksum: 0040dbf72a9b98a66a9a078904a97051 (MD5) / Este trabalho visa a analisar o gênero textual alocução, com base nos pressupostos teóricos da Teoria Semiolinguística de análise do discurso. Considerações a respeito da construção da identidade militar no contrato de comunicação desse gênero serão feitas, considerando textos produzidos por cadetes da Academia Militar das Agulhas Negras, em 2012 e 2013, para as formaturas em comemoração ao aniversário das Armas do Exército Brasileiro. Defende-se a hipótese de que os valores do Exército assim como o ethos assumirão importante papel nessa construção por meio dos processos de transação e transformação / This paper aims to analyze the textual genre allocution, based on the theoretical assumptions of Semiolinguistic Discourse Analysis. Considerations in relation to the construction of the military identity in the communication contract of this genre will be made, considering texts produced by cadets of Agulhas Negras Military Academy, in 2012 and 2013, for the parades in celebration of the anniversary of the Brazilian Army branches. We shall hereby defend a hypothesis that the Army values as well as the ethos will assume an important role in this construction by means of the processes of transaction and transformation

Orientador: Miriam Dambros Lorenzetti / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-28T00:11:28Z (GMT). No. of bitstreams: 1 Souza_FelipeGoncalvesSchrodere_M.pdf: 1431848 bytes, checksum: df85a182625e0c75b33faa908d302d6c (MD5) Previous issue date: 2015 / Resumo: Introdução: A neoplasia de próstata é a segunda mais prevalente entre os homens, com estimativa de cerca de 68 mil casos novos no Brasil em 2014. Além disso, é a segunda causa de morte no sexo masculino por neoplasias. O câncer de próstata raramente causa sintomas em seus estágios iniciais, por isso existe a necessidade do diagnóstico precoce. Atualmente a forma de rastreamento desta neoplasia ainda é controverso, porém quando realizado, baseia-se em exame digital retal da próstata e na mensuração sérica dos níveis do PSA. Estudos de rastreamento populacional mostraram uma diminuição de 41% no casos de neoplasia avançada de próstata e risco de diagnóstico de câncer 46% maior, quando comparados a grupos não submetidos a rastreamento. O PSA não é câncer específico, então, os refinamentos do PSA (relação do PSA livre/total, densidade do PSA e velocidade do PSA) aparecem como métodos para melhorar sua especificidade, na tentativa de diminuir o número de biópsias desnecessárias. Quando existe suspeita diagnóstica, é indicada uma biópsia guiada por ultrassonografia transretal, procedimento que não é isento de complicações, principalmente as infecciosas. Objetivos: Avaliar a positividade para adenocarcinoma de próstata em biópsias guiadas por ultrassonografia transretal, e estratificá-la de acordo com a idade, com o valor do PSA total, com a densidade do PSA e com a relação entre a fração livre do PSA e o PSA total. Materiais e Métodos: Analisamos retrospectivamente os resultados obtidos no serviço de urologia do Hospital Municipal Dr. Mário Gatti com relação à positividade das biópsias estratificadas pela idade, PSA total, percentual da fração livre do PSA e densidade do PSA, comparando-os com os dados descritos na literatura. Resultados: Foram realizadas 314 biópsias no período de janeiro de 2011 à novembro de 2012. A média de idade dos pacientes foi de 65,2 (± 8,32) anos e a positividade foi de 44,9%. A positividade das biópsias foi maior com o aumento da idade (p<0,001), com o aumento do PSA (p<0,001), com o aumento da densidade (p<0,001) e com a diminuição da relação do PSA (p=0,002) Conclusão: A neoplasia prostática correlacionou-se significativamente com o aumento da idade, do PSA total, da densidade do PSA, e com a diminuição da relação entre o PSA livre sobre o PSA total / Abstract: Introduction: Prostate neoplasia is the second most prevalent neoplasia in men and about 68 thousand new cases were estimated in 2014 in Brazil. In addition, it is the second most common cause of cancer related death in men. Prostate cancer rarely causes symptoms at an early stage, hence the need of an early diagnosis. Although there is still no consensus about how to screen this neoplasia, it is done through digital rectal examination and measurement of PSA levels. Population screening trials showed a decrease of 41% in new cases of advanced prostate neoplasia. The risk of a cancer diagnosis increased 46% when compared to the group who was not screened. PSA is not cancer specific. Therefore, PSA features (relation between free PSA and total PSA, PSA density, PSA velocity) are used to increase its specificity, attempting to reduce the number of unnecessary biopsies. Once there is a cancer suspicion, a biopsy guided by transrectal ultrasonography is indicated, which is not a complication free procedure, mainly infection. Objective: to assess the positiveness of prostatic adenocarcinoma in transrectal ultrasonography guided biopsies and to evaluate it according to age, total PSA value, PSA density, and the relation between free PSA and total PSA. Materials and Methods: This is a retrospective study with patients who underwent prostatic biopsy guided by transrectal ultrasonography done by the urology team from Hospital Municipal Dr. Mário Gatti. Collected data included patient¿s age, total PSA value, PSA density and the relation between free PSA and total PSA. Results: 314 prostatic biopsies guided by transrectal ultrasonography were analyzed between January 2011 and November 2012. Patient¿s mean age was 65.2 (+/-8.32) years. A positive biopsy to adenocarcinoma was found in 44.9% of the patients. The number of positive biopsies was higher among older patients (p<0.001). It was also higher the higher the PSA (p<0.001) and the higher the PSA density (p<0.001). It was inversely related to PSA relation (p=0.002). Conclusion: There is a direct correlation between prostatic neoplasia and age, value of PSA and PSA density. Additionally, prostatic neoplasia is inversely proportional to the relation of free PSA over total PSA / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências da Cirurgia

La distribution d'espèces benthiques intertidales est contrainte par l'océanographie côtière. On connaît moins les effets sur l'écologie des prédateurs. Les côtes sud de l'Afrique sont caractérisées par des contrastes de production primaire et d'assemblages intertidaux dus aux deux courants majeurs qui les longent. Le prédateur apical de ces côtes est un oiseau limicole endémique, l'huîtrier noir africain (Haematopus moquini), qui présente un polymorphisme favorable à la spécialisation alimentaire. Ces travaux ont étudié l'effet des variations spatiales de structure de communautés benthiques sur l'écologie alimentaire de l'huîtrier à l'aide des isotopes stables. Les oiseaux répondent aux fluctuations qualitative et quantitative des communautés de proies à plusieurs échelles. A large échelle ils montrent de forts contrastes entre les côtes ouest et sud-ouest où le régime alimentaire est dominé par les moules, notamment l'espèce invasive Mytilus galloprovincialis et le sud-est où un mélange de moules et patelles est consommé. Localement les individus montrent des différences faibles d'alimentation liées à l'abondance relative des moules et patelles. Cela s'explique par le caractère généraliste de l'espèce et le relâchement de compétition intra-spécifique pour les ressources. La transition alimentaire d'H. moquini vers une consommation quasi-exclusive à l'ouest d'une moule introduite et la multitude de comportements alimentaires ailleurs indiquent un fort potentiel d'adaptation aux modifications de son habitat d'alimentation. En revanche la dégradation des plages par l'Homme augmente la compétition pour l'espace et affecterait aujourd'hui le succès reproducteur de l'espèce. / The distribution of intertidal benthic species is constrained by coastal oceanography. Less is known about the effects on the ecology of predators. Along the southern coasts of Africa the two main currents constraint both the patterns of primary production and the structure of benthic communities. The top predator on these coasts is an endemic shorebird, the African Black Oystercatcher (Haematopus moquini), which exhibits a polymorphism favourable for food specialization. This study investigates the effect of spatial variations in benthic community structure on the feeding ecology of oystercatchers using stable isotopes. Birds respond to changes in quality and quantity of prey at multiple scales. At large scale they show strong contrasts between west and southwest coasts where the diet is dominated by mussels, including the invasive species Mytilus galloprovincialis, and south-east shores where a mixture of mussels and limpets is consumed. Locally individuals show weak dietary differences related to relative abundances of mussels and limpets. This reflects the generalist foraging behaviour of the species and the release of intra-specific competition for resources. The dietary shift of H. moquini on the west coast toward the invasive mussel and the multiplicity of foraging behaviours elsewhere reveal strong capacities to face changes in its foraging habitat. On the other hand the degradation of beaches by humans increases the competition for space and today affects the reproductive success of the species

Objetivo: Estudo comparativo da pressão intraocular (PIO) após agulhamento transconjuntival (ATC) com 5-fluoracil (5-FU) e tratamento clínico (TC) em olhos glaucomatosos com bolha encapsulada e PIO não controlada após trabeculectomia com mitomicina C (MMC), no final de 12 meses de seguimento. Desenho: Estudo prospectivo, randomizado, intervencionista. Participantes: 40 olhos de 39 pacientes com bolha encapsulada, desenvolvida em 5 meses ou menos, após trabeculectomia primária com mitomicina e PIO >= 20mmHg. Métodos: Os olhos foram randomizados para ATC com 5-FU e TC. Um máximo de dois ATC foi permitido no estudo. Todos os olhos foram acompanhados por 12 meses. O sucesso foi definido como PIO <= 18 mmHg e redução de 20% da PIO basal (sem medicações no grupo ATC). Resultados: A média da PIO em 12 meses de acompanhamento foi de 12,14 ± 2,80 mmHg no grupo do ATC e 15,13 ± 2,07 mmHg no grupo do TC (p = 0,004). 14 olhos (70%) foram considerados sucesso no grupo do ATC e 15 olhos (75%) no grupo do TC (p = 0,89). O número médio de agulhamentos foi de 1,35 ± 0,49 e a quantidade média de medicamentos foi de 2,15 ± 0,74. Conclusões: Houve uma taxa de sucesso semelhante nos olhos randomizados para ATC com 5-FU em comparação com TC em 12 meses de seguimento. No entanto, foi observada uma significativa menor média da PIO, após o ATC / Objective: To compare de efficacy of transconjuctival needling revision (TNR) with 5-fluorouracil (5-FU) and medical treatment (MT) in glaucomatous eyes with encapsulated bleb and uncontrolled intraocular pressure (IOP) after trabeculectomy with mitomycin C (MMC) at 12 months follow-up. Design: Prospective, randomized, interventional study. Participants: Forty eyes of 39 patients with encapsulated bleb developed in 5 months or less following primary trabeculectomy with mitomycin and IOP >= 20mmHg. Methods: Eyes were randomized to either TNR with 5-FU or MT. A maximum of two TNR was allowed in the study. All eyes were followed-up for 12 months. Success of treatment was defined as IOP <= 18mmHg and a 20% reduction from baseline (no medications in TNR group). Results: Mean IOP at 12 months follow-up was 12.14 ± 2.80 mmHg in the TNR group and 15.13 ± 2.07 mmHg in the MT group (p=0.004). Fourteen eyes (70%) were considered a success in the TNR group and 15 eyes (75%) in the MT group (p=0.89). The number of needling procedure was 1.35 ± 0.49 procedures and the number of medication was 2.15 ± 0.74 medications. Conclusions: We have demonstrated a similar success rates in eyes randomized to MT in comparison to TNR with 5-FU at the last follow-up. However, a significant lower mean IOP after TNR was observed

CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior / O presente trabalho consiste numa abordagem didÃtico-pedagÃgica do estudo e do ensino da Teoria das Probabilidades na EducaÃÃo BÃsica, com Ãnfase no conceito de Probabilidade GeomÃtrica, sua importÃncia e relevÃncia para uma aprendizagem mais significativa, efetiva e atrativa. Inicia-se com a histÃria e evoluÃÃo deste singular ramo da MatemÃtica Aplicada, seguindo-se uma seÃÃo com teoria e prÃtica atravÃs da resoluÃÃo de exercÃcios. O conceito de probabilidade geomÃtrica à introduzido e desenvolvido a fim de mostrar quÃo mais abrangente pode ser a Teoria das Probabilidades (como apresentada nos livros didÃticos no Brasil), tanto em termos de conteÃdo quanto de aplicaÃÃes e relaÃÃes com outras Ãreas da prÃpria MatemÃtica. Algumas aplicaÃÃes interessantes e conhecidas na literatura sÃo apresentadas, resolvidas e analisadas de modo simples, algumas vezes fazendo uso de matemÃtica menos elementar, outras explorando apenas os aspectos intuitivos. Nesta seÃÃo voltada para as aplicaÃÃes do conceito de probabilidade geomÃtrica, trata-se da soluÃÃo de problemas como o Problema das Agulhas de Buffon, o Problema do MacarrÃo e o Problema do Encontro, dentre outros, encerrando com o problema do Paradoxo de Bertrand. Seguem-se as consideraÃÃes finais do autor e um apÃndice com algumas demonstraÃÃes de resultados de geometria plana que sÃo utilizados ao longo do texto. / This work is a didactic-pedagogical approach to the study and teaching of Probability Theory in Basic Education, with emphasis on the concept of Geometric Probability, its importance and relevance to a more meaningful, effective and attractive learning. It begins with the history and evolution of this unique branch of Applied Mathematics, followed by a section with theory and practice by means of problem solving. The concept of geometric probability is introduced and developed in order to show how broad the theory of probability can be (as presented in textbooks in Brazil), both in terms of content, as well as applications and relations with other areas of mathematics itself. Some interesting and well-know applications in the literature are presented, analyzed and solved in a simple fashion, sometimes by making use of less elementary mathematics, others times by exploring only intuitive aspects. In this section, focused on the application of the concept of geometric probability, we deal with the solving of problems, such as the Problem of Buffonâs Needles, the Pasta Problem and the Problem of the Encounter, among others, closing with the problem of Bertrandâs Paradox. On the sequence the author offers his final remarks and appendix with some demonstrations of results in plane geometry that are used throughout the text.

Objetivo: Estudo comparativo da pressão intraocular (PIO) após agulhamento transconjuntival (ATC) com 5-fluoracil (5-FU) e tratamento clínico (TC) em olhos glaucomatosos com bolha encapsulada e PIO não controlada após trabeculectomia com mitomicina C (MMC), no final de 12 meses de seguimento. Desenho: Estudo prospectivo, randomizado, intervencionista. Participantes: 40 olhos de 39 pacientes com bolha encapsulada, desenvolvida em 5 meses ou menos, após trabeculectomia primária com mitomicina e PIO >= 20mmHg. Métodos: Os olhos foram randomizados para ATC com 5-FU e TC. Um máximo de dois ATC foi permitido no estudo. Todos os olhos foram acompanhados por 12 meses. O sucesso foi definido como PIO <= 18 mmHg e redução de 20% da PIO basal (sem medicações no grupo ATC). Resultados: A média da PIO em 12 meses de acompanhamento foi de 12,14 ± 2,80 mmHg no grupo do ATC e 15,13 ± 2,07 mmHg no grupo do TC (p = 0,004). 14 olhos (70%) foram considerados sucesso no grupo do ATC e 15 olhos (75%) no grupo do TC (p = 0,89). O número médio de agulhamentos foi de 1,35 ± 0,49 e a quantidade média de medicamentos foi de 2,15 ± 0,74. Conclusões: Houve uma taxa de sucesso semelhante nos olhos randomizados para ATC com 5-FU em comparação com TC em 12 meses de seguimento. No entanto, foi observada uma significativa menor média da PIO, após o ATC / Objective: To compare de efficacy of transconjuctival needling revision (TNR) with 5-fluorouracil (5-FU) and medical treatment (MT) in glaucomatous eyes with encapsulated bleb and uncontrolled intraocular pressure (IOP) after trabeculectomy with mitomycin C (MMC) at 12 months follow-up. Design: Prospective, randomized, interventional study. Participants: Forty eyes of 39 patients with encapsulated bleb developed in 5 months or less following primary trabeculectomy with mitomycin and IOP >= 20mmHg. Methods: Eyes were randomized to either TNR with 5-FU or MT. A maximum of two TNR was allowed in the study. All eyes were followed-up for 12 months. Success of treatment was defined as IOP <= 18mmHg and a 20% reduction from baseline (no medications in TNR group). Results: Mean IOP at 12 months follow-up was 12.14 ± 2.80 mmHg in the TNR group and 15.13 ± 2.07 mmHg in the MT group (p=0.004). Fourteen eyes (70%) were considered a success in the TNR group and 15 eyes (75%) in the MT group (p=0.89). The number of needling procedure was 1.35 ± 0.49 procedures and the number of medication was 2.15 ± 0.74 medications. Conclusions: We have demonstrated a similar success rates in eyes randomized to MT in comparison to TNR with 5-FU at the last follow-up. However, a significant lower mean IOP after TNR was observed

This study examines the efficacy of Sentinel-1 Radial Velocity (RVL) imagery at determining the position of ocean current front features, using the Gulf Stream (GS) and Agulhas Current (AC) as case studies. Fronts derived from RVL imagery are compared to fronts derived from Sea Surface Temperature (SST) imagery, specifically Multi-scale Ultra-high Resolution Sea Surface Temperature Analysis (MURSST) data. In the case of the GS, front locations from the Naval Oceanographic Office (NAVOCEANO) were also used for comparison. Only the northern walls of ocean current features are considered in this study, which is broken into three main steps: Preprocessing, front extraction, and front comparison. First, RVL imagery is selected from Sentinel-1 ocean products, preprocessed to remove antenna mispointing artifacts, and all products from the same orbit are combined into a single swath. Second, front features are extracted from both the RVL and MURSST imagery using a ridge detection algorithm, the main ocean current is chosen from all ridge features using a ranking algorithm, and the northern wall of this current is extracted. Third, the RVL, SST, and in the case of the GS, NAVOCEANO GS locations, features are compared using a symmetric Hausdorff Distance (HD) measure, and Mean Hausdorff Distance (MHD). In some cases, the automatic front extraction failed by either misclassifying an eddy or similar ocean feature as the ocean current in either the RVL or SST image or failed to extract the entire length of the front visible within the image. All the SST and RVL fronts were classified manually to determine the success rate of the automatic front extraction and to exclude failed front extractions from the analysis, as they are not accurate representations of the SST and RVL data’s ability to detect fronts. In special cases, the RVL image itself does not detect the entire ocean current, such that there are noticeable gaps in the ocean current. Similarly, in special cases the MURSST does not detect the entire ocean current. The automatic front extraction succeeded 65% of the time, including the special cases. The results demonstrated that RVL products were effective at determining the location of ocean fronts where the angle of the front's normal vector is within approximately 40° of the sensor’s azimuthal heading. A mean HD of 31.9 km and a mean MHD of 13.2 km was calculated for all front pairs over all study areas. The RVL fronts appeared consistently to the north of the SST fronts, with an average offset of 25.4 km between the centroids of the SST and RVL fronts. Positive correlations were noted between cloud coverage and MURSST error in both study regions. Several RVL images detected ocean currents in regions of high MURSST error where the MURSST did not detect the ocean currents, suggesting that RVL may provide more accuracy than SST-based products in clouded regions where there is no auxiliary data.

L’océan Indien est le lieu de processus atmosphériques et océaniques majeurs dont les répercussions en terme climatique peuvent être de grandes importances. Cette thèse se propose de documenter les forçages, les variabilités, les impacts et les interactions de la mousson Indo-asiatique et du courant des Aiguilles à l’échelle orbitale (incluant les conditions glaciaires-interglaciaires) au cours de la période Quaternaire.Si le maximum d’insolation (minimum de précession et maximum d’obliquité) initie les fortes moussons Indo-asiatiques, des forçages internes au système climatique jouent également un rôle majeur pour expliquer leur dynamique (fort vents et précipitations), en particulier le changement de volume de glace de l’hémisphère Nord et l’export de chaleur latente de l’océan Indien Sud. La prédominance de ces forçages internes est propre à la mousson Indo-asiatique et la distingue des moussons boréales Africaines. Ceci indique que le concept de mousson globale n’est pas valable à l’échelle orbitale.Concernant l’hémisphère Sud, les variations de température de surface du courant des Aiguilles exercent un contrôle important sur le climat Sud Africain (la végétation et les précipitations). Ce courant permet également le transfert plus ou moins important de chaleur et de sel vers l’océan Atlantique Sud par l’intermédiaire de la migration de la convergence subtropicale et des vents d’ouest associés. Ce mécanisme, contrôlé fortement par la dynamique des hautes latitudes Sud, affecte la circulation thermo-haline globale et constitue un acteur important des transitions glaciaires-interglaciaires et des changements de mode de variabilité climatique au cours du Quaternaire (Transition Mid-Pleistocène et évènement du Mid-Brunhes). Les changements induits dans le climat de l’Hémisphère Nord, et notamment le volume de glace, pourraient ensuite se répercuter sur la dynamique de la mousson. En revanche, l’effet des moussons sur le courant des Aiguilles parait mineur. Toutefois, les interactions entre la mousson Indo-asiatique, l’ENSO et les éventuels IOD (dipôles climatiques de l’océan Indien) pourraient affecter la dynamique du courant. / The Indian Ocean is the place of major atmospheric and oceanic processes with large potential repercussions on the global climatic system. This thesis investigates forcing, variations, impacts and interactions of the Indo-Asian monsoon and of the Agulhas current at the orbital scale (including glacial-interglacial conditions) over the Quaternary period.Insolation maximum (precession minimum and obliquity maximum) initiates strong Indo-Asian monsoons, but processes internal to the climate system, in particular Northern Hemisphere (NH) ice volume changes and the latent heat export of the south Indian Ocean, play a major role to explain their dynamics (strongest winds and precipitation). The predominance of these internal forcings is a specificity of the Indo-Asian monsoon and distinguishes it from African boreal monsoons. This indicates that the concept of a global monsoon at the orbital scale is a misnomer.Concerning the Southern hemisphere, sea surface temperature variations of the Agulhas current exert an important control upon the South African climate (vegetation and precipitation). This current also participates to the transfer of heat and salt towards the South Atlantic Ocean whose intensity is mainly related to the migration of the subtropical convergence and associated westerlies winds. This mechanism, strongly controlled by high southern latitudes dynamics, affects the global overturning circulation and plays an important role for glacial-interglacial transitions and changes in modes of climate variability during the Quaternary (Mid-Pleistocene Transition and Mid-Brunhes event). Induced Northern hemisphere climate changes, in particular ice volume, could in turn influence monsoon dynamics. On the other hand, the effect of monsoons on the Agulhas current seems to be of minor importance. However, interactions between the Indo-Asian monsoon, ENSO and the possible IOD (Indian Ocean climatic Dipole) could affect the dynamic of the current.