Die vorliegende Arbeit beschreibt, wie depressive und somatoforme Beschwerden auf die global konzeptualisierte Lebenszufriedenheit wirken. Anhand einer bevölkerungsrepräsentativen Stichprobe (N=2510) wird diese Fragestellung analysiert. Ziel ist es zum einen zu klären, ob bereits subklinische Beschwerden zu deutlichen Einschränkungen der Lebenszufriedenheit führen und zum anderen, wie sich die beiden Beschwerdegruppen im Zusammenspiel auf die Lebenszufriedenheit auswirken. Somatische und depressive Symptome werden dimensional (subklinische Symptome eingeschlossen) untersucht und somatoforme und depressive Syndrome kategorial (auf ICD-10 Diagnose-Ebene) analysiert – quantifiziert jeweils mit dem Patient Health Questionnaire (PHQ). Lebenszufriedenheit wird mit den Fragen zur Lebenszufriedenheit (FLZ-M) gemessen. Univariate Kovarianzanalysen dienen zur statistischen Prüfung. Die Ergebnisse werden in einer Publikation dargestellt. Unter Berücksichtigung komorbider depressiver Symptome/Syndrome wirken sich somatische Symptome und somatoforme Syndrome nur auf einige Bereiche der Lebenszufriedenheit negativ aus. Eine dimensionale Auswertung ist sinnvoll, um den Einfluss subklinischer Symptome zu beschreiben.

Motivation: Ischemic heart disease is the eighth leading cause of death in an African population. Silent ischemia can be defined as an ischemic episode without associated pain. The clinical significance of silent ischemia is growing and can now be considered as a risk factor in the development of coronary disease. Hypertension and associated risk factors, hypercholesterolemia and diabetes are associated with silent ischemia. Other factors such as higher pulse pressure, double product, heart rate and higher carotid intima-media thickness are also associated with silent ischemia. Urbanisation is rising in South-Africa. This new lifestyle is associated with several risk factors including: poor diets, lower physical activity levels, hypertension and increased smoking and alcohol abuse. The prevalence of stroke is high among Africans, which can be due to a higher prevalence of hypertension, diabetes and obesity. Purpose: The purpose of this study was to determine the associations between silent ischemia and cardiovascular function in African men. The focus fell on hypertension and associated risk factors, higher total cholesterol levels, and increased pulse pressure, heart rate and sub-clinical atherosclerosis. vi Methodology: This study constituted a population study in the North-West province carried out on urbanized African male teachers aged between 20-60 years. The SABPA (Sympathetic activity and Ambulatory Blood Pressure in Africans) sub-study consisted of a total of 80 African male volunteers. The Cardiotens apparatus was placed on each participant on the first morning. This apparatus took ambulatory blood pressure measurements as well as Electrocardiogram measurements. Hereafter, participants continued with their normal work day until 1700. After an overnight stay at the Metabolic unit of the North-West University Potchefstroom campus, the apparatus was removed at 0600. During statistical analyses, the African males were divided into groups of participants with silent ischemia (SI) and those without silent ischemia (nSI), as determined by the ambulatory electrocardiogram. Statistical analyses were performed by means of the Statistica version 10 software program. Results: In comparison with the nSI men, the SI showed the following: above normal high sensitivity C-reactive protein and glucose, higher ambulatory blood pressure, heart rate, pulse pressure, resting ST-segment depression and carotid intima-media thickness. Multiple regression analyses indicated that ambulatory silent ischemia is associated with sub-clinical atherosclerosis, possibly increasing their stroke risk. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2012.

Motivation: Ischemic heart disease is the eighth leading cause of death in an African population. Silent ischemia can be defined as an ischemic episode without associated pain. The clinical significance of silent ischemia is growing and can now be considered as a risk factor in the development of coronary disease. Hypertension and associated risk factors, hypercholesterolemia and diabetes are associated with silent ischemia. Other factors such as higher pulse pressure, double product, heart rate and higher carotid intima-media thickness are also associated with silent ischemia. Urbanisation is rising in South-Africa. This new lifestyle is associated with several risk factors including: poor diets, lower physical activity levels, hypertension and increased smoking and alcohol abuse. The prevalence of stroke is high among Africans, which can be due to a higher prevalence of hypertension, diabetes and obesity. Purpose: The purpose of this study was to determine the associations between silent ischemia and cardiovascular function in African men. The focus fell on hypertension and associated risk factors, higher total cholesterol levels, and increased pulse pressure, heart rate and sub-clinical atherosclerosis. vi Methodology: This study constituted a population study in the North-West province carried out on urbanized African male teachers aged between 20-60 years. The SABPA (Sympathetic activity and Ambulatory Blood Pressure in Africans) sub-study consisted of a total of 80 African male volunteers. The Cardiotens apparatus was placed on each participant on the first morning. This apparatus took ambulatory blood pressure measurements as well as Electrocardiogram measurements. Hereafter, participants continued with their normal work day until 1700. After an overnight stay at the Metabolic unit of the North-West University Potchefstroom campus, the apparatus was removed at 0600. During statistical analyses, the African males were divided into groups of participants with silent ischemia (SI) and those without silent ischemia (nSI), as determined by the ambulatory electrocardiogram. Statistical analyses were performed by means of the Statistica version 10 software program. Results: In comparison with the nSI men, the SI showed the following: above normal high sensitivity C-reactive protein and glucose, higher ambulatory blood pressure, heart rate, pulse pressure, resting ST-segment depression and carotid intima-media thickness. Multiple regression analyses indicated that ambulatory silent ischemia is associated with sub-clinical atherosclerosis, possibly increasing their stroke risk. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2012.

Elevated Thyroid-Stimulating Hormone (TSH) is associated with an increased risk of cardiovascular disease (CVD). We hypothesized that TSH-stimulated FA release from adipocytes contributes to macrophage inflammation. 3T3-L1 and human subcutaneous differentiated adipocytes were treated with TSH for 4 hours under various conditions and lipolysis assessed via glycerol secretion. Optimal conditions were determined and protein expression of ATGL, HSL and perilipin remained stable. TSH-stimulated 3T3-L1 or human adipocyte-conditioned medium (T-ACM) was placed on murine J774 or human THP-1 macrophages, respectively, and macrophage cytokine mRNA levels (IL-1β, IL-6, MCP-1, and TNFα) were measured by real-time RT-PCR. T-ACM did not change cytokine mRNA expression in J774 macrophages or THP-1 macrophages when compared to ACM. Absence of BSA in the medium may have hindered release of FA from differentiated adipocytes into the medium, BSA may be required to permit adequate FA accumulation in the medium to then evaluate the effect of T-ACM on macrophages. Further investigation is required to determine the effect of FA on J774 and THP-1 inflammatory response.

The aim of this study was to evaluate new methods to improve detection and investigation of the effects of chronic or subclinical infection with Trypanosoma evansi in various mammalian species. Some of the more resistant host species, including pigs and buffaloes, are present in large feral populations in the northern parts of Australia, the area where T. evansi is most likely to gain entry to the country. Existing tests are not sufficiently reliable to detect all cases of disease and they cannot distinguish acute from chronic infections. Furthermore, the tests have different sensitivities in different host species. Surveillance for trypanosomiasis in Australia is problematic because of the need to work in remote parts of northern Australia where provision of a cold-chain for traditional blood and serum storage is difficult. An existing dried blood storage system was modified by treating cotton lint filter paper (Whatman #903) with a commercial post coating buffer (TropBio, Queensland). This treatment increased the longevity of antibodies to T. evansi in serum and blood stored on the paper (detected using an antibody-detection ELISA) compared to samples stored on plain paper, especially when the papers were stored under humid conditions and at high ambient temperatures. Attempts were made to improve the diagnostic utility and repeatability of antibody-ELISAs through the use of 2 recombinant T. brucei antigens (PFRA and GM6) and to optimize a competitive ELISA using RoTat 1.2 variable surface antigen and its monoclonal antibody. Antibody-detection using the two recombinant proteins was not sufficiently specific to enable their use for the detection of T. evansi. The RoTat 1.2 cELISA had good sensitivity and specificity (75% and 98% respectively) when used to test serum from cattle and buffaloes experimentally infected with T. evansi and uninfected animals. However, the test was not able to detect anti-T. evansi antibodies in serum from wallabies, pigs, a dog or a horse that were experimentally infected with T. evansi. The inability of the cELISA to detect anti-T. evansi antibodies may be due to the small number of samples tested or the lack of RoTat 1.2 specific antibodies in the animals tested. The feasibility of using an enzymatic test to detect trypanosome aminotransferase or antibodies to this enzyme was evaluated. Prior publications suggested that the detection of TAT was an appropriate diagnostic tool for the detection of T. evansi infection in camels. However, the results from this study did not support the use of this test for the detection of T. evansi infection in cattle or buffaloes with low to moderate parasitaemia. Trypanosomiasis is an immunological disease that affects most of the body’s organs, with more severe disease developing over time. Attempts were made to determine key cytokine and biochemical patterns that would distinguish infected from uninfected animals and acute from chronic infections. The results from this study showed that there was no specific pattern in serum cytokines or serum biochemistry that could be used to distinguish infected from uninfected animals, or different stages of disease. Immunohistochemistry was used on tissues from buffaloes and mice experimentally infected with T. evansi and T. brucei gambiense respectively to characterise the cellular immune response that was present. The immune response was predominantly cell mediated, with CD3+ T lymphocyte and macrophage infiltration occurring in most tissues. In end stage disease there was often suppression of the immune system with disruption of the architecture of the spleen and a decrease in B lymphocytes in the circulation. Trypanosomes were rarely visible in the tissues and were only seen in those animals with high parasitaemia. Lesions generally became more severe over time, but there was a large variation between animals, which suggests that immunohistochemistry is unsuitable as a diagnostic tool.

Submitted by LUCAS EDUARDO PILON null (lucaseduardopilon@yahoo.com.br) on 2016-03-07T12:00:11Z No. of bitstreams: 1 Tese Lucas Eduardo Pilon.pdf: 1670960 bytes, checksum: 4da72578d702faee29a2735a07314cd0 (MD5) / Approved for entry into archive by Sandra Manzano de Almeida (smanzano@marilia.unesp.br) on 2016-03-07T13:38:08Z (GMT) No. of bitstreams: 1 pilon_le_dr_jabo.pdf: 1670960 bytes, checksum: 4da72578d702faee29a2735a07314cd0 (MD5) / Made available in DSpace on 2016-03-07T13:38:08Z (GMT). No. of bitstreams: 1 pilon_le_dr_jabo.pdf: 1670960 bytes, checksum: 4da72578d702faee29a2735a07314cd0 (MD5) Previous issue date: 2016-02-05 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A mastite em ovelhas de dupla aptidão é reconhecida por afetar a qualidade do leite. Staphylococcus coagulase-negativos (SCN) são os principais micro-organismos responsáveis pela doença, e o tratamento ao final da lactação, pode contribuir para a cura e prevenção de casos subclínicos na lactação consecutiva. Entretanto, fatores de virulência e mecanismos de resistência apresentados por SCN podem reduzir as taxas de cura. Os objetivos deste trabalho foram identificar no leite de ovelhas tratadas e não tratadas à secagem com antimicrobianos, as espécies de SCN antes e após o tratamento e identificar nesses micro-organismos a presença dos genes mecA, icaA, icaC, icaD, bap, bhp, sea, seb, sec, sed e tsst-1, determinar o perfil clonal das principais espécies identificadas e relacionar os casos de cura após o tratamento com a presença/ausência dos respectivos genes. Sessenta ovelhas foram divididas em três grupos experimentais: G1, controle, metades mamárias que não receberam antimicrobiano; G2, metades mamárias em que foram administrados 10 mL de cloxacilina-benzatina 100 mg via intramamária / estrutura convencional; G3, metades mamárias em que foram administrados 86 mL de cloxacilina-benzatina 50 mg via intramamária / estrutura nanoencapsulada. As amostras de leite foram coletadas à secagem e aos 15 e 30 dias pós-parto da lactação seguinte. As análises para identificação das espécies de SCN foram realizadas por meio de testes bioquímicos e Internal Transcribe Spacer (ITS-PCR), e a pesquisa dos genes responsáveis pelos fatores de virulência e pela resistência à oxacilina foram realizados por meio da técnica de reação em cadeia de polimerase (PCR). Dentre as espécies identificadas S. warneri prevaleceram nos três grupos experimentais. Nenhuma amostra foi positiva para o gene mecA. O único gene relacionado com a produção de enterotoxinas encontrado foi o sec. Dentre os genes relacionados com a produção de biofilme, icaD foi o único identificado nos três grupos experimentais. Staphylococcus warneri, S. simulans e S. epidermidis apresentaram clones na mesma metade mamária no pré e pós-parto das ovelhas. A cloxacilina benzatina nanoparticulada 50mg / 86 mL foi eficiente para reduzir a mastite subclínica no pós-parto de ovelhas (P= 0,0192). Staphylococcus warneri, S. simulans, S. epidermidis e S. xylosus foram as espécies de maior ocorrência. Os genes icaA, icaC, icaD e bap foram encontrados no momento da desmama e no pós-parto, os genes sec e icaD estão associados à ausência de cura da mastite subclínica no pós-parto. Ovelhas em que foram isolados SCN portadores de genes responsáveis pela formação de biofilme não apresentaram resultados satisfatórios quando submetidas a esquemas de controle e ao tratamento da mastite subclínica. Os genes sec e icaD, estão associadas à ausência de cura microbiológica da mastite subclínica no pós-parto. Staphylococcus epidermidis e S. xylosus portador do gene bap estão associados à reinfecção. / Mastitis in dual-purpose sheep is recognized to affect their milk quality. Coagulase-negative Staphylococcus (CNS) is the main microorganism responsible for this disease and treatment at the end of lactation may contribute towards curing it and preventing subclinical cases during the consecutive lactation. However, virulence factors and resistance mechanisms presented by CNS may reduce the cure rates. The aims of this study were to identify CNS species in sheep’s milk with and without treatment with antimicrobials at the time of drying off and, in these microorganisms, to identify presence of the genes mecA, icaA, icaC, icaD, bap, bhp, sea, seb, sec, sed and tsst-1, determine clonal profile of the main species identified and correlate the cases of cure after treatment with the presence or absence of the respective genes. Sixty sheep were divided into three experimental groups: G1 (control), mammary glands that did not receive antimicrobials; G2, mammary glands to which 10 mL of cloxacillin-benzathine (100 mg) was administered via the intramammary route in a conventional structure; and G3, mammary glands to which 86 mL of cloxacillin-benzathine (50 mg) was administered via the intramammary route in a nanoencapsulated structure. Milk samples were collected at the time of drying off and 15 and 30 days after lambing in the next lactation. The analyses to identify the CNS species were performed by means of biochemical tests and internal transcribe spacer polymerase chain reaction (ITS-PCR), and the genes responsible for the virulence factors and resistance to oxacillin were investigated by means of the PCR technique. Among the species identified, Staphylococcus warneri was most prevalent in the three experimental groups. None of the samples were positive for the gene mecA. The only gene relating to production of enterotoxins that was found was sec. Among the genes relating to biofilm production, icaD was the only one identified in the three experimental groups. Staphylococcus warneri, S. simulans and S. epidermidis presented clones in the same mammary gland before and after lambing. The dose of 86 mL of nanoparticulate cloxacillin-benzathine (50 mg) was efficient for reducing subclinical mastitis after lambing (P = 0.0192). Staphylococcus warneri, S. simulans, S. epidermidis and S. xylosus were the species that occurred most frequently. The genes icaA, icaC, icaD and bap were found at the time of weaning and in the postpartum period. The genes sec and icaD were correlated with absence of cure for subclinical mastitis after lambing. Sheep in which CNS carrying genes responsible for biofilm formation was isolated did not present satisfactory results when they were subjected to regimens for controlling and treating subclinical mastitis. The genes sec and icaD were correlated with absence of microbiological control over subclinical mastitis after lambing. Staphylococcus epidermidis and S. xylosus carrying the gene bap were correlated with reinfection. / FAPESP: 2012/23044-0

Several studies have associated subclinical hypothyroidism with risk factors for atherosclerotic disease, but its correlation with a decreased tolerance to the physical effort has been little studied. In this context, the hormonal replacement with L-thyroxine for the treatment of these patients remains controversial. The present study aimed to analyze the effect of sodium L-thyroxine on the tolerance to the physical effort and the lipidic profile of patients with subclinical hypothyroidism. Seven female volunteers aged between 40 and 60 years, without clinical signs of hypothyroidism and with TSH > 4.4 mU/dL, total T3 and free T4 in the plasma were selected. The plasmatic lipidic profile was evaluated before and after treatment of all patients. For the evaluation of tolerance to the physical effort, all patients were submitted to a progressive effort test. Levels of blood lactate before and after treatment were analyzed as parameters of effort. There was a significant improvement in tolerance to the lactate and consequently, in tolerance to the effort after treatment with thyroxine. The results demonstrated a significant decrease of LDL-c and triglycerides after the normalization of TSH levels with the hormonal replacement. Significant differences were not observed in the levels of HDL, VLDL and total cholesterol. / Vários estudos associam o hipotireoidismo subclínico a fatores de risco para doença aterosclerótica, mas poucos correlacionam este distúrbio à diminuição da tolerância ao esforço físico. Neste contexto, a reposição hormonal com o emprego da L-tiroxina no tratamento destes pacientes permanece controvertida. O presente estudo teve como objetivo analisar o efeito da Ltiroxina sódica na tolerância ao esforço físico e no perfil lipídico de pacientes com hipotireoidismo subclínico. Foram selecionados sete voluntárias, com idade entre 40 e 60 anos, TSH acima de 4,4mU/dl, T3 total e T4 livre no plasma, sem sinais clínicos de hipotireoidismo. Avaliou-se o perfil lipídico plasmático no pré e pós tratamento de todas as pacientes. Para avaliação da tolerância ao esforço, todas as pacientes foram submetidas a um teste de esforço progressivo. Como parâmetro de esforço foram analisados os níveis de lactato sangüíneo no pré e no pós tratamento. Houve melhora significativa na tolerância ao lactato e consequentemente, na tolerância ao esforço após tratamento com tiroxina. Os resultados demonstraram diminuição significativa do LDL-c e dos triglicérides após normalização dos níveis de TSH com a reposição hormonal. Não foi observada diferença significativa nos níveis de HDL, VLDL e colesterol total. / Mestre em Ciências da Saúde

1 Abstract The cluster of obesity, insulin resistance and other associated comorbidities represents a significant health risk for the affected individuals as well as the whole population. Chronic low-grade inflammation of adipose tissue is considered one of the main mechanisms respon- sible for the progression from simple obesity to a fully developed metabolic syndrome. The aim of our study was to explore two different approaches that could potentially ameliorate adipose tissue inflammation - therapeutic hypothermia and the adipocytokine clusterin. In the first part, we showed that a period of deep hypothermia associated with the an- oxic phase of cardiac surgery significantly delayed the onset of systemic inflammatory re- sponse induced by surgery. The relative gene expression of the studied genes was not altered during the hypothermic period, but was significantly increased in five out of ten studied genes (IL-6, MCP-1, TNF-α, HIF1-α, GLUT1) and decreased in two genes (IRS1, GPX1) at the end of surgery. We conclude that deep hypothermia delays the onset of local adipose tissue hy- poxia and inflammation. These results could partially explain the positive effects of therapeu- tic deep hypothermia on postoperative morbidity and mortality in cardiac surgery patients. In the second part, we examined plasma...

O uso de antibióticos para tratamento da mastite bovina subclínica durante a lactação apresenta restrições econômicas e a administração indiscriminada e inadequada destes medicamentos os torna potencialmente tóxicos aos animais e aos consumidores finais dos produtos lácteos. A utilização de medicamentos homeopáticos oferece menor custo, facilidade de administração, não há risco de resistência microbiana e não é necessário o descarte do leite dos animais em tratamento. Além disso, a homeopatia é reconhecida no Brasil como especialidade médica veterinária e aceita para uso no sistema de produção animal orgânico. Portanto, o presente trabalho teve como objetivo avaliar a eficácia de dois protocolos homeopáticos para tratamento da mastite bovina subclínica durante a lactação. O experimento foi realizado no período de seis meses e dividido em duas etapas. Na Etapa I, um grupo foi medicado com Sulphur 30CH, enquanto que o outro recebeu placebo. Na Etapa II, um grupo foi medicado com Calcarea carbonica 30CH e o outro grupo recebeu placebo. Os medicamentos foram administrados a cada trinta dias na Etapa I e a cada quinze dias na Etapa II. Em cada etapa foram coletadas amostras de leite antes, durante e após o tratamento. Para avaliar a eficácia dos protocolos, durante o experimento foram analisadas 138 amostras de leite na Etapa I e 72 amostras na Etapa II, realizando-se prova de Tamis, California Mastitis Test (CMT), contagem de células somáticas (CCS), quantificação de polimorfonucleares (PMN) e mononucleares (MN) por microscopia óptica, exame microbiológico e mensuração da produção leiteira. As análises estatísticas foram realizadas utilizando o software Graphpad Instat 1990-93. Os protocolos homeopáticos testados não diminuíram a celularidade do leite, pois não houve diferenças significativas nos resultados do CMT e da CCS no decorrer do experimento. Também não foi constatada nenhuma alteração significante na produção láctea. O microrganismo isolado com maior frequência no rebanho estudado foi o Corynebacterium bovis. Porém, não houve diferenças significativas em relação à frequência de isolamento deste microrganismo ao longo dos tratamentos, indicando a sua permanência nas glândulas mamárias. Além disso, observou-se durante todo o experimento o predomínio de células PMN em relação às MN. Sugere-se o estudo de novos protocolos homeopáticos com outros medicamentos, potência e frequência de administração, a fim de buscar alternativas para o tratamento de vacas com mastite subclínica / The use of antibiotics for treatment of bovine subclinical mastitis during lactation presents economic restrictions and the indiscriminate and inappropriate administration of these drugs makes them potentially toxic to animals and consumers of dairy products. The use of homeopathic medicine offers lower cost, ease of administration, no risk of microbial resistance and is not necessary to discard milk from animals under treatment. Furthermore, homeopathy is recognized as a medical specialty in Brazil and support for veterinary use in organic livestock production system. Therefore, this study aimed to evaluate the effectiveness of two protocols for homeopathic treatment of bovine subclinical mastitis during lactation. The experiment was performed between six months and divided into two stages. In Phase I, one group was treated with Sulphur 30CH, while the other received placebo. In Phase II, one group was treated with Calcarea carbonica 30CH and the other group received placebo. The drugs were administered every thirty days in the Phase I and every fifteen days in the Phase II. At each step the milk samples were collected before, during and after treatment. To evaluate the effectiveness of the protocols during the experiment were analyzed 138 samples of milk at Phase I and 72 samples at Phase II, performing proof Tamis, California Mastitis Test (CMT), somatic cell count (SCC), quantification of polymorphonuclear (PMN) and mononuclear (MN) by optical microscopy, microbiological examination and measurement of milk production. Statistical analysis was performed using the software Graphpad Instat 1990-93. The homeopathic protocols tested not diminished cellularity of milk because there were no significant differences in the results of CMT and SCC during the experiment. Nor was it found no significant change in milk production. The organism isolated most frequently in the herd studied was Corynebacterium bovis. However, no significant differences were observed in the frequency of isolation of this microorganism during the treatments, indicating his permanence in the mammary glands. Furthermore, it was observed during the experiment a predominance of PMN cells compared to MN. It is suggested the study of new protocols with other homeopathic medicines, potency and frequency of administration, to find alternatives for the treatment of cows with subclinical mastitis

The general objectives of the present thesis were to evaluate: (i) the effects of subclinical mastitis (SM) caused by major pathogens on SCC, milk leukocyte differentials (MLD) and milk yield; (ii) milk yield losses caused by SM at the cow and quarter level; and (iii) the economic impact of SM caused by major pathogens. The thesis was structured in four studies. In study 1, quarter milk samples (n = 302) from 78 cows with SCC gt;200,000 cells/mL were analyzed by milk leukocyte differential (MLD) methodology and by microbiological culture (MC). Quarters with positive-culture results were obtained from 102/156 (65.4%) of MLD-positive milk samples, while 28/135 (20.7%) of MLD-negative milk samples were MC-positive. When MC was considered the gold standard for mastitis diagnosis, the sensitivity (Se) of the MLD was 65.4% (IC95% = 57.4 to 72.8%) and the specificity (Sp) was 79.3% (IC95% = 71.4% to 85.7%). In conclusion, the use of the MLD on cows with monthly composite SCC > 200×103 cells/mL for screening at quarter level identified quarters more likely to be culture-positive. In study 2, the effect of different pathogens was evaluated by comparison of contralateral (healthy and infected) mammary quarters of 146 lactating cows. The impact of SM on economic return (quarter milk yield × milk price) was determined by applying milk payment estimates on milk collected from healthy versus infected glands. The milk losses ranged from 0.07 Kg/quarter.milking to 2.9 Kg/quarter.milking, and varied according to the pathogen causing SM. Economic losses were higher for SM caused by Enterococcus spp. (US$0.43/quarter.milking), Strep. Dysgalactiae (US$ 0.74/quarter.milking) and E. coli (US$0.98/quarter.milking). Additionally, there was a trend for Staph. aureus and Citrobacter spp. To induce economic losses of US$ 0.26 and 0.29/quarter.milking, respectively. In general, the economic return was lower in quarters with SM caused by environmental and contagious pathogens (US$ 0.18 and 0.22/quarter.milking, respectively) when compared to their healthy contralateral quarters. In study 3, a total of 146 out of 650 lactating cows were selected from seven dairy herds for having composite milk SCC > 200,000 cells/mL in combination with the isolation of a major mastitis pathogen. From these selected cows, 1,436 quarter milk samples were collected during three successive sampling occasions at intervals of 15-20 days. Quarter milk yield was measured by milking the mammary quarters individually using three successive milk samplings over time. Bacterial isolates were identified by microbiological culture, MALDI-TOF MS and partial sequencing of the 16S rRNA gene. Milk losses and economic returns varied according to the type of mastitis-causing pathogen: 0.24 to -0.87 kg/quarter.milking for environmental streptococci, and -1.57 to -1.69 kg/quarter.milking for Staph. aureus. Overall, mammary quarters that were cured from SM caused by Staph. aureus and environmental streptococci exhibited an increase in economic return of approximately 0.47 and 0.69 US$/quarter.milking, respectively. In study 4, test day records (n = 1,200,002) were obtained from the Paraná State Holstein Association, which included data from 92,560 lactating cows, from 781 herds, from January 2010 to December 2015. A segmented regression was fitted to estimate the cut-off point of Log10SCC scale where milk yield started to be affected by mastitis: 0.90 (~7,963 cells/mL). In conclusion, first lactation cows have a reduction of 1.37 to 2.28 kg/cow/d of milk yield for each increase of one unit of Log10SCC over the cutoff point, whereas second and later lactation cows are expected to have milk yield losses of 2.36 to 4.20 kg/cow/d for each unit increase of Log10SCC over the cutoff point. Overall, the results of this thesis indicated that milk losses depend on the type of pathogen causing SM. Major pathogens have showed greater effects on milk quality than when it was observed using the approach of culture results of negative or positive. The methodology for evaluation of subclinical mastitis effect on milk yield interferes in the estimation of milk losses, and should include factors such as DIM and number of parity. / Os objetivos gerais da tese foram avaliar: (i) os efeitos da mastite subclínica (MS) causada por patógenos primários sobre a CCS, contagem diferencial de células e produção de leite; (ii) perdas de produção de leite ocasionadas pela MS, em nível de vacas e quartos mamários; e (iii) o impacto econômico da MS causado por patógenos primários. A tese foi estruturada em quatro estudos. No estudo 1, amostras de leite de quartos mamários (n = 302) foram submetidas a cultura microbiológica (CM) e contagem diferencial de leucócitos (MLD). Quartos com resultados cultura-positiva apresentaram 102/156 (65,4%) amostras de leite MLD-positivas, e 28/135 (20,7%) das amostras de leite MLD-negativas tiveram CM-positivas. Quando a CM foi considerada o padrão-ouro para o diagnóstico da mastite, o diagnóstico por meio da MLD apresentou sensibilidade (Se) de 65,4% (IC95% = 57,4 a 72,8%) e especificidade (Sp) de 79,3% (IC95% = 71,4% a 85,7%). Em conclusão, o uso da MLD em vacas com CCS mensal > 200,000 células/mL para triagem de quartos identificou os mais prováveis de ser cultura-positivos. No estudo 2, o efeito de diferentes tipos de patógenos foi estudado avaliando pares de quartos mamários contralaterais (sadios e infectados) de 146 vacas em lactação. O impacto da MS sobre o retorno econômico (produção de leite × preço do leite) foi determinado pela aplicação de estimativas de pagamento do leite de quartos sadios e infectados. As perdas de leite variaram de 0,07 Kg/quarto.ordenha a 2,9 Kg/quarto.ordenha de acordo com o patógeno causador de MS. As perdas econômicas foram maiores em casos de MS causados por Enterococcus spp. (US$ 0,43/quarto.ordenha), Strep. dysgalactiae (US$ 0,74/quarto.ordenha) e E. coli (US$ 0,98/quarto.ordenha). Além disso, houve uma tendência de Staph. aureus e Citrobacter spp. ocasionar perdas de US$ 0,26 e 0,29/quarto.ordenha, respectivamente. Em geral, o retorno econômico foi menor em quartos com MS causada por patógenos ambientais e contagiosos (US$ 0,18 e 0,22/quarto.ordenha, respectivamente) quando comparados com os quartos contralaterais sadios. No estudo 3, um total de 146 das 650 vacas em lactação foram selecionadas de sete rebanhos por apresentar amostras compostas de leite com alta CCS (> 200.000 células/mL) e isolamento de patógeno primário causador de MS. Destas vacas selecionadas, 1.436 amostras de leite de quartos foram coletadas durante três amostragens sucessivas com intervalos de 15-20 dias. A produção de leite em nível de quartos mamários foi mensurada por meio de ordenha completa e individual. Os isolados bacterianos foram identificados por CM, MALDI-TOF MS e sequenciamento parcial do gene 16S rRNA. As perdas de leite e os retornos econômicos variaram de acordo com o tipo de patógeno causador da mastite: - 0,24 a -0,87 kg/quarto.ordenha (Streptococcus ambientais) e -1,57 a -1,69 kg/quarto.ordenha (Staph. aureus). Em geral, os quartos mamários que apresentaram cura da MS causada por Staph. aureus e Streptococcus ambientais apresentaram aumento no retorno econômico de aproximadamente 0,47 e 0,69 US$/quarto.ordenha, respectivamente. No estudo 4, registros do controle leiteiro (n = 1.200.002) foram obtidos da associação Paranaense do gado Holandês, os quais incluíram dados de 92.560 vacas Holandesas em lactação de 781 rebanhos, de janeiro de 2010 a dezembro de 2015. Uma regressão segmentada foi ajustada para estimar o ponto de corte na escala Log10CCS em que a produção de leite começou a ser afetada pela MS: 0.90 (~ 7.963 células/mL). Como conclusão, vacas de primeira cria apresentaram redução de 1,37 a 2,28 kg/vaca/dia na produção de leite para cada aumento de uma unidade Log10CCS acima do ponto de corte, enquanto vacas com duas ou mais crias apresentaram perdas de 2,36 a 4,20 kg/vaca/dia. Em geral, os resultados desta tese indicaram que as perdas de leite dependem do tipo de patógeno que causa SM. Os patógenos primários mostraram maiores efeitos sobre a qualidade do leite do que quando foram observados pela abordagem com base nos resultados de cultura negativa ou positivos. A metodologia de avaliação do efeito da mastite subclínica sobre a produção de leite interfere na estimativa das perdas de leite e deve incluir fatores como DIM e número de paridade.