Resumen Antecedentes: Los diagnósticos tardíos elevan los costes de atención del cáncer de mama. Objetivo: Analizar los costes directos de la atención del cáncer de mama en etapa temprana y avanzada en el tercer nivel de atención en el Instituto Mexicano del Seguro Social (IMSS). Método: Estudio observacional que compara los costes directos de atención en cáncer de mama en estadios clínicos inicial y avanzado. Los datos analizados fueron estudios de laboratorio, gabinete, tratamiento y hospitalización. El tiempo evaluado incluyó desde la primera atención hasta la finalización del primer tratamiento. Se determinaron los costes de acuerdo con la tabla de Costes Unitarios por Nivel de Atención Médica para el año 2019 del IMSS. Se utilizó la prueba t de Student para diferencias entre grupos, así como estadística descriptiva. Resultados: El estadio avanzado, comparado con el estadio inicial, ocasiona un número mayor de estudios de laboratorio-gabinete, cirugías, día/cama e interconsultas. El coste promedio de la atención del cáncer de mama por paciente es $99,280,36 (US$5,230.78) y $148,023.60 (US$7,789.92) para los estadios inicial y avanzado, respectivamente (p = 0.024). Conclusiones: El coste de la atención médica del estadio inicial es menor que el del estadio avanzado.

Abstract Background: Management of breast cancer is increased by late diagnoses. Objective: To analyse direct costs of breast cancer in early and advanced stage in a third level medical facility at Mexican Social Security Institute. Method: Observational study, direct costs of care in breast cancer in initial and advanced clinical stages are compared. Variables analysed were laboratory and diagnostic imaging studies, drugs, as well as hospitalization costs. The evaluated period included from the first care to the completion of the treatment. Costs were determined according to the table of Unit Costs by Level of Medical Care for the year 2019 of the Mexican Social Security Institute. Student's t test was used to determinate differences between groups, as well as descriptive statistics. Results: The advanced stage compared to the initial stage, causes a greater number of laboratory-cabinet studies, surgeries, day/bed and interconsultations. The average cost of breast cancer care per patient is $99,280.36 (US$5,230.78) and $148,023.60 (US$7,789.92) for the initial and advanced stages, respectively (p = 0.024). Conclusions: Cost of medical attention in the initial stage is lower than that of the advanced stage.

Resumo No presente manuscrito narramos em ficção experiências e questionamentos disruptivos que saboreamos com nossas corpas no processo de invenção e criação desse dossiê, que escuta e compartilha uma gama de possibilidades de “usos” do conceito de poder e de modos de subjetivação, seja na compreensão/vivência das relações raciais, na produção de estratégias de cuidado e de modos de existência de pessoas e comunidades negras, seja no enfrentamento ao racismo e às violências produzidas pela branquitude e pelos variados processos de atualização da lógica colonial. Caos-mundo é a encruzilhada, é a voz de criação, que protagoniza e fia conceitos diante de questionamentos sobre a Psicologia Social e do modo como tem trombado com a luta antirracista. Desde arte-fatos científicos, apresentamos o conjunto de artigos que constituem esse dossiê. dossiê usos “usos subjetivação compreensãovivência compreensão vivência raciais negras colonial Caosmundo Caos mundo encruzilhada antirracista artefatos arte fatos científicos

Resumen En este manuscrito narramos en ficción experiencias y preguntas disruptivas que saboreamos con nuestros cuerpos en el proceso de invención y creación de este dossier, que escucha y comparte un abanico de posibles "usos" del concepto de poder y modos de subjetivación, ya sea en la comprensión/vivencia de las relaciones raciales, en la producción de estrategias de cuidado y modos de existencia para las personas y comunidades negras, ya sea en la lucha contra el racismo y la violencia producida por la blanquitud y los variados procesos de actualización de las lógicas coloniales. Caos-mundo es la encrucijada, es la voz de la creación, que lidera y hila conceptos ante los interrogantes sobre la psicología social y su forma de chocar con la lucha antirracista. A partir de arte-factos científicos, presentamos el conjunto de artículos que componen este dossier. dossier usos "usos subjetivación comprensiónvivencia comprensión vivencia raciales negras coloniales Caosmundo Caos mundo encrucijada antirracista artefactos arte factos científicos

Abstract In this manuscript we narrate in fiction disruptive experiences and questions that we savored with our bodies in the process of invention and creation this dossier, which listens to and shares a range of possible "uses" of the concept of power and modes of subjectivation, in the understanding/experience of racial relations, in the production of care strategies and ways of existence for black people and communities, whether in confronting racism and the violence produced by whiteness and the varied processes of updating colonial logic. Chaos-world is the crossroads, it is the voice of creation, which leads and spins concepts in the face of questions about Social Psychology and the way it has collided with the anti-racist struggle. From scientific art-facts, we present the set of articles that constitute this dossier. dossier uses "uses subjectivation understandingexperience understanding experience relations communities logic Chaosworld Chaos world crossroads antiracist anti racist struggle artfacts, artfacts art facts, facts art-facts

Abstract The thermal and mechanical indices are the best estimators of fetal risk in an ultrasound and their values should be controlled in order to minimize exposure as much as possible. We compared the values of the thermal and mechanical indices obtained in obstetric ultrasound examinations of pregnant patients, with the value recommended by the international community. These indices were estimated in 421 obstetric ultrasounds during 2019. The estimated values were compared with each other and with the recommended value for each index and according to the display mode (B, color Doppler and spectral Doppler). Of the total sample, for the thermal index in color Doppler mode, 0.24% exceeded the recommended standard value and 2.85%. in spectral Doppler mode. For the mechanical index, the recommended value was exceeded in B mode by 11.16%, in 8.08% in color Doppler mode and, finally, by 0.48% for spectral Doppler mode. The mechanical and thermal indices in this sample of obstetric ultrasound examinations are on average below the reference value. However, there is a significant number of cases in which the standards are exceeded, which should be a warning to the medical community.

Resumen Los índices térmico y mecánico son estimadores de riesgo fetal en una ecografía y se deben controlar sus valores minimizando la exposición. Comparamos los valores de los índices térmico y mecánico obtenidos en exámenes ecográficos obstétricos de pacientes gestantes, con el valor recomendado por la comunidad internacional. Se realizó la estimación de estos índices en 421 ecografías obstétricas en 2019. Los valores fueron comparados entre ellos y con el valor recomendado para cada índice y según el modo de visualización (B, Doppler color y Doppler espectral). Del total de la muestra, para el índice térmico en modo Doppler color un 0,24% superó el valor estándar recomendado y en modo Doppler espectral un 2,85%. Para el índice mecánico se sobrepasó el valor recomendado en modo B en un 11,16%, en un 8,08% en modo Doppler color y, por último, en un 0,48% para el modo Doppler espectral. Los índices mecánico y térmico en esta muestra de exámenes ecográficos obstétricos se encuentran en promedio bajo el valor de referencia. Sin embargo, existe un número importante de casos en que se superan las normas, lo que debe ser una voz de alerta para la comunidad médica.

Resumen Introducción: La prevalencia de los diferentes genotipos de virus del papiloma humano (VPH) varía dependiendo de la severidad de la lesión y región geográfica. Objetivo: Identificar infecciones múltiples de VPH en lesiones cervicales de bajo y alto grado en un grupo de mujeres del Bajío mexicano referidas con citología no concluyente. Métodos: Estudio piloto de mujeres referidas de unidades del primer nivel de atención de Guanajuato, México, por citología sugerente de lesión cervical. Los raspados cervicales fueron sujetos a extracción de ADN y genotipificación del VPH mediante microarreglos. Resultados: Se colectaron 100 casos consecutivos y fueron analizados 90; se observó 26 % de positividad a VPH en mujeres sanas y 62 % presentó algún grado de lesión. Los genotipos de VPH más frecuentes fueron 59, 31, 16 y 51. En la mayoría de las muestras se encontró infección múltiple. Conclusiones: Se identificó heterogeneidad de VPH en las muestras de la población estudiada en contraste con los reportes internacionales; además, son comunes las infecciones múltiples en lesiones precursoras y disminuyen en las lesiones de alto grado. Estos datos podrían influir en los actuales programas de vacunación anti-VPH.

Abstract Introduction: The prevalence of the different genotypes of human papillomavirus (HPV) varies depending on lesion severity and geographic region Objective: To identify multiple HPV infections in low- and high-grade cervical lesions in a group of women from the Mexican Bajío region referred with inconclusive cytology. Methods: Pilot study of women referred from primary care units of Guanajuato, Mexico, with cytology suggestive of cervical lesion. Cervical smears were subjected to DNA extraction and HPV genotyping using microarrays. Results: 100 consecutive cases were collected and 90 were analyzed; HPV positivity was observed in 26% of healthy women, 62% had some degree of cervical lesion. The most common HPV genotypes were 59, 31, 16 and 51. Multiple infections were found in most samples. Conclusions: HPV heterogeneity was identified in the samples of the study population in contrast to worldwide reports; furthermore, multiple infections are common in precursor lesions and decrease in high-grade lesions. These data could have an impact on current HPV vaccination programs.

ABSTRACT Introduction: The alteration in gas exchange is a complication of cardiac surgery with extracorporeal circulation. The cause of this deterioration is multifactorial. During the shunt, both lungs collapse and at the end of the extracorporeal circulation the lungs expand again, without a standard technique for it. The application of alveolar recruitment during general anesthesia in this type of surgery improves arterial oxygenation. Multiple strategies are used and have as a reference the extracorporeal circulation and its contribution to the pulmonary and systemic inflammatory response. This forces the anesthesiologist to understand the pathophysiology of lung injury associated with mechanical ventilation. Objective: Describe essential aspects of pathophysiology of pulmonary injury associated with mechanical ventilation in cardiac surgical procedures and the effect of perioperative protective mechanical ventilation as a strategy to prevent it. Method: A search of the literature published during the period between January 1990 and December 2020 was carried out that referred to protective mechanical ventilation strategies in cardiovascular surgery. Results: Experimental and clinical evidence suggest that low current volumes of pulmonary ventilation and the application for a short period of increased inspiratory pressures, known as "recruitment maneuvers" followed by the application of positive pressure at the end of expiration to keep the recruited alveoli open, increase functional residual capacity and reduce lung injury associated with mechanical ventilation. These recommendations have been extrapolated from retrospective studies conducted in other types of populations. Conclusions: There is no strong evidence that this strategy decreases the pro-inflammatory response, improves postoperative lung function and decreases perioperative mortality, when compared to conventional ventilation.

RESUMEN Introducción: La alteración en el intercambio gaseoso es una complicación de la cirugía cardíaca con circulación extracorpórea. La causa de este deterioro es multifactorial. Durante la derivación, ambos pulmones colapsan y al término de la circulación extracorpórea los pulmones se vuelven a expandir, sin existir una técnica estándar para ello. La aplicación de reclutamiento alveolar durante la anestesia general en este tipo de cirugía mejora la oxigenación arterial. Objetivo: Describir aspectos esenciales de fisiopatología de la injuria pulmonar asociada a la ventilación mecánica en procedimientos quirúrgicos cardíacos y el efecto de la ventilación mecánica protectora perioperatoria como estrategia para prevenirla. Método: Se realizó una búsqueda de la literatura publicada durante el período comprendido entre enero de 1990 y diciembre de 2020 que hiciera referencia a las estrategias de ventilación mecánica protectora en cirugía cardiovascular. Resultados: La evidencia experimental y clínica sugiere que los bajos volúmenes corrientes de ventilación pulmonar y la aplicación por un corto período del aumento de las presiones inspiratorias, conocidas como “maniobras de reclutamiento” seguidas de la aplicación de presión positiva al final de la espiración para mantener los alveolos reclutados abiertos, incrementan la capacidad residual funcional y reducen la injuria pulmonar asociada a la ventilación mecánica. Estas recomendaciones han sido extrapoladas de estudios retrospectivos realizados en otro tipo de poblaciones. Conclusiones: No existe evidencia contundente de que esta estrategia disminuya la respuesta proinflamatoria, mejore la función pulmonar posoperatoria y disminuya la mortalidad perioperatoria, cuando se compara con la ventilación convencional.

RESUMEN Introducción: La llegada de la pandemia de COVID-19 al Perú requirió una respuesta inmediata y múltiples cambios tanto en la atención sanitaria como en el entrenamiento de los profesionales de la salud. La Facultad de Medicina de la Universidad Peruana Cayetano Heredia implementó el Programa de Teleconsulta Docente (PTD), para continuar con la formación de estudiantes de medicina en un entorno virtual, sin embargo, se desconoce la aceptación de los involucrados respecto a una educación virtual, condición que puede reflejar lo ocurrido en otras escuelas de medicina del país. Objetivo: nuestro estudio buscó evaluar la percepción de alumnos y docentes respecto al PTD. Métodos: estudio observacional, descriptivo y transversal. Se elaboró un cuestionario para explorar las percepciones de la telemedicina en el escenario de la enseñanza. Resultados: más del 80 % de los profesores y el 60 % de los alumnos consideraron que la PTD podía utilizarse como herramienta de enseñanza. Más del 90 % de los profesores y los estudiantes consideran que realizar la telemedicina no fue más difícil que hacer una consulta presencial. El 60 % de los estudiantes y el 80 % de los profesores perciben que los estudiantes deben desarrollar habilidades en telemedicina; el 80 % de los profesores y estudiantes consideran que la PTD constituye un servicio de responsabilidad social. Profesores y alumnos consideran que el éxito en la implantación de un PTD está influenciado por el nivel de aceptación de la población (20,2 %), el uso de la historia clínica electrónica (19,4 %) y la formación en competencias digitales (18,6 %). Conclusión: los profesores y los estudiantes del PTD perciben la telemedicina como una herramienta útil para evaluar los problemas de salud de la población. Ambos perciben que a través de las sesiones de telemedicina se podrían adquirir las habilidades necesarias para completar el perfil de egresado de la carrera de medicina.

ABSTRACT Introduction : The occurrence of the COVID-19 pandemic in Peru required an immediate response and multiple changes in both healthcare and health professional training. The School of Medicine in Universidad Peruana Cayetano Heredia implemented the Teleconsultation Faculty Program (FTP), aiming to continue with training medicine students in a virtual environment. However, the acceptance of those involved in virtual education is unknown, a condition that may reflect what has happened in other medical schools in our country. Main : our study sought to assess the perception of students and teachers regarding FTP. Methods : observational, descriptive, cross-sectional study. A questionnaire was developed to explore perceptions of telemedicine in a teaching scenario. Results : More than 80% of teachers and 60% of students considered that the FTP could be used as a teaching tool. More than 90% of teachers and students consider that performing telemedicine was not more difficult than doing a face-to-face consultation. Sixty percent of students and 80% of teachers perceive that students must develop skills in telemedicine; 80% of teachers and students consider that FTP constitutes a service with social responsibility. Teachers and students consider that the success in the implementation of an FTP is influenced by the level of acceptance of the population (20.2%), the use of electronic medical records (19.4%), and training in digital skills (18.6%). Conclusion : Teachers and students using FTP perceive telemedicine as a useful tool for assessing health problems. Both perceive that through telemedicine sessions, skills required to complete the medical school graduate profile could be acquired.

Background: Anticoagulation in continuous renal replacement therapy (CRRT) is essential to counteract the coagulation cascade activation, induced by the dialysis circuit. Heparin is the most widely used anticoagulant, followed by regional citrate anticoagulation (RCA). Aim: To determine the effectiveness and safety of anticoagulant treatment with citrate in CRRT. Material and Methods: Retrospective study of adults in CRRT hospitalized between the years 2014 and 2020 in critical units, who required change to RCA according to established protocols. Results: We studied 24 patients aged 63 ± 13 years (12 females). The reasons for admission were acute kidney injury (AKI) in 80% and stage 5 chronic kidney disease in 20%. The indication of RCA in 75% of patients was by coagulation of more than 3 circuits in 24 hours. The duration of the circuit in RCA was 18.5 ± 4.8 hours versus 11.9 ± 4.9 hours with heparin (p < 0.0001). There were 19 mild complications that did not affect the RCA. Conclusions: RCA is feasible to perform, it is a safe and efficient procedure if it is protocolized, allowing a longer duration of the dialysis circuit.

Resumo: Atualmente o hotspot da Mata Atlântica tem menos de 11% de sua cobertura original. Porém aproximadamente 300 espécies de répteis são conhecidas por habitar esta ecorregião, das quais 34% são endêmicas. A criação de unidades de conservação representa uma estratégia de preservação de ecossistemas e gestão do uso do solo, e para o manejo adequado dessas áreas protegidas é fundamental a informação sobre a biodiversidade local. Apresentamos aqui a primeira lista de espécies de répteis para a Estação Ecológica e Área de Proteção Ambiental de Murici, duas unidades de conservação parcialmente sobrepostas localizadas no estado de Alagoas, um dos conjuntos de remanescentes florestais mais importantes para a conservação da Mata Atlântica no nordeste do Brasil. A lista de espécies foi construída com base em expedições e encontros ocasionais na área entre 1994 e 2022. Um total de 89 espécies de répteis foram registradas durante os 28 anos de coleta, sendo duas espécies de Crocodylia, três espécies de Testudines e 84 espécies de Squamata. Essa riqueza é de longe uma das maiores já documentadas para a Mata Atlântica. Além disso, duas espécies registradas na área são consideradas ameaçadas segundo a lista nacional (Amerotyphlops paucisquamus e Bothrops muriciensis) e seis são definidas como dados insuficientes para a avaliação de seu status de conservação. Três espécies são registradas pela primeira vez na Mata Atlântica ao norte do rio São Francisco: Dipsas indica, Trilepida salgueiroi e Cercophis auratus. Afirmamos que a lista de espécies aqui fornecida servirá como ponto de partida para novos estudos neste rico “hotspot” de répteis dentro da Mata Atlântica.

Abstract: Currently the Atlantic Forest hotspot has less than 11% of its original coverage. However approximately 300 species of reptiles are known to inhabit this ecoregion, of which 34% are endemic. The creation of protected areas represents a strategy for preserving ecosystems and managing land use, and for attaining the proper management of these protected areas, information on local biodiversity is essential. Herein we provide the first list of reptile species for the Estação Ecológica and Área de Proteção Ambiental de Murici, two overlapping protected areas located in the state of Alagoas, one of the most important sets of forest remnants for the conservation of the Atlantic Forest in the northeast of Brazil. The species list was constructed based on expeditions and occasional encounters in the area between 1994 and 2022. A total of 89 reptile species were obtained during the 28 years of collection, being two species of Crocodylia, three species of Testudines and 84 species of Squamata. This richness is by far one of the greatest ever documented for the Atlantic Forest. Additionally, two species registered in the area are considered threatened according to the national list (Amerotyphlops paucisquamus and Bothrops muriciensis) and six are defined as data deficient for the assessment of their conservation status. Three species are recorded for the first time in the Atlantic Forest north of the São Francisco River: Dipsas indica, Trilepida salgueiroi and Cercophis auratus. We claim that the species list provided here will serve as a starting point for further studies in this rich reptile “hotspot” within the Atlantic Forest.

ABSTRACT Background: Leishmaniasis is a vector-borne disease caused by a parasite protozoon from the genus Leishmania. Among the molecular techniques applied for detecting these parasites, real-time PCR with High Resolution Melting (PCR-HRM) proved advantageous since it simultaneously determines both the presence and species of the pathogen in one step, through amplification and later analysis of curves generated by melting temperature. Methods: Based on this molecular technique, the goal of this study was to estimate the PCR-HRM sensitivity for Leishmania spp. detection in different canine tissues by evaluating biological samples obtained from popliteal, submandibular, and pre-scapular lymph nodes, from bone marrow and ear pinnae of 28 stray dogs captured in the metropolitan area of Asunción (Paraguay). Results: The rk39 immunochromatographic test showed that 25/28 tested dogs (89%) presented antibodies against L. infantum. In 20/25 dogs that tested positive for rk39 (80%), it was possible to detect Leishmania spp. by PCR-HRM and determine that the species corresponded entirely to L. infantum. Regarding the analysis of different tissues, the parasite was detected in all popliteal lymph node samples, followed by high detection in submandibular (at 95%) and pre-scapular lymph nodes (at 90%), bone marrow (at 85%), and ear pinnae (at 85%). Conclusions: This study demonstrated that the use of real-time PCR-HRM using the molecular marker hsp70 was a highly sensitive method for simultaneously detecting and identifying Leishmania species in different tissues taken from infected dogs. In addition, the usefulness of ear pinnae as easily accessible tissue for molecular diagnosis was emphasized.

RESUMO Objetivo: conhecer como o familiar vivencia o cuidado da pessoa com dependência química. Método: História Oral Temática Híbrida, com quatro colaboradores, tendo como local um hospital psiquiátrico localizado na cidade de Curitiba, Paraná, Brasil. Coleta de dados entre os meses de outubro e novembro de 2020. Os dados foram analisados seguindo os passos de transcrição absoluta, textualização e transcriação. Resultados: revelaram-se dois temas: A vivência sofrida do familiar com o tratamento do dependente químico e Espiritualidade e religiosidade como suporte para lidar com os desafios da dependência. Conclusão: a dependência química causa impactos nos familiares, que sofrem em virtude do surgimento dessa doença, gerando sofrimento, frustação e, por vezes, desesperança por parte dos familiares. Experiências diversas sobre o mesmo evento podem servir como reflexão e alerta para todos sobre a importância do cuidado voltado aos familiares.

ABSTRACT Objective: to know how family members experience the care provided to a person with a chemical addiction. Method: Hybrid Thematic Oral History, with four collaborators and having as locus a psychiatric hospital located in the city of Curitiba, Paraná, Brazil. Data collection took place between October and November 2020. The data were analyzed following the absolute transcription, textualization and transcreation steps. Results: two topics were revealed, namely: The family member’s experience regarding treatment of a person with a chemical addiction; and Spirituality and religiousness as support to deal with the challenges inherent to the chemical addiction. Conclusion: chemical addiction exerts a number of impacts on the family members, who suffer due to onset of this disease, leading to distress, frustration and sometimes hopelessness in the relatives. Various experiences regarding the same event can be useful as a reflection and warning for everyone about the importance of care targeted at the family members.

RESUMEN Objetivo: averiguar de qué manera los familiares experimentan el cuidado de personas con adicciones a sustancias químicas. Método: Historia Oral Temática Híbrida con cuatro colaboradores, realizada en un hospital psiquiátrico situado en la ciudad de Curitiba, Paraná, Brasil. La recolección de datos tuvo lugar durante los meses de octubre y noviembre de 2020. Los datos se analizaron siguiendo los pasos de transcripción absoluta, textualización y transcripción. Resultados: se hicieron evidentes dos temas, a saber: La experiencia de los familiares con respecto al tratamiento de personas con adicciones a sustancias químicas; y Espiritualidad y religiosidad como apoyo para lidiar con los desafíos de la adicción. Conclusión: la adicción a sustancias químicas ejerce diversos efectos en los familiares, que sufren a raíz de la aparición de esta enfermedad, generando angustia, frustración y, en ocasiones, desesperanza en los integrantes de la familia. Diversas experiencias con respecto al mismo evento pueden servir como reflexión y alerta para todos los involucrados en relación a la importancia del cuidado dirigido a los familiares.

Abstract The fortification of dairy beverages is a widely developed strategy using non-heme or heme iron. Heme iron has a higher bioavailability. The investigation aimed to elaborate pasteurized milk with fortified chocolate flavor with heme iron that has good sensory acceptability. The preparation of the flavored milk was carried out based on the regulations and heme iron, obtained from a commercial source of whole blood of porcine origin, was added before the pasteurization process to achieve its complete dilution. The concentration of iron and chocolate flavoring was established as variables in order to evaluate the optimal formulation based on Sensory Acceptability (SA). The experimental design was a 32 factorial design in which eight formulations were established, which were sensory acceptability evaluated by a total of 35 school-age children, aged between 8 and 11 years using a five-point facial hedonic scale. The results of the analysis of variance and optimization of the response showed that SA was 4.71 (on a scale of 1 to 5) for a fortification of 6.76 mg Fe kg-1 sample and a chocolate concentration of 2.0 g kg-1 sample. The physicochemical characterization indicated a higher percentage of carbohydrates, a higher concentration of iron (9.3 mg Fe kg-1 sample) and vitamin C (349.0 mg kg-1 sample) with respect to fresh milk. According to the physicochemical and microbiological results, the approximate life time of the beverage was 5 days, which is in accordance with Peruvian regulations. These results showed a method of fortification of flavored milk that allowed the use of heme iron, whose content could contribute to the daily requirement of this mineral in children aged between 8 and 11 years old (8 mg of iron per day).

Resumo A fortificação de bebidas lácteas é uma estratégia amplamente desenvolvida, usando ferro não heme ou heme. O ferro heme tem maior biodisponibilidade. O objetivo da presente investigação foi elaborar um leite pasteurizado com sabor chocolate e fortificado com ferro heme que tenha boa aceitabilidade sensorial. O preparo do leite aromatizado foi realizado com base nas normas regulamentares do Peru e o ferro heme, obtido de fonte comercial de sangue de origem suína, foi adicionado antes do processo de pasteurização, para obtenção de sua diluição completa. As concentrações de ferro e sabor de chocolate foram estabelecidas como variáveis para avaliar a formulação ideal, com base na aceitabilidade sensorial. O delineamento experimental foi um esquema fatorial de 32, em que foram estabelecidas oito formulações, cuja aceitabilidade sensorial foi avaliada por um total de 35 crianças em idade escolar, com idades entre 8 e 11 anos, utilizando uma escala hedônica facial de cinco pontos. Os resultados da análise de variância e otimização da resposta mostraram que aceitabilidade senorial foi de 4,71 (em uma escala de 1 a 5) para uma amostra de fortificação de 6,76 mg Fe kg-1 e uma concentração de chocolate de 2,0 g kg-1 de amostra. A caracterização físico-química indicou maior percentual de carboidratos, maior concentração de ferro (amostra 9,3 mg Fe kg-1) e vitamina C (349,0 mg kg-1 amostra), em relação ao leite in natura. De acordo com os resultados físico-químicos e microbiológicos, a vida útil aproximada da bebida láctea fortificada foi de cinco dias, o que está de acordo com a regulamentação peruana. Estes resultados mostraram um método de fortificação do leite aromatizado que permite a utilização de ferro heme, cujo teor poderia contribuir para suprir a necessidade diária desse mineral em crianças de 8 a 11 anos (8 mg de ferro por dia).