O cuidado em cenas: nas trilhas de Dona Violeta / Care in scenes: on the trail of Dona Violeta / El cuidado en escenas: en los caminos de Doña Violeta

Discutem-se as possibilidades reflexivas e práticas para compreensão do cuidado nas práticas de saúde com base na exploração de narrativas, inspiradas em vivências práticas, e em um filme, orientadas pela tríplice concepção de mimeses, que medeia tempo e narrativa (Paul Ricoeur). Essas histórias permitiram problematizar os limites de intervenções exclusivamente voltadas ao alcance de finalidades técnicas, evidenciando múltiplas possibilidades de conceber-se a noção de sucesso prático. Ao se abrirem para elementos significativos na vida dos personagens, as narrativas, como refiguração das experiências, possibilitaram cogitar sobre lacunas e projetar outros porvires, inclusive para o cuidado.(AU)

This article discusses reflective and practical possibilities for understanding care in health practices, drawing on the analysis of narratives inspired by practical experiences and a film guided by Ricoeur's theory of triple mimesis, which mediates time and narrative. The stories allowed us to problematize the limits of interventions exclusively geared towards achieving technical ends, evidencing multiple possibilities of conceiving the notion of practical success. By opening up significant elements of the protagonists' lives, the narratives, as a reconfiguration of experiences, allowed us to cogitate on gaps and project other futures, including those for care.(AU)

Se discuten las posibilidades reflexivas y prácticas para comprensión del cuidado en las prácticas de salud, a partir de la exploración de narrativas, inspiradas en vivencias prácticas y en una película orientadas por la triple concepción de mimesis, presente en tiempo y narrativa (Paul Ricoeur). Esas historias permitieron problematizar los límites de intervenciones exclusivamente enfocadas en el alcance de finalidades técnicas, poniendo en evidencia múltiples posibilidades de concebir la noción de éxito práctico. Al abrirse para elementos significativos en la vida de los personajes, las narrativas, como reconfiguración de las experiencias, posibilitaron pensar sobre lagunas y proyectar otros porvenires, incluso para el cuidado.(AU)

[AIDS and pregnancy: meanings of risk and challenges for care]. / Aids e gravidez: os sentidos do risco e o desafio do cuidado.

OBJECTIVE: To understand how the risk of vertical HIV transmission is perceived and interpreted by people living with HIV/AIDS, when making decisions regarding reproductive health. METHODS: This was a qualitative study carried out at three municipal health clinics specializing in STD/AIDS, in the city of São Paulo. Semi-structured thematic interviews were conducted with eight patients (male and female), from July to December 2001. The interviewees were key informants and either they or their partners were seropositive. All of them were aged 18 or over and had been living with their partners for at least one year. RESULTS: Among the motivations for having children, those related to the partner's expectations were highlighted, especially as a form of "recompense" for their actions. The risk of vertical transmission was used by health professionals both for discouraging pregnancy and for giving guidance on transmission prophylaxis. However, reproductive issues were not voiced at the health clinics, either by the patients or by the healthcare providers. CONCLUSIONS: Attention should be directed not only towards controlling the infection, but also most importantly towards the wellbeing of people living with HIV/AIDS. There is a need to clarify the different points of view of users and professionals in order to achieve the most effective and appropriate solution for each specific caregiving situation.

Purification and immunological characterization of human pancreatic ribonuclease.

Three alkaline RNases were purified from human pancreatic juice to near homogeneity as judged by sodium dodecyl sulfate and native polyacrylamide gel electrophoreses. The molecular weights of these RNases determined by sodium dodecyl sulfate electrophoresis were 27,000, 19,000, and 13,000. The activities of these three RNases were increased by addition of Mg2+, Ca2+, Co2+, K+, Na+, spermine, and spermidine and decreased by the addition of heparin, Cu2+, and Zn2+. These RNases showed higher hydrolytic activity toward polycytidylic acid than toward polyguanylic acid, polyuridylic acid, or polyadenylic acid. The three human pancreatic RNases were immunologically identical but differed from human liver RNase, as shown by Ouchterlony double-diffusion test. Radioimmunoassay of human pancreatic RNase showed that immunologically similar RNases are present in human saliva, and serum.

Radioimmunoassay for human pancreatic ribonuclease and measurement of serum immunoreactive pancreatic ribonuclease in patients with malignant tumors.

A method for radioimmunoassay of human pancreatic RNase was developed. The method is sensitive, reproducible, and specific. Almost no cross-reactivity exists between human pancreatic and liver RNases. A good correlation was observed between the serum concentration of pancreatic RNase as measured by radioimmunoassay and its enzymatic activity using polycytidylic acid as substrate. The concentration of serum pancreatic RNase correlates well with age, blood urea nitrogen, and albumin contents but does not correlate with serum amylase activity. Using the data of 52 patients with malignant tumors except pancreatic cancer, serum RNase level could be expressed by a multiple regression equation: Immunoreactive RNase content in pancreatic cancer was elevated in patients with complications from renal failure. Serum pancreatic RNase contents in patients with pancreatic cancer measured by radioimmunoassay agreed well with the values calculated using the equation derived from the data of patients with other malignant tumors.

Between flows and therapeutic projects: revisiting the notions of lines of care in health and therapeutic itineraries.

This essay discusses the possibilities of conceptual and practical connections between the ideas of line of care and therapeutic itineraries, beginning with the theoretical contributions that lay the foundations for the Line of Integrated Healthcare and the hermeneutic approaches to Care. The implementation of lines of care tuned to individual and collective health needs can be glimpsed in the construction of therapeutic projects, inasmuch as they privilege the particularities of each situation in the agreement of flows of appointments, exams, and other procedures. The therapeutic project - taken as an arrangement, strategy, device, or basic dimension of Care in the work process in health - can be seen as an image that lays out a possibility of the future, which in turn is a projection conditioned by past experiences of health, illness, and life. From the criticism of explanatory models, preponderant in the studies of therapeutic itineraries, we defend the investment in approaches that privilege interpretation and understanding, capable of recuperating, contextualizing, and reconstructing trajectories, beginning with the subjects involved in the care process.

Comunicação científica na Política Nacional de Ciência, Tecnologia e Inovação em Saúde: análise do discurso oficial / Science communication in the National Policy on Science, Technology, and Innovation in Health: analysis of the official speech

Resumo A partir da indagação sobre as possibilidades de participação social e efetiva interação da população nas pesquisas científicas na saúde, buscou-se analisar como a Política Nacional de Ciência, Tecnologia e Inovação em Saúde aborda essa dimensão comunicativa. Deste modo, examinou-se o documento oficial desta política por meio da análise temática. A comunicação sobre ciência, tecnologia e inovação à população é tratada, principalmente, no item sobre a difusão dos avanços científicos e tecnológicos, sendo designada com diferentes termos, cujos significados e objetivos, embora distintos, são tratados como sinônimos. A ideia central de comunicação gira em torno de um conteúdo a ser transferido a determinados públicos, de forma unidirecional e verticalizada, de um "emissor" para um "receptor". Tal perspectiva contrasta com a possibilidade de uma comunicação mais horizontalizada e participativa na produção de conhecimento e apropriação de tecnologias, como vislumbrado e desenvolvido por estudos e práticas sobre engajamento público na ciência ou letramento científico. Reconhecendo-se o mérito do processo que culminou nesta política e considerando o contexto político, social e cultural brasileiro é importante impulsionar propostas comunicativas de participação efetiva da sociedade nas questões de ciência, tecnologia e inovação na saúde, coerentemente com os princípios democráticos e participativos do Sistema Único de Saúde (SUS).

Abstract From the inquiry about the possibilities of social participation and effective popular interaction in health research, this article aims to analyze how the National Policy on Science, Technology, and Innovation in Health approaches the communicative dimension. For that, the official document of this policy underwent a thematic analysis. The communication of science, technology, and innovation for population features mainly at the "scientific and technological advances diffusion" section, designated under different expressions that, although presenting distinct meanings and goals, are stated as synonymous in the document. Overall, the policy considers communication as the upright and unidirectional transfer of content to specific audiences - from a sender to a receiver. Such perspective contrasts with the horizontal and participative perspective of knowledge construction and technological appropriation preconized by studies on public engagement in science and scientific literacy. Considering our political, social, and cultural context, along with the merit of the Policy's creation process, communication proposals must include an effective public participation in science, technology, and innovation in health, respecting the democratic and participative principles postulated by the National Health System.

Paulo freire e o inédito viável: esperança, utopia e transformação na saúde / Paulo freire and untested feasibility: hope, utopia and transformation in health / Paulo freire y lo inédito viable: esperanza, utopía y transformación en la salud

Resumo Trata-se de ensaio sobre o constructo 'inédito viável', de Paulo Freire, com objetivo de explorar suas potencialidades na saúde coletiva. Foram analisadas 38 obras do autor, das quais nove abordavam o inédito viável, permitindo reconhecer significados subjacentes ao constructo. Foram explorados três eixos para a compreensão: condições e contextos de emergência dos inéditos viáveis; exemplos; e sentidos de inéditos viáveis. A emergência dos inéditos viáveis resulta de complexo processo pedagógico, que vai do estranhamento da realidade à percepção crítica dos sujeitos envolvidos, a qual propicia a construção dos inéditos viáveis, como etapa que antecede a ação. Embora algumas obras analisadas citem exemplos de inéditos viáveis, estes não foram elucidativos na apreensão de possíveis significados do inédito viável. Com base nas ideias da obra freireana de práxis, projeto, futuridade, sonho, utopia e esperança, a compreensão do inédito viável ancorou-se no sentido de projeto coletivo. Propõe-se uma pedagogia aplicada à saúde coletiva que incorpore o 'inédito viável' como possibilidade de transcender o adestramento técnico, baseado, exclusivamente, em conteúdos informativos, investindo, também, nas capacidades de indignação e denúncia e na construção de projetos coletivos.

Abstract This essay is about Paulo Freire's "untested feasibility" construct, and it aims to explore its potentialities in collective health. A total of 38 works by the author were analyzed, nine of which discuss untested feasibility, which enables the recognition of the construct's underlying meanings. Three core ideas were explored for this understanding: the conditions and contexts of emergency of the untested feasibilities; examples; and the meanings of the untested feasibilities. The emergence of untested feasibilities results from a complex pedagogical process, which goes from the defamiliarization regarding reality to the critical perception of the subjects involved, which contributes to the development of untested feasibilities, as a step that precedes action. Even though some of the analyzed works mention examples of untested feasibilities, those were not clarifying regarding the understanding of the possible meanings of untested feasibility. Based on the ideas contained in Freire's works regarding praxis, project, futurity, dream, utopia and hope, the comprehension of untested feasibility was based on the sense of collective project. We propose a pedagogy applied to collective health that incorporates "untested feasibility" as a possibility of transcending the technical training, which is based exclusively on informational contents, also investing in the capacities of indignation and denunciation and in the development of collective projects.

Resumen Este es un ensayo sobre lo "inédito viable" de Paulo Freire, con el objetivo de explorar su potencial en la salud colectiva. Se analizaron un total de 38 obras del autor, nueve de las cuales se referían a lo inédito viable, permitiendo el reconocimiento de significados subyacentes de la construcción. Se exploraron tres ejes para la comprensión: condiciones y contextos de emergencia de los inéditos viables; ejemplos; y significados de inéditos viables. La aparición de los inéditos viables es el resultado de un complejo proceso pedagógico, que va desde la extrañeza de la realidad hasta la percepción crítica de los sujetos involucrados, lo que permite la construcción de inéditos viables, como paso previo a la acción. Aunque algunas de las obras analizadas citan ejemplos de inéditos viables, éstos no fueron explicativos a la hora de captar posibles significados de lo inédito viable. A partir de las ideas de la obra freireana de praxis, proyecto, futuro, sueño, utopía y esperanza, la comprensión de lo viable inédito se ancló en el sentido de proyecto colectivo. Se propone una pedagogía aplicada a la salud colectiva que incorpora lo "inédito viable" como posibilidad de trascender la formación técnica, basada exclusivamente en contenidos informativos, invirtiendo también en las capacidades de indignación y denuncia y en la construcción de proyectos colectivos.

Radioimmunoassays for two types of human urinary ribonucleases: differential determination of ribonucleases in human serum.

We developed radioimmunoassays for two types of human urinary ribonucleases. The assays are sensitive, reproducible and specific. One human urinary ribonuclease (RNase UL) showed strong immunological identity with human pancreatic ribonuclease, and the other ribonuclease (RNase Us) showed strong immuno cross-reactivity with human liver ribonuclease. There was no immuno cross-reactivity between these two urinary ribonucleases. Serum immunoreactive RNase UL was eluted as four peaks on phosphocellulose chromatography, whereas immunoreactive RNase US was eluted as a single peak. Serum content of immunoreactive RNase UL was 354 +/- 105 ng/ml (mean +/- SD) in normal individuals, and that of immunoreactive RNase Us was 15.9 +/- 5.7 ng/ml (mean +/- SD). No correlation was demonstrated between these two ribonuclease contents in serum.

Extramammary Paget's disease of the bronchial epithelium.

We report the first case, to our knowledge, of extramammary Paget's disease of the bronchial epithelium. The tumor displayed Paget's cells scattered within the bronchial epithelium in most of the lesion, but infiltrating into the bronchial submucosa and pulmonary parenchyma with microglandular and papillary patterns in some area. In addition to the histologic findings of coexistence with adenocarcinomatous components, in situ involvement into bronchial glands and ducts by Paget's cells was observed, suggesting that extramammary Paget's disease of the bronchial epithelium may be a variant of pulmonary adenocarcinoma, which is associated with bronchial glands.

A case of basal cell carcinoma of the nipple and areola with intraductal spread.

We report an 82-year-old Japanese woman with basal cell carcinoma of the left nipple and areola extending into the lactiferous duct. The patient developed a small papular lesion of the left areola about 1 year before admission. The lesion, which had slowly progressed to involve the nipple, had become symptomatic showing weeping and bleeding. Mammography revealed microcalcification in the nipple. Although Paget's disease was suspected from these clinical features, histologically basal cell carcinoma was diagnosed. There was no axillary lymphadenopathy, and no evidence of distant metastasis. The lesion of the nipple and areola was resected with a 2 cm free margin along with the underlying mammary tissue. The patient has remained well without signs of recurrence for 2 years after surgery. We reviewed cases of basal cell carcinoma of the nipple or areola and discuss considerations and problems of this rare tumor.

[Limitations of multiprofessional work: a case study of STD/AIDS reference centers]. / Limites do trabalho multiprofissional: estudo de caso dos centros de referência para DST/Aids.

OBJECTIVE: To understand the possibilities and limitations of developing coordinated work among professionals of different background in order to promote work collaboration and improve the quality of care of HIV/AIDS patients. METHODS: A qualitative study on multiprofessional work was carried out in five STD/AIDS reference centers in the city of São Paulo, Brazil. Semi-structured interviews were applied to 26 professionals from different background, focusing on how they position their practices in a multiprofessional setting. RESULTS: Significant differences were observed as to the outreach of multiprofessional work collaboration and possibilities of improving health care are related to the circumstances the multiprofessional work is done. CONCLUSIONS: When the multiprofessional team has to deal with predictable circumstances and the planning of long-term care projects where demands are anticipated from situations found in their practices, this creates better working conditions for effective collaboration. This collaboration favors interventions that promote a more productive interaction between the medical treatment and other relevant dimensions of care, such as social, psychological, and emotional needs of the patients.

[Chemo-hyperthermotherapy following thoracic surgery].

Local radiofrequency hyperthermia combined with chemotherapy was performed on patients with thoracic malignancy, who had under gone non-curative resection because of disseminated pleural involvement or positive surgical margin, and who had metastatic lesions (after curative surgery). In some patients, subjective symptoms were decreased or tumor necrosis was proved cytologically. This therapy may therefore be useful for patients with thoracic malignancy.

[Hepatic metastases from jejunal leiomyosarcoma treated effectively by repeated transarterial embolization with carboplatin].

A 67-year-old man complained of abdominal mass, abdominal pain and tarry stool. He was diagnosed as having jejunal leiomyosarcoma and multiple liver metastases after examination. The jejunal leiomyosarcoma was resected by operation. Unrectable liver metastases were repeatedly treated by transarterial embolization with carboplatin and Lipiodol, and a significant reduction was achieved. TAE with carboplatin and Lipiodol was considered evaluating efficiency therapy without side effect. He has remained well presently for 1 years 10 months after operation.

[Postoperative local thermo-chemotherapy in control of residual pleural diseases after resection of primary lung carcinoma--regulation of dissemination].

Pleural dissemination was proved by intraoperative histodiagnosis in 11 of 121 patients who underwent pulmonary resection for non-small cell carcinoma of the lung between April, 1985 and December, 1986. To control such intrathoracic residual diseases, we devised a means of local thermo-chemotherapy. Ten of 11 patients were treated with intrapleurally administrated cisplatin (50-100mg, bolus) combined with simultaneous radiofrequency hyperthermia (13.56 MHz) for 2 to 3 weeks after surgery. Courses were repeated at 5-to 7-day intervals. Eight patients had N2-disease, one N1 and the other NX. Eight were adenocarcinomas. Thermal burn of the chest wall with hyperkalemia was observed in only one patient who received thermotherapy at the over a magnetrode power of 450 watts for 50 minutes. In the other 9, side effects were minimal under the thermotherapy to obtain a peripleural temperature beyond 42 degrees C. Of the 10 patients, three lived more than 12 months after treatment. Although distant metastases were recognized in 6 cases, none had local recurrence for the median follow-up period of 6 months. One patient had metastasis to the contralateral supraclavicular lymph nodes. Because there was no evidence of intrathoracic recurrences in this patient, radical neck dissection were performed 15 months after the initial operation. This experience warrants further investigation of thermo-chemotherapy as a treatment for controlling pleural dissemination after resection of primary tumor.

[Surgical treatment and indication for metastatic lung tumor].

Prognostic factors of patients with metastatic lung tumors were evaluated on 72 patients who were treated with pulmonary resection (49 via lateral thoracotomy and 23 via median sternotomy). The 5-year survival rate of these patients was 41.3%. Two factors, i.e., tumor free interval (TFI) and tumor size, significantly affected the survival after surgery. Patients with a longer TFI and smaller tumor(s) were associated with a favorable prognosis. The prognosis, however, was neither affected by the number of metastatic lung tumors nor whether they were unilateral or bilateral. The prognosis of lung metastases from colorectal cancer was the most favorable (61.4% at 5-year). On the other hand, patients with lung metastases from renal cell carcinoma and breast carcinoma showed poor prognosis respectively. As for testicular tumors and bone or soft tissue sarcomas, chemo-sensitivity is the most important prognostic factor. Good responders to prior chemotherapy showed a better prognosis than poor responders. These results urge the reappraisal of the role of surgery in the treatment of metastatic lung tumors and demonstrate that aggressive surgery can be indicated even for multiple or bilateral lung metastases. Nature of metastatic tumors, i.e., their origin and chemo-sensitivity, must be taken into consideration when the indication for surgery is decided.

[Four operative cases of lung carcinoma with intra-atrial extension via the pulmonary vein].

We experienced four operative cases of lung carcinoma with intra-atrial extension via the pulmonary vein. In two cases, after assessment of the cardiac involvement, we performed extensive surgery under cardiopulmonary bypass. Their postoperative courses were uneventful, and their performance status was improved. However, seven months later one patient died of widespread metastases, while the other is alive but has recurrence. The other two patients underwent ordinary lobectomy because there were no abnormal findings in the hilar examination. However, the lumen of the resected pulmonary vein was filled with tumor tissue. One patient had massive embolism and died on the second postoperative day. The last case had residual tumor dislodging from the left atrium to the aorta. Though he was discharged without any complication, he developed multiple brain metastases 4 months after operation. We conclude that extensive surgery using cardiopulmonary bypass for lung cancer patients with such intracardiac involvement is effective for improvement of PS and reduces the risk of sudden death due to cardiac failure or emboli. Accurate diagnosis of intracardiac extension in these unusual cases is important.

Teatro do oprimido e promoção da saúde: tecendo diálogos / Teatro del oprimido y promoción de la salud: tejiendo diálogos / Theatre of the oppressed and health promotion: building dialogues

Resumo O estudo aqui apresentado buscou discutir as contribuições do teatro do oprimido na promoção da saúde, visando a colaborar para a consolidação desse diálogo de maneira que as repercussões no desenvolvimento das experiências práticas sejam potencializadas. Dentre as duas principais vertentes da promoção da saúde, registra-se a incompatibilidade entre os alicerces éticos, estéticos e políticos que fundamentam o teatro do oprimido e os pressupostos teóricos da corrente behaviorista, uma vez que esse teatro se afasta de qualquer tentativa de domesticação dos corpos e de normatização de comportamentos, hábitos e estilos para que sejam atingidos padrões (classificados por alguns como) saudáveis. Já com relação à perspectiva da nova promoção da saúde, de politização e busca de aproximação entre saberes científicos e técnicos com os saberes populares, observaram-se maiores consonâncias entre ela e o teatro do oprimido, a partir do momento em que ambos logram o fortalecimento de práticas cidadãs questionadoras do status quo e de mudanças sociais em prol de uma transformação libertária e crítica.

Abstract The aim of this study is to discuss the contributions of the theatre of the oppressed in health promotion and to collaborate with the improvement of the consolidation of this dialogue in practice experiences. Comparing the main perspectives of health promotion, there is a mismatch between the ethical, aesthetic and political foundations of the theatre of the oppressed and the theoretical assumptions of the behaviorist health promotion, because this kind of theatre pulls away from any attempt at domestication of bodies and norms of behavior, habits and lifestyles to reach healthy standards. There are greater consonance between the theatre of the oppressed and the new health promotion, its politicization and its searches to approach scientific and technical knowledge with popular knowledge, since both seek the fortification of humane practice that put in question the status quo and the social change towards a libertarian and critical transformation.

Resumen El presente estudio objetivó analizar las aportaciones del teatro del oprimido en promoción para la salud logrando contribuir a la consolidación de este diálogo para que se potencie el impacto en el desarrollo de experiencias prácticas. Entre las dos principales perspectivas de la promoción de la salud, se ha observado una falta de correspondencia entre los fundamentos éticos, estéticos y políticos que subyacen al teatro del oprimido y los supuestos teóricos de la promoción de la salud behaviorista, ya que este teatro se aleja de cualquier intento de domesticación de los cuerpos y de regulación de comportamientos, hábitos y estilos de forma que se cumplan las normas (clasificados por algunos como) saludables. En cuanto a la perspectiva de la nueva promoción de la salud, su politización y busqueda de acercamiento entre los saberes científicos y técnicos con los saberes populares, hay una mayor consonancia entre ellos desde el momento en que ambos logran fortalecer la práctica de cuestionar el status quo y el cambio social hacia una transformación libertaria y crítica.

Imaginário social sobre o SUS e vulnerabilidade de homens ao acesso a diagnóstico e tratamento de infecções sexualmente transmissíveis / The social imaginary about SUS and the vulnerability of men to access todiagnosis and treatment of sexually transmitted infections / El imaginario social sobre el SUS y la vulnerabilidad de los hombresen el acceso al diagnóstico y tratamiento de infecciones sexualmentetransmisibles

A partir do reconhecimento da importância das dimensões socioculturais e simbólicas no acesso dos homens ao diagnóstico e tratamento de infecções sexualmente transmissíveis (IST), discute-se se e como suas concepções sobre o SUS podem vulnerabilizá-los na busca de cuidado, diante de suspeita de IST, tendo como referência a noção de imaginário social. Foram realizados quatro grupos focais, a partir dos quais foram apreendidos e analisados os discursos dos homens sobre possíveis locais em que procurariam ajuda,em caso de suspeita de IST. A imagem negativa que fazem do sistema público de saúde é construída a partir de referências que extrapolam suas vivências diretas, na qual a mídia parece ter um papel preponderante. À crítica do SUS, os planos de saúde privados emergem como solução redentora. A despeito da importânciada participação social, essa noção não se fez presente nos discursos, levando à necessidade de melhor compreender e fomentar tal iniciativa...

It is postulated the difficulty of men in the access to diagnosis and treatment of sexually transmittedinfections (STI). Considering that access is also molded by sociocultural and symbolic dimensions, it isdiscussed if and how men’s apprehensions of SUS (the Unified Health System), can make them vulnerablewhen seeking for care, facing a suspicion of STI, holding as reference the notion of social imaginary. Fromthe execution of four focal groups, it was analyzed the speeches of men about places where they would lookfor help, in case of suspicion of STI. The negative image that they have about the public health system is builtfrom references that extrapolate their direct experience, in which the media seems to have a preponderantrole. To the criticism of SUS private health insurance emerge with redeeming solution. Despite theimportance of social participation, this notion was not present in those speeches, leading to the necessity ofbetter comprehending and fomenting such initiative...

A partir del reconocimiento de la importancia de las dimensiones socio-culturales y simbólicas en el accesode los hombres al diagnóstico y tratamiento de infecciones sexualmente transmisibles (IST), se discutesi y cómo sus concepciones sobre el SUS lo pueden vulnerabilizar en la búsqueda de cuidado, frente a lasospecha de IST, teniendo como referencia la noción de imaginario social. Fueron realizados cuatro gruposfocales, a partir de los cuales fueron aprehendidos y analizados los discursos de los hombres sobre posibleslugares en que buscarían ayuda, en caso de sospecha de IST. La imagen negativa que tienen del sistemapúblico de salud es construida a partir de referencias que extrapolan sus vivencias directas, en la cual losmedios de comunicación parecen tener un papel preponderante. A la crítica del SUS, los planes de saludprivados emergen como solución redentora. A pesar de la importancia de la participación social, esa nociónno está presente en los discursos, llevando a la necesidad de comprender mejor y fomentar tal iniciativa...