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SUMMARY OBJECTIVE: The aim of this study was to investigate the dosimetric outcomes and planning efficiency of volumetric modulated arc therapy compared to the field-in-field technique for whole brain radiotherapy, with a focus on the oral cavity as a newly defined organ at risk. The study also evaluates the impact of volumetric modulated arc therapy re-optimization on reducing oral cavity doses while ensuring target coverage. METHODS: Treatment plans for 20 technique for whole brain radiotherapy patients treated with volumetric modulated arc therapy were retrospectively analyzed and re-evaluated using field-in-field and volumetric modulated arc therapy re-optimization techniques. Dosimetric parameters, including D2%, D98%, V30(Gy), homogeneity index, and conformity index, were compared for the planning target volume. Mean and maximum doses to the oral cavity and bilateral lenses were assessed. RESULTS: Volumetric modulated arc therapy provided superior conformity (CI 0.82±0.07) and homogeneity (HI: 1.05±0.00) compared to field-in-field (CI 0.65±0.13, HI: 1.06±0.10) with significant differences (p<0.001). However, volumetric modulated arc therapy resulted in higher mean and maximum oral cavity and lens doses. Volumetric modulated arc therapy re-optimization significantly reduced oral cavity doses (p<0.001) while maintaining similar target coverage and dosimetric performance to volumetric modulated arc therapy. CONCLUSIONS: Volumetric modulated arc therapy improves dose conformity and homogeneity compared to field-in-field but increases doses to non-contoured organ at risk. Volumetric modulated arc therapy re-optimization effectively lowers oral cavity doses without compromising target coverage, underscoring the importance of identifying and addressing non-standard organ at risk. These findings highlight volumetric modulated arc therapy's clinical advantages, particularly in high-demand settings, while emphasizing the need for optimizing organ at risk to reduce toxicity.

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OBJECTIVE: The aim of this study was to investigate the effect of passive music listening in addition to conventional physiotherapy on pain, anxiety, and quality of life in patients with chronic neck pain. METHODS: The study included 40 people aged 30–50 years with chronic neck pain, who volunteered to participate in it. The participants were randomized into a control group (n=20) and a music group (n=20). Participants in the control group received a classical physiotherapy programme, 5 days a week for 4 weeks. Participants in the music group listened to music through headphones throughout the treatment. RESULTS: At the end of treatment, there was a statistical difference in the Beck Anxiety Inventory, visual analog scale, Neck Disability Index, and SF-36 physical scores in intragroup comparisons in both groups (p<0.05), When comparing the differences between the groups before and after treatment, it was found that the decrease in visual analog scale score of the participants in the music group was statistically significant compared to the decrease in visual analog scale score of the participants in the control group (p<0.01). CONCLUSION: Passive listening to music has been shown to have a positive effect on chronic neck pain when used in addition to conventional physiotherapy.

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SUMMARY OBJECTIVE: The aim of this study was to examine the prevalence of burnout among pregnant working individuals and its effects on both obstetric complications and issues that may arise in the early postpartum period. METHODS: Healthy pregnant women were questioned regarding their working life and Maslach Burnout Inventory. They were divided into two groups—burnout and non-burnout—according to the burnout score. The two groups were compared in terms of pregnancy and postpartum complications and breastfeeding. RESULTS: Burnout was identified in 164 pregnant women (54.1%). The age of the women with burnout was statistically significantly higher than that of the group without burnout. The breastfeeding rate was lower in the burnout group. In the evaluation of postpartum infective complications, 19.5% of the women with burnout and 8.6% of those without burnout developed infections, and this difference was statistically significant. CONCLUSION: It has been demonstrated that burnout increases the risk of infectious complications in pregnancy, reduces postpartum breastfeeding rates, and contributes to other negative outcomes.

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SUMMARY OBJECTIVE: The aims of this study were to gain more comprehensive information about the preferences of midwives and nurses regarding cesarean childbirth and the reasons behind their decisions. METHODS: This study was made phenomenological research using a qualitative study with 16 midwives and nurses between 1 January and 30 December 2023, at a state hospital. Content analysis was performed on the data obtained from the interviews. RESULTS: The study led to the conclusions that midwives and nurses preferred the mode of cesarean delivery based on their doctor's advice, their desire to avoid taking any risks, and their fear of pain and complications that could arise in vaginal childbirth, but that they also encountered postoperative problems following the C-section procedure that included respiratory issues in the newborn, delays in lactation, and difficulties with breastfeeding. It was also found that the midwives and nurses were aware that they were in a position as health workers to influence women choosing a mode of delivery and that they could have a part in contributing to the rising cesarean rates. CONCLUSION: On the basis of these conclusions, it might be recommended that midwives and nurses recognize that they are role models in the community and as health workers, they must consider current evidence-based data when deciding on a mode of childbirth, and ground their health application decisions on scientific knowledge.

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SUMMARY OBJECTIVE: The aim of this study was to compare the diagnostic accuracy and initial diagnostic test selection capabilities of large language models with an experienced emergency medicine specialist in simulated emergency department scenarios. METHODS: A series of brief case presentations were created by an expert committee to reflect real-world emergency conditions. Each brief case presentation included clinical history and physical examination findings but excluded laboratory and imaging data. The study compared the diagnostic accuracy and initial test selection performance of an emergency medicine specialist with three different large language model versions: ChatGPT-4, ChatGPT-4o, and ChatGPT-3.5-mini. The accuracy of responses was assessed based on predefined correct diagnoses and appropriate first-line tests. Statistical comparisons were conducted using the Cochran-Q test and McNemar test. RESULTS: The diagnostic accuracy rates were 92% for the human expert, 97% for ChatGPT-4, and 99% for both ChatGPT-4o and ChatGPT-3.5-mini (p=0.039 for ChatGPT-4o and ChatGPT-3.5-mini vs. human expert). The accuracy of initial diagnostic test selection was 88% for the human expert, 80% for ChatGPT-4, 87% for ChatGPT-4o, and 89% for ChatGPT-3.5-mini (p>0.05 for all comparisons). The most frequent diagnostic errors were related to cardiovascular (7/13) and gastrointestinal (4/13) cases. CONCLUSIONS: Large language models demonstrated acceptable diagnostic accuracy, outperforming the human expert in diagnosis while performing comparably in selecting initial diagnostic tests. These findings suggest that artificial intelligence models could serve as valuable decision-support tools in emergency medicine. However, further research is needed to evaluate their performance in real-world clinical settings.

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SUMMARY OBJECTIVE: The aims of this study were to investigate the effects of core stabilization exercises delivered through telerehabilitation on blood pressure, quality of life, and levels of asymmetric dimethylarginine, total antioxidant status, total oxidant status, and oxidative stress index in hypertensive patients. METHODS: We recruited 58 individuals diagnosed with hypertension and randomized 29 patients to the core stabilization exercise group and 29 patients to the control group. Patients in the exercise group performed core stabilization exercises under supervision of a physiotherapist by telerehabilitation. The measurements of asymmetric dimethylarginine, total antioxidant status, total oxidant status, oxidative stress index, ambulatory blood pressure, and questionnaires were evaluated before and after the 12-week training. RESULTS: Compared to the basal levels, total antioxidant status (1.848±0.207 vs. 1.861±0.198; p=0.784), total oxidant status (17.872±5.552 vs. 19.288±5.516; p=0.165), oxidative stress index (9.770±3.073 vs. 10.450±3.113; p=0.252), and asymmetric dimethylarginine (825.2±165.1 vs. 817.4±161.6; p=0.718) did not differ after the 12 weeks in control group. After 12-week training, total antioxidant status (1.814±0.232 vs. 1.936±0.294; p=0.010), total oxidant status (17.798±6.799 vs. 15.492±4.157; p=0.022), oxidative stress index (9.888±3.683 vs. 8.099±2.107; p=0.009), and asymmetric dimethylarginine (848.6±143.7 vs. 807.1±127.3; p=0.010) were improved in exercise group compared to basal levels. Quality of life, anxiety, and fatigue severity levels did not differ in both groups after 12 weeks. The sleep quality was slightly improved in both groups after 12 weeks (exercise group: 8.2±2.9 vs. 7.2±2.5; p>0.001 and control group: 8.6±4.2 vs. 7.6±3.9; p=0.007). CONCLUSION: Core stabilization exercises may improve oxidative balance and endothelial function in patients with hypertension.

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SUMMARY OBJECTIVE: This study assessed sleep quality and habits affecting sleep among medical students in Alagoas, Brazil. METHODS: An online survey was conducted using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale, and a questionnaire on caffeinated beverage and calming herbal tea intake, medication use, and daily screen time was administered. RESULTS: A total of 165 students participated, 56.36% of whom were female. The Pittsburgh Sleep Quality Index results showed that 58.2% were poor sleepers, 15.2% had poor sleep quality, and 26.7% were good sleepers. Only 36% met the recommended 7–9 h of sleep per day. Shorter sleep duration correlated with poorer sleep quality and increased daytime sleepiness (rho=-0.5). No significant sex differences were observed. Participants were categorized as early-to-bed (51.5%, 23.9±4.9 years; 62% women) and late-to-bed (48.5%, 23.7±5.7 years; 50% women). The late-to-bed group showed poorer sleep quality, greater daytime sleepiness, and 1.4 h less sleep than the early-to-bed group (p<0.01). A later sleep schedule was significantly associated with poorer sleep quality, shorter duration, and greater daytime sleepiness (p<0.01). The semester of study did not significantly influence bedtime (p=0.45). No significant group differences were found in beverage or medication use. CONCLUSION: This study highlights the need for targeted interventions to improve sleep quality and duration by addressing late bedtimes and contributing factors to daytime sleepiness.

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SUMMARY OBJECTIVE: The aim of this study was to determine the care dependency levels of geriatric patients undergoing surgical interventions. METHODS: The study included patients aged 65 years and older who underwent surgery in the surgical clinics of a research and training hospital. The sample consisted of 150 patients (75 males and 75 females). Data were collected using a Personal Information Form and the Care Dependency Scale during the postoperative period. RESULTS: The majority of the patients (70.7%) were aged 65–74 years, while 21.3% were aged 75–84 years, and 8% were aged 85 years or older. The mean age was 72.26±7.17 years, and the mean body mass index was 27.35±5.86 kg/m2. The average hospital stay was 13.71±18.16 days. Chronic diseases were present in 86% of the patients, with hypertension (78.7%) being the most common. The mean Care Dependency Scale score was 56.02±16.98. Care dependency levels were not significantly affected by alcohol use, chronic disease status, surgical history, body mass index, or hospitalization duration. However, care dependency levels varied significantly by age, sex, education level, marital status, employment status, and smoking habits. CONCLUSION: An association was observed between increased age and higher care dependency levels. Additionally, female sex, lower education levels, being single, and hospitalization in neurosurgery or orthopedic clinics were associated with higher care dependency. Age-related biopsychosocial changes affect care dependency before and after surgery. Therefore, healthcare professionals—especially nurses—should adopt a holistic approach in providing geriatric care.

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SUMMARY OBJECTIVE: The effectiveness of fluidotherapy has not been investigated in patients with distal radius fracturedistal radius fracture. AIMS: The aim of this study was to investigate the effectiveness of fluidotherapy added to conventional rehabilitation programs on pain, edema, muscle strength, and functionality in conservatively followed distal radius fracture patients. METHODS: The present randomized controlled, single-blinded study was conducted with 40 distal radius fracture patients who were followed conservatively with a cast. The patients were divided into two groups: the fluidotherapy and conventional rehabilitation groups. In addition to the conventional rehabilitation programs, the patients in the fluidotherapy group received 30 sessions of fluidotherapy for 6 weeks. Rest and activity pain were measured with the Numeric Rating Scale, edema with the Figure 8 method, joint range of motion with goniometry, handgrip strength with a dynamometer, and functionality with the patient-rated wrist evaluation questionnaire. Outcome measures were assessed at baseline, at week 2, and at week 6. RESULTS: Statistically significant changes were found in the intragroup measurements for all parameters in both groups (p<0.05). In the measurements between the groups, there was a statistical difference in the Numeric Rating Scale rest and range of motion flexion values in the conventional rehabilitation group and in the range of motion pronation parameters in the fluidotherapy group (p<0.05). No difference was found between the groups in the other parameters (p>0.05). CONCLUSION: Adding fluidotherapy to distal radius fracture rehabilitation had no effect on activity pain, edema, muscle strength, or functionality. Improvement in resting pain among distal radius fracture patients was less with the addition of fluidotherapy. Fluidotherapy was effective only on wrist pronation.

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SUMMARY OBJECTIVE: Artificial intelligence chatbots are increasingly used to disseminate health information. The aim of this study was to evaluate the accuracy, reliability, quality, and readability of responses generated by four artificial intelligence chatbots regarding human papillomavirus vaccination. METHODS: Frequently asked questions about human papillomavirus vaccination were identified using a Google search tool, and these questions were posed to the ChatGPT-3.5, Gemini, Copilot artificial intelligence, and ChatGPT-4 models. Responses were assessed for accuracy (five-point Likert scale), reliability (modified DISCERN scale), quality (Global Quality Scale), and readability (Flesch Reading Ease Score). Interobserver agreement was evaluated by the intraclass correlation coefficient. The results were evaluated at a significance level of p<0.05. SPSS 23.0 package programme was used in the analyses. RESULTS: There were significant differences between chatbots in terms of accuracy (p=0.001), reliability (p<0.001), and quality (p<0.001), but no significant difference in readability (p=0.497). ChatGPT-4 demonstrated the highest accuracy and quality, while Copilot artificial intelligence demonstrated superior reliability. All models produced responses that were moderately difficult to read. The intraclass correlation coefficient values for inter-rater reliability ranged from 0.034 to 0.512. CONCLUSION: Artificial intelligence chatbots show promising potential for use as patient information counsellors regarding human papillomavirus vaccination. However, improvements in readability and consistent evidence-based content generation are required before widespread clinical application.

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SUMMARY OBJECTIVE: Placental insufficiency, which plays a crucial role in both preeclampsia and fetal growth restriction, can cause oxidative stress and high reactive oxygen species production that could lead to hypoxia. Carbonic anhydrase IX is induced by hypoxia-inducible factor-1α, an important transcriptional regulator of genes involved in response to hypoxia. Considering this, we aimed to determine carbonic anhydrase IX levels in early preeclampsia with and without fetal growth restriction, and also to evaluate the predictive role of carbonic anhydrase IX for the development of fetal growth restriction in early onset preeclampsia. METHODS: This prospective study included a total of 180 participants, who were divided into two groups—early onset preeclampsia (n=90) and control (n=90). Then, preeclamptic patients were followed and subgrouped as preeclampsia with fetal growth restriction (n=35) and without fetal growth restriction (n=55). Sociodemographic and obstetric characteristics and laboratory features including carbonic anhydrase IX were compared between groups. RESULTS: Median carbonic anhydrase IX was higher in preeclampsia than controls [2.07 (0.78–5.48) vs. 1.32 (0.63–2.12), p<0.001]. Moreover, median carbonic anhydrase IX was higher in the preeclampsia with fetal growth restriction group as compared to the preeclampsia without fetal growth restriction group [2.76 (0.78–5.48) vs. 1.77 (0.89–5.14), p=0.018]. The carbonic anhydrase IX >1.83 pg/mL predicted fetal growth restriction with 77.14% sensitivity and 52.73% specificity (p=0.015, AUC=0.649) in the early onset preeclampsia. CONCLUSION: Carbonic anhydrase IX could reflect the insufficiency of the placenta in early onset preeclampsia and fetal growth restriction, and it could be used in early onset preeclampsia patients for the prediction of fetal growth restriction.

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SUMMARY OBJECTIVE: The aim of this study was to determine the anxiety, embarrassment, and pain levels of patients undergoing a cystoscopy procedure. METHODS: This cross-sectional study was conducted on 151 male patients who underwent cystoscopy in a hospital operating room between October 2021 and 2022. Data were collected with the Beck Anxiety Inventory for anxiety in preoperative; the Numeric Rating Scale for anxiety, embarrassment, and pain in intraoperative. RESULTS: The mean score of the patients’ Beck Anxiety Inventory was 3.810±6.905; the mean scores of the first and second Numeric Rating Scale measurements were 1.79±1.23; 1.94±1.28 for anxiety; 2.77±2.54; 2.32±2.30 for embarrassment; 1.44±0.75; 3.46±2.15 for pain, respectively. As a result of the regression analysis, the anxiety levels of the patients before the procedure explained 15.2 and 38.6% of the embarrassment and pain levels during the procedure, respectively. CONCLUSION: Anxiety, embarrassment, and pain levels of the patients in terms of the cystoscopy procedure were related to each other, and these parameters varied during different steps of the procedure.

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SUMMARY OBJECTIVE: The aim of the study was to assess national trends in advanced maternal age pregnancies in Brazil between 2011 and 2021 and discuss their implications for maternal health care planning. METHODS: This ecological time-series study analyzed data from the Brazilian Live Birth Information System between 2011 and 2021. Births among women aged ≥35 years were identified, and temporal trends were evaluated using segmented regression models (joinpoint regression) to estimate Annual Percent Change and Average Annual Percent Change, both nationally and across the five Brazilian macro-regions. RESULTS: A sustained increase in pregnancies among women of advanced maternal age was observed nationwide. From 2011 to 2019, the Annual Percent Change in Brazil was 5.3%, followed by a slower rise from 2019 to 2021 (Annual Percent Change=2.4%). The most pronounced growth was seen among women aged ≥45 years after 2016 (Annual Percent Change=6.4%). Regionally, the highest Average Annual Percent Changes were observed in the Central-West (5.5%), Northeast (5.2%), and North (5.0%), reflecting geographic variations in the pace and timing of this demographic shift. The overall Average Annual Percent Change for Brazil was 4.7%, confirming a consistent upward trend over the study period. CONCLUSION: The rising prevalence of advanced maternal age in Brazil reflects broader demographic and social trends. Public health strategies must adapt to this reality, strengthening prenatal care and risk management protocols for older mothers.

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SUMMARY OBJECTIVE: The aim of the study was to compare the surgical outcomes of vaginal natural orifice transluminal endoscopic surgery and conventional vaginal hysterectomy for benign gynecological conditions. METHODS: A prospective randomized controlled trial was conducted at a tertiary hospital from January 2025 to February 2025. Patients aged 40–80 who underwent hysterectomy for benign indications were included. Outcomes assessed included surgical outcomes, visual analog scale pain scores, and complication rates. RESULTS: A total of 144 patients were included, with 72 undergoing vaginal natural orifice transluminal endoscopic surgery and 72 undergoing vaginal hysterectomy. No significant differences were found in demographic characteristics, surgical duration (100.8±14.1 min for vaginal natural orifice transluminal endoscopic surgery vs. 99.3±26.7 min for vaginal hysterectomy, p=0.646), or complication rates. The vaginal natural orifice transluminal endoscopic surgery group had a higher rate of bilateral salpingo-oophorectomy (97.2 vs. 36.1%, p<0.001) and required fewer non-steroidal anti-inflammatory drugs postoperatively (median 2.0 vs. 3.0, p=0.003). CONCLUSION: This study indicates that vaginal natural orifice transluminal endoscopic surgery is a feasible alternative to vaginal hysterectomy for benign hysterectomies, demonstrating comparable outcomes and potential benefits in postoperative pain management. Future multi-center studies are warranted to strengthen the evidence base and explore long-term outcomes.

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SUMMARY OBJECTIVE: The aim of the study was to determine the prevalence, socio-demographic, and health-related predictors of frailty among community-dwelling elderly Chinese with hypertension. METHODS: It's a cross-sectional survey design among 338 respondents; the Chinese version of the Tilburg Frailty Assessment Scale was used to screen elderly hypertensive adults for frailty. The socio-demographic data were collected using a self-developed questionnaire. Data collected were analyzed using binary logistic regressions at a of 95%CI. RESULTS: The result of the study shows that the prevalence of frailty among community-dwelling older adults with hypertension in Henan province was 32.5%. The result of the socio-demographic predictors was being a female (p=0.001, OR 3.669 [CI 1.967–6.843]) and living in a rural area (p=0.032, OR 3.487 [CI 1.116–10.898]). While the leading health predictors were found to be a comorbidity of three or more conditions (p=0.001, OR 57.233 [CI 21.883–149.689]); history of hypertension spanning longer than 11 years (p=0.001, OR 10.541 [CI 5.404–20.561]). CONCLUSION: More attention should be focused on elderly hypertensive women to reduce the impact.

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SUMMARY OBJECTIVE: In this study, an investigation was undertaken to determine whether the well-being of the fetus is affected in pregnant women who have a severe fear of childbirth. METHODS: Participants were nulliparous pregnant women at 37 weeks of gestation. The Wijma Delivery Expectancy Questionnaire-A questionnaire, validated for the Turkish population, was used to assess the degree of fear of childbirth of the study subjects. Cases where labor began spontaneously and resulted in a vaginal delivery were included in the study. A total of 44 patients were investigated during the study period. The cases were divided into two groups according to the Wijma Delivery Expectancy Questionnaire-A scores. RESULTS: There were no statistically significant differences between the groups regarding fetal cord blood gas parameters and Apgar scores at the first and fifth minutes. Fear of childbirth in nulliparous cases did not affect the fetal cord blood gas parameters or Apgar scores. It was observed that the duration of the second stage of labor was statistically significantly longer in women with severe fear of birth (p=0.036). CONCLUSION: As a result, tocophobia can prolong the duration of the second stage of labor, does not affect fetal oxygenation, and does not change fetal cord blood gas parameters and Apgar scores. It is aimed to verify this result with large-scale studies and to encourage prospective studies.

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SUMMARY INTRODUCTION: The aim of the study was to compare the effects of dry needling and kinesio taping on pain intensity, mandibular range of motion, sleep quality, and depression levels in patients diagnosed with myogenous temporomandibular dysfunction (TMD). METHODS: Ninety patients with TMD were included in this two-center randomized controlled trial. Participants were randomly assigned to three groups: Group A (dry needling), Group B (kinesio taping), and Group C (control—conservative recommendations). Interventions were applied over 6 weeks. Primary outcome measures included the visual analog scale, Beck Depression Inventory, Pittsburgh Sleep Quality Index, and mandibular mobility assessment. RESULTS: Both intervention groups demonstrated significant improvements in pain reduction, increased mandibular range of motion, and improved sleep quality (p<0.05). The dry needling group showed superior outcomes compared to the other groups. While both the dry needling and kinesio taping groups showed within-group improvements in depression scores, between-group differences were not statistically significant (p=0.464), and lateral mandibular movements did not differ significantly among groups. CONCLUSION: Dry needling and kinesio taping are effective, safe, and clinically feasible interventions for the management of TMD. Dry needling, in particular, appears more effective in reducing pain and improving function. These findings highlight the importance of incorporating conservative physical therapy approaches within multidisciplinary TMD treatment protocols.

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SUMMARY OBJECTIVE: The aim of this study was to compare maternal plasma soluble urokinase plasminogen activator receptor levels in pregnant women diagnosed with intrahepatic cholestasis of pregnancy with those in healthy pregnant women and to evaluate its predictive value for neonatal intensive care unit admission. METHODS: This study is a prospective case-control study and was conducted with a total of 80 participants, including 38 pregnant women with intrahepatic cholestasis of pregnancy and 42 healthy pregnant women between 28 and 37 weeks of gestation. To evaluate the predictive value of maternal suPAR and bile acid levels for neonatal intensive care unit admission, receiver operating characteristic curves were generated. RESULTS: Maternal serum alanine aminotransferase, aspartate aminotransferase, and direct bilirubin levels were statistically significantly higher in the intrahepatic cholestasis of pregnancy group compared to the control. In the intrahepatic cholestasis of pregnancy group, the plasma soluble urokinase plasminogen activator receptor level was 0.42±0.6 ng/mL, whereas in the control group it was 0.18±0.1 ng/mL (p=0.038). The intrahepatic cholestasis of pregnancy group delivered at an earlier gestational age and with lower birth weight, and the need for neonatal intensive care unit admission was statistically significantly higher. In both the severe and mild intrahepatic cholestasis of pregnancy groups, spontaneous preterm birth was more frequent than iatrogenic preterm birth. In the severe intrahepatic cholestasis of pregnancy group, there was one neonatal death and one meconium-stained birth. The discriminatory power of soluble urokinase plasminogen activator receptor levels in predicting neonatal intensive care unit need was found to be statistically significant (area under the curve: 0.757; 95%CI 0.552–0.962; p=0.022). CONCLUSION: High maternal plasma soluble urokinase plasminogen activator receptor levels may predict adverse pregnancy outcomes.

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SUMMARY OBJECTIVE: The aim of this study was to analyze the provision of lato sensu postgraduate courses within the context of specialist medical training in Brazil. METHODS: Using a qualitative research approach, in-depth interviews were conducted based on a semi-structured guide with 24 key informants occupying strategic roles in the training of medical specialists. Participants included health system managers, medical educators, leaders of professional Medical Societies, and representatives from both public and private sectors. RESULTS: Four core themes emerged from the interviews regarding lato sensu postgraduate courses in medicine, reflecting key concerns and perceptions raised by participants: the lack of regulation and oversight amid an expanding market; risks to the quality of specialist medical training; the predominance of private-sector provision, often misaligned with the needs of Brazil's Unified Health System; and the importance of preserving the existing framework for specialist certification, as overseen by the National Commission for Medical Residency and the Brazilian Medical Association. CONCLUSION: Lato sensu postgraduate courses may serve a complementary role in the continuing education of doctors, but they are not a substitute for Medical Residency or the Specialist title granted by the Brazilian Association or Society of the respective specialty, which is affiliated to the Brazilian Medical Association. These programs should be subject to formal regulation and oversight, whether implemented by governmental authorities or delegated to competent civil society organizations.