Gallbladder diseases, including chronic cholecystitis and cholesterolosis, impose a significant burden on global health. Monitoring their evolving trends is vital to refine diagnostic strategies and improve clinical outcomes. This study evaluates a decade of gallbladder pathology data to identify epidemiological shifts and associated risk factors. This retrospective study analyzed 6665 cholecystectomy specimens from January 2014 to December 2023. Diagnoses included chronic and acute cholecystitis, cholesterolosis, metaplasia, dysplasia, and adenocarcinoma. Annual trends, demographic patterns, and risk factor correlations were examined using advanced statistical analyses, including multivariable logistic regression. Chronic cholecystitis remained the most common diagnosis (87.92%), showing a stable incidence and strong female predominance (4115:1745; P < .001). Cholesterolosis (24.07%) exhibited a rising trend, peaking in 2022, linked to dietary and metabolic changes. Notably, premalignant lesions such as metaplasia (12.54%) and dysplasia (3.11%) increased significantly, with dysplasia peaking in 2022–2023. Adenocarcinoma was rare (0.33%) but strongly correlated with dysplasia (r = 0.186, P < .001). Logistic regression analysis identified age and intestinal metaplasia as independent predictors of dysplasia. For adenocarcinoma, high-grade dysplasia (odds ratio [OR] = 308.9), polyps (OR = 2.9), and intestinal metaplasia (OR = 3.8) emerged as significant risk factors, while chronic cholecystitis (OR = 0.18) and gallstones (OR = 0.31) were independently associated with a reduced risk. The rise in premalignant gallbladder conditions, particularly dysplasia, underscores the importance of routine histopathological examinations following cholecystectomy. Targeted monitoring for high-risk patients and standardized early detection strategies are critical. Future studies should aim to validate these findings in larger, prospective cohorts and investigate the underlying mechanisms—both protective and promotive—by which various histopathological and clinical factors may influence the progression from benign to malignant gallbladder lesions.

Background: Solid organ transplantation relies on dynamic, evidence-based clinical algorithms. This study evaluates the educational reliability and feasibility of large language models (LLMs) for rapid protocol drafting by comparing GPT-4 and Gemini 2.5 Pro in generating step-wise diagnostic and management algorithms for common post-transplant scenarios. We assess LLMs as tools for synthesizing existing guidance rather than proposing new clinical practice guidelines. Methods: Ten high-stakes post-transplant scenarios (eg, acute cellular rejection and unexplained graft dysfunction) were evaluated. Both LLMs received identical, structured prompts. Three transplant specialists independently scored each algorithm using a 5-point rubric for Clinical Concordance (primary outcome), Logical Flow, and Completeness. Inter-rater reliability was assessed with weighted kappa, and median scores were compared using non-parametric tests. Model identifiers, access dates, and prompting procedures were reported to support reproducibility. Results: Inter-rater agreement was high (κ = 0.81). Gemini 2.5 Pro achieved a higher median Clinical Concordance score than GPT-4 (4.5 vs 3.8, P < .01) and higher Logical Flow and Completeness scores. Performance differences were most apparent in high-complexity scenarios requiring sequential differentiation of infectious vs alloimmune causes of graft dysfunction. Conclusion: Gemini 2.5 Pro outperformed GPT-4 in generating clinically concordant, structured, and complete transplant algorithms. LLM outputs remain model- and version-dependent and require expert validation prior to any clinical use. In practice, LLMs should be used only within a governance framework (specialist review, institutional oversight, and periodic revalidation after model updates), not as autonomous clinical tools.

Turkey is undergoing a significant demographic transition characterized by an increasing elderly population and a declining youth demographic. This study a