Divisions AdventHealth Orlando (formerly Florida Hospital Orlando) is a 1432-bed, faith-based, non-profit, tertiary, research and academic medical center located in Orlando, Florida, servicing Central Florida and the Orange county region. It is the second largest hospital in Florida and largest in Central Florida. AdventHealth Orlando is the region's largest academic university-level teaching center. AdventHealth Orlando is the oldest Seventh-day Adventist Hospital in the state of Florida. The hospital is owned by AdventHealth and is the largest hospital in the system. AdventHealth Orlando is affiliated with the AdventHealth University. AdventHealth Orlando also features an adult and pediatric emergency department and has a helipad to handle medevac patients. Attached to the medical center is the AdventHealth For Children that treats infants, children, adolescents, and young adults up to the age of 21. On January 2, 2019, Adventist Health System and Florida Hospital Orlando rebranded to AdventHealth.
Peroral endoscopic myotomy (POEM) is an effective treatment for esophageal motility disorders. There is limited data regarding the safety and feasibility of same-day discharge after POEM, and postoperative care lacks standardization. This study aims to assess the data on readmission rate, emergency department (ED) visits, and adverse events between same-day discharge (SDD) and admitted patients after POEM. Several databases were reviewed from inception to October 12, 2025. Outcomes of interest were readmissions, emergency department (ED) visits, adverse events, and post-procedural pain. Data were analyzed using a random-effect model. Seven retrospective studies with a total of 637 patients (384 SDD, 253 admitted) were included in the final analysis. There was no significant difference in 30-day readmission rate, OR (95
PURPOSE The primary objective of this randomized, double-blind, placebo-controlled, multicenter phase II study (Alliance A221805) was to screen two doses of duloxetine for preventing sensory oxaliplatin-induced peripheral neuropathy (OIPN). METHODS Participants were randomly assigned 1:1:1 to receive once daily 30 mg duloxetine, 60 mg duloxetine, or placebo. Eligible participants had stage II to III colorectal cancer and no baseline neuropathy, had Eastern Cooperative Oncology Group performance status 0-2, were age 25 years and older, and received oxaliplatin via one of the following doses and schedules: 85 mg/m 2 every 2 weeks (6 or 12 doses) or 130 mg/m 2 every 3 weeks (4 doses). Duloxetine/placebo was taken once daily beginning day 1 of cycle 1 and continued for 17 weeks. The primary end point, a composite response reflecting sensory OIPN symptom severity and onset, was measured in weeks 19-21 using a validated participant-reported outcome survey assessing extremity numbness, tingling, and pain. Response was defined as a participant-reported highest score of ≤2 (ie, 1 = not at all; 2 = a little) on survey items. To be evaluable for the response end point, eligible participants must have initiated oxaliplatin and submitted ≥1 postbaseline OIPN survey. RESULTS Of the 199 participants (n = 66, 30 mg duloxetine; n = 66, 60 mg duloxetine; n = 67, placebo), 46, 47, and 50 (N = 143, 71.8%), respectively, were evaluable for primary end point analysis based on modified intention-to-treat criteria. Participant mean age was 55.1 years (standard deviation = 10.4). Most were White (n = 113, 80.7%) and male (n = 82, 58.6%). The proportion of responders among those receiving placebo (68.0%) was similar to those receiving duloxetine 30 mg (65.2%) or 60 mg (66.0%). Duloxetine adherence rates, measured via pill counts—30 mg (54%), 60 mg (57%), and placebo (59%) groups—were low (<75%). CONCLUSION Duloxetine is not more promising than placebo for preventing sensory OIPN.
The Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity (SELECT) trial demonstrated cardiovascular benefits of semaglutide in patients with obesity without diabetes; however, the real-world effect across multiple glucagon-like peptide-1 receptor agonist (GLP-1 RA) agents in patients with established atherosclerotic cardiovascular disease (ASCVD) and overweight or obesity without diabetes mellitus remains unknown. We conducted a target trial emulation using data from the TriNetX US Collaborative Network (January 1, 2010, to December 1, 2025) in adults aged ≥45 years with established ASCVD (history of myocardial infarction, stroke, or coronary or peripheral revascularization), BMI ≥27 kg/m², and without type 2 diabetes. New initiation of any GLP-1 RA (liraglutide, semaglutide, dulaglutide, or exenatide) was compared with no GLP-1 RA use. The primary outcome was all-cause mortality; secondary outcomes were acute myocardial infarction, stroke, and heart failure hospitalization over 5 years, analyzed using Cox proportional hazards and Fine-Gray subdistribution hazard models to account for the competing risk of death. Among 14,844 propensity-matched patients without diabetes (7,422 per group; median age 63 [interquartile range 55 to 71] years; 64% women), GLP-1 RA use was associated with lower all-cause mortality (hazard ratio [HR] 0.68; 95% CI 0.53 to 0.88; p = 0.003), acute myocardial infarction (subdistribution HR [sHR] 0.63; 95% CI 0.41 to 0.98; p = 0.040), and heart failure hospitalization (sHR 0.61; 95% CI 0.39 to 0.95; p = 0.028); no significant association was observed for stroke (sHR 0.76; 95% CI 0.52 to 1.10; p = 0.146). Findings were consistent in landmark and age subgroup analyses; a sensitivity analysis including patients with diabetes (N = 31,910 matched pairs) showed similar associations. In conclusion, these real-world findings are broadly directionally consistent with the SELECT trial and provide complementary observational evidence across multiple GLP-1 RA agents in patients with established ASCVD and overweight or obesity without diabetes mellitus, though causal inference cannot be established from observational data alone.
