Persistent ventricular fibrillation after three shocks is a practical trigger, not just a pharmacology problem. The HEMS debrief focuses on DSED, vector change, pad position and training so shock strategy does not add pauses or confusion during cardiac arrest.

Pertussis can be easy to miss when the classic whoop is absent. This concise review anchors the timeline from coryzal symptoms to paroxysmal cough, and links swab timing, macrolides, exclusion advice and vulnerable contacts to transmission control.

Rectal bleeding in an adult under 50 still needs a colorectal frame. The focus is PR bleeding, altered bowel habit, iron deficiency, family history and persistent abdominal symptoms, with early referral when initial tests do not explain the clinical picture.

Patients taking semaglutide or tirzepatide still need structured lifestyle support. The practical emphasis is diet quality, protein, hydration, gastrointestinal adverse effects and resistance exercise, especially when appetite changes, fatigue or treatment discontinuation make weight regain more likely.

Young people with medical complexity need transition planning before the final transfer appointment. The teaching is concrete: clarify family roles, consent, equipment, medication refills, adult primary care links and transfer summaries so care is not lost between paediatric and adult systems.

Ileocolic Crohn’s surgery is framed around patient-specific reconstruction rather than one superior anastomosis. Key points include recurrence after resection, bowel and mesenteric tissue quality, Kono-S uncertainty, endoscopic access and safe haemostasis in thick Crohn’s mesentery.

Developmental regression after near-normal early milestones deserves a Rett syndrome lens when hand function, language, gait or head size changes. The short neurology update also flags MECP2 testing and common comorbidities such as epilepsy, scoliosis and autonomic dysfunction.