Clin Med
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Polymyalgia rheumatica (PMR) was defined in 1957 and is linked with giant cell arteritis (GCA) in approximately 25% of cases. The peak incidence is between 60 and 75 years old and is increasing with the ageing population. Polymyalgia rheumatica is a clinical diagnosis without a 'gold standard' serological or histological test and there are other conditions that may mimic PMR. ⋯ The rate of reduction should be adjusted depending on the individual's response. Where temporal arteritis is suspected, this manifestation of GCA is a treatable medical emergency to prevent possible blindness, and steroids should be commenced immediately. There remain many unknowns in the cause, diagnosis and treatment of PMR and its overlap with GCA, and it is an ongoing challenge requiring further research.
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Key influences may be hard to identify. In this personal paper I reflect on the role of the Chair of the Committee for Ethical Issues in Medicine (CEIM) and on ethical issues that have involved the Royal College of Physicians (RCP). ⋯ In order to fulfil additional responsibilities the committee chair must bring to the CEIM practical ethics experience from outside bodies and, in turn, contribute externally through a variety of invitations and opportunities. It is impossible to know how far these spheres of influence extend, but I believe they are, on balance, significant, positive and necessary to the overall life of the RCP.