Max Yates

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Verified

Max verified their affiliation via an institutional email.

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• BSc (Hons), MBBS, MRCP, MRCP (Rheumatology), MSc, PhD FHEA
• Professor (Associate) at University of East Anglia

Purpose of Review This review aims to summarise recent evidence on the effects of dietary patterns on the risk of bone fractures and sarcopenia. Recent Findings Several dietary patterns have been investigated in relation to musculoskeletal health, including Mediterranean Dietary Patterns (MDP), Dietary Inflammatory Indices, vegetarian and vegan di...

OBJECTIVE To perform a systematic literature review on definitions and instruments used to measure remission, relapse, and disease activity in polymyalgia rheumatica (PMR), to inform an OMERACT project to endorse instruments for these outcomes. METHODS A search of Pubmed/MEDLINE, EMBASE, CINAHL, Cochrane, and Epistemonikos was performed May 2021 a...

Background The ageing demographics of many European countries will result in a greater number of people diagnosed with disease, particularly those correlated with older age. In many European countries, people of older age tend to migrate from urban to rural and coastal areas. Polymyalgia Rheumatica (PMR) is strongly correlated to age, with rising i...

Background Current guidelines recommend glucocorticoids (GCs) for the treatment of Polymyalgia Rheumatica (PMR) for 1 to 2 years. Surveys and administrative datasets from many European countries and the USA show that approximately 50% of patients are on GCs for at least 2 years. A previous study looking at individuals with PMR and GC dependence, fo...

Background Giant Cell Arteritis (GCA) is a large vessel vasculitis associated with severe morbidity and requiring prompt assessment and treatment. The National Early Inflammatory Arthritis Audit (NEIAA) is a mandated audit of rheumatology care in England and Wales. In April 2023 GCA was added to the list of conditions included in NEIAA to character...

Background/Aims Multiple long-term conditions (MLTC) refers to the co-existence of two or more chronic conditions. Rheumatic diseases (RMDs) are important long-term conditions which are common in individuals with MLTC. The effect of rheumatic disease on disability is well known and often requires support with activities of daily living, i.e. social...

Background Sensory changes due to aging or disease can impact brain tissue. This study aims to investigate the link between glaucoma, a leading cause of blindness, and alterations in brain connections. Methods We analyzed diffusion MRI measurements of white matter tissue in a large group, consisting of 905 glaucoma patients (aged 49-80) and 5292 h...

Background Amblyopia is a common neurodevelopmental condition and leading cause of childhood visual impairment. Given the known association between neurodevelopmental impairment and cardiometabolic dysfunction in later life, we investigated whether children with amblyopia have increased risk of cardiometabolic disorders in adult life. Methods This...

The last British Society for Rheumatology (BSR) guideline on PMR was published in 2009. The guideline needs to be updated to provide a summary of the current evidence for pharmacological and non-pharmacological management of adults with PMR. This guideline is aimed at healthcare professionals in the UK who directly care for people with PMR, includi...

Objective There is growing evidence that genetic data are of benefit in the rheumatology outpatient setting by aiding early diagnosis. A genetic probability tool (G‐PROB) has been developed to aid diagnosis has not yet been tested in a real‐world setting. Our aim was to assess whether G‐PROB could aid diagnosis in the rheumatology outpatient settin...

Importance Calcium channel blocker (CCB) use has been associated with an increased risk of glaucoma in exploratory studies. Objective To examine the association of systemic CCB use with glaucoma and related traits among UK Biobank participants. Design, Setting, and Participants This population-based cross-sectional study included UK Biobank parti...

Imaging is increasingly being used to guide clinical decision-making in patients with giant cell arteritis (GCA). While ultrasound has been rapidly adopted in fast-track clinics worldwide as an alternative to temporal artery biopsy for the diagnosis of cranial disease, whole-body PET/CT is emerging as a potential gold standard test for establishing...

Background Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are common inflammatory rheumatic diseases with distinct clinical phenotypes, that can both result in significant disability. Whilst some data in selected samples report no difference in Health Assessment Questionnaire scores (HAQ) between RA and PsA(1), there is a lack of definitiv...

Background The relationship between multiple long term conditions (MLTC) and rheumatoid arthritis (RA) is well known; however the trajectory of accumulation of MLTC and the factors that influence the rate of progression of MLTC following the onset of RA are yet to be fully established. The Norfolk Arthritis Register (NOAR) is a cohort study establi...

Background There is growing evidence that genetic information can offer valuable information to a clinician in a diagnostic setting, and that it is feasible that genetic data would be of benefit to the rheumatology outpatient setting by aiding early diagnosis. A genetic probability tool (G-PROB) has recently been developed to aid diagnosis using ex...

Pharmacological management has advanced considerably since the 2015 British Society for Rheumatology axial spondyloarthritis (axSpA) guideline to incorporate new classes of biologic DMARDs (bDMARDs, including biosimilars), targeted synthetic DMARDs (tsDMARDs) and treatment strategies such as drug tapering. The aim of this guideline is to provide an...

Background/Aims Recent translational advances in genetics report the ability to accurately predict the diagnosis of patients presenting with synovitis, providing potential to accelerate treatment and improve patient outcomes. One tool is G-PROB, which uses genetic information to calculate conditional probabilities, known as G-probabilities ranging...

Background/Aims Polymyalgia rheumatica (PMR) is the most common autoimmune musculoskeletal condition in the developed world. Current BSR guidelines recommend glucocorticoid treatment for one to two years and give suggested taper regimens. The project examines national primary care data to assess the level of adherence to current guidelines, and the...

Background: High myopia (HM), defined as a spherical equivalent refractive error (SER) ≤ -6.00 diopters (D), is a leading cause of sight impairment, through myopic macular degeneration (MMD). We aimed to derive an improved polygenic score (PGS) for predicting children at risk of HM and to test if a PGS is predictive of MMD after accounting for SER...

Objectives: To explore current management practices for polymyalgia rheumatica (PMR) by general practitioners (GPs) and rheumatologists including implications for clinical trial recruitment. Methods: An English language questionnaire was constructed by a working group of rheumatologists and GPs from 6 countries. The questionnaire focused on: 1:...

Background/objectives This study aims to describe the grading methods and baseline characteristics for UK Biobank (UKBB) participants who underwent retinal imaging in 2009–2010, and to characterise individuals with retinal features suggestive of age-related macular degeneration (AMD), glaucoma and retinopathy. Methods Non-mydriatic colour fundus p...

Background In most countries polymyalgia rheumatica (PMR) is diagnosed and managed by both general practitioners (GP) and rheumatologists. However, the referral pattern from GP’s to specialist around the world has not been described. The initial prednisolone dose recommended by EULAR/ACR is between 12.5 and 25 mg¹, but little is known about whether...

Background Polymyalgia rheumatica (PMR) is diagnosed and treated by both general practitioners (GP) and rheumatologists. How rheumatologists around the world manage the referral process of patients with PMR from GP’s has not been described. EULAR/ACR guidelines recommend initial prednisolone doses between 12.5 and 25 mg, but it is unknown if guidel...

Background Polymyalgia rheumatica (PMR) is the most common autoimmune musculoskeletal condition in the developed world, with UK prevalence of 1.7% in those aged older than 55 years. Current guidelines recommend glucocorticoid treatment for one to two years. Since PMR affects older individuals and is associated with prolonged treatment with glucocor...

Purpose of Review Plasma exchange (PLEX) is often recommended as an adjunctive therapy for patients with ANCA-associated vasculitis (AAV) in the setting of rapidly progressive glomerulonephritis or diffuse alveolar haemorrhage. Since ANCAs are pathogenic, it seems a reasonable and justified approach to remove them through therapeutic PLEX, as despi...

Importance: Understanding the effects of modifiable risk factors on risk for multiple sclerosis (MS) and associated neurodegeneration is important to guide clinical counseling. Objective: To investigate associations of alcohol use, smoking, and obesity with odds of MS diagnosis and macular ganglion cell layer and inner plexiform layer (mGCIPL) t...

Objectives To determine the impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases (RMDs) and to explore how people adapted to these measures over time. Design Mixed-methods investigation comprising a national online longitudinal survey and embedded qualitative study. Setting UK online survey...

Objective: To identify the clinical and biomechanical characteristics associated with falls in people with RA. Methods: 436 people aged 60 years or older with RA completed a one-year prospective survey of falls in the UK. At baseline, questionnaires recorded data including: personal and medical history, pain and fatigue scores, health related qu...

Importance Uncertainty currently exists about whether the same genetic variants are associated with susceptibility to low myopia (LM) and high myopia (HM) and to myopia and hyperopia. Addressing this question is fundamental to understanding the genetics of refractive error and has clinical relevance for genotype-based prediction of children at risk...

Primary open-angle glaucoma (POAG), is a heritable common cause of blindness world-wide. To identify risk loci, we conduct a large multi-ethnic meta-analysis of genome-wide association studies on a total of 34,179 cases and 349,321 controls, identifying 44 previously unreported risk loci and confirming 83 loci that were previously known. The majori...

Background The risk of cognitive decline and dementia is of particular interest for patients exposed to prolonged inflammation. In rheumatoid arthritis (RA), the inflammatory mechanisms that are central to the disease’s pathology share many features with those seen in Alzheimer’s disease (AD). However, published reports on the strength and directio...

Background Visual loss is the most serious consequences of a diagnosis of polymyalgia rheumatic (PMR) and giant cell arteritis (GCA). To date, information on the occurrence of eye disease in GCA has been based almost exclusively on small hospital-based patient series. Furthermore the lack of control group for these studies results in a lack of rela...

Background Several individual dietary components have been associated with the risk of rheumatoid arthritis (RA) and recent studies have suggested that dietary indices, which account for the consumption of multiple foods, can be used as more complete measures of risk. Objectives In this study we aimed to use the Dietary Inflammatory Index (DII), a...

IMPORTANCE: Myopia is a leading cause of untreatable visual impairment and is increasing in prevalence worldwide. Interventions for slowing childhood myopia progression have shown success in randomized clinical trials; hence, there is a need to identify which children would benefit most from treatment intervention. OBJECTIVES: To examine whether ge...

Objective The aim of this study was to survey participants with PMR to evaluate the face validity, acceptability and domain match of proposed candidate outcome measures. Methods A structured, online, anonymous survey was disseminated by patient support groups via their networks and online forums. The candidate outcome measures comprised: 1. visual...

Spectral-domain OCT (SD-OCT) provides high resolution images enabling identification of individual retinal layers. We included 32,923 participants aged 40–69 years old from UK Biobank. Questionnaires, physical examination, and eye examination including SD-OCT imaging were performed. SD OCT measured photoreceptor layer thickness includes photorecept...

Objectives: PMR and GCA are associated with increased risk of vascular disease. However, it remains unclear whether this relationship is causal or reflects a common underlying propensity. The aim of this study was to identify whether known cardiovascular risk factors increase the risk of PMR and GCA. Methods: Clinical records were examined using...

Background Excess weight and components of the metabolic syndrome have been associated with knee osteoarthritis (OA). However, the precise timing of when this risk operates in the natural history of the disease is unknown. An understanding of the sequence in which risk factors operate in OA is important for delivering effective preventative interve...

Background Vascular risk factors are implicated in the aetiology of polymyalgia rheumatica (PMR) but lack sensitivity as a screening tool to assess risk of future disease or disease progression. Retinal vascular measures from digital images of the retinal fundus provide a direct objective measure of vascular health and have potential value in estim...

Full Abstract to download at DOI: 10.1093/rheumatology/kez107.075

Objective To report the progress of the OMERACT Polymyalgia Rheumatica (PMR) Working Group in selecting candidate instruments for a core outcome measurement set. Methods A systematic literature review identified outcomes measured and instruments used in PMR studies, and a respondent survey and raw data analysis assessed their domain match and feas...

p>The morphometric characteristics of the retinal vascular network have been associated with risk markers of many systemic and vascular diseases. However, analysis of data from large population based studies is needed to help resolve uncertainties in these associations. QUARTZ (QUantitative Analysis of Retinal vessel Topology and siZe) is a fully a...

The following topics are dealt with: feature extraction; learning (artificial intelligence); image classification; image segmentation; computer vision; object detection; feedforward neural nets; image colour analysis; image representation; medical image processing.

We thank Chemouny et al for their letter and concur with their conclusions.1 As we state2: “A positive biopsy for ANCA associated vasculitis (AAV) is helpful when considering an initial diagnosis or recurrent disease”. In our view, renal biopsy is important to establish diagnosis …

The European League Against Rheumatism recommendations for the management of antineutrophil cytoplasmic antibody-associated vasculitis have been recently published. Unique to recommendation development, they were also voted on by members of a learned society. This paper explores the wider validity of the recommendations among people who self-identi...

The vasculitides are a heterogeneous group of conditions typifi ed by their ability to cause vessel infl ammation with or without necrosis. They present with a wide variety of signs and symptoms and, if left untreated, carry a signifi cant burden of mortality and morbidity. The antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV...

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Objective: Blindness is a recognized complication of GCA; however, the frequency of and risk factors for this complication have not been firmly established. The aim of this study was to examine the incidence and determinants of blindness in patients with GCA, using a large international cohort. Methods: The analysis was conducted among subjects...

In this article, the 2009 European League Against Rheumatism (EULAR) recommendations for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) have been updated. The 2009 recommendations were on the management of primary small and medium vessel vasculitis. The 2015 update has been developed by an international tas...

Background: To update community-based prevalence values for Polymyalgia Rheumatic (PMR) and Giant Cell Arteritis (GCA) using case record review supplemented by population survey and subsequent clinical review. Methods: Clinical data were obtained from case records of a large primary care practice in Norfolk, UK and reviewed for diagnoses of GCA...

Background Muscular weakness is a cause of instability that has been reported to contribute to falling. Isokinetic and isometric dynamometry is a method of muscle assessment useful to measure the muscular strength and gives a quantification of the weakness and a comparison of strength across limbs and in reciprocal muscles. Objectives To compare i...

Background The European League Against Rheumatism (EULAR) Recommendation for primary and small vessel vasculitis were published in 2009. Objectives To update the 2009 recommendations with the focus being ANCA-Associated Vasculitis (AAV) using systematic literature review, as well as expert opinion where appropriate. Methods A combined taskforce f...

To describe the associations of physical and demographic factors with Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated intraocular pressure (IOPcc) in a British cohort. Cross-sectional study within the UK Biobank, a large-scale multisite cohort study in the United Kingdom. We included 110 573 participants from the UK Biobank...

To derive macular thickness measures and their associations by performing rapid, automated segmentation of spectral-domain optical coherence tomography (SD OCT) images collected and stored as part of the UK Biobank (UKBB) study. Large, multisite cohort study in the United Kingdom. Analysis of cross-sectional data. Adults from the United Kingdom age...

To report the methodology and findings of a large scale investigation of burden and distribution of refractive error, from a contemporary and ethnically diverse study of health and disease in adults, in the UK. U K Biobank, a unique contemporary resource for the study of health and disease, recruited more than half a million people aged 40-69 years...

Collaborative clinical trials over the last 25 years have revolutionised the care of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. This has led to production of management recommendations and standards of care. This paper reviews the existing standards and the recent evidence that has fed further evolution of stand...

To determine ocular, demographic, and socioeconomic associations with self-reported glaucoma in the U.K. Biobank. Biobank is a study of U.K. residents aged 40-69 years registered with the National Health Service. Data were collected on visual acuity, intraocular pressure (IOP), corneal biomechanics, and questionnaire from 112,690 participants. Rela...

To investigate, in a pilot randomized controlled trial, whether etanercept (ETN) 25 mg once weekly is effective at maintaining a clinical response in patients with ankylosing spondylitis (AS) who have responded to the standard 50 mg dose. Adults with AS not responding to conventional therapies were prescribed ETN 50 mg once weekly for 6 months. Res...

Introduction The development of both Barrett’s oesophagus (BO) and oesophageal adenocarcinoma (OAC) may involve oxidative stress. We investigated whether the antioxidants vitamins C and E, selenium, zinc and carotene were associated with a decreased risk of BO and OAC, in the same population, using nutritional information from 7-day food diaries, t...

To assess the suitability of retinal images held in the UK Biobank--the largest retinal data repository in a prospective population-based cohort--for computer assisted vascular morphometry, generating measures that are commonly investigated as candidate biomarkers of systemic disease. Non-mydriatic fundus images from both eyes of 2,690 participants...

Background: GCA is the commonest form of large vessel vasculitis. Its association with permanent visual loss in up to 23% of patients makes prompt recognition and treatment essential. However, the high prevalence of headache and the lack of specificity of a raised ESR (two key items of the current classification criteria) pose a challenge to identi...

Visual impairment due to myopia is an important public health issue. A prior analysis of population-based cohorts aged 15 to 22 years recruited from the United Kingdom and Israel suggested myopia and high myopia were approximately 10% more common in first-born compared with later-born children. To examine whether myopia was associated with birth or...

Background: GCA is the most common vasculitis in the western world. It typically affects individuals >55 years of age and has significant morbidity from its pathology and its treatment. There are no recent (after 2001) estimates of the occurrence in the UK. The aim of this study was to estimate the occurrence of GCA in the UK. Methods: All temporal...

The timing of the risk factors cigarette smoking, alcohol and obesity in the development of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) is unclear. To investigate these exposures in the aetiology of BE and EAC in the same population. The cohort included 24,068 men and women, aged 39-79 years, recruited between 1993 and 1997 into th...

Background Giant cell arteritis is the most common vasculitis in the western world in those aged greater than 50yrs old and has significant morbidity from both its pathology and treatment. There are no recent (after 2001) estimates of the occurrence in the UK. Objectives The aim of this study was to estimate the occurrence of GCA in the UK and to r...

To conduct a meta-analysis of published data of the effectiveness of drug treatment in giant cell arteritis (GCA) to provide evidence to support the optimal use of glucocorticoids (GCs) and adjunct therapy. MEDLINE, CENTRAL and EMBASE searches were used to identify randomised control trials on the treatment of GCA. Studies included were trials in w...