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Topic:Equine Diseases

Equine diseases encompass a wide range of health conditions that can affect horses, including infectious diseases, metabolic disorders, and genetic conditions. These diseases can impact the overall health, performance, and well-being of horses. Common equine diseases include equine influenza, equine herpesvirus, laminitis, and equine metabolic syndrome. Diagnosis and management of these diseases often require a combination of clinical evaluation, laboratory testing, and appropriate treatment strategies. This page gathers peer-reviewed research studies and scholarly articles that explore the etiology, pathophysiology, diagnosis, and treatment options for various equine diseases, providing valuable insights for veterinarians and researchers in the field.
Smart textiles biotechnology for electrocardiogram monitoring in horses during exercise on treadmill: Validation tests.
Equine veterinary journal    July 7, 2020   Volume 53, Issue 2 373-378 doi: 10.1111/evj.13296
There are several bioengineering solutions aimed at improving human health and welfare. Smart electrodes based on textile substrates have met the growing demand for comfort, reliability, and robustness when acquiring physiological signals. Objective: Given the importance of good quality electrocardiograms (ECG) in equine sports medicine, this study focuses on the validation of smart textile electrodes to acquire ECG signals in horses during treadmill exercise. Methods: The performance of the smart textile electrodes is compared with standard silver/silver chloride (Ag/AgCl) electrodes in terms...
Localisation of cannabinoid and cannabinoid-related receptors in the equine dorsal root ganglia.
Equine veterinary journal    July 4, 2020   Volume 53, Issue 3 549-557 doi: 10.1111/evj.13305
Chiocchetti R, Rinnovati R, Tagliavia C, Stanzani A, Galiazzo G, Giancola F, Silva M, Capodanno Y, Spadari A.Growing evidence recognises cannabinoid receptors as potential therapeutic targets for pain. Consequently, there is increasing interest in developing cannabinoid receptor agonists for treating pain. As a general rule, to better understand the actions of a drug, it would be of extreme importance to know the cellular distribution of its specific receptors. The localisation of cannabinoid receptors in the dorsal root ganglia of the horse has not yet been investigated. Objective: To localise the cellular distribution of canonical and putative cannabinoid receptors in the equine cervical dorsal roo...
Hoof kinetic patterns differ between sound and laminitic horses.
Equine veterinary journal    July 2, 2020   Volume 53, Issue 3 503-509 doi: 10.1111/evj.13311
Al Naem M, Litzke LF, Failing K, Burk J, Röcken M.No kinetic data on hoof loading in laminitic horses are available, despite their importance for optimising supportive shoeing therapies. Objective: To quantify the load distribution pattern in laminitic and sound horses. Methods: Controlled observational study. Methods: Fifty-four sound and laminitic horses were assigned to three groups: control group (sound horses), group 1 (G1) horses with acute laminitis, evaluated immediately after acute clinical signs subsided, and group 2 (G2) horses that had been free of acute laminitis signs for 6-12 weeks. Measurements on both forelimbs in barefoot c...
Prognostic Indicators after Musculoskeletal Injuries in Standardbred Racehorses in Italy.
Journal of equine veterinary science    July 2, 2020   Volume 92 103180 doi: 10.1016/j.jevs.2020.103180
Bertuglia A, Pagliara E, Manca F, Pozzolo P, Mannelli A.The objective of this study was to report recovery time, retirement rate, racing performance, and presence of compensation pattern after musculoskeletal injuries (MSIs) in Standardbred racehorses (STBRs). This is a retrospective single open-cohort study, enrolling 356 STBRs in training in a single racetrack. Musculoskeletal injury was defined as any training-related injury after which the horse did not train for at least 15 days. The first and second MSIs encountered during the horse's racing career were considered. Medical records, training logbooks, and racing data were reviewed to determin...
Harvesting, processing, and evaluation of in vitro-manipulated equine preantral follicles: A review.
Theriogenology    July 2, 2020   Volume 156 283-295 doi: 10.1016/j.theriogenology.2020.06.044
Gastal EL, Aguiar FLN, Gastal GDA, Alves KA, Alves BG, Figueiredo JR.The mammalian ovary is responsible for essential stages of folliculogenesis and hormonal production, regulating the female physiological functions during the menstrual/estrous cycles. The mare has been considered an attractive model for comparative studies due to the striking similarities shared with women regarding in vivo and in vitro folliculogenesis. The ovarian follicular population in horses contains a large number of oocytes enclosed in preantral follicles that are yet to be explored. Therefore, the in vitro manipulation of equine preantral follicles aims to avoid the process of atre...
The effect of prior thecal puncture on cerebrospinal fluid analytes in normal adult horses.
Journal of veterinary internal medicine    July 2, 2020   Volume 34, Issue 5 2117-2121 doi: 10.1111/jvim.15842
Chidlow H, Giguère S, Camus M, Wells B, Berghaus R, McConachie Beasley E.Serial cerebrospinal fluid (CSF) analysis might be required in clinical neurologic disease. The effect of lumbosacral (LS) or cervical (C1-C2) centesis on subsequent CSF cytologic analyses has not been investigated in horses. Objective: To evaluate the effect of thecal puncture on subsequent CSF analyses ANIMALS: Ten healthy adult horses. Methods: Prospective study. Horses were randomly assigned to undergo CSF collection twice, 14 days apart, from either the C1-C2 or LS space. After a 4-month washout period, CSF collection was repeated from the alternate site. Continuous data were analyzed u...
Conditions predict heightened Hendra virus spillover risk in horses this winter: actions now can change outcomes.
Australian veterinary journal    July 1, 2020   Volume 98, Issue 6 270-271 doi: 10.1111/avj.12964
Eby P, Plowright RK, McCallum H, Peel AJ.No abstract available
Effects of endurance racing on horse plasma extracellular particle miRNA.
Equine veterinary journal    July 1, 2020   Volume 53, Issue 3 618-627 doi: 10.1111/evj.13300
de Oliveira GP, Porto WF, Palu CC, Pereira LM, Reis AMM, Marçola TG, Teixeira-Neto AR, Franco OL, Pereira RW.Physical exercise is an essential factor in preventing and treating metabolic diseases by promoting systemic benefits throughout the body. The molecular factors involved in this process are poorly understood. Micro RNAs (miRNAs) are small non-coding RNAs that inhibit mRNA transcription. MiRNAs, which can participate in the benefits of exercise to health, circulate in plasma in extracellular particles (EP). Horses that undergo endurance racing are an excellent model to study the impact of long-duration/low intensity exercise in plasma EP miRNAs. Objective: To evaluate the effects of 160 km end...
Supportive techniques to investigate in vitro culture and cryopreservation efficiencies of equine ovarian tissue: A review.
Theriogenology    July 1, 2020   Volume 156 296-309 doi: 10.1016/j.theriogenology.2020.06.043
Aguiar FLN, Gastal GDA, Alves KA, Alves BG, Figueiredo JR, Gastal EL.During the reproductive lifespan of a female, only a limited quantity of oocytes are naturally ovulated; therefore, the mammalian ovary possesses a substantial population of preantral follicles available to be handled and explored in vitro. Hence, the manipulation of preantral follicles enclosed in ovarian tissue aims to recover a considerable population of oocytes of high-value animals for potential application in profitable assisted reproductive technologies (ARTs). For this purpose, the technique of preantral follicle in vitro culture (IVC) has been the most common research tool, achievin...
Monolateral chronicon orchitis in a stallion.
Veterinaria italiana    June 30, 2020   Volume 56, Issue 2 133-135 doi: 10.12834/VetIt.2330.13219.1
De Amicis I, Bucci R, Giangaspero B, D'Alterio N, Trachtman AR, Robbe D.Orchitis and epididymo-orchitis are inflammatory lesions of the testicle. We herein describe a case of monolateral chronic orchitis which occurred in a Tiro Pesante Rapido (TPR) stallion, born in 2002, with a history of good fertility. The stallion was healthy and asymptomatic although the left testis was found to be smaller as compared with the right one and was hard in consistency. Histopathology examination revealed tubular atrophy and parenchymal sclerosis. Scattered foci of calcification and chronic inflammation, the latter dominated by macrophages and lymphocytes, were also observed. Alt...
Effect of Mycobacterium cell wall fraction on endometrial histomorphometry of mares resistant and susceptible to persistent breeding-induced endometritis.
Theriogenology    June 30, 2020   Volume 156 2-10 doi: 10.1016/j.theriogenology.2020.06.034
Herrera MF, Otermin M, Herrera JM, Simoy MV, Bianchi CP, Aguilar JJ, Fumuso EA.Mycobacterium cell wall fraction (MCWF) is a biological component made up of molecules with immunostimulant properties, which is therapeutically used to modulate persistent breeding-induced endometritis (PBIE). The aim of this study was to analyze the effect of this immunomodulator on the endometrial histological structure during the diestrus of PBIE-resistant and -susceptible mares that either received treatment with MCWF or not. The experiment was conducted with 10 resistant mares (RM) and 9 susceptible mares (SM). In the first estrous cycle of the trial, all mares were inseminated with dead...
Evaluating 5.5 Years of Equinella: A Veterinary-Based Voluntary Infectious Disease Surveillance System of Equines in Switzerland.
Frontiers in veterinary science    June 30, 2020   Volume 7 327 doi: 10.3389/fvets.2020.00327
Özçelik R, Graubner C, Remy-Wohlfender F, Dürr S, Faverjon C.Equine health is important in regard to trade, economy, society, and the veterinary, as well as public health. To reduce the burden of equine infectious diseases internationally, it is important to collect, review, and distribute equine health surveillance data as accurate and timely as possible. Within this study, we aimed at providing a comprehensive descriptive analysis of data submitted to Equinella, a voluntary veterinary-based surveillance system of non-notifiable equine infectious diseases and clinical signs, in Switzerland. This was achieved by reviewing the reports submitted since its...
Teratoma Associated With Testicular Tissue in a Female-Like Horse With 64,XY (SRY-Positive) Disorder of Sex Development.
Journal of equine veterinary science    June 30, 2020   Volume 92 103177 doi: 10.1016/j.jevs.2020.103177
Sant'Anna Monteiro da Silva E, Zanzarini Delfiol DJ, Fabris VH, Mendonça Santos B, Nogueira GM, Oliveira Guimarães GB, Paulo de Oliveira Nogueira P....A four-year-old female-like Quarter Horse was admitted for clinical evaluation because of masculinized-aggressive behavior and lack of estrous signs. On external inspection, a hypertrophied clitoris and prominent muscles were observed. On gynecological examination, apparently normal mammary glands, vulva, vagina, and cervix were noted. On the other hand, the uterus had no tone and was smaller than normal. The left gonad was very soft on palpation and the right gonad was mostly firm, irregular, and wider than the left gonad. On ultrasound examination, there were no signs of regular ovarian stru...
Histomorphometric and vascular changes in equine endometrium after the infusion of conceptus fragments.
Animal reproduction    June 29, 2020   Volume 17, Issue 2 e20200006 doi: 10.1590/1984-3143-AR2020-0006
Camacho CA, Estradé MJ, Cazales N, Caballeros JE, Fiala-Rechsteiner SM, Neves AP, Mattos RC.This experiment aimed to verify if the proteins present in a 13 day conceptus induce changes in the equine endometrial ultra-structure, histology, and vascularization, two days after its infusion. Ten healthy cyclic mares were used. Once estrus was confirmed, mares were examined daily to detect ovulation (day 0). After ovulation, mares were examined daily until day seven by transrectal palpation and B-mode and Doppler ultrasonography. In this first cycle, intrauterine biopsies were collected at day seven after ovulation, constituting the Cyclic group (n = 10). In the second cycle, the same mar...
Radiographic anatomy of the equine distal tibia. Huguet EE, Porter EG, Chapman KA, Saunders FC, Davis B, Berry CR.The radiographic anatomy of the equine distal tibia is complex and is not widely described in the current literature. Superimposition and radiographic similarities between the different osseous structures of the equine distal tibia can make it difficult for anatomic localization of pathology. The purpose of this prospective, descriptive, anatomic study was to detail the normal anatomy of the equine distal tibia using routine radiographic projections and CT of the equine tarsus. Radiographic identification of the different osseous protuberances of the distal tibia on three cadaveric limbs was a...
Quantification and validation of nine nonsteroidal anti-inflammatory drugs in equine urine using gas chromatography-mass spectrometry for doping control.
Drug testing and analysis    June 28, 2020   Volume 12, Issue 8 1065-1077 doi: 10.1002/dta.2864
Göktaş EF, Kabil E, Arıöz F.Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used in therapeutic doses in human and veterinary medicine for the treatment of inflammation, pain, and fever. A method for the simultaneous determination of nine NSAIDs, known as therapeutic prohibited substances, in equine urine was developed and fully validated according to the European Commission Decision 2002/657/EC and Association of Official Racing Chemists criteria. The validation was performed for naproxen, flunixin, ketoprofen, diclofenac, eltenac, meclofenamic acid, phenylbutazone, vedaprofen, and carprofen in equine urine i...
Detection of atrial fibrillation with implantable loop recorders in horses.
Equine veterinary journal    June 28, 2020   Volume 53, Issue 2 397-403 doi: 10.1111/evj.13301
Buhl R, Hesselkilde EM, Carstensen H, Fenner MF, Jespersen T, Tfelt-Hansen J, Michael Sattler S.Cardiac arrhythmias in horses are diagnosed by auscultation or electrocardiogram (ECG), which results in a low sensitivity for detecting arrhythmias that occur sporadically. Implantable loop recorders (ILRs) are small ECG devices placed subcutaneously, to automatically detect arrhythmias in human patients. Objective: To test ILRs ability to detect atrial fibrillation (AF) in horses. Furthermore, we hypothesised that anatomical location of the implant site might influence signal quality. Signal quality was evaluated both during exercise and over time. Methods: Experimental study. Methods: In fi...
Comparative Efficacy of the Prokinetic Effects of Cisapride and Tegaserod in Equines.
Journal of equine veterinary science    June 27, 2020   Volume 92 103179 doi: 10.1016/j.jevs.2020.103179
Ocampo L, Coello M, Aquino I.The aim of this study was to compare the effects of cisapride and tegaserod on intestinal smooth muscle activity in equines. Efficacy was evaluated through measurement of gastrointestinal transit time, bowel movements per day, stool weight, and bowel sounds. Drug safety was evaluated via heart rate, respiratory rate, and rectal temperature. Records were obtained throughout three periods: a control phase without treatment, a period of cisapride administration at a dose of 0.22 mg/kg, and a period of tegaserod treatment at a dose of 0.27 mg/kg. Gastrointestinal transit time, bowel movements pe...
Evaluation of Brix Refractometry for the Estimation of Colostrum Quality in Jennies.
Journal of equine veterinary science    June 26, 2020   Volume 92 103172 doi: 10.1016/j.jevs.2020.103172
Donkey placenta does not allow the passage of immunoglobulins; thus, foals are born hypogammaglobulinemic and an adequate intake of high-quality colostrum in the first 24 hours of life is crucial for the surviving. The study aims to assess the relation between colostrum immunoglobulin G (IgG) concentration evaluated by the single radial immunodiffusion (SRID) test and the Brix refractometer in donkeys to establish a cutoff value for high quality of colostrum based on Brix refractometry. Colostrum was collected at foaling, and at 6, 12, and 24 hours after foaling from the left and the right h...
Candidate gene expression and coding sequence variants in Warmblood horses with myofibrillar myopathy.
Equine veterinary journal    June 25, 2020   Volume 53, Issue 2 306-315 doi: 10.1111/evj.13286
Williams ZJ, Velez-Irizarry D, Petersen JL, Ochala J, Finno CJ, Valberg SJ.Myofibrillar myopathy (MFM) of unknown aetiology has recently been identified in Warmblood (WB) horses. In humans, 16 genes have been implicated in various MFM-like disorders. Objective: To identify variants in 16 MFM candidate genes and compare allele frequencies of all variants between MFM WB and non-MFM WB and coding variants with moderate or severe predicted effects in MFM WB with publicly available data of other breeds. To compare differential gene expression and muscle fibre contractile force between MFM and non-MFM WB. Methods: Case-control. Methods: 8 MFM WB, 8 non-MFM WB, 33 other WB,...
Correlation Between Serum Activity of Muscle Enzymes and Stage of the Estrous Cycle in Italian Standardbred Horses Susceptible to Exertional Rhabdomyolysis.
Journal of equine veterinary science    June 25, 2020   Volume 92 103175 doi: 10.1016/j.jevs.2020.103175
Pasolini MP, Pezzella R, Santoro P, Cocchia N, Greco M, Del Prete C, Della Valle G, Auletta L.Equine exertional rhabdomyolysis (ER) is a well-recognized clinical syndrome affecting racehorses. Prevalence analysis of ER showed that female sex was a significant risk factor. The aim of this research was to evaluate the differences and correlations in the serum activity of muscle enzymes and the stage of the estrous cycle in ER-susceptible and control (C) mares. Serum muscle enzyme activity before and after exercise and sex hormones were analyzed in the two groups of mares. Ten cyclic ER and 10 cyclic C mares were examined weekly for 4 weeks. During diestrus, ER horses had significantly hi...
Extension Horses, Inc. experts act fast to create online resources to assist the horse industry during COVID-19.
Translational animal science    June 25, 2020   Volume 4, Issue 3 txaa085 doi: 10.1093/tas/txaa085
Greene EA, Hein W, Wickens CL, Smarsh DN.The COVID-19 pandemic and resulting stay-at-home directives, adopted out of necessity to protect human health, introduced significant challenges for horse owners and small equine businesses. Restricted access, and in many cases closure of barns, resulted in a multitude of questions and concerns within the equine community which needed to be addressed rapidly. Extension Horses, Inc. (EH) coordinated the development and delivery of a variety of educational resources utilizing a combination of online formats and dissemination through social media and EH member contact lists. A series of infograph...
Effect of digital hypothermia on lamellar inflammatory signaling in the euglycemic hyperinsulinemic clamp laminitis model.
Journal of veterinary internal medicine    June 25, 2020   Volume 34, Issue 4 1606-1613 doi: 10.1111/jvim.15835
Stokes SM, Burns TA, Watts MR, Bertin FR, Stefanovski D, Medina-Torres CE, Belknap JK, van Eps AW.Continuous digital hypothermia (CDH) prevents lamellar failure in the euglycemic hyperinsulinemic clamp (EHC) model of laminitis, but the protective mechanisms are unclear. Objective: To determine if CDH inhibits lamellar inflammatory signaling in the EHC model of laminitis. Methods: Eight Standardbred horses. Methods: Prospective experimental study. Horses underwent an EHC, with 1 forelimb treated with CDH and the other kept at ambient temperature (AMB). Horses were euthanized 48 hours after initiation of the EHC and lamellar tissue was analyzed via polymerase chain reaction (pro-inflammato...
Retroperitoneoscopy in the horse: Anatomical study of the retroperitoneal perirenal space and description of a surgical approach.
Equine veterinary journal    June 24, 2020   Volume 53, Issue 2 364-372 doi: 10.1111/evj.13293
Pujol R, De Fourmestraux C, Symoens A, Branchereau J, Tessier C.Surgical approaches to the kidneys and perirenal structures are uncommonly performed in horses and several complications have been described with the current procedures. Objective: To describe the anatomy of the retroperitoneal perirenal space and investigate a retroperitoneal minimally invasive approach to access the kidney and perirenal structures in horses. Methods: Descriptive, cadaveric study. Methods: Anatomical description of the retroperitoneal space was performed on three equine cadavers and the surgical approach was developed based on these dissections. Ten cadaveric horses underwent...
Effect of selective IK,ACh inhibition by XAF-1407 in an equine model of tachypacing-induced persistent atrial fibrillation.
British journal of pharmacology    June 24, 2020   Volume 177, Issue 16 3778-3794 doi: 10.1111/bph.15100
Fenner MF, Carstensen H, Dalgas Nissen S, Melis Hesselkilde E, Scott Lunddahl C, Adler Hess Jensen M, Loft-Andersen AV, Sattler SM, Platonov P....Inhibition of the G-protein gated ACh-activated inward rectifier potassium current, IK,ACh may be an effective atrial selective treatment strategy for atrial fibrillation (AF). Therefore, the anti-arrhythmic and electrophysiological properties of a novel putatively potent and highly specific IK,ACh inhibitor, XAF-1407 (3-methyl-1-[5-phenyl-4-[4-(2-pyrrolidin-1-ylethoxymethyl)-1-piperidyl]thieno[2,3-d]pyrimidin-6-yl]azetidin-3-ol), were characterised for the first time in vitro and investigated in horses with persistent AF. The pharmacological ion channel profile of XAF-1407 was investigated us...
Quantitative analysis of paracetamol, metacetamol, and orthocetamol in equine urine from racehorses in Japan using liquid chromatography-electrospray ionization-tandem mass spectrometry.
Drug testing and analysis    June 24, 2020   Volume 12, Issue 8 1196-1202 doi: 10.1002/dta.2860
Ishii H, Obara T, Kusano K, Kijima-Suda I.Paracetamol is commonly used as an over-the-counter analgesic and antipyretic medication for humans, but not sold as a legitimate therapeutic medication for horses in Japan. However, paracetamol is commonly found in horses together with its two isomers, metacetamol and orthocetamol. We previously reported that paracetamol and orthocetamol were both present in selected feed consumed by Japanese racehorses. For the purpose of the doping control of paracetamol in local Japanese horses, we proposed establishing residue limits (Japanese residue limits, JRLs) to minimize the risk of reporting parace...
Evaluation of articular cartilage with quantitative MRI in an equine model of post-traumatic osteoarthritis.
Journal of orthopaedic research : official publication of the Orthopaedic Research Society    June 24, 2020   Volume 39, Issue 1 63-73 doi: 10.1002/jor.24780
Kajabi AW, Casula V, Sarin JK, Ketola JH, Nykänen O, Te Moller NCR, Mancini IAD, Visser J, Brommer H, René van Weeren P, Malda J, Töyräs J....Chondral lesions lead to degenerative changes in the surrounding cartilage tissue, increasing the risk of developing post-traumatic osteoarthritis (PTOA). This study aimed to investigate the feasibility of quantitative magnetic resonance imaging (qMRI) for evaluation of articular cartilage in PTOA. Articular explants containing surgically induced and repaired chondral lesions were obtained from the stifle joints of seven Shetland ponies (14 samples). Three age-matched nonoperated ponies served as controls (six samples). The samples were imaged at 9.4 T. The measured qMRI parameters included ...
Genetics of equine bleeding disorders.
Equine veterinary journal    June 23, 2020   Volume 53, Issue 1 30-37 doi: 10.1111/evj.13290
Dahlgren AR, Tablin F, Finno CJ.Genetic bleeding disorders can have a profound impact on a horse's health and athletic career. As such, it is important to understand the mechanisms of these diseases and how they are diagnosed. These diseases include haemophilia A, von Willebrand disease, prekallikrein deficiency, Glanzmann's Thrombasthenia and Atypical Equine Thrombasthenia. Exercise-induced pulmonary haemorrhage also has a proposed genetic component. Genetic mutations have been identified for haemophilia A and Glanzmann's Thrombasthenia in the horse. Mutations are known for von Willebrand disease and prekallikrein deficienc...
Wound Retractor Laparoscopic Port System for Standing Laparoscopic Cryptorchidectomy in the Horse: A Case Report.
Journal of equine veterinary science    June 23, 2020   Volume 92 103168 doi: 10.1016/j.jevs.2020.103168
Lacitignola L, Imperante A, De Siena R, Acquafredda C, Trisciuzzi R, Stabile M, Confalonieri E, Crovace AM, Staffieri F.Cryptorchidectomy is the most commonly performed laparoscopic procedure in horses. However, its use for the extraction of an abdominal testis has disadvantages such as loss of a resected testis from grasp and fragmentation of the specimen because of the excessive tension required for extraction through a thick body wall. The ring wound retractor laparoscopic port system was recently used in human and small animal surgery to perform laparoscopic-assisted procedures and retrieve large specimens from the abdomen. In the present case, the wound retractor was placed as the ventral port in the right...
Comparative studies on the histological characteristics of equine nasomaxillary aperture and paranasal sinus mucosa considering topographic and age-related differences.
Acta veterinaria Scandinavica    June 23, 2020   Volume 62, Issue 1 34 doi: 10.1186/s13028-020-00534-2
Schwieder A, Pfarrer C, Ohnesorge B, Staszyk C, Bienert-Zeit A.Horses may acquire a range of paranasal sinus diseases. Clinical studies show slight differences regarding anatomical regions and age. Histopathological examination of tissue samples could play an important role in the diagnostic process. Therefore, detailed knowledge of the histological appearance of the paranasal sinus mucosa (PSM) and the nasomaxillary aperture mucosa (NAM) is essential. The objective of this study was to determine topographic and age-related differences within the healthy equine PSM. In addition, we aimed to gain detailed knowledge of the histological appearance of the NAM...