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Up to Date in Pulmonary and Critical Care.

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Up to Date in Pulmonary and Critical Care.Steven E Weinberger. USA: American Thoracic Society.

Up To Date in Pulmonary and Critical Care, a product from the stable of the American Thoracic Society, is one of a rising tide of PC based medical texts. The programme is based on the concept of providing quick and authoritative answers to common specific questions that arise during specialist clinical practice but not as a resource to use when faced with a rare disease.

Presented on CD-ROM for Windows or Macintosh and supported by clear installation instructions, it ran efficiently on a 266 MHz based laptop from the hard disc or CD-ROM drive. The search functions were easy to use with helpful cross referencing links and section content outlines. The initial cost is approximately £300 for the first year with the CD-ROM being regularly updated throughout the year.

Have they succeeded in their aim? Overall, the answer is yes.

Useful practical advice is given on simple but irritatingly difficult questions to answer—for example, provision of oxygen during air travel, the choice of agent for chemical pleurodesis, the role of inhaled steroids in chronic obstructive pulmonary disease, etc. However, the programme is slanted toward the American market, as highlighted in the section on long term oxygen therapy (LTOT) which gives, in detail, the billing mechanism. Similarly, nasal calcitonin suggested for the treatment of steroid induced osteoporotic bone pain is not licensed in the UK.

Its functionality makes it a valuable tool in the outpatient setting, being described by one trainee as “really helpful”. This programme would be best suited to hospitals and practices with adequate provision for computing facilities in the clinical area, ideally over a local area network and not locked away in the library. The added bonus for the chest physician with a commitment to general medicine is that the disc also has sections on cardiology, gastroenterology, and other main stream disciplines of similar quality. This programme sets a formidable standard for the UK government’s proposed NICE (National Institute for Clinical Excellence) clinical information system.—SPH

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