|
THYROID, Vol. 8, No. 8 (1998), 735 Isadore N. Rosenberg Thyroware (EM Pharma Company, Hockessin, DE*) ist an educational program on the physilogy and pathophysiology of the thyroid, provided on a diskette for a personal computer. The program is by four physicans in Germany: Drs. Gartner, Fischer, Kittel, Hostalek; and Dr. Ott from EM Pharma, with contributions to the English version by Drs. Braverman and Chin. The material is organized into four units: feedback regulation; the follicular cell (including thyroid hormone synthesis and secretion, autoimmune disorders, chronic and acute thyroiditis, and altered thyroid function secondary to mutated thyroid proteins); functional disorders (goiter, hyperthyroidism, and hypothyroidism), and therapy (including antithyroid drugs, ß-blockers, surgery, iodine, radioiodine, and thyroid hormones). The presentation is authoritative, logical, and in outline form with emphasis on broad principles and pathophysiology. The facts are accurate and the text is focused. The presentation is lively with dynamic graphics and cartoons that, for example, show the successive activation of the throtropin (TSH) receptor by binding TSH, the formation of cyclic adenosine monophosphate (cAMP), the activation of protein kinase A, and the synthesis of thyroid hormones. The program may be stopped at any time and it is easy to identify the various moving symbols and their interaction. The program is "user friendly" and requires no computer experimence. The program is suitable for medical students studying thyroid disease in biology of disease-type courses covering both basic science and clinical aspect of the thyroid, and would be useful for an internist or primary care physican seeking a rapid factual review of thyroid basics. It takes about an hour to complete the program. The material is up-to-date and the emphasis ist on breadth rather than depht. The section on the mechanism and clinical aspects of autoimmunity and the clinical consequences of genetic alteration of thyroid proteins is especially good as is the discussion of the type 1 and type 2 polyglandular autoimmune endocrine deficiency disorders and the difference between them. A few minor errors are encountered, eg, the terms mono- and di-iodo thyronine are used where mono- and di-iodo tryosine are clearly intended**. Also, whether radioiodine is really contraindicated in patients with compensated renal failure and whether decreases formation of iodinated lipids in iodine deficiency is a major factor in stimulating protein kinase C and cellular growth are not fully established. This program would benefit from a bibliography or at least a list of key references to provide the student access to deeper analysis of the topics that are covered. Some material on thyroid tumors and carcinoma would also have been a reasonable addition. This is a useful program. It is no substitute for a textbook, but for students and physicans seeking a brief overview of basic thyroidology it could be quite helpful. * EM Pharma is an associate of Merck KGaA, Darmstadt, Germany. ** The errors have been eliminated meanwhile. |