Back in 1999, when I first talked to McGraw-Hill Interamericana about my project for a critical dictionary of English-Spanish medical doubts, I mentioned how useful it would be to publish the dictionary in compact disc format too, because electronic reference resources had already become an essential part of a language professional’s toolkit. However, the publishers decided to put an electronic edition on hold because of the uncontrollable risk of pirated copies, a risk that is still as real today as it was back then. And thus, for far too many years, my dictionary was relegated to being a well-thumbed tome on a bookshelf.

Fourteen years on, I am delighted to be able to offer doctors, specialised translators, scientific writers and translation students this new edition of my dictionary, in an online format at long last. Online access not only offers the well-known benefits of electronic formats (fast searches, cross-referencing, two-way Spanish and English translation, traceability of the full content of every entry, etc.), it also means that the dictionary can be accessed from anywhere with an internet connection, and it becomes a living resource, through an ongoing updating process.

The leap from paper to cloud was so big that I realised that a new name was warranted. For the first two editions, the libro rojo was called Diccionario crítico de dudas inglés-español de medicina (2000 and 2005). For this third edition, I have renamed it Diccionario de dudas y dificultades de traducción del inglés médico (2013). Despite this rechristening, the internal structure of the dictionary has not undergone substantial change: two versions later, the lexicographical design remains largely identical. Proof of this is that the introduction for first-time Cosnautas users (see below), is a simple copy-paste of the original version from the first edition, with very few changes at all. If you are familiar with either of the first two editions of the Diccionario crítico de dudas, you will be able to start using this third edition immediately, without having to learn the meanings of any new symbols or typographical conventions.

You will, however, notice some other changes. For example, before, you looked up terms in alphabetical order and leafed backwards or forwards to locate cross references. Now, simply type a term in the search box and click on the links that take you to the cross references.

You will also notice that colours have been added to indicate headwords, numbered meanings, cross references and comments’ symbols. This has freed up formatting types. Now, the most relevant translations are emphasised in bold, and different degrees of contraindication or error are *encased in asterisks* or marked with a strikethrough effect (in the latter case, following the example of Diccionario de términos médicos [2011] published by the Real Academia Nacional de Medicina).

In this third edition, I have continued my efforts to reduce the dogmatic tone of the dictionary. This is no easy task, because in my pursuit of concision, I have to solve translation dilemmas in a question of lines rather than pages, and this inevitably entails the risk of dogmatism. When my dictionary was still at an embryonic stage, I followed the wise counsel of Ortega y Gasset: “whenever you teach, teach also to question what you teach”. Therefore, I set out my preferred translation solutions, while trying to explain the academic criteria behind them, common usage in medical practice, recommendations from standardised nomenclatures, terminology traditions in the Spanish language, relevant etymological criteria and analogies with similar terms. This strategy has a clear goal: to enable you to make an informed decision - your own decision, not mine - on the most suitable option for a translation, depending on your specific text and personal context. I look on my dictionary, above all, as a medium between two translators, a pointer in the right direction, an informal chat between colleagues. And my comments are written safe in the knowledge that all translators, both new and old, will be using the dictionary in the valuable company of their intelligence and common sense, which are the most powerful work tools of all. I do not seek to convince anyone of anything. With this dictionary, I simply wish to share my knowledge and experience with my medical and translation colleagues, to help them improve professionally and enjoy the legitimate satisfaction of a scientific translation well done.

This electronic version of the Diccionario de dudas y dificultades de traducción del inglés médico is a new, revised, improved and hugely extended edition. I have added thousands of new entries since the second edition, such as acid-fast, add-on therapy, amplatzer, anisakis, annulation, appy, attending, bareback sex, Big Pharma, binge drinking, biogeneric, blunt, breathalyzer, BTC drug, carry over, chaperone, chemical pregnancy, chemonaive, club, concierge medicine, didactic, disease mongering, droptainer, drug-eluting stent, echolocation, ex novo, expanded access, first-hour quintet, forest plot, gamification, ghrelin, grant, grommet, hamstring, high-ceiling diuretics, hot flush, human medicine, junk food, lab-on-a-chip, lap, leakage, locavore, lost to follow-up, luer lock, machine, mindfulness, mourning, multiple, to need, nonvertebral fracture, orthorexia, patch clamp, perfusate, pouch, pregnancy loss, premetabolic syndrome, rare disease, readability, recall, Red Crystal, resurfacing, ritalin, schedule, sexting, sibship, signaling, small molecule, smokeless tobacco, spa, spike, spot, standard drink, statutory, subcentimeter, surrogate mother, system organ class, targeted, tiger mosquito, toddler, tooth numbering, trainee, translational research, transthyretin, to tube-feed, vocational training, wear, webinar, wilderness medicine, workup and yellow flag . I am proud to announce that a large number of these terms are making their very first appearance in a Spanish dictionary; in fact, it will be a first for many of them in international specialist lexicography.

The extended content is not limited to the addition of new entries or sections, however. I have expanded the comments in many sections that already existed in the second edition of the dictionary. To see what I mean, compare, for example, the sections devoted to the following terms in the second and third editions: aggressive, auditory nerve, bar chart, bay, BC, biologicals, blood alcohol, breath alcohol test, °C, capture, carrier, charge, chart, chikungunya, clavus, clinical pathology, counseling, criminal, -cytic, death, dipping, district nurse, driving while intoxicated, to empower, ex-, finally, foul, height, hematinic, ICH, international normalized ratio, intestinal obstruction, to irradiate, judgment, kinky, local, mg%, -olimus, operator, PD, pulp, pump, to qualify, smart drugs, social worker, to socialize, ST, survival, three Rs, toilet water and veil.

The 15,000 or so cross references in the first edition have now grown to more than 52,000 clickable links embedded in the dictionary, helping you make full use of the dictionary as a whole, while maximising the educational and professional yield of each search. As a result, you will also perceive the internal coherence and uniform criteria that can only be achieved by a single author in projects of this size and characteristics.

And this brings me to the unavoidable issue of geographical variation in the Spanish language. When I published the first edition of the libro rojo, I had never set foot in Latin America; the United States of America was the only part of the New Continent that I knew. It is not surprising, therefore, that the first edition focused heavily on the differences between UK and US English, but as far as the Spanish was concerned, I relied almost exclusively on the medical language used in faculties, hospitals and clinics in Spain. In my opinion, this was one of the biggest oversights in my dictionary, and it was also one that Latin American users repeatedly pointed out.

The second edition marked a clear change in this aspect. It was still obvious that the dictionary had been written in Spain, by an author whose native language was European Spanish, who viewed the Spanish-speaking medical community as a whole. However, peach-flavored tablets were no longer simply tablets with sabor a melocotón, but also sabor a durazno. The animalario now lived side by side with the bioterio; placas de Petri with cajas de Petri; frigorífico with refrigeradora and heladera; datos fiables with datos confiables; biberón with mamadera; hormigón with concreto, and accidentes de tráfico with accidentes de tránsito. The second edition showed that basic language units and their geographical variants are quite compatible, as acknowledged in socorrista and salvavidas, beber and tomar, conducir and manejar, recuento and conteo, inversor and inversionista, mantequilla de cacahuete and manteca de maní.

In the third edition, this greater focus on American variants of Spanish became much more patent. To check this out yourself, take a look at entries such as band-aid, bikini, bleach, booties, brassiere, breast pump, capitation, cartoon, chance, computer, concrete, constipation, contact lens, cost, cream, croissant, cutter, decimal point, dental technician, denture, diesel, donut, dummy, dynamo, earrings, elevator, epidural anesthesia, GDP, grocery, Guinea pig, hair-band, hangover, heel, highchair, hot flush, icon, insulin pen, intensive care unit, jersey, juice, junk food, lemon, lifeguard, lollipop, mammagraphy, marijuana, marker, mask, mat, medical device, mosquito net, notifiable disease, number sign, oxygen tank, pacifier, panties, panty liner, parole, peanut, pertussis, Petri dish, petrol, plaster, prescription, pus, pyjamas, refrigerator, sanitary towel, sauna, -scopy, soya, spectacles, stapler, stethoscope, teether, tin loaf, tongue depressor, traffic, truant, tub, umpteen, unemployment, varicose veins, VAT, white coat and zipper. I trust my Latin American colleagues will notice a considerable difference in this aspect since the first edition.

Three main factors influenced this major change in my approach between the first and third editions: a) from 2001 onwards, I started travelling frequently to different Latin American countries (including five trips to Argentina), and everywhere I went, people asked me to please, oh please, give more weight to regional and national language variants in the second edition; b) the spectacular development of Google with geographical filters in search settings that gave reliable results, and c) e-mail exchanges and forum debates with medical translators and users of my dictionary in different Latin American countries.