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Careful Listening Can Prevent Needless Deaths

Sharron Ladd, BSc

The Baycrest Centre for Geriatric Care hosted the Dr. Ira Pollock Clinic Day entitled "Issues in Geriatric Medicine," on November 27th. The morning session was comprised of short lectures followed by afternoon workshops. The event, chaired by Dr. Michael Gordon, proved to be both a humorous and sobering experience.

"It used to be common practice to recommend patients stop taking anticoagulants if they are going to the dentist," began Dr. John A. Blakely, director of the Anticoagulation Clinic at Sunnybrook Hospital in Toronto, in his lecture on anticoagulation. A recent study concluded that there were no serious bleeding problems in patients remaining on anticoagulants while receiving dental care (Arch Int Med 1998;158(15):1596-608). Patients should remain on anticoagulants if going for dental work.

Blakely concluded his talk advising that atrial fibrillation (AF) must be treated with warfarin, not aspirin. He admitted that anticoagulants are difficult to prescribe. There are a lot of tests involved, numerous telephone calls, collecting of patient information and discussions with family, for only $9 a month. Conversely, aspirin is easy to prescribe. Despite difficulties, warfarin is the drug of choice for AF!

In a section on fall prevention and assessment, Dr.