CHA2DS2-VASc score 1,2 : Clinical prediction rule for assessing the risk of stroke in patients with non-valvular atrial fibrillation. Oral anticoagulation is recommended for a CHA 2 DS 2 -VASc score of 2 or greater (Table 2). Practice Pearls: Atrial Fibrillation and Stroke Risk. Privacy Policy, Calculates stroke risk for patients with atrial fibrillation, possibly better than the, Calcs that help predict probability of a disease, Subcategory of 'Diagnosis' designed to be very sensitive, Disease is diagnosed: prognosticate to guide treatment. In these patients (female < 65 years old without other risk factors), antithrombotic therapy should not be given. Validation study included 1,084 patients with non-valvular AF, not on anticoagulation, over age 18 with ECG or Holter diagnosed AF in the ambulatory and hospital . Copyright 2021 GlobalRPH - Web Development by. This Chads vasc score rechner medcalc helps to fast and easily solve any math problems. Press 'Calculate' to view calculation results. CHADSVASC, CHA2DS2VASC and HASBLED risk score calculator for atrial fibrillation. You can save time by doing things efficiently. by B Kummer 2021 Cited by 2 - We analyzed metadata tags from MDCalc's calculator use data to the CHA2DS2-VASc score for atrial fibrillation stroke risk calculator, The older CHADS2 Score was designed to identify high risk patients for warfarin, but many common (and important) stroke risk factors in AF are not included, How to find perimeter and area of a trapezoid, Use properties and mental math to find the sum of 204 87 3 and 16. Frequently Asked Questions (FAQ) Chads-vasc score for atrial fibrillation stroke risk - mdcalc chads-vasc score for atrial fibrillation stroke risk calculates stroke risk for patients with atrial fibrillation, possibly better than the chads score. 2015. For the rest of the cases, please look at the table below. Use the inverse matrix to solve this system of equations. First published in 2001, the CHADS 2 score (congestive heart failure, hypertension, age 75 years, diabetes mellitus, stroke [double weight]) was developed to more accurately predict the risk. CHADSVASC, CHA2DS2VASC and HASBLED risk score The older CHADS2 Score was designed to identify high risk patients for warfarin, but many common (and important) stroke risk factors in AF . Adapted from Lip et al. 2010; 137: 263272. The CHADS-VASc score can be considered an extension of the CHADS2 scheme by considering additional stroke risk factors that may influence a decision whether. Concomitantly, you should fill in the HAS-BLED score. Except that the second S means sex, not stroke. 2010 Oct;12(10):1360-420. doi: 10.1093/europace/euq350. The Swedish Atrial Fibrillation cohort study allowed us to determine precisely the risk for particular results. RISK FACTORS. Signs/symptoms of heart failure confirmed with objective evidence of cardiac dysfunction, Resting BP > 140/90 mmHg on at least 2 occasions, Fasting glucose > 125 mg/dL or treatment with oral hypoglycemic agent and/or insulin, Includes any history of cerebral ischemia. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. chads2 the chads 2 score does not include some common stroke risk factors, and its various pros/cons have been carefully discussed. However, many times - on the Internet, in the spoken language - you may encounter not a 'CHA2DS2-Vasc' name, but rather 'CHADSVasc calculator, CHADSVasc score'. In both scoring systems, a score of 0 is "low" risk of stroke, 1 is "moderate", and any score above 1 is a "high" risk. Please be aware that the CHA2DS2Vasc risk score is only validated in non-valvular atrial fibrillation! About the Creator Adapted from Pisters et al. Calcs that help predict probability of a disease, Subcategory of 'Diagnosis' designed to be very sensitive, Disease is diagnosed: prognosticate to guide treatment. Lip GY, Frison L, Halperin JL, Lane DA. Each piece of the equation fits together to create a complete picture. In these patients (female < 65 years old without other risk factors), antithrombotic therapy should not be given. x. CHA 2 DS 2. It is used to solve problems in a variety of fields, from engineering to economics. Taking a medical history and a close examination are the best tool for any doctor in this case. CHA2DS2-VASc Score The CHA2DS2-VASc score calculates the stroke risk for patients with atrial fibrillation, possibly better than the CHADS2 score. By taking the time to explain the problem and break it down into smaller pieces, anyone can learn to solve math problems. The technical part of using our calculator is very simple - just mark all the conditions that your patient presents with a 'Yes', and your CHA2DS2-Vasc score will appear at the bottom of the calculator right away. (!) PAD, MI, aortic plaque) = 1pt CHADSVASC clinical risk estimation. By Jonas de Jong, MD, PhD, cardiologist. Comparative Performance of ATRIA, CHADS2, and CHA2DS2-VASc The ORBIT score can be used in conjunction with the CHA 2DS 2-VASc score to risk The CHA 2 DS 2 -VASc score contains more risk factors and has a greater range of points, thus switching to the CHA 2 DS 2 -VASc score will increase the number of patients eligible for anticoagulation. Scoring the 'V' in the CHA 2DS 2-VASc score Most respondents (95.4%) chose 'peripheral vascular disease' as the qualifying condition to score the 'V' in the CHA 2DS 2 . The SEAL team works directly with clinicians . The CHADS-VASc score can be considered an extension of the CHADS2 scheme by considering additional stroke risk factors that may influence a decision whether . Apps Lab integrates the MdCalc CHADS-VASc Risk Calculator into Epic risk calculator, clinicians can call up the SEAL CHA 2DS 2-VASc Score for . MDCalc loves calculator creators - researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. Atrial fibrillation is a growing medical problem that affects a large part of the population. You may notice that most of the stroke risk factors are major bleeding factors as well. When CHA 2 DS 2 -VASc was calculated, 52.3% had a score of 1 (stroke risk of 1.75%). official version of the modified score here. The CHA2DS2-VASc Score for AF calculator is created by QxMD. The CHA 2 DS 2 -VAS c score calculates the stroke risk for patients with atrial fibrillation, possibly better than the CHADS 2 score. CHADSVASC, CHA2DS2VASC and HASBLED risk score calculator for atrial fibrillation Chadsvasc risk factors [click on present risk factors] CHADSVASC clinical risk estimation. CHADSVASC, CHA2DS2VASC and HASBLED risk score calculator for atrial fibrillation. But in everyday life, and with tools such as Omni's CHA2DS2 Vasc calculator, you don't have to worry about those things anymore. The scale was developed in 2010 to complement the previous ruling scale - CHADS2 - with stroke risk factors, like female sex, vascular disease, and age. Copyright 1993-2021 The explanations for the solutions are coherent. by B Kummer 2021 Cited by 2 - We analyzed metadata tags from MDCalc's calculator use data to the CHA2DS2-VASc score for atrial fibrillation stroke risk calculator order now. CHADSVASC, CHA2DS2VASC and . Chest 2010; March 18 [Epub ahead of print]. The result can be used to determine whether or not treatment is required with anticoagulation therapy or antiplatelet therapy. Our expert instructors are here to help, in real-time. You can get calculation support online by visiting websites that offer mathematical help. peripheral arterial disease or aortic None of the included patients were anticoagulated. Major international AF guidelines recommend the CHA 2 DS 2 -VASc score [congestive heart failure, hypertension, age 75 (doubled), diabetes, previous stroke/transient ischaemic attack/thromboembolism (doubled), vascular disease, age: 65-74, sex (female)] as the stroke risk assessment tool in patients with AF. Mathematics is a field of study that deals with numbers, shapes, and patterns. Apps Lab integrates the MdCalc CHADS-VASc Risk Calculator into Epic risk calculator, clinicians can call up the SEAL CHA 2DS 2-VASc Score for . when to use pearls/pitfalls why use age . anticoagulation based on CHA2DS2-VASc score anticoagulation may be with apixaban, dabigatran etexilate, rivaroxaban or a vitamin K antagonist consider anticoagulation for men with a CHA2DS2-VASc score of 1. Validation study included 1,084 patients with non-valvular AF, not on anticoagulation, over age 18 with EKG or Holter diagnosed AF in the ambulatory and hospital settings from 182 hospitals in 35 countries from 2003 to 2004 and had known thromboembolic status at 1 year from the Euro Heart Survey database. 2 The one exception, however, is in patients who have a score of 1 due to gender alone. The interaction was statistically significant ( P <0.001). 2 Apps Lab integrates the MdCalc CHADS-VASc Risk Calculator into Epic risk calculator, clinicians can call up the SEAL CHA 2DS 2-VASc Score for, The CHADS2 score and its updated version, the CHA2DS2-VASc score, are clinical prediction rules for estimating the risk of stroke in people with, by B Kummer 2021 Cited by 2 - We analyzed metadata tags from MDCalc's calculator use data to the CHA2DS2-VASc score for atrial fibrillation stroke risk calculator, 1 what is the answer to an addition problem called, All things algebra gina wilson 2016 answer key, Find greatest common factor calculator with variables, Find the volume of the triangular pyramid calculator, Mortgage amortization schedule with extra payments excel, Z critical value calculator good calculator. Do Not Copy, Distribute or otherwise Disseminate without express permission. Helps with math alot well i mostly use it for homework 5/5 recommendation im not a bot, so if anyone thinks that this is only for students or for those who are weak in mathematics then for your kindly info I score usually between 90 to 100 percent and still its useful if you don't have any books. Risk of ischaemic stroke (%) per one year, Risk of stroke/ TIA/ peripheral embolism (%) per one year. This site complies with the HONcode standard for trust- worthy health information: verify here. It is used on every patient with atrial fibrillation before anticoagulant therapy is administered. MDCalc recommends the CHA2DS2-VASc score over the original CHADS2 score to assess stroke risk in patients with atrial fibrillation. MDCalc recommends the CHA2DS2-VASc score over the original CHADS2 score to assess stroke risk in patients with atrial fibrillation. HASBLED clinical characteristic [click on present risk factors] First, it's worth mentioning that the CHA2DS2-Vasc score (represented here) is built on the background of the CHADS score (or CHADS2 to be precise). The risk ratio (male as reference) across points >1 indicated that women exhibit a higher stroke risk. below for actual risks in a larger population. We're here to help you! The cha 2 ds 2 -vasc score is a widely used medical tool used to guide physicians on blood thinning treatment to prevent stroke in people with non-valvular atrial fibrillation (af) . CHADS2-VAsc calculator for evaluating ischemic stroke risk in patients with atrial fibrillation. You can always count on us for help, 24 hours a day, 7 days a week. Intuitively, the larger the patient's score in the CHA2DS2-Vasc calculator, the greater the risk of inauspicious incidents. . We try our best to make our Omni Calculators as precise and reliable as possible. MNEMONICS. A CHADS 2 of 0 is NOT low risk, and stroke rate can be as high as 3.2%/year if untreated ( Olesen et al, Thromb Haemostat 2012 ). Also, the scale is not yet set in stone - scientific reports are trying to add obstructive sleep apnea as another major stroke risk factor to CHA2DS2-Vasc. According to some studies, patients with a CHADS, Among patients aged 65-95 years old with non-valvular atrial fibrillation, very few (<7%) will be classified as low risk according to the CHADS. HTN = 1 pt Adding the numbers '2' to the name is meant to help doctors memorize the scale, in this case - which stroke risk factors carry two points. A novel user- friendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey. The researchers took into consideration not only the stroke risk but also other incidents, such as peripheral embolism or TIA - transient ischaemic attack. Stroke = 2 pts These patients could have had thromboembolic events, causing them to be lost to follow-up. Get detailed step-by-step resolutions to your computer issues with our easy-to-use searchable database. The CHA2DS2-Vasc Score is one of the most widely-used clinical risk scores for stroke. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients. See Van den Ham et al. JACC. All factors have a different significance, so this should be taken into account. It is used to solve problems in a variety of fields, including science, engineering, and business. The presence of signs and symptoms of either right or left ventricular The CHADS2-VASc system, with having three more potential variables, inevitably classifies more patients into a high-risk group. In this case, CHADS2 was 0.637 compared to CHADS2-VASc at 0.647.1. If you're struggling to clear up a math equation, try breaking it down into smaller, more manageable pieces. Age 75 years = 2 pts In general, a CHA 2 DS 2 -VASc score of 1 should warrant strong consideration for full oral anticoagulation. One way to think about math equations is to think of them as a puzzle. Its basically CHADS-VAS with the two subscripts put on the two letters in the first part that repeat in the second part. Very helpful during the math questions, would recommend. oral anticoagulation should be considered (!). CHADSVASC, CHA2DS2VASC and HASBLED risk score. official version of the modified score here. Adapted from Lip et al. The C statistic is a number between 0.5 (no better than chance) and 1.0 (perfect prediction) indicating predictive ability. More sleep more happy i am, i can finally answer my modules faster thanks to this app. You will also find some statistical data about the scoring and a short comment regarding anticoagulation. Chads vasc score rechner medcalc is a mathematical tool that helps to solve math equations. EHRA / EACT / ESC Committee for Practice Guidelines. It risk stratifies these . Math app got it the first time. CHADSVASC, CHA2DS2VASC and HASBLED risk score Stanford Emerging Apps Lab integrates the MdCalc CHADS-VASc Risk Calculator into Epic Shreya Shah, M.D.. MDCalc loves calculator creators researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. There are seven significant stroke risk factors in the CHA2DS2-Vasc scale. This is why treating and controlling the factors that can be is so important. It risk stratifies these. This special situation may not be intuitive with the CHA2DS2-VASc scoring system. Click here to use it on MDCalc.com. 65 0 65-74 +1 75 +2 sex female +1 male 0 chf history no 0 yes +1 hypertension history no. The SEAL team works directly with clinicians to The CHADS-VASc score can be considered an extension of the CHADS2 scheme by considering additional stroke risk factors that may influence a, CHA2DS2-VASc Score The CHA2DS2-VASc score calculates the stroke risk for patients with atrial fibrillation, possibly better than the CHADS2 score. Stanford Emerging Apps Lab integrates the MdCalc CHADS-VASc Risk Calculator into Epic Shreya Shah, M.D.. . CHADSVASC, CHA2DS2VASC and HASBLED risk score calculator for atrial fibrillation. Used previously developed Birmingham 2009 schema, under the acronym CHA. SCORE Congestive heart failure. The acronym CHA2DS2-VASc stands for, MDCalc recommends the CHA2DS2-VASc score over the original CHADS2 score to assess stroke risk in patients with atrial fibrillation. At 24/7 Customer Support, we are always here to help you with whatever you need. 31% of the patients in their original study group were lost to follow-up at one year and thus were not included in the analysis. Suggestions for improvement are welcome at: Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. Click here. . Math is a subject that can be difficult to understand, but with practice and patience, anyone can learn to figure out math problems. With our tool for calculating the CHA2DS2-Vasc stroke risk, clinical assessment is faster and easier. If you want to improve your performance, you need to focus on your theoretical skills. The CHA 2 DS 2 -VASc stroke score (congestive heart failure, hypertension, age 75 (doubled), diabetes mellitus, prior stroke or transient ischemic attack (doubled), vascular disease, age 65-74, female) is used in most guidelines for risk stratification in atrial fibrillation (AF), but most data for this score have been derived in Western CHADS score used only seven factors (congestive heart failure, hypertension, age 75, diabetes, prior stroke/thromboembolism/TIA), and the maximum result was 6. CHA2DS2-VASc Score. But, if they mention the 'CHADS score', they might think of the older version of the scale. There was a need for improvement - and so the CHA2DS2-Vasc was created. The CHADS 2 score was validated by a study of nonrheumatic atrial fibrillation patients aged 65 to 95 who were not prescribed the anticoagulant warfarin. Check our CVD 10-year risk calculator to see if your patient has a high chance of developing one. Not only does it give you the answer it tells you every step you need to know and the definitions of the words that you may not know. Mathematics is the study of numbers, shapes, and patterns. CHADSVASC, CHA2DS2VASC and HASBLED risk score calculator for atrial fibrillation. The presence of signs and symptoms of either right or left ventricular, How to divide a fraction by a square root, How to find area of a trapezoid with fractions, Solving multi step inequalities with fractions worksheet, What is the definition of parallel lines in math, What is the slope of the line shown on the grid. The CHA2DS2-Vasc score considers seven stroke risk factors to score your patient's risk. Since then, the American Heart Association has recommended it. In these patients (female < 65 years old without other risk factors), antithrombotic therapy should not be given. 2 The one exception, however, is in patients who have a score of 1 due to gender alone. A and S are the only two repeating numbers in the whole score. . Mathematicians use their expertise to solve complex problems and to develop new and improved methods of doing so. Math can be a difficult subject for many people, but it doesn't have to be! A subsequent study examining the performance of CHA. Please select CHADSVASC and HASBLED risk factors, EHRA score and click copy to clipboard to copy and paste in your electronic files, Chadsvasc risk factors [click on present risk factors]. Chads vasc score rechner medcalc - The CHADS-VASc score can be considered an extension of the CHADS2 scheme by considering additional stroke risk factors that . The 1-year absolute risk of thromboembolism was 0.5% among men and women with a CHA 2 DS 2 -VA score of 0 and increased up to >7% among very comorbid patients (score >5). Most of the CHA2DS2-Vasc stroke risk factors are factors for other cardiovascular diseases, as well. To classify the predictive ability of a scoring system, a C statistic is sometimes used. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). CHADSVASC, CHA2DS2VASC and HASBLED risk score calculator for atrial fibrillation. Identifying patients at high risk for stroke despite anticoagulation: a comparison of contemporary stroke risk stratification schemes in an anticoagulated atrial fibrillation cohort. Stroke. HASBLED clinical characteristic [click on present risk factors]. Stanford Emerging Apps Lab integrates the MdCalc CHADS-VASc Risk Calculator into Epic Shreya Shah, M.D.. However, 54.9% respondents chose the wrong answer'office/clinic BP above 140/90mmHg or 130/ 85mmHg(ifdiabetic)'forthe'H'element(seeFigure 2). HASBLED clinical risk estimation. It is used to determine whether or not treatment is required with anticoagulation therapy or antiplatelet therapy. Click here to use it on MDCalc.com. All Rights Reserved. HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication, Congestive heart failure (or Left ventricular systolic dysfunction), Hypertension: blood pressure consistently above 140/90 mmHg (or Sex Female =1; Male=0, Designed by Elegant Themes | Powered by WordPress. DM = 1 pt Plz download this app if u don't want to waste your time calculating the numbers using a calculator, i am taking Intermediate Algebra as a graduation requirement to get my college degree. Van den Ham et al. It is used mainly in patients with atrial fibrillation, but there are reports that it might be useful for other medical conditions, such as sick sinus syndrome. We Answer! Mathematics is the study of numbers, shapes, and patterns. below for actual risks in a larger population. The older CHADS2 Score was designed to identify high risk patients for warfarin, but many common (and important) stroke risk factors in AF are not included. If you're struggling with math, don't forget that you can also solve word problems. Stroke Risk Assessment (CHADS2, CHA2DS2-VASc) The CHADS 2 score is a validated stroke risk assessment tool for patients with AF that was first presented at the 2001 International Stroke Meeting. CHADS2-VASc Score: Stroke Risk Assessment in A. Fib. HAS-BLED Calculator for Atrial Fibrillation. plaque). CHADSVASC, CHA2DS2VASC and HASBLED . treated hypertension on medication), Vascular disease (previous MI, The presence of signs and symptoms of either right or left ventricular . The presence of signs and symptoms of either right or left ventricular. Classificaton of AF-related symptoms (EHRA score), Mild symptoms; normal daily activity not affected, Severe symptoms; normal daily activity affected, Disabling symptoms; normal daily activity discontinued. We analyzed metadata tags from MDCalc's calculator use data to the CHA2DS2-VASc score for atrial fibrillation stroke risk calculator. Estimates stroke risk in patients with atrial fibrillation. Patients with 0 point, or 1 point if they are a woman, are patients with 'isolated atrial fibrillation'. There are several areas within the original validation trial that would infer that deep vein thrombosis (DVT) or pulmonary embolism (PE) would be included within the score1. It's arguably the best validated and is consistently, Expert instructors will give you an answer in real-time. The CHA2DS2-Vasc risk stratification is presented in the table below. The CHADS2 score and its updated version, the CHA2DS2-VASc score, are clinical prediction rules for estimating the risk of stroke in people with . These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients. The CHA2DS2-VAScscore calculates the stroke risk for patients with atrial fibrillation, possibly better than the CHADS2 score. Guidelines recommend initiation of oral anticoagulant (OAC) therapy in atrial fibrillation (AF) patients with a CHA 2 DS 2-VASc score 2 (males) and 3 (females) for lowering stroke risk (IA), while OAC in patients with a CHA 2 DS 2-VASc score of 0 is not recommended (IIIB) [1].. OAC should be considered (IIaB) for AF patients with a CHA 2 DS 2-VASc score of 1 (males) and of 2 (females . CHADSVASC, CHA2DS2VASC and HASBLED risk score Classification of CHADS2 vs CHADS2-VASc In both scoring systems, a score of 0 is low risk of stroke, 1 is moderate, and any score above 1 Save time. . For those who struggle with math, equations can seem like an impossible task. The confusion within this component of the CHA2DS2-VASc score comes from the inclusion of TE. It is important to notice, that if someone refers to 'CHADSVasc score' or 'CHADSVasc calculator', they mean this scale. Apps Lab integrates the MdCalc CHADS-VASc Risk Calculator into Epic risk calculator, clinicians can call up the SEAL CHA 2DS 2-VASc Score for 892 PhD Experts 9 . When is the CHA2DS2-Vasc calculator used? However, with a little bit of practice, anyone can learn to solve them. Each increase in CHADS2-VASc was shown to predict ischemic stroke rate per year in a linear fashion: In a comparison study of multiple risk assessment tools for atrial fibrillation, CHA2DS2-VASc did not seem to outperform CHADS2. There was no statistically significant difference found between the CHA. - despite suggestions, clinical judgment and individual approach should always have the last word while making medical decisions. The presence of signs and symptoms of either right or left ventricular Get Started. CHA 2 DS 2 -VASc score of 1: recommend antithrombotic therapy with oral anticoagulation or antiplatelet therapy but preferably oral anticoagulation. 2-VASc score. For predicting the need for anticoagulation in people diagnosed with atrial fibrillation, the CHA 2 DS 2 -VASc score was retained as the recommended stroke risk tool (fig 1) because it was the most accurate tool for discriminating between those at risk of stroke and those not at risk. However, it was widely discussed and eventually qualified as 'simple, broadly applicable, but with many potential detriments'. See Van den Ham et al. Have you ever had a hard clinical decision to make? . Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary or valve interventions: a joint consensus document of the European Society of Cardiology Working Group on Thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI) and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS) and Asia-Pacific Heart Rhythm Society (APHRS). Looking for an answer to your question? References: [1 ] Gage BF, van Walraven C, Pearce L, et al. You'll also get a short comment about the CHA2DS2-Vasc risk stratification and any further recommendations. Those at particularly high risk for a TE event may have been already anticoagulated by their PMD, potentially skewing the TE rates. About This Calculator CHADS 2 was designed as a scoring system to classify the risk of stroke in patients with atrial fibrillation. If you want to improve your math skills, the best way is to practice as often as possible. The presence of signs and symptoms of either right or left ventricular failure or both, confirmed by non-invasive. I love spending time with my family and friends. Risk Scores Predicting Stroke in Patients With Atrial Fibrillation. To solve a math equation, you need to find the value of the variable that makes the equation true. by A Gaov 2019 Cited by 21 - The CHA2DS2-VASc score is a point-based system used to stratify the risk of stroke in AF patients. The CHADS2 score and its updated version, the CHA2DS2-VASc score, are clinical prediction rules for estimating the risk of stroke in people with . Find more in the last section of the text.
Asheboro High School Lockdown Today, Best Airbnb In Austin For Bachelorette Party, William Seymour Miracles, What Is Weight Transfer In A Race Car?, Dea Spanos Berberian Husband, Articles C