ktothestein:

and so it goes…  (went)

5 hours ago  —  7/24/2014  —  2,288 notes
#holy fuck #hahahaha




sherlockocity:

Muggleborn students at Hogwarts (part 1/?)

5 hours ago  —  7/24/2014  —  31,267 notes




invisiblelad:

perpetual reblogging

5 hours ago  —  7/24/2014  —  357,584 notes




ingberry:

biblioprincessdalian:

jethroq:

Bromeo and Dudeliet, a forbidden bromance between two bros in rival fraternities, in fair Vebrona where we lay our scene

Two frat houses, broth alike in dignity

in fair Verbrona where we lay our scene

From mancient grudge break to new dudetiny

Where civil blood makes civil mands unclean

5 hours ago  —  7/24/2014  —  220,479 notes
#lmfao




mynotes4usmle:

WARFARIN-INDUCED SKIN NECROSIS
Warfarin necrosis usually occurs three to five days after drug therapy is begun, and a high initial dose increases the risk of its development.[3]:122 Heparin-induced necrosis can develop both at sites of localinjection and - when infused intravenously - in a widespread pattern.[3]:123
In warfarin’s initial stages of action, inhibition of protein C and Factor VII is stronger than inhibition of the other vitamin K-dependent coagulation factors II, IX and X. This results from the fact that these proteins have different half-lives: 1.5 to six hours for factor VII and eight hours for protein C, versus one day for factor IX, two days for factor X and two to five days for factor II. The larger the initial dose of vitamin K-antagonist, the more pronounced these differences are. This coagulation factor imbalance leads to paradoxical activation of coagulation, resulting in a hypercoagulable state and thrombosis. The blood clots interrupt the blood supply to the skin, causing necrosis. Protein C is an innate anticoagulant, and as warfarin further decreases protein C levels, it can lead to massive thrombosis with necrosis and gangrene of limbs.
Notably, the prothrombin time (or international normalized ratio, INR) used to test the effect of coumarins is highly dependent on factor VII, which explains why patients can have a therapeutic INR (indicating good anticoagulant effect) but still be in a hypercoagulable state.[1]
In one third of cases, warfarin necrosis occurs in patients with an underlying, innate and previously unknown deficiency of protein C. The condition is related to purpura fulminans, a complication in infants with sepsis (blood stream infection) which also involves skin necrosis. These infants often have protein C deficiency as well. There have also been cases in patients with other deficiency, including protein S deficiency,[6][7] activated protein C resistance (Factor V Leiden)[8] and antithrombin III deficiency.[9]
Although the above theory is the most commonly accepted theory, others believe that it is a hypersensitivity reaction or a direct toxic effect.[1]

mynotes4usmle:

WARFARIN-INDUCED SKIN NECROSIS

Warfarin necrosis usually occurs three to five days after drug therapy is begun, and a high initial dose increases the risk of its development.[3]:122 Heparin-induced necrosis can develop both at sites of localinjection and - when infused intravenously - in a widespread pattern.[3]:123

In warfarin’s initial stages of action, inhibition of protein C and Factor VII is stronger than inhibition of the other vitamin K-dependent coagulation factors IIIX and X. This results from the fact that these proteins have different half-lives: 1.5 to six hours for factor VII and eight hours for protein C, versus one day for factor IX, two days for factor X and two to five days for factor II. The larger the initial dose of vitamin K-antagonist, the more pronounced these differences are. This coagulation factor imbalance leads to paradoxical activation of coagulation, resulting in a hypercoagulable state and thrombosis. The blood clots interrupt the blood supply to the skin, causing necrosis. Protein C is an innate anticoagulant, and as warfarin further decreases protein C levels, it can lead to massive thrombosis with necrosis and gangrene of limbs.

Notably, the prothrombin time (or international normalized ratio, INR) used to test the effect of coumarins is highly dependent on factor VII, which explains why patients can have a therapeutic INR (indicating good anticoagulant effect) but still be in a hypercoagulable state.[1]

In one third of cases, warfarin necrosis occurs in patients with an underlying, innate and previously unknown deficiency of protein C. The condition is related to purpura fulminans, a complication in infants with sepsis (blood stream infection) which also involves skin necrosis. These infants often have protein C deficiency as well. There have also been cases in patients with other deficiency, including protein S deficiency,[6][7] activated protein C resistance (Factor V Leiden)[8] and antithrombin III deficiency.[9]

Although the above theory is the most commonly accepted theory, others believe that it is a hypersensitivity reaction or a direct toxic effect.[1]

5 hours ago  —  7/24/2014  —  78 notes




6 hours ago  —  7/24/2014  —  230,743 notes
#headdesk #'just stop being poor' #how about just stop being an asshole




morganperreault:

whatisgoingonpleasehelp:

whooops

how do you even

morganperreault:

whatisgoingonpleasehelp:

whooops

how do you even

6 hours ago  —  7/24/2014  —  137,527 notes
#whaaaaaat?




glowcloud:

i love the Women Against Feminism that are like “I dont need feminism because i can admit i need my husband to open a jar for me and thats ok!” cause listen 1. get a towel 2. get the towel damp 3. put it on the lid and twist. BAM now men are completely useless. you, too, can open a jar. time to get a divorce

6 hours ago  —  7/24/2014  —  20,893 notes




bcruz2390

bcruz2390

6 hours ago  —  7/24/2014  —  109,052 notes
#hahaha




my meals in the summer
2 days ago  —  7/23/2014  —  301,026 notes




liamstewrt:

love turns to  a s h e s
with all that I wish I could say

2 days ago  —  7/23/2014  —  2,239 notes
#no whyyyy #my badass warrior woman #sweet angel #queen of my heart #allison argent #teen wolf




teenwolf:

LOL I love when Stiles is a smartass

2 days ago  —  7/22/2014  —  10,967 notes
#ilu stiles #stiles stilinski #scott mccall #teen wolf




teenwolf:

That SMILE though

2 days ago  —  7/22/2014  —  16,422 notes
#derek is so proud lol #derek hale #scott mccall #teen wolf




teenwolf:

It’s okay, Lydia. You can have one extra hour in the ball pit.

2 days ago  —  7/22/2014  —  4,764 notes
#oop #lol #lydia martin #teen wolf




teenwolf:

PARRISH WHO ARE YOU???

2 days ago  —  7/22/2014  —  9,028 notes
#lol #sheriff stilinski #deputy parrish #teen wolf