Download Vitamin-R 3.26. For Intel & Apple Silicon Macs running macOS 10.11 or later, Big Sur compatible. Download Vitamin-R 2.58. For Intel Macs running macOS 10.10 to 10.14. Vitamin-R 2.51 – Personal productivity tool. October 27, 2017 Vitamin-R creates the optimal conditions for your brain to work at its best by structuring your work into short bursts of distraction-free, highly focused activity alternating with opportunities for renewal, reflection and intuition. The combination of vitamin K 2 and vitamin D 3 achieved good differentiation in a laboratory study of leukemic cells, suggesting that it might be effective therapy for both MDS and leukemia. The oral dose for MDS is 45 to 90 mg of vitamin K 2 analogue MK-4 daily. Vitamin R 2 2 45 + Vitamin R 2 2 45 X 2; Vitamin R 2 2 45 Inch; Vitamin R 2 2. Vitamin-R 2 2.58 Vitamin-R creates the optimal conditions for your brain to work at its best by structuring your work into short bursts of distraction-free, highly focused activity alternating with opportunities for. It is an antioxidant and free radical scavenger that has anti-inflammatory properties, influences cellular immunity and vascular integrity, and serves as a cofactor in the generation of endogenous catecholamines. 1,2 Because humans may require more vitamin C in states of oxidative stress, vitamin C supplementation has been evaluated in numerous.
Last Updated: November 3, 2020
Vitamin C (ascorbic acid) is a water-soluble vitamin that is thought to have beneficial effects in patients with severe and critical illnesses. It is an antioxidant and free radical scavenger that has anti-inflammatory properties, influences cellular immunity and vascular integrity, and serves as a cofactor in the generation of endogenous catecholamines.1,2 Because humans may require more vitamin C in states of oxidative stress, vitamin C supplementation has been evaluated in numerous disease states, including serious infections and sepsis. Because serious COVID-19 may cause sepsis and acute respiratory distress syndrome (ARDS), the potential role of high doses of vitamin C in ameliorating inflammation and vascular injury in patients with COVID-19 is being studied.
Recommendation for Non-Critically Ill Patients With COVID-19
- There are insufficient data for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of vitamin C for the treatment of COVID-19 in non-critically ill patients.
Rationale
Because patients who are not critically ill with COVID-19 are less likely to experience oxidative stress or severe inflammation, the role of vitamin C in this setting is unknown.
Recommendation for Critically Ill Patients With COVID-19
- There are insufficient data for the Panel to recommend either for or against the use of vitamin C for the treatment of COVID-19 in critically ill patients.
Rationale
There are no completed controlled trials of vitamin C in patients with COVID-19, and the available observational data are sparse and inconclusive. Studies of vitamin C in sepsis patients and ARDS patients have reported variable efficacy and few safety concerns.
Clinical Data on Vitamin C in Critically Ill Patients Without COVID-19
Intravenous Vitamin C Alone
A small, three-arm pilot study compared two regimens of intravenous (IV) vitamin C to placebo in 24 critically ill patients with sepsis. Over the 4-day study period, patients who received vitamin C 200 mg/kg per day and those who received vitamin C 50 mg/kg per day had lower sequential organ failure assessment (SOFA) scores and levels of proinflammatory markers than patients who received placebo.3
In a randomized controlled trial in critically ill patients with sepsis-induced ARDS (n = 167), patients who received IV vitamin C 200 mg/kg per day for 4 days had SOFA scores and levels of inflammatory markers that were similar to those observed in patients who received placebo. However, 28-day mortality was lower in the treatment group (29.8% vs. 46.3%; P = 0.03), coinciding with more days alive and free of the hospital and the intensive care unit.4 A post hoc analysis of the study data reported a difference in median SOFA scores between the treatment group and placebo group at 96 hours; however, this difference was not present at baseline or 48 hours.5
Intravenous Vitamin C Plus Thiamine With or Without Hydrocortisone
Two small studies that used historic controls reported favorable clinical outcomes (i.e., reduced mortality, reduced risk of progression to organ failure, and improved radiographic findings) in patients with sepsis or severe pneumonia who received a combination of vitamin C, thiamine, and hydrocortisone.6,7
Three recent randomized trials in which patients received vitamin C and thiamine (with or without hydrocortisone) to treat sepsis and septic shock showed that this combination conferred benefits for certain clinical parameters. However, no survival benefit was reported. Two trials observed reductions in organ dysfunction (as measured by a SOFA score at Day 3)8,9 or the duration of shock10 without an effect on clinical outcomes. Two other trials found no differences in any physiologic or outcome measure between the treatment and placebo groups.11,12
Vitamin R 2 2 53 Epizoda
See ClinicalTrials.gov for a list of clinical trials that are evaluating the use of vitamin C in patients with COVID-19.
Other Considerations
It is important to note that high circulating concentrations of vitamin C may affect the accuracy of point-of-care glucometers.13
References
- Wei XB, Wang ZH, Liao XL, et al. Efficacy of vitamin C in patients with sepsis: an updated meta-analysis. Eur J Pharmacol. 2020;868:172889. Available at: https://www.ncbi.nlm.nih.gov/pubmed/31870831.
- Fisher BJ, Seropian IM, Kraskauskas D, et al. Ascorbic acid attenuates lipopolysaccharide-induced acute lung injury. Crit Care Med. 2011;39(6):1454-1460. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21358394.
- Fowler AA, 3rd, Syed AA, Knowlson S, et al. Phase I safety trial of intravenous ascorbic acid in patients with severe sepsis. J Transl Med. 2014;12:32. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24484547.
- Fowler AA, 3rd, Truwit JD, Hite RD, et al. Effect of vitamin C infusion on organ failure and biomarkers of inflammation and vascular injury in patients with sepsis and severe acute respiratory failure: the CITRIS-ALI randomized clinical trial. JAMA. 2019;322(13):1261-1270. Available at: https://www.ncbi.nlm.nih.gov/pubmed/31573637.
- Fowler AA, 3rd, Fisher BJ, Kashiouris MG. Vitamin C for sepsis and acute respiratory failure–reply. JAMA. 2020;323(8):792-793. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32096845.
- Marik PE, Khangoora V, Rivera R, Hooper MH, Catravas J. Hydrocortisone, vitamin C, and thiamine for the treatment of severe sepsis and septic shock: a retrospective before-after study. Chest. 2017;151(6):1229-1238. Available at: https://www.ncbi.nlm.nih.gov/pubmed/27940189.
- Kim WY, Jo EJ, Eom JS, et al. Combined vitamin C, hydrocortisone, and thiamine therapy for patients with severe pneumonia who were admitted to the intensive care unit: propensity score-based analysis of a before-after cohort study. J Crit Care. 2018;47:211-218. Available at: https://www.ncbi.nlm.nih.gov/pubmed/30029205.
- Fujii T, Luethi N, Young PJ, et al. Effect of vitamin C, hydrocortisone, and thiamine vs hydrocortisone alone on time alive and free of vasopressor support among patients with septic shock: the VITAMINS randomized clinical trial. JAMA. 2020;323(5):423-431. Available at: https://www.ncbi.nlm.nih.gov/pubmed/31950979.
- Chang P, Liao Y, Guan J, et al. Combined treatment with hydrocortisone, vitamin c, and thiamine for sepsis and septic shock: a randomized controlled trial. Chest. 2020;158(1):174-182. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32243943.
- Iglesias J, Vassallo AV, Patel VV, Sullivan JB, Cavanaugh J, Elbaga Y. Outcomes of metabolic resuscitation using ascorbic acid, thiamine, and glucocorticoids in the early treatment of sepsis: the ORANGES trial. Chest. 2020;158(1):164-173. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32194058.
- Hwang SY, Ryoo SM, Park JE, et al. Combination therapy of vitamin C and thiamine for septic shock: a multi-centre, double-blinded randomized, controlled study. Intensive Care Med. 2020; Published online ahead of print. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32780166.
- Moskowitz A, Huang DT, Hou PC, et al. Effect of ascorbic acid, corticosteroids, and thiamine on organ injury in septic shock: the ACTS randomized clinical trial. JAMA. 2020;324(7):642-650. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32809003.
- Hager DN, Martin GS, Sevransky JE, Hooper MH. Glucometry when using vitamin C in sepsis: a note of caution. Chest. 2018;154(1):228-229. Available at: https://www.ncbi.nlm.nih.gov/pubmed/30044741.
Vitamin-R 2 2.58
Vitamin-R creates the optimal conditions for your brain to work at its best by structuring your work into short bursts of distraction-free, highly focused activity alternating with opportunities for renewal, reflection and intuition.
The built-in task logging and statistics features create a positive momentum towards productivity by providing visible feedback on your progress and achievements.Features
- Time Slice Your Work. Vitamin-R breaks down large, vaguely defined tasks into a series of short 'time slices' of between 10 and 30 minutes, each with specific, easily reachable and actionable objectives. During these time slices it keeps you focused on accomplishing only this one objective and provides you with mechanisms for dealing with interruptions, poor concentration, etc.
- Get Started. Vitamin-R concentrates on getting you started allowing you to break through the resistance of procrastination and create a positive feedback loop of small achievements that get you closer to your ultimate aims. You will experience less stress caused by looming deadlines and a lack of clear direction, thus enabling you to enjoy guilt-free breaks that allow your intuition and creativity to emerge.
- Find Your Rhythm. Each one of us is different. Finding out what works best for you is the key to true productivity. Vitamin-R helps you by giving you the tools to gain more awareness of how you spend your time, what works for you and what does not. Armed with this new knowledge, you can eliminate unproductive work patterns and discover the work rhythm that suits you best.
- Get It Out of Your Head Quickly. Did you know that your short term memory can only hold 4-6 'chunks' of information? The slightest interruption and it's all gone and you have to start from scratch. That's why Vitamin-R provides you with the 'Now and Later Board', complete with FastType magic, to give you a place to quickly dump all those things that go through your head and allow you to quickly return to your task.
- Make It Your Own. Vitamin-R plugs into your life rather than trying to take it over. You can use it occasionally to overcome procrastination or mental blocks or re-organize your entire working life around the concepts that it embodies. It complements rather than replaces traditional to-do list managers, such as Things or OmniFocus for which direct integrations exist.
- Now With Cloud Synching! If you routinely work on multiple Macs, you will love Vitamin-R's new ability to effortlessly synch your time slice log across the cloud using the free Dropbox service. Setup is as easy as ticking a checkbox.
- Recapture the lost of art of joyful concentration. Overcome procrastination. Rediscover the motivation within yourself.
What's New:
- fixes a minor bug affecting the default objectives dialog
- fixes a minor bug in the AppleScript sample file
- other minor fixes
Screenshots:
- Title: Vitamin-R 2 2.58
- Developer: Frank Reiff
- Compatibility: OS X 10.7 or later, 64-bit processor
- Language: English
- Includes: K'ed by TNT
- Size: 63.5 MB
- visit official website