A 26-year-old male was presented to a military treatment facility in Afghanistan shortly after taking a weight-lifting supplement called Jack3d with a severe headache and was subsequently found to have suffered a Dejerine-Roussy variant right thalamic hemorrhagic stroke. Jack3d active ingredients include geranamine, schizandrol A, caffeine, beta-alanine, creatine monohydrate, and L-arginine alpha-ketoglutarate. A literature search revealed case reports suggesting some of the constituent ingredients may predispose to stroke and hemorrhage and also revealed a substantial paucity of data existed regarding schizandrol A, a herb used in traditional eastern medicine. The product has no readily apparent disclaimer or warning regarding the risks or lack of data regarding the components. Jack3d is sold as a nutritional supplement and is therefore not subject to same FDA regulation and scrutiny that a pharmaceutical receives. The potential adverse effect was reported to the FDA via MedWatch in accordance with the recently passed Dietary Supplement and Nonprescription Drug Consumer Protection Act.

Medical students' definition of a "good lifestyle" includes four themes, which should be used in future research of the lifestyle factor of specialty selection.

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Background Spin—the misrepresentation of a study’s actual results—has the potential to alter a clinician’s interpretation of the study’s findings and therefore could affect patient care. Studies have shown spin frequently occurs in abstracts of systematic reviews from a variety of other medical disorders and specialties. Aims Our primary aim was to evaluate whether the nine most severe types of spin occurred in systematic review abstracts’ concerning diabetic neuropathy treatments. Secondly, we aimed to determine whether spin presence was associated with the methodological quality of a systematic review. Methods A search of MEDLINE and Embase collected 1297 articles focused on diabetic neuropathy treatments, of which we included 114 systematic reviews for spin assessment. Each included study was evaluated for the nine most severe types of spin as defined by Yachitz et al. The methodological quality of a systematic review was determined by using the AMSTAR-2 instrument. All screening and data extraction were conducted in a masked, duplicate fashion. Since the final sample size of 114 was not sufficiently powered to do multivariable logistic regression, we calculated unadjusted odds ratios which evaluated relationships between spin presence within abstracts and study characteristics. Results From the 114 articles reviewed, spin was present in 7.9% of the studies (9/114), with spin type 5: “conclusion claims the beneficial effect of the experimental treatment despite the high risk of bias in the included primary studies” as the most frequent in our study. Spin types 1, 2, 6, and 8 were not identified. No association was observed between the study characteristics and spin presence, including the methodological quality of a systematic review. Conclusions Overall, spin is infrequently observed in abstracts of systematic reviews covering diabetic neuropathy treatments. When comparing our results to other fields of medicine, the field of diabetic neuropathy research publishes systematic reviews whose abstracts mostly portray the findings of the review’s full-text to reflect the results adequately.