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We also speculate the possibility of occult and undiagnosed eating disorders in some of the slender NTM lung disease patients with no known risk factors for the opportunistic infection other than their low body weight.Thoracic aortic injury is fatal but rare in blunt chest trauma, which usually requires urgent surgical treatment. It is mostly caused by posterior rib fractures. Chest wall stabilization (CWS) has been widely performed in patients with multiple rib fractures all over the world in the past two decades with satisfactory outcomes. However, the surgical treatment of posterior rib fracture within 2-3 cm from transverse process is still a difficult problem for thoracic surgeons. Under this circumstance, rib-transverse process internal fixation method was developed and widely performed for above patients at present. In this article, we presented a case of thoracic aortic injury caused by multiple rib fractures. A 54-year-old female was admitted to our hospital with dyspnea and severe chest pain caused by a falling object. Thoracic aortic injury with multiple rib fractures were diagnosed basing on image date and emergency CWS was performed for this patient. Rib-transverse process internal fixation was not performed in this case since the patients combined with transverse process fracture. We firstly performed transverse process resection combined with CWS for this patient. The results of our study showed this method is safe and feasible for patients with multiple rib fractures combined with transverse process fracture.Pulmonary arterial hypertension (PAH) is an uncommon but potentially life-threatening illness. The elevated pulmonary arterial blood pressure will lead to right heart failure and even cardiopulmonary collapse if it is severe. Apart from general supportive measures, pulmonary hypertension-specific therapies (PHST) are available to slow down disease progression, but they are not curative. According to previous studies, many patients with severe PAH often had significant physical symptoms and psychological distress for both themselves and their families at the end of life. Moreover, they would have repeated admissions due to physical deterioration and decline in functioning associated with worsening in cardiac function. Some of these patients might suffer from unnecessary aggressive interventions and resuscitation because of lack of advance care planning discussion. As such, Palliative Care (PC) would be an important element as part of the overall management. Hereby, we reported a patient with severe PAH and schizoaffective disorder achieved good outcome from the use of combination PHST and PC input. Her physical and psychosocial needs could be addressed well by PC team. This case report showed the collaborative work between PC and parent teams. While parent team was able to manage the medical conditions related to PAH, however the physical and psychosocial needs should be addressed by PC team. More importantly, the PC team has essential roles of providing advance care planning discussions with the patient and help to reduce unnecessary interventions. Furthermore, PC would coordinate the community service to support her while staying at home. Roles of PHST will also be discussed in this case. Tacrolimus price Clinicians must take into account possible hemodynamic effects of any palliative intervention for PAH.Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as coronavirus disease 2019 (COVID-19) is known to cause a cluster of flu-like illnesses and pneumonia with evolving understanding of other systemic manifestations. Currently, the known cardiac manifestations of COVID-19 include myocardial injury, acute coronary syndrome, and arrhythmias. In this report, we describe a case of pericarditis-an unusual cardiac manifestation observed in a patient with COVID-19. A 63-year-old male presented with history of fever, cough and chest pain. Electrocardiogram (EKG) demonstrated diffuse ST-T wave changes on all the leads, with normal troponin-T levels. Echocardiograph showed mild pericardial effusion without any regional wall motion abnormality. Subsequent chest radiograph and coronary angiography were normal. In view of ongoing COVID-19 pandemic, nasopharyngeal swab was performed, which was positive. Detailed etiological workup for pericarditis, including infectious and inflammatory causes were unremarkable. Viral pericarditis (possibly caused by COVID-19) was diagnosis of exclusion and patient was treated with hydroxychloroquine 200 mg twice a day, colchicine 0.5 mg twice a day, and lopinavir/ritonavir 200 mg/50 mg tablet twice a day for 10 days during admission. He was discharged with hydroxychloroquine 200 mg twice daily and colchicine 0.5 mg once daily for 15 days. On subsequent follow-up clinic visit, he reported resolution of symptoms. The purpose of this report is to add a potential cardiovascular complication of COVID-19 to the literature. Awareness of this manifestation can lead to timely laboratory and imaging examinations with potential to provide correct treatment and good outcome.Pancreatic cancer (PaCa) is very aggressive malignancy with poor prognosis. Individuals with a family history of PaCa have a higher risk of developing cancer which points to a hereditary component. Here, we report a unique case of CHEK2 mutant PaCa in a patient with no medical but significant family history. A 59-year old female presented with 3-month history of worsening epigastric pain and jaundice. CT abdomen/pelvis with contrast showed pancreatic head mass which was confirmed by endoscopic ultrasound guided biopsy. She was diagnosed with pancreatic adenocarcinoma harboring CHEK2 mutation. She had extensive surgery followed by adjuvant chemotherapy. Follow up imaging in 3 months obtained after surgery and adjuvant chemotherapy showed extensive liver metastasis and patient decided to pursue hospice. Germline testing in all PaCa patients has become essential as mutations in CHEK2 and other DNA repair genes constitute a unique subset of PaCas. Not only does it help in assessment of cancer risk in the individual and family members but also guide anticancer therapy selection. PaCa patients harboring CHEK2 mutations do not usually respond to chemotherapeutic agents such as gemcitabine. However, new treatment strategies such as PARP inhibitors targeting defective DNA repair mechanism are currently being investigated and showed some promise in treating CHEK2 mutant PaCa patients.