Our study results suggest that significant racial and ethnic disparities exist in the ESI scores assigned to patients during nursing triage evaluation and in the intensity of services provided during physician evaluation for patients presenting with the same acute chief symptoms. When nurses assign White patients more acute ESI scores at triage, they may also order diagnostic tests prior to a physician's involvement, leading to downstream increases in wRVUs. Additional decisions made at triage associated with race, ethnicity, and socioeconomic status, such as assignment to a room or hallway bed, may also influence physicians. 6 However, our findings suggest that when controlling for triage, significant racial and ethnic disparities persist in physicians' evaluations, particularly for Black and Hispanic patients.This study has several significant limitations, including a smaller proportion of patients identifying as Asian and American Indian or Alaska Native and a heterogenous other race or ethnicity category, limiting our ability to draw conclusions about these populations. More work is needed to determine where in the triage and physician evaluation processes these disparities arise and what can be done to remedy them.

Purpose of review Chimeric antigen receptor -(CAR) T-cell therapy has become a commonly used immunotherapy originally used in the treatment of B-cell leukemias but which are now applied broadly across tumor classes. Although high rates of remission are associated with CAR T-cell therapy, toxicities associated with these novel treatment regimens can be lethal if not recognized in a timely manner. Recent findings Cytokine release syndrome and neurotoxicity are the two most common toxicities associated with CAR T-cell therapy. Cytokine release syndrome is characterized by a flu-like illness accompanied by significant hemodynamic instability; treatments include administration of tocilizumab and corticosteroids. Neurotoxicity is associated with nonpattern-specific neurological changes and can rapidly progress to a comatose state from cerebral edema and death. Other potential toxicities from CAR T-cell therapy include tumor lysis syndrome, B-cell aplasia, graft versus host disease, and dermatological eruptions. Summary Clinical awareness of CAR T-cell toxicities is important because prompt treatment leads to improved survival and remission rates.

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