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[11] Some researchers suggest continued education for behavioral health practitioners, increasing surveillance of appropriate nicotine dependence symptoms, and engaging clients with mental illnesses in conversations about cessation resources as appropriate ways to help reduce tobacco use among individuals with mental illnesses

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14,15 Interestingly in our case patient, her IgE level was within normal limits while her histamine level was elevated, possibly highlighting a nonimmunological urticaria from molecular binding of cadmium directly to mast cells, activating the release of histamine

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