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The CDC, as well as the New York State Department of Health, in conjunction with the University of Rochester Medical Center have proposed a diagnostic algorithm which includes an evocative history of E_cigarette use in the last 90 days, a compatible clinical presentation with respiratory, gastrointestinal or systemic symptoms and suggestive radiological findings [11]

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[23] Today, the pipes often had several tubes to accommodate multiple smokers, or smokers would pass the nozzle around in the many smoking houses that functioned as social hubs in major centers of Muslim culture like Istanbul, Baghdad, and Cairo