I have stumbled a few times on the expression "capish" (I'm not sure how to spell it), if I'm not mistaken it's of Italian origin and means something like "you get it?". The question I have is how widely spread is it in modern American English?

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Capiche. It is Italian for “do you understand.” It is not widely used in the US, except for areas on the east coast (mostly NY & NJ) which have a larger population of Italian descendants.

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Yes, it is very mafiosi, I think it is Capisce, which means “ do you understand?”