Background/aims-Cryptogenetic multifocal ulcerous stenosing enteritis (CMUSE) is a rare disease whose origin is unknown. The aim of this study was to describe the clinical spectrum of CMUSE, to determine the origin and pathophysiology of the disease, and to propose a treatment strategy. Methods-A total of 220 French gastroenterology departments were contacted to review patients with unexplained small bowel strictures. Of 17 responses, 12 corresponded to a diagnosis of CMUSE. These patients were hospitalised between 1965 and 1993 and their medical records were reviewed. Results-All patients (mean age 42.1 (4.4) years) had intestinal and five had extraintestinal symptoms (peripheral neuropathy, buccal aphthae, sicca syndrome, polyarthralgia, Raynaud's phenomenon, arterial hypertension). One patient had heterozygous type I C2 deficiency (28 base pair gene deletion). Two to 25 (mean 8.3 (1.9)) small intestine strictures were found. Stenoses of the large jejunoileal arteries were observed on two and aneurysms on three of five mesenteric angiograms. Despite surgery, symptoms recurred in seven of 10 patients and strictures in four. Steroid therapy was eVective but caused dependence. One untreated patient died. Small bowel pathology showed superficial ulceration of the mucosae and submucosae, and an inflammatory infiltrate made of neutrophils and eosinophils. Conclusions-CMUSE is an independent entity characterised by steroid sensitive inflammation of the small bowel which often recurs after surgery. CMUSE may be related to a particular form of polyarteritis nodosa with mainly intestinal expression or with an as yet unclassified vasculitis. (Gut 2001;48:333-338)

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Poor social support is a contributory factor in development of addictive disorders, but it has rarely been evaluated in pathological gamblers. This study examined social support in pathological gamblers and its relationship with treatment outcomes. Low baseline social support was associated with increased severity of gambling, family, and psychiatric problems and poorer post-treatment outcomes. Further, social support assessed post-treatment was significantly related to severity of gambling problems at the 12-month follow-up. These findings demonstrate that social support plays an important role in moderating outcomes, and enhancing social support may be an important aspect of effective gambling treatments.

Environmental, interpersonal, and psychological factors contribute to gambling, but no standardized instrument for assessing high-risk gambling situations exists. This study evaluates the factor structure of the Inventory of Gambling Situations (IGS), a newly developed measure to examine situations that precipitate gambling. Pathological gamblers (n = 233) beginning a treatment study completed the IGS. Principal component analysis revealed that a 5-factor solution best fit the data, representing items related to Negative Affect, Luck and Control, Positive Affect, Social Situations, and Gambling Cues. Overall, Cronbach alpha was 0.960, ranging from 0.820 to 0.935 for the 5 factors. IGS scores correlated with other indices of gambling problems. Women scored higher on the Gambling Cues factor than men, and younger respondents, regardless of gender, scored higher on the Luck and Control factor than older respondents. The IGS may assist in better understanding situations in which pathological gamblers wager, and individual differences with respect to these situations.