Disease and Health Research: Recent Developments Vol. 4

Psychological Principles in the Health-Illness Continuum: A Conceptual Framework for Understanding Patient Behavior and Well-Being Interventions

Priya Magesh — Wed, 28 Oct 2026 00:00:00 +0000

Psychological processes influence how symptoms are interpreted, care is sought, treatment is negotiated and living with illness is accommodated, yet the field often fragments these processes into separate theories of risk perception, health behaviour, emotional adjustment and clinical outcomes. This critical narrative review examines how psychological principles can be organised across a dynamic health–illness continuum without reducing health to either disease status or subjective happiness. Scholarly evidence published from 1977 to 14 August 2026 was considered, combining foundational conceptual contributions with peer-reviewed systematic reviews, meta-analyses and intervention studies. The synthesis examines illness representations, motivation and self-efficacy, stress and emotion regulation, social relationships, patient activation, health literacy, shared decisions and structural opportunity. Evidence supports the value of psychologically informed interventions for selected proximal outcomes, particularly distress reduction, treatment knowledge and self-care capabilities. Translation to sustained behaviour, biological outcomes and equitable improvement is more variable. The strongest interventions address identifiable mechanisms while recognising the interaction of individual resources with treatment burden, care-system design and material constraints. A proposed multilevel, feedback-based framework connects changing illness demands and social conditions with appraisal, affect, capability, action, clinical experience and personally valued functioning. It distinguishes established associations from pathways requiring prospective and experimental validation. Major limitations in the literature include conceptual overlap, heterogeneous intervention components, short follow-up, common-method measurement, inadequate reporting of implementation fidelity and under-representation of disadvantaged groups. A continuum-oriented approach should therefore use repeated multidimensional assessment, collaborative formulation and proportionate intervention choice rather than assigning patients to fixed psychological stages. Future studies should test temporal mechanisms, clinically meaningful endpoints, treatment burden and distributional consequences in diverse settings. The framework offers a theoretically coherent basis for designing and evaluating patient-centred well-being interventions, not an independently validated predictive model.

Knee–Spine Syndrome: Current Concepts in Pathomechanics, Clinical Evaluation, and Management

Balaji Zacharia — Wed, 28 Oct 2026 00:00:00 +0000

Knee–spine syndrome describes the coexistence and biomechanical interaction of degenerative disorders affecting the knee and lumbar spine, particularly in older adults. Degeneration or deformity in either region may alter posture, gait, pelvic orientation, lumbar lordosis, and lower-limb alignment, producing compensatory changes throughout the hip–pelvis–spine–knee kinetic chain. Knee flexion contracture associated with osteoarthritis may contribute to posterior pelvic compensation and reduced lumbar lordosis, whereas sagittal spinal imbalance may promote compensatory knee flexion to maintain an upright posture. Because symptoms arising from knee osteoarthritis and lumbar degenerative disease may overlap, identifying the predominant source of pain and functional limitation can be challenging. Evaluation therefore requires a detailed clinical examination together with appropriate standing knee, lower-limb, and spinal imaging, with magnetic resonance imaging or neurophysiological investigations used selectively when neurological pathology is suspected. Initial management generally includes conservative measures directed at the predominant symptomatic disorder. When surgery is required, treatment sequencing should consider neurological urgency, the severity of knee deformity, predominant symptoms, and overall sagittal alignment. Total knee arthroplasty can correct knee deformity and may improve some pelvic and global compensatory parameters, although established degenerative spinal abnormalities and lumbar lordosis may show limited correction. Comprehensive assessment of both the knee and spine is therefore important for appropriate treatment planning and realistic functional expectations.

The Multimarker Approach in Acute Coronary Syndrome: Integrating Markers of Myocardial Injury, Ischemia, Inflammation and Cardiac Dysfunction

Sangita M. Patil, Pradnya Padalkar — Wed, 28 Oct 2026 00:00:00 +0000

Background: Acute coronary syndrome (ACS) involves myocardial ischaemia, injury, inflammatory activation, and ventricular dysfunction; no single biomarker fully reflects these processes.

Objective: This narrative review examines how combining biomarkers from distinct pathophysiological domains may support diagnosis and risk stratification without displacing validated cardiac troponin pathways.

Methods: A structured narrative synthesis was undertaken using publications identified in PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar, principally spanning January 2015 to September 2026, with earlier landmark papers also considered. Evidence was organised into four domains: myocardial injury, ischaemia or early cellular stress, inflammation, and cardiac dysfunction.

Findings: High-sensitivity cardiac troponin I and T remain the preferred biomarkers for detecting myocardial injury and informing the diagnosis of acute myocardial infarction in conjunction with clinical evidence of ischaemia. Ischaemia-modified albumin, heart-type fatty acid-binding protein, copeptin, and related biomarkers have been investigated as adjuncts, but their incremental diagnostic performance is variable. High-sensitivity C-reactive protein and other inflammatory markers may provide information about inflammatory burden and prognosis. B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide reflect myocardial wall stress and may contribute to assessment of subsequent heart failure and mortality risk.

Conclusions: Multimarker assessment may provide complementary prognostic information, particularly when integrated with clinical examination, electrocardiography, imaging, and established risk scores. Its broader adoption requires standardised assays, clinically useful thresholds, prospective validation, and evidence that additional testing improves decision-making and outcomes.