Peak plantar pressure increases with loaded body weight. The midfoot area seems to be a sensitive area in case of adapting increasing foot load. Considering the clinical relevance, loaded body weight has to be seen as risk factor for increasing plantar pressure patterns and should be considered in recurrence of plantar ulcers or stress fractures.

The variations in plasma erythropoietin (EPO) concentration during preoperative deposit of autologous blood were studied in 12 patients (8 men, 4 women). Four donations were scheduled at weekly intervals. A predonation hemoglobin concentration of 11 g per dL (110 g/L) was required. Hemoglobin concentration decreased from 14.3 ± 1.1 g per dL (143 ± 11 g/L) (mean ± SD) before the first donation to 11.7 ± 0.7 g per dL (117 ± 7 g/L) on Day 22 (p<0.0001). Reticulocyte counts increased from a median of 31,800 (range, 4900-95,000) per \xL (median, 32 x 10 9 /L [range, 5-95 x 10 9 /L]) to 93,800 (16,800-194,900) per \iL (median, 94 x 10 9 /L [range, 17-195 x 10 9 /L]) on Day 28 (p<0.01). Plasma EPO concentration was 17.8 ± 5.1 mU per mL prior to the first donation and displayed a small and transient peak after each donation. A sustained elevation followed each peak. Although plasma EPO concentration differed significantly from the baseline value after the first donation, only the peak concentrations after the second (35.5 ± 15.5 mU/mL), third (38.0 ± 14.5 mU/ mL), and fourth (36.1 ±11.0 mU/mL) donations exceeded the normal range. The moderate, biphasic increase in plasma EPO concentration and the moderate increase in erythropoiesis suggest two strategies in autologous blood donation that should be investigated with respect to efficiency and safety: 1) more aggressive donation schemes, which reduce donation intervals and/or the minimum hemoglobin concentration and 2) the administration of recombinant human EPO. TRANSFUSION 1991;31:650-654. Abbreviations: EPO = erythropoietin.THE IMMUNOLOGIC AND INFECTIOUS risks of transfusion 1,2 can be minimized by the use of autologous blood. Preoperative autologous blood donation considerably reduces homologous transfusion requirements in surgery. 3 " 8 Frozen storage of red cells allows the preoperative deposit of a large number of blood units, but it is costly and time-consuming. On the other hand, liquid storage is limited to 5 weeks for whole blood and 7 weeks for packed red cells. 9,10 The efficiency of preoperative deposit in the liquid state thus depends on the rate of recovery from blood loss, that is, on the degree of stimulation of erythropoiesis.Erythropoietin (EPO) is the primary humoral regulator of erythropoiesis. 11 Increasing the availability of EPO may therefore enhance the efficiency of preoperative donation programs. This increased availability of EPO may be achieved by allowing the modulation of donation schemes (shorter donation intervals, lower minimum

Hindfoot relief shoes leave a considerable amount of peak pressure, predominantly under the hindfoot. The extent of peak pressure reduction for the heel and the hindfoot varies between different hindfoot relief shoes. Depending on the affected foot area, the kind of hindfoot relief shoe should be carefully chosen.

In running, soccer boots generate excessive foot loadings predominantly under the lateral midfoot, as compared with running shoes. Players should be trained with a thoughtfully designed workout regimen that allows performing as many straight running exercises as possible in running shoes instead of soccer boots. This may help to prevent fifth metatarsal stress fractures in elite male soccer players.

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The Vacoped® vacuum ankle orthosis significantly reduces plantar peak pressure. The integrated physical strain trainer seems unsuitable to monitor a limitation to 10% BW adequately for the total foot. The concept of controlling partial weight bearing with the hindfoot-addressing device within the orthosis seems debatable but may be useful when the hindfoot in particular must be off-loaded.

The neutral shoe is a feasible tool to assess reference values for dynamic pedobarography. Such a reference tool may help to standardise several steps in the development and construction of shoes and orthotic devices.

As can be seen from the perspective of foot load, the intact function of adjacent joints seems to compensate an extension lag of the knee joint up to 20 degrees, but hindfoot load changes significantly with 30 degrees or more, which may be clinically relevant for patients at risk of plantar ulcerations.