MUNICH, Germany — The one and only exhibition stand for stethoscopes stood out at the European Society of Cardiology (ESC; Sophia Antipolis, France) congress here last week for being the lowest-tech display of products among acres of high-end imaging equipment, but also for the constant queuing up of cardiologists crowding the counter.

It was also the only exhibit booth where sales reps were taking direct orders and prominently displayed price lists.

Warren Wasescha, new product marketing manager for Littman Stethoscopes, a division of 3M Deutschland (Neuss, Germany), laughed at the suggestion he was being put out of business by the pocket ultrasound equipment being displayed all around him.

"The stethoscope remains not only the icon of medicine, it is essential for cardiology practice," he said.

"The stethoscope allows the doctor to touch the patient," which is the gold standard for clinical practice, Wasescha added. "And for the patient, this stethoscope is not as frightening as the high-end technology . . . in fact, it is reassuring."

Sale growth for 3M stethoscopes are running in double digits this year, he said.

"Among cardiologists, the stethoscope can be a fashion statement as well as a working tool," he said, the same way that businessmen judge each other by the cut and quality of a suit and tie.

"Cardiologists are medical professionals, not machine operators," he said.

"We have touch screens and key pads everywhere today for business tools, yet we all carry a pen and paper," he said, adding that the stethoscope is not threatened by the expanding role of higher-end technologies for clinical practice.

Move your mass to lose weight

In the fight against obesity, Aipermon (Munich) believes it is not the mass you are carrying around that is important but how much you move it that counts.

The company came across town to display to cardiologists at ESC some simple tools for monitoring patient activity as part of a personal health program to reduce weight by tracking motion.

The AiperSunny 333, sold for 160 ($85), is the low end, yet leading edge, for a line of motion detectors that use an extremely simple user interface to signal whether an individual has been sufficiently active during the day to meet goals for weight reduction.

The interface is the classic Happy Face, displayed as a smiling sun icon. If the sun is less-than-happy, the user needs to walk faster or climb some stairs to record a higher level of activity and score a radiating sun icon.

The one-ounce unit the size of a credit card clips onto the user's belt at the center of gravity and measures motion every 90 seconds, with a 3-D acceleration sensor keeping a record in the onboard memory chip.

Data can be stored for up to 21 days and transferred at any time to a computer loaded with software for a deeper analysis and for setting fitness levels for the untrained user, the moderately fit individual and the "sporty" person.

Moving up in sophistication is the AiperSunny 444 that includes a calorie counter.

The high end of the line is the AiperMotion, selling for 1300 ($428), which features more advanced 3-D sensors and a USB interface for downloading data.

To give an idea of the sophistication of the AiperMotion, head of business development for Aipermon, Christian Hirschbeck, said he wore the detector during a recent ski trip to Austria and once back at the home office after downloading his data was able to recreate images of the somersaults he performed on the slopes.

User data for advanced detectors can be transferred wirelessly through the Aipermon Homebox to an internet server over conventional telephone lines.

Patients can contract with a medical service center for monitoring data, useful for tracking Alzheimer's patients or fragile seniors who may experience a fall while gardening, shopping or other daily activities.

Ultrasound for extreme conditions

The fast-growing market for portable ultrasound in Europe is powering the growth of mid-sized imaging companies as well as the major manufacturers.

At the ESC congress, Esaote Group (Genoa, Italy) rolled out enhancements to its MyLab platform and the Imagic line from its affiliate Kontron (Plaisir, France), acquired in 2007.

The new MyLab 30 Gold Cardiovascular is a portable cardiovascular system that while remaining highly portable and battery-driven, can be hand-carried or mounted on a trolley to support applications for mobile response teams, emergency and critical care unites, or, for anesthesiologists in fixed surgical suites.

"It's an ambitious expansion of capabilities built for extreme requirements," a spokesman at the company's booth told Medical Device Daily.

Esaote showed an extension of its X-Strain technology across its line of portable ultrasound devices.

Originally introduced with the company's MyLab XVision series, the X-Strain advanced technique for myocardial function evaluation applies an innovative digital signal processing that Esaote licensed from Texas Instruments in 2006.

X-Strain is an angle-independent technology, enabling it to assess and to quantify cardio physiology, specifically the contractibility of both the left and the right ventricles as well as to estimate and quantify endocardial velocities of contraction and relaxation.

This allows cardiologists to detect early impairment of myocardial contractility far before an impairment of the pump function assessed as ejection fraction or stroke volume, Esaote's spokesman said.

The technique was demonstrated during an ESC symposium, "Cardiovascular Ultrasound: from Diagnosis to Predictive Value."

Included with the Esaote and Kontron units is a suite of data connectivity capabilities including real-time archiving, state-of-the-art health informatic peripheral configuration with DICOM compliance, and integrated wireless connection.

The interoperability of Esaote equipment with hospital information systems and competitors picture archiving systems was demonstrated at the European Integrating the Healthcare Enterprise Connect-a-thon in Oxford in April.

Esaote reported consolidated sales of 1281.5 million ($402.8 million) for 2007, a 8.2% increase over 2006 with international sales contributing 56% of revenue.

In November, 2007 Esaote said it sold 1,000 MyLab ultrasound scanners to the People's Republic of China for supplying 592 rural health care systems with diagnostic imaging systems.

The Kontron affiliate, created through the merger of the Hoffman La Roche (Basel, Switzerland) medical imaging group and Dassault (Paris) in 1970, claims that in France its ultrasound units can be found in one of every three cardiologists' offices.

In August, Esaote said it will go public on the Milan Stock Exchange before the end of this year, subject to "acceptable market conditions."