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Radiologists, Medical Physicists Collaborate to Make Imaging Procedures Safer

By MedImaging International staff writers
Posted on 09 Sep 2009

Radiologists recently reported that imaging procedures are a major source of ionizing radiation exposure in the United States, and that repeat exams can result in high cumulative doses of radiation.

The Radiological Society of North America (RSNA; Oak Brook, IL, USA) reaffirmed its commitment to patient safety in responding to a study and accompanying perspective on radiation dose from medical imaging procedures published in the August 27, 2009, in The New England Journal of Medicine (NEJM).

Reza Fazel, M.D., M.Sc., from Emory University School of Medicine (Atlanta, GA, USA), and colleagues from a number of U.S.-based medical institutions authored the report. A perspective in the same issue of NEJM by cardiologist Michael S. Lauer, M.D., director of the Divisions of Prevention and Population Sciences and of Cardiovascular Diseases at the [U.S.] National Heart, Lung, and Blood Institute (NHLBI; Bethesda, MD, USA), goes beyond that conclusion to assert that most medical imaging exams offer net negative results with little high-level evidence of benefit.

The article has elicited media and public attention to a topic that many radiology specialists believe should be at the forefront. It is important that one of the salient points from the authors not be overlooked, "an important reason for the growing use of such procedures stems from their ability to radically improve patient care.”

There is overwhelming agreement in the radiology community that specific imaging procedures carry risk, but with appropriate utilization, low-dose protocols, and implementation of programs that track cumulative dose in the patient's medical record, the potential benefits far outweigh that risk.

Radiologists, medical physicists, and other radiology professionals have long recognized that there needs to be conscientious implementation of medical procedures that deliver ionizing radiation and have assumed a collective responsibility for maintaining thorough standards of practice. Radiologists recognize their responsibility to implement and to follow appropriateness criteria for performing imaging exams. Recent studies have shown that the most significant growth in utilization of imaging procedures has occurred as the result of nonradiologist "self-referral.”

In addition to following strict appropriate imaging utilization standards, radiologists and medical physicists have worked together to improve the safety of imaging exams by minimizing dose without sacrificing diagnostic ability. They are directly involved in the development of technologies and protocols to ensure patient safety in medical imaging scenarios. Radiologic scientists are working closely with manufacturers to lower radiation doses to patients without losing image quality.

To increase awareness of cumulative dose and other radiation risks and to explore opportunities to improve patient safety, RSNA has partnered with the American College of Radiology (ACR; Philadelphia, PA, USA) to create the ACR/RSNA Task Force for Adult Radiation Protection. Launched in 2007 by the Alliance for Patient Safety in Pediatric Imaging, the "Image Gently” campaign seeks to raise awareness of pediatric radiation safety and to lower radiation dose in the imaging of children.

While cumulative dose risk remains a significant concern, programs are being initiated to track individual patients' medical imaging procedures and their associated radiation doses. The Radiology and Imaging Sciences at the U.S. National Institutes of Health Clinical Center recently announced computed tomography (CT) and positron emission tomography (PET)/CT equipment purchased by the Clinical Center would be required to record routinely radiation dose exposure in a patient's hospital-based electronic medical record. This represents a significant step to ensure the safety of patients who are exposed to ionizing radiation during imaging tests, according to the investigators.

Medical imaging exams are an invaluable tool in the diagnosis and treatment of patients, and radiology professionals will continue to strive to improve the safety of these exams.

Related Links:
Radiological Society of North America
Emory University School of Medicine
Cleveland Clinic Foundation
American College of Radiology

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61 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

62 (179.05235290527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

63 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

64 (146.15058898926): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

65 (504.97055053711): SELECT fid FROM jos_deeppockets WHERE id=294725344 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294725344 AND published='1' LIMIT 1

66 (46.968460083008): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

67 (80.108642578125): select jos_twitters.link from jos_twitters where cat=10

68 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

69 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

70 (52.928924560547): select jos_linkedin.link from jos_linkedin where cat=10

71 (85.115432739258): SELECT fid FROM jos_deeppockets WHERE id=294725344 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294725344 AND published='1' LIMIT 1

72 (36.954879760742): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

73 (386.95335388184): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294725344 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (270.84350585938): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294725344 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (61.988830566406): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

76 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (50.783157348633): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (46.014785766602): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294725344 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (38.862228393555): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294725344 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (36.001205444336): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

93 (50.783157348633): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (70.810317993164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

108 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

109 (61.03515625): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294725344 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (48.87580871582): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294725344 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

112 (55.789947509766): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

113 (47.922134399414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294725344 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (519.99092102051): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294725344 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (529.05082702637): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

116 (342.13066101074): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

118 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

119 (44.822692871094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

120 (38.14697265625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

121 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

122 (34.809112548828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

123 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

124 (35.04753112793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

125 (283.00285339355): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 19993.06678772): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

127 (515.93780517578): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294725344 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294725344 AND type='deeppockets_item' AND published='1' LIMIT 1

128 (!!!!! 7025.9571075439): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

129 (68.187713623047): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

131 (29.087066650391): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

132 (38.14697265625): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

133 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

134 (302.07633972168): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

135 (35.04753112793): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

136 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

137 (29.087066650391): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

138 (648.97537231445): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (516.89147949219): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (61.988830566406): SELECT name FROM jos_deeppockets WHERE id=215

141 (41.961669921875): SELECT name FROM jos_deeppockets WHERE id=215

142 (784.15870666504): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (720.97778320312): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (136.13700866699): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

145 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

146 (!!!!! 15920.877456665): TRUNCATE TABLE jos_trademed_module

147 (94.890594482422): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294725344 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (55.074691772461): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294725344 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (787.01972961426): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

152 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

153 (!!!!! 1131.0577392578): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

154 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

155 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

156 (33.855438232422): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294725344 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294725344 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (30.040740966797): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

158 (26.941299438477): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

159 (36.954879760742): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

161 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725344 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725344 AND published='1' LIMIT 1

162 (41.961669921875): select jos_twitters.link from jos_twitters where cat=10

163 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

164 (32.901763916016): select jos_google_plus.link from jos_google_plus where cat=10

165 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

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