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Guidelines Established for Preventing MRSA Infections in MRI Scanning

By MedImaging International staff writers
Posted on 08 Dec 2008

There is a growing concern that patients may contract methicillin-resistant Staphylococcus aureus (MRSA) infections when undergoing magnetic resonance imaging (MRI) scanning. This concern is based on a combination of highly contagious patients being scanned at MRI centers that lack even the most rudimentary infection control procedures.

Dr. Peter Rothschild, M.D., a recognized expert in open MRI technology and former medical director of the research laboratory at the University of California, San Francisco (USA) where he helped develop the first commercially available open MRI scanner), has developed guidelines that encompass 11 steps for infection control in MRI with the assistance of the Infectious Disease Control division of The Joint Commission (Oakbrook Terrace, IL, USA). This report is meant to be a guideline for imaging centers and hospital radiology departments to develop their own infectious disease policies.

According to Dr. Rothschild, these 11 steps should be thought of as baseline procedures necessary to assure patient safety from life-threatening infectious diseases during their MRI. Each imaging center or hospital radiology department should develop procedures that meet their own specific needs. When writing procedures, personnel at mobile MRI units should also address the unique concerns of the mobile environment, such as the lack of a sink and running water, necessary for hand washing.

Some of the procedures may not be appropriate for every MRI center. However, having no written procedures at all is an unacceptable situation that relies upon the individual MRI technologist to decide what, if anything, he or she thinks is appropriate. Very few of these technologists have a thorough understanding of infectious disease control. Therefore, a policy that is well thought through will not only protect patients but will protect MRI centers in case of an MRSA lawsuit. Unfortunately, there are an increasing number of law firms specializing in MRSA lawsuits, and without an infection control policy it would be very difficult, if not impossible, to defend the center, particularly after MRSA was cultured from the pads or the bore of the MRI unit.

The most common source for transmission of MRSA is by direct or indirect contact with individuals who have MRSA infections or are asymptomatic carriers. A major concern for imaging centers is MRSA carried by asymptomatic patients. Worldwide, it is estimated that up to 53 million people are asymptomatic carriers of MRSA. Of these, it is estimated that 2.5 million reside in the United States. About 1% of the U.S. population is colonized with MRSA. Both infected and colonized patients contaminate their environment with the same relative frequency.

The morbidity and mortality of these bacteria is staggering. On average, hospitalizations for the treatment of MRSA versus other infections have a length of stay approximately three times longer and are three times more expensive. Moreover, the risk of death is three to five times greater for patients infected with MRSA versus methicillin-sensitive Staph infections.

Any patient lying on an imaging table could be a carrier capable of contaminating surfaces in the radiology suite. MRSA and other pathogens can live on and in common MRI table pads and positioners for periods as long as several months.

At many MRI centers, there exists a mistaken belief that just by placing a clean sheet over contaminated table pads, without actually cleaning them between patients, will somehow prevent the spread of infectious agents. What is most concerning is that very few MRI centers routinely clean their pads even once a day, much less between patients. Moreover, almost all pad sets Dr. Rothschild reported that he has seen in use that are over a few years old are torn or frayed, and should have been discarded long ago. Old, torn, and frayed pads are impossible to properly clean and are a breeding ground for bacteria.

This is why many of the 11 steps are centered on the pads that come in contact with the patient, according to Dr. Rothschild. For example, using a magnifying glass to thoroughly examine all the seams for tears or fraying and the use of a black light to check pads for biologic contamination are critical to prevent spread of infection. This will be the first thing an expert witness in a court case will do. However, few, if any MRI centers have adopted even these simple safety procedures.

Another area of great concern, according to Dr. Rothschild, is the lack of special procedures for dealing with highly contagious patients, particularly at outpatient imaging centers as well as mobile centers. These patients are simply put on the table and scanned and the next patient, possibly an immunosuppressed child with a sprained knee, is put on the table directly after this highly contagious patient without cleaning the table, pads, or washing their hands. This can be, Dr. Rothschild reported, a serious situation and infection control procedures must be in place to protect patients.

Dr. Rothschild has created a video concerning these issues (please see related links below). It provides additional insight into understanding how to perform these procedures and why they are very important.

Suggestions for infection control procedures for free-standing imaging centers and hospital radiology departments include: (1) Have a written infectious control policy to include MRI cleaning procedures as well as the cleaning schedule and have it posted throughout the center. (2) Implement a mandatory hand-washing/hand-sanitizing procedure between patient exams for technologists and any others who come into contact with patients. (3) Clean the MRI tables, inside the bore of the magnet and any other items that come into contact with a patient. Infection control experts recommend this be done between each patient. (4) Clean all pads and positioners with an approved disinfectant. Infection control experts recommend cleaning after each patient. (5) Periodically inspect the pads with a magnifying glass, particularly at the seams, to identify fraying or tearing. If present, the pads should be replaced. (6) Regularly check all padding material with an ultraviolet (black) light and make sure that any biologic material detected on the pads can be removed. (7) Replace damaged or contaminated pads with new pads incorporating permanent antimicrobial agents. (8) Use pillows with a waterproof covering that is designed to be surface wiped. Replace pillows when their barrier is compromised. (9) Promptly remove body fluids, and then surface disinfect all contaminated areas. (10) If a patient has an open wound or any history of MRSA/other infection: (a) gloves and gowns should be worn by all staff coming in contact with the patient. These barriers must be removed before touching other areas not coming in contact with the patient, i.e., door knobs, scanner console, and computer terminals; (b) the table and all the pads should be completely cleaned with disinfectant before the next patient is scanned, if it is not already being performed between every patient. For patients with any known infectious process, add 10-15 minutes onto the scheduled scan time to assure there is enough time to thoroughly clean the room and all the pads. (11) Lastly, all furniture should be periodically cleaned. Ideal surfaces are those that are waterproof and wipeable. Infection control experts recommend this be done between each patient.

Dr. Rothschild is founder and president of Patient Comfort Systems, Inc. (Hayward, CA, USA), a company focused on patient comfort and safety.

Related Links:
The Joint Commission
Patient Comfort Systems
Video: MRSA and Lack of Infection Control in MRI

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49 (775.81405639648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

50 (91.791152954102): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

51 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

52 (367.16461181641): SELECT name FROM jos_deeppockets WHERE id=294721307 LIMIT 1

53 (269.88983154297): SELECT name FROM jos_deeppockets_archive WHERE id=294721307 LIMIT 1

54 (55.789947509766): SELECT a.* FROM jos_components AS a WHERE ( a.admin_menu_link = 'option=com_syndicate' OR a.admin_menu_link = 'option=com_syndicate&hidemainmenu=1' ) AND a.option = 'com_syndicate'

55 (80.108642578125): 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=294721307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

56 (412.94097900391): 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=294721307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

57 (!!!!! 1266.9563293457): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

58 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

59 (120.87821960449): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

60 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

61 (82.969665527344): 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

62 (503.0632019043): SELECT fid FROM jos_deeppockets WHERE id=294721307 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294721307 AND published='1' LIMIT 1

63 (305.17578125): 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=212 ORDER BY `ordering`

64 (44.822692871094): select jos_twitters.link from jos_twitters where cat=10

65 (28.848648071289): select jos_facebook.link from jos_facebook where cat=10

66 (29.802322387695): select jos_google_plus.link from jos_google_plus where cat=10

67 (27.894973754883): select jos_linkedin.link from jos_linkedin where cat=10

68 (35.04753112793): SELECT fid FROM jos_deeppockets WHERE id=294721307 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294721307 AND published='1' LIMIT 1

69 (32.901763916016): 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=212 ORDER BY `ordering`

70 (277.99606323242): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (207.90100097656): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (63.180923461914): 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`

73 (54.836273193359): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (730.99136352539): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (39.815902709961): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (39.815902709961): 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`

90 (132.79914855957): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (149.96528625488): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (252.00843811035): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (57.93571472168): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (148.05793762207): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (259.8762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (87.976455688477): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (401.97372436523): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (202.17895507812): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

105 (270.84350585938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

106 (65.803527832031): 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=294721307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (242.94853210449): 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=294721307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (107.0499420166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

109 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

110 (402.92739868164): 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=294721307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 5280.9715270996): 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=294721307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (512.12310791016): 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

113 (351.90582275391): 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

114 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

115 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

116 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

117 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

118 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

119 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

120 (173.80714416504): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

121 (!!!!! 1644.1345214844): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

122 (202.89421081543): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 49150.943756104): 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

124 (!!!!! 5991.9357299805): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721307 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721307 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 16476.86958313): ( 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

126 (112.77198791504): ( 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

127 (446.79641723633): 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

128 (54.121017456055): 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

129 (293.01643371582): 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

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 = 294803276 LIMIT 1

131 (252.96211242676): 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

132 (36.001205444336): 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

133 (236.98806762695): 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

134 (46.968460083008): 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

135 (574.11193847656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (552.17742919922): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (344.03800964355): SELECT name FROM jos_deeppockets WHERE id=212

138 (52.928924560547): SELECT name FROM jos_deeppockets WHERE id=212

139 (725.98457336426): 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 '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (689.98336791992): 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 '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (!!!!! 5378.0078887939): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

142 (68.187713623047): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

143 (!!!!! 11688.947677612): TRUNCATE TABLE jos_trademed_module

144 (80.108642578125): 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=294721307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (907.18269348145): 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=294721307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (423.90823364258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (!!!!! 3915.0714874268): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (180.95970153809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

149 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

150 (!!!!! 1481.0562133789): 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

151 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

152 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

153 (47.206878662109): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721307 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721307 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (41.007995605469): 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=212 or channel_id is null)

155 (35.04753112793): 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=212 or channel_id is null)

156 (87.02278137207): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (164.98565673828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

158 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721307 AND published='1' LIMIT 1

159 (61.03515625): select jos_twitters.link from jos_twitters where cat=10

160 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

161 (55.074691772461): select jos_google_plus.link from jos_google_plus where cat=10

162 (37.908554077148): select jos_linkedin.link from jos_linkedin where cat=10

163 (315.90461730957): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1127.0046234131): insert into jos_banners_delta values (14615,'2025-06-30 03:18:15','216.73.216.249','view'),(14202,'2025-06-30 03:18:15','216.73.216.249','view'),(14203,'2025-06-30 03:18:15','216.73.216.249','view')

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