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Blast-Related Brain Injuries Detected with Diffusion Tensor MRI

By MedImaging International staff writers
Posted on 20 Jun 2011

Image: Colored 3D diffusion tensor imaging (DTI) scan of the bundles of white matter nerve fibers in the cerebellum (Photo courtesy of Simon Fraser / Science Photo Library).

An imaging technique has revealed that some US military personnel with mild blast-related traumatic brain injuries have abnormalities in the brain that have not been seen with other types of imaging. The abnormalities were found in the brain's white matter.

The study is reported June 2, 2011, in the New England Journal of Medicine (NEJM) by scientists from Washington University School of Medicine in St. Louis (MO, USA) and the Landstuhl Regional Medical Center (Landstuhl, Germany).They evaluated 84 US military personnel evacuated to Landstuhl from Iraq and Afghanistan after exposure to many types of explosive blasts. Abnormalities were seen in 18 of 63 patients diagnosed with mild traumatic brain injury, but not among 21 injured in other ways.

Traumatic brain injuries are estimated to have affected as many as 320,000 military personnel in the wars in Iraq and Afghanistan. Most of these are classified as mild traumatic brain injuries (concussions). "We call these injuries ‘mild,' but in reality they sometimes can have serious consequences," said senior author David L. Brody, MD, PhD, assistant professor of neurology at Washington University School of Medicine in St. Louis.

In the new study, white matter abnormalities were detected using an advanced magnetic resonance imaging method called diffusion tensor magnetic resonance imaging (MRI). Diffusion tensor imaging allows scientists to evaluate the movement of water in tissue. Changes in the patterns of water movement are often linked to injury or disease, but the significance of the abnormalities seen in the military service personnel is not yet fully understood.

Mild traumatic brain injury has been a controversial topic, and the new approach may provide an additional tool to help resolve some of the debate. Much of the controversy has revolved around whether symptoms following mild traumatic brain injuries are due to structural injury to the brain, disruptions in brain chemistry, psychological factors or a combination of these.

"There is still a lot more work to be done before we fully understand whether these abnormalities truly represent significant damage to the brain white matter," said lead author Christine L. Mac Donald, PhD, research instructor in neurology at Washington University. "And if so, this damage affects attention, memory, emotional regulation, balance, coordination, sleep, and other functions. Likewise, the relationship between mild traumatic brain injury and posttraumatic stress disorder is especially important. Our ongoing studies will hopefully start to answer some of these questions."

Researchers have utilized diffusion tensor magnetic resonance imaging (MRI) to examine mild civilian brain injuries previously and did not see abnormalities in the regions highlighted by the new study. These regions included the orbitofrontal cortex, an area involved in emotional regulation and reward-based behaviors, and the cerebellum, an area linked to coordination, movement, organization, and planning.

These regions were predicted to be particularly susceptible to blasts based on earlier published computer simulations. The findings suggest that there may be basic differences between blast-related traumatic brain injuries and the sorts of mild traumatic brain injuries sustained by civilians, such as those caused by car accidents, falls, blows to the head and sports injuries.

Moreover, advanced imaging also showed abnormalities in areas of the brain known to be harmed in civilian trauma. Military personnel in the study all had blast-related injuries plus other injuries such as falls, motor vehicle crashes, or being struck by blunt objects. The precise contribution of blast effects versus other injuries could not be fully determined in the study.

Up to one year after injury, the white matter abnormalities were still detectible, though their appearance on the scans had changed over time. The Landstuhl Regional Medical Center has been the central triage point for the wars in Iraq and Afghanistan for many years and is the closest hospital with an effective MRI scanner.

Dr. Brody emphasized that mild traumatic brain injury is still a diagnosis based on a history of an injury to the head that causes loss of consciousness, memory loss, confusion, or other disruption in the function of the brain. "A negative MRI scan, even with these advanced methods, does not rule out mild traumatic brain injury," he noted. "These MRI-based methods show great promise, but are not yet ready to be used in routine clinical practice."

Dr. Brody stated he believes the approach used in the study may prove helpful in military and civilian contexts and in children and adults. "Our hope is that these advanced MRI-based methods will one day help make more accurate diagnoses, assist with triage and allow treatment interventions to start early for people with traumatic brain injuries," he said.

Related Links:
Washington University School of Medicine in St. Louis
Landstuhl Regional Medical Center

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56 (487.08915710449): 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=294735643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

57 (!!!!! 1418.8289642334): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

58 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

59 (133.03756713867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

60 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

61 (99.897384643555): 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 (785.82763671875): SELECT fid FROM jos_deeppockets WHERE id=294735643 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294735643 AND published='1' LIMIT 1

63 (460.86311340332): 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 (65.088272094727): select jos_twitters.link from jos_twitters where cat=10

65 (38.862228393555): select jos_facebook.link from jos_facebook where cat=10

66 (37.908554077148): select jos_google_plus.link from jos_google_plus where cat=10

67 (61.03515625): select jos_linkedin.link from jos_linkedin where cat=10

68 (60.081481933594): SELECT fid FROM jos_deeppockets WHERE id=294735643 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294735643 AND published='1' LIMIT 1

69 (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=212 ORDER BY `ordering`

70 (361.91940307617): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (231.98127746582): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (43.153762817383): 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 (120.87821960449): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (53.167343139648): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (56.982040405273): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (40.054321289062): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (48.160552978516): 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 (73.19450378418): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (105.14259338379): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

105 (149.01161193848): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

106 (69.141387939453): 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=294735643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (52.928924560547): 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=294735643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

109 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

110 (50.783157348633): 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=294735643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (663.04206848145): 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=294735643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (519.0372467041): 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 (320.9114074707): 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 (109.19570922852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

115 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

116 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

117 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

118 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

119 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

120 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

121 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

122 (304.9373626709): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 22219.896316528): 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 (623.94142150879): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735643 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735643 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 8450.984954834): ( 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 (127.07710266113): ( 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 (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

128 (30.040740966797): 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 (36.001205444336): 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 (41.007995605469): 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 (309.22889709473): 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 (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

134 (27.894973754883): 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 (560.99891662598): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (461.10153198242): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (277.99606323242): SELECT name FROM jos_deeppockets WHERE id=212

138 (41.007995605469): SELECT name FROM jos_deeppockets WHERE id=212

139 (771.99935913086): 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 (620.12672424316): 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 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

142 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

143 (!!!!! 10292.053222656): TRUNCATE TABLE jos_trademed_module

144 (160.93254089355): 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=294735643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (76.055526733398): 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=294735643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (559.80682373047): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

149 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

150 (!!!!! 1445.0550079346): 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 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

152 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

153 (59.843063354492): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735643 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735643 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (49.114227294922): 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 (61.988830566406): 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 (63.896179199219): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (126.83868408203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

158 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735643 AND published='1' LIMIT 1

159 (68.187713623047): select jos_twitters.link from jos_twitters where cat=10

160 (37.908554077148): select jos_facebook.link from jos_facebook where cat=10

161 (41.961669921875): select jos_google_plus.link from jos_google_plus where cat=10

162 (39.100646972656): select jos_linkedin.link from jos_linkedin where cat=10

163 (389.09912109375): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1327.9914855957): insert into jos_banners_delta values (14615,'2025-06-27 07:27:43','216.73.216.249','view'),(14202,'2025-06-27 07:27:43','216.73.216.249','view'),(14203,'2025-06-27 07:27:43','216.73.216.249','view')

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