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In Veterans with PTSD, PET/CT Imaging Reveals Pituitary Abnormalities

By MedImaging International staff writers
Posted on 16 Dec 2014

Image: PET/CT on the left and an MRI on the right demonstrating the relative locations of both the hypothalamus and the pituitary (Photo courtesy of RSNA).

Hybrid imaging with positron emission tomography and computed tomography (PET/CT) in the pituitary region of the brain has been shown to be a potential new approach for distinguishing military veterans with post-traumatic stress disorder (PTSD) from those with mild traumatic brain injury (MTBI).

The study’s findings were presented at the annual meeting of the Radiological Society of North America (RSNA), held November 30 to December 5, 2014, in Chicago (IL, USA). Moreover, these findings build support to the hypothesis that many veterans diagnosed with PTSD may actually have hormonal irregularities caused by pituitary gland damage from blast injury.

MTBI involves injury to the brain from an external force, while PTSD is typically defined as a mental health disorder that can develop after someone has experienced a traumatic event. Research has shown that up to 44% of returning veterans with MTBI and loss of consciousness also meet the criteria for PTSD. Differentiating PTSD from MTBI can be problematic for clinicians because of symptom overlap, and in many instances, normal structural neuroimaging results.

Researchers recently used PET/CT to study the hypothalamus and pituitary glands of veterans who had suffered blast-related MTBI. The pituitary gland is a pea-sized structure that sits in the bony enclosure located at the base of the skull and is connected to a part of the brain called the hypothalamus. Together with the adrenal glands above each kidney, the hypothalamus and pituitary gland form the HPA axis, an important regulator of many body processes, including mood, stress response, and energy expenditure.

“The HPA axis is a complex system with a feedback loop, so that damage to any one of the three areas will affect the others,” said study lead author Thomas M. Malone, BA, from the department of neurosurgery at Saint Louis University School of Medicine (Saint Louis, MO, USA). “It’s suspected of playing an important role in PTSD, but there is limited neuroimaging research in the veteran population.”

The investigators centered on ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET/CT, which provides a picture of metabolism by measuring uptake of the radiopharmaceutical FDG. A review of 159 brain ¹⁸F-FDG PET/CT scan records revealed that FDG uptake in the hypothalamus was significantly lower in the MTBI-only group compared with normal controls. FDG uptake in the pituitary gland was substantially raised in the MTBI and PTSD group compared with the MTBI-only group.

The finding of higher FDG uptake in the pituitary glands of PTSD sufferers supports the theory that many veterans diagnosed with PTSD may actually have hypopituitarism, a condition in which the pituitary gland does not produce normal amounts of one or more of its hormones. “This raises the possibility that some PTSD cases are actually hypopituitarism masking itself as PTSD,” Dr. Malone said. “If that’s the case, then we might be able to help those patients by screening for hormone irregularities and treating those irregularities on an individual basis.”

Dr. Malone reported that the increased FDG uptake in the pituitary glands of veterans with MTBI and PTSD may be due to the gland working harder to produce hormones. “It’s analogous to having your car stuck in the snow and you keep flooring the gas pedal but you don't go anywhere,” he said.

The findings suggest that PET/CT may provide an effective way to diagnose and differentiate PTSD from MTBI and offer more clues into the biologic manifestations of the disorder. “This study sheds light on the complex issue of PTSD, which also has symptom overlap with depression and anxiety,” Dr. Malone concluded. “Currently, treatment for PTSD is typically limited to psychological therapy, antidepressants and anxiety medications. Our findings reinforce the theory that there is something physically and biologically different in veterans who have MTBI and PTSD compared to those who just have MTBI.”

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Saint Louis University School of Medicine

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62 (616.07360839844): SELECT fid FROM jos_deeppockets WHERE id=294756212 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294756212 AND published='1' LIMIT 1

63 (356.91261291504): 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=213 ORDER BY `ordering`

64 (60.081481933594): select jos_twitters.link from jos_twitters where cat=10

65 (36.001205444336): select jos_facebook.link from jos_facebook where cat=10

66 (46.014785766602): select jos_google_plus.link from jos_google_plus where cat=10

67 (36.001205444336): select jos_linkedin.link from jos_linkedin where cat=10

68 (42.200088500977): SELECT fid FROM jos_deeppockets WHERE id=294756212 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294756212 AND published='1' LIMIT 1

69 (38.862228393555): 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=213 ORDER BY `ordering`

70 (316.85829162598): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756212 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (298.02322387695): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756212 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (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`

73 (105.85784912109): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (65.088272094727): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (62.942504882812): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756212 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (38.14697265625): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756212 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (41.961669921875): 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 (80.108642578125): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

105 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

106 (84.161758422852): 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=294756212 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (72.002410888672): 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=294756212 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (104.18891906738): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

109 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

110 (71.048736572266): 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=294756212 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (653.98216247559): 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=294756212 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (804.90112304688): 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 (622.98774719238): 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 (203.84788513184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

115 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

116 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

117 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

118 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

119 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

120 (416.04042053223): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 31072.854995728): 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

122 (146.15058898926): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

123 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

124 (597.95379638672): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756212 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756212 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 828639.98413086): ( 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 (!!!!! 1190.9008026123): ( 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 (571.01249694824): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (36.001205444336): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (37.193298339844): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (32.186508178711): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (687.1223449707): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (663.04206848145): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (323.05717468262): SELECT name FROM jos_deeppockets WHERE id=213

136 (32.901763916016): SELECT name FROM jos_deeppockets WHERE id=213

137 (815.86837768555): 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 '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (404.11949157715): 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 '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (320.9114074707): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

140 (300.16899108887): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

141 (!!!!! 14227.151870728): TRUNCATE TABLE jos_trademed_module

142 (480.89027404785): 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=294756212 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (82.015991210938): 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=294756212 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (405.78842163086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

147 (!!!!! 2570.1522827148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

148 (!!!!! 1341.1045074463): 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

149 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

150 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

151 (77.009201049805): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756212 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756212 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (36.001205444336): 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=213 or channel_id is null)

153 (31.948089599609): 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=213 or channel_id is null)

154 (33.855438232422): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 3370.0466156006): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

156 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756212 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756212 AND published='1' LIMIT 1

157 (80.108642578125): select jos_twitters.link from jos_twitters where cat=10

158 (37.908554077148): select jos_facebook.link from jos_facebook where cat=10

159 (34.809112548828): select jos_google_plus.link from jos_google_plus where cat=10

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

161 (293.01643371582): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1173.0194091797): insert into jos_banners_delta values (14615,'2025-05-02 10:23:58','3.131.95.159','view'),(14202,'2025-05-02 10:23:58','3.131.95.159','view'),(14203,'2025-05-02 10:23:58','3.131.95.159','view')

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