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Altepase Treatment Clears Deep Vein Clots

By HospiMedica staff writers
Posted on 13 Feb 2008

Image: Digitized light micrograph of a cross section of a blocked vein: a condition known as deep vein thrombosis (DVT) (Photo courtesy of CMSP / SPL).

A recent report described a novel treatment for deep vein thrombosis (DVT) that effectively cleared the clot while reducing the risk of subsequent recurrence or bleeding.

DVT commonly affects the leg veins, such as the femoral vein or the popliteal vein or the deep veins of the pelvis. Occasionally the veins of the arm are affected (known as Paget-Schrötter disease). Thrombophlebitis is the more general class of pathologies of this kind. There is a significant risk of the thrombus embolizing and traveling to the lungs causing a pulmonary embolism.

Investigators at the [U. S.] National Institutes of Health (Bethesda, MD, USA) sought a treatment regimen that would allow direct clearance of the clot without requiring continuous infusion of a thrombolytic agent. They chose to work with the drug alteplase (tissue plasminogen activator [TPA]), an enzyme that occurs naturally in humans and causes blood clots to dissolve. In its pharmaceutical form, it is manufactured by recombinant DNA technology. Alteplase possesses such high affinity for fibrin that it was not necessary to continuously infuse this thrombolytic agent.

In the current study, 20 patients (13 men and seven women aged 18-79 years) with first-onset acute DVT were treated with direct intraclot lacing of the clot with alteplase (maximum daily dose, 50 mg per leg per day; maximum of four treatments) and full systemic anticoagulation. Ventilation-perfusion (V/Q) scans were performed for evaluation of embolic risks, and clinical and imaging examinations were supplemented with pharmacokinetic studies to enable further assessment of treatment outcomes.

Results published in the February 2008 issue of the journal Radiology revealed that blood flow was restored throughout the deep venous system in 16 patients (80%) during thrombolytic therapy, with complete resolution of symptoms in 18 patients (90%) after six months of anticoagulation. Pharmacokinetic studies showed rapid clearance of circulating alteplase and recovery of plasminogen activator inhibitor-1 levels within two hours after termination of alteplase treatment.

V/Q scans revealed a 40% incidence of pulmonary embolism before treatment and a 15% incidence of asymptomatic pulmonary embolism during thrombolytic therapy. There were no cases of clinically important pulmonary embolism or serious bleeding during thrombolytic therapy. During a mean follow-up period of 3.4 years, no patient developed a post-thrombotic syndrome or recurrent thromboembolism.

"This treatment regimen is able to clear blood clots rapidly and safely, restoring blood flow in the veins of the lower leg, and the results are durable,” said first author Dr. Richard Chang, chief of the interventional radiology section of the department of radiology at NIH.

Related Links:
[U. S.] National Institutes of Health

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56 (56.982040405273): 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'

57 (82.969665527344): 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=271330000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

58 (435.11390686035): 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=271330000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

59 (!!!!! 1858.9496612549): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

60 (290.87066650391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

61 (267.02880859375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

62 (129.93812561035): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

63 (778.9134979248): 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

64 (!!!!! 1089.8113250732): SELECT fid FROM jos_deeppockets WHERE id=271330000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=271330000 AND published='1' LIMIT 1

65 (557.89947509766): 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=211 ORDER BY `ordering`

66 (!!!!! 7472.038269043): select jos_twitters.link from jos_twitters where cat=10

67 (153.0647277832): select jos_facebook.link from jos_facebook where cat=10

68 (240.08750915527): select jos_google_plus.link from jos_google_plus where cat=10

69 (177.86026000977): select jos_linkedin.link from jos_linkedin where cat=10

70 (355.00526428223): SELECT fid FROM jos_deeppockets WHERE id=271330000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=271330000 AND published='1' LIMIT 1

71 (252.00843811035): 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=211 ORDER BY `ordering`

72 (!!!!! 1347.0649719238): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=271330000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (392.91381835938): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=271330000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (247.95532226562): 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`

75 (921.01097106934): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (44.822692871094): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (207.90100097656): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (339.03121948242): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (261.06834411621): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (352.14424133301): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (!!!!! 5249.0234375): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=271330000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (562.90626525879): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=271330000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (67.949295043945): 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`

92 (507.11631774902): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (197.8874206543): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (100.85105895996): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (130.17654418945): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (69.856643676758): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (134.94491577148): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (154.01840209961): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (72.002410888672): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (99.897384643555): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (128.03077697754): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (72.956085205078): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (606.06002807617): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (174.99923706055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

107 (273.9429473877): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

108 (169.99244689941): 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=271330000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (!!!!! 1140.1176452637): 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=271330000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (442.0280456543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

111 (214.0998840332): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

112 (570.05882263184): 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=271330000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (!!!!! 1001.1196136475): 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=271330000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (416.99409484863): 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=271320000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (432.01446533203): 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=271320000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (563.8599395752): 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 (361.91940307617): 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

118 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

119 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

120 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

121 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

122 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

123 (35.04753112793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

124 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

125 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

126 (373.84033203125): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

127 (!!!!! 38727.045059204): 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

128 (653.02848815918): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=271330000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=271330000 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 28248.071670532): ( 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 (180.00602722168): ( 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

131 (404.83474731445): 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 (276.08871459961): 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

133 (434.87548828125): 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 (51.021575927734): 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

135 (658.98895263672): 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 (59.127807617188): 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

137 (178.09867858887): 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 (167.1314239502): 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

139 (!!!!! 1613.8553619385): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (!!!!! 1574.9931335449): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

141 (115.87142944336): SELECT name FROM jos_deeppockets WHERE id=211

142 (87.976455688477): SELECT name FROM jos_deeppockets WHERE id=211

143 (592.94700622559): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (439.16702270508): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

145 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

146 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

147 (!!!!! 7406.9499969482): TRUNCATE TABLE jos_trademed_module

148 (785.82763671875): 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=271330000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (208.13941955566): 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=271330000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

150 (454.90264892578): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

152 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

153 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

154 (!!!!! 1214.9810791016): 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

155 (118.97087097168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

156 (154.97207641602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

157 (123.02398681641): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=271330000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=271330000 AND type='deeppockets_item' AND published='1' LIMIT 1

158 (125.16975402832): 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=0 or channel_id is null)

159 (78.916549682617): 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=0 or channel_id is null)

160 (92.983245849609): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

161 (494.95697021484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

162 (196.93374633789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=271330000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=271330000 AND published='1' LIMIT 1

163 (!!!!! 8746.862411499): select jos_twitters.link from jos_twitters where cat=10

164 (149.01161193848): select jos_facebook.link from jos_facebook where cat=10

165 (102.04315185547): select jos_google_plus.link from jos_google_plus where cat=10

166 (55.074691772461): select jos_linkedin.link from jos_linkedin where cat=10

167 (351.1905670166): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

168 (!!!!! 1030.9219360352): insert into jos_banners_delta values (14615,'2025-08-25 01:48:07','216.73.216.171','view'),(14202,'2025-08-25 01:48:07','216.73.216.171','view'),(14203,'2025-08-25 01:48:07','216.73.216.171','view')

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