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AAPM 2025 - 67th Annual Meeting & Exhibition of the American Association of Physicists in Medicine

Radiology Has Multiple Roles in Stroke Management

By MedImaging International staff writers
Posted on 01 Apr 2009

Over the past 20 years, imaging has become part of the routine diagnosis of stroke victims. Studies that show that pretreatment computed tomography (CT) scans can improve a patient's prognosis have been widely accepted. The question remains which modality to use and how.

Most patients are screened with CT, explained Prof. Rüdiger von Kummer, from Dresden University Hospital (Germany), who presented new research at the annual meeting of the European Congress of Radiology (ECR), held in Vienna, Austria in March 2009. CT scanners are more widely available than magnetic resonance imaging (MRI) systems, and CT scans, because of their rapidity, are easier for ill patients to tolerate. CT angiography and perfusion measurement are also more robust techniques than MR angiography (MRA) or MR perfusion imaging.

On the other hand, MRI with diffusion-weighted imaging (DWI) is a highly sensitive technique for detecting small lesions caused by embolic events, which can be missed by CT. MRI is as sensitive as CT in the detection of acute brain hemorrhages, but has a higher sensitivity for old brain hemorrhages.

The application of imaging findings is still under discussion. Based on randomized trials, systemic thrombolysis is approved for the first three hours after stroke only. But these studies have used brain hemorrhage and major infarction alone as contra-indications to drug therapy. A very recent study demonstrated the efficacy of rt-PA (recombinant tissue plasminogen activator), the only approved treatment for acute ischemic stroke up to now, up to 4.5 hours. The identification of patients with small ischemic damage, despite arterial occlusion and extended perfusion impairment, may allow effective reperfusion treatment beyond currently accepted time windows.

Because intravenous thrombolytics may fail to recanalize arterial obstructions, Prof. von Kummer suggested that the angiography suite is prepared for endovascular intervention when drug-based stroke treatments are to be used. Intra-arterial recanalization can then begin immediately if the treatment fails, and may thus considerably improve the patient's prognosis.

Endovascular recanilization can be performed up to six hours after onset of acute stroke, with a good outcome, explained Prof. Gerhard Schroth, director of diagnostic and interventional neuroradiology at Bern University Hospital (Switzerland) at the ECR meeting. Recanalization rates now approach 80%, and one in every three procedures saves a patient from severe impairment.

The procedure consists of injecting a clot-busting drug directly into the thrombus, and no longer just in front of the occlusion site as it used to be performed a few years ago. Recanalization can be achieved for the majority of patients by this way and is associated with improved outcome. Moreover, other mechanical recanalization techniques (retriever devices, percutaneous transluminal angioplasty [PTA], or stenting) can be employed by interventional radiologists if vessel occlusion persists after thrombolysis. Referrals for endovascular treatment can come at any time, and the faster interventional radiologists can respond, the more likely is a successful outcome. "Endovascular treatment is one of the most cost-effective treatments in healthcare, given the high rates of handicap associated with stroke," Prof. Schroth concluded.

Stroke is the third leading cause of death in the West, it is alone responsible for 10% of deaths worldwide and it can leave survivors with significant mental and physical impairment. Prompt management of victims can help reduce fatalities and disabilities, and radiologists can play many roles in diagnosing and treating stroke patients.

The European Congress of Radiology (ECR) is the annual meeting of the European Society of Radiology (ESR), the fastest growing medical society worldwide, currently with 44,500 members.

Related Links:
Dresden University Hospital
Bern University Hospital

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61 (96.08268737793): 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 (542.87910461426): SELECT fid FROM jos_deeppockets WHERE id=294722632 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294722632 AND published='1' LIMIT 1

63 (348.09112548828): 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`

64 (46.014785766602): select jos_twitters.link from jos_twitters where cat=10

65 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

66 (35.04753112793): select jos_google_plus.link from jos_google_plus where cat=10

67 (29.802322387695): select jos_linkedin.link from jos_linkedin where cat=10

68 (60.081481933594): SELECT fid FROM jos_deeppockets WHERE id=294722632 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294722632 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=211 ORDER BY `ordering`

70 (388.14544677734): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722632 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (277.99606323242): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722632 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (51.021575927734): 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 (63.180923461914): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (26.226043701172): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (73.909759521484): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722632 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (34.093856811523): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722632 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (36.001205444336): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (71.048736572266): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

105 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

106 (68.187713623047): 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=294722632 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (74.148178100586): 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=294722632 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (109.91096496582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

109 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

110 (78.201293945312): 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=294722632 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (553.84635925293): 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=294722632 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (669.00253295898): 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 (846.14753723145): 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 (180.00602722168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

115 (135.18333435059): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

116 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

117 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

118 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

119 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

120 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

121 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

122 (420.80879211426): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 27944.087982178): 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 (554.80003356934): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722632 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722632 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 8048.0575561523): ( 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 (71.048736572266): ( 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 (284.91020202637): 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 (36.954879760742): 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 (307.79838562012): 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 (55.074691772461): 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 (211.95411682129): 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 (35.04753112793): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (324.01084899902): 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 (37.908554077148): 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 (366.9261932373): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (296.83113098145): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (123.02398681641): SELECT name FROM jos_deeppockets WHERE id=211

138 (81.062316894531): SELECT name FROM jos_deeppockets WHERE id=211

139 (582.93342590332): 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

140 (586.98654174805): 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

141 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

142 (44.822692871094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

143 (!!!!! 8655.0712585449): TRUNCATE TABLE jos_trademed_module

144 (118.01719665527): 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=294722632 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (406.98051452637): 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=294722632 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (397.2053527832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (90.837478637695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 1691.8182373047): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

149 (185.96649169922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

150 (!!!!! 1581.9072723389): 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 (540.01808166504): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

152 (246.04797363281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

153 (437.97492980957): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722632 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722632 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (298.97689819336): 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=211 or channel_id is null)

155 (207.18574523926): 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=211 or channel_id is null)

156 (!!!!! 8049.0112304688): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (833.03451538086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

158 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722632 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722632 AND published='1' LIMIT 1

159 (651.12113952637): select jos_twitters.link from jos_twitters where cat=10

160 (38.14697265625): select jos_facebook.link from jos_facebook where cat=10

161 (29.802322387695): select jos_google_plus.link from jos_google_plus where cat=10

162 (211.00044250488): select jos_linkedin.link from jos_linkedin where cat=10

163 (548.12431335449): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1303.1959533691): insert into jos_banners_delta values (14615,'2025-06-29 11:50:49','216.73.216.249','view'),(14202,'2025-06-29 11:50:49','216.73.216.249','view'),(14203,'2025-06-29 11:50:49','216.73.216.249','view')

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