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Radiation Safety Addressed by Interventional Radiology Society

By MedImaging International staff writers
Posted on 03 May 2011

Spokespersons from an American interventional radiology society have reported that the society has a long-term commitment to radiation safety, and is taking a leading role in measuring and assessing radiation dosage; developing educational programs on radiation safety, radiation protection, and reduction of skin dosage; and promoting the safety of patients and healthcare professionals.

Four articles, published in April 2011 in the Journal of Vascular and Interventional Radiology (JVIR), clarify the Society of Interventional Radiology's (SIR; Fairfax, VA, USA) standpoint on issues of patient safety and standards of care by exploring opportunities to improve patient safety through lower dosages that still provide excellent imaging results and even new equipment advances to protect both patients and the diagnostic and interventional radiologist.

"The Society of Interventional Radiology views patient care and safety for patients and health care professionals among its absolute top priorities. To this end, SIR continually encourages clear communications between informed doctors and patients to recognize risks and benefits of radiation in diagnosis and treatment to save lives,” stated SIR president Timothy P. Murphy, MD, FSIR, who represents the national society of nearly 4,700 physicians, scientists, and allied health professionals dedicated to improving health care through minimally invasive treatments.

"Interventional radiologists pioneered the procedures and standards for safely providing minimally invasive medicine. Patient safety is always incorporated into interventional radiology advances and treatments because interventional radiologists are highly trained in radiation safety, radiation physics, and the biologic effects of radiation and injury protection,” said Dr. Murphy, an interventional radiologist and director of the Vascular Disease Research Center at Rhode Island Hospital (Providence, USA).

"The articles' unifying element is patient safety,” said JVIR editor-in-chief Ziv J Haskal, MD, FSIR. "By lowering a patient's exposure to damaging radiation--without compromising the treatment or diagnostic ability--and developing tools that provide improved functionality and protective properties for use by both the diagnostic and interventional radiologist, interventional radiologists again show why they are the driving force behind the development and implementation of the field's best practices,” said Dr. Haskal, who is also professor of radiology and surgery at the University of Maryland School of Medicine and vice chair of strategic development and chief of vascular and interventional radiology, image-guided therapy and interventional oncology at the University of Maryland Medical Center, both in Baltimore, USA.

"Exploring ways to promote and practice safe radiation procedures and minimize radiation damage caused by medical imaging and image-guided treatments is of paramount concern to SIR members,” said Dr. Murphy.
The four new articles reported on safety studies and examine new techniques in imaging used for diagnosis and treatment. The topics range from ways to optimize radiation dosages during fluoroscopic procedures, an examination of an ultra-low-dose protocol for computed tomography (CT)-guided lung biopsies, a comparison of a suspended protection system versus standard lead apron used by interventional and diagnostic radiologists, and an exploration of dosage differences during conventional CT guidance and a new cone-beam CT-guidance technique.

In one study, coauthor James R. Duncan, MD, PhD, from the Mallinckrodt Institute of Radiology, Washington University School of Medicine (St. Louis, MO, USA), noted that while fluoroscopic procedures have dramatically improved patient care and outcomes, the rapid rise in the use of ionizing radiation has renewed concerns about exposure during medical imaging.

The SIR Foundation--a scientific organization focused on fostering research and education in interventional radiology for the purposes of advancing scientific knowledge and developing innovative therapies that lead to improved patient care and quality of life--initiated a call for a multidisciplinary consensus panel on radiation use in 2010. The article describes the panel's findings that in both diagnostic and interventional radiology the aim should be optimization during exposure--a strategy that recognizes the need to weigh the risks versus the benefits of ionizing radiation--with patients remaining the key stakeholders in this improvement process. The panel recommended the development of a registry to capture and analyze data from fluoroscopic procedures, acknowledging the need for long-term support from both patient advocacy groups and federal agencies.

Jason C. Smith, MD, from Loma Linda University Medical Center (Loma Linda, CA, USA), and his coauthors hypothesized in their article that effective results could still be achieved during lung biopsies by radically lowering the CT dose. The study's conclusion confirmed that with an ultra-low-dose (ULD) protocol, the dose to the chest during CT-guided percutaneous lung biopsies is reduced greater than 95% from the standard protocol without decreasing technical success or compromising patient safety.

Daniel A. Marichal, MD, from Baylor University Medical Center (Dallas, TX, USA), and his colleagues evaluated the characteristics, effectiveness, and ease of use of two radiation protection systems in their article. The group assessed the effectiveness of a suspended radiation protection system that offers protection from the top of the head to the calves using a sophisticated overhead motion system that eliminates weight on the operator and allows range of motion. When compared to the conventional lead apron and tested on a mock interventionalist in a simulated clinical setting, the system greatly reduced exposures to many body areas.

A group of Dutch interventionalists, led by Sicco J. Braak, MD, St. Antonius Hospital (Nieuwegein, the Netherlands), learned that using a recently developed needle intervention technique, called cone-beam CT (CBCT)-guidance, was effective, and resulted in a significantly reduced dosage for patients when compared with conventional CT-guidance.

Related Links:
Society of Interventional Radiology
Washington University School of Medicine
St. Antonius Hospital

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56 (612.97416687012): 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=294734827 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

57 (!!!!! 1621.9615936279): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

58 (!!!!! 1832.9620361328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

59 (!!!!! 7328.0334472656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

60 (!!!!! 11564.016342163): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

61 (!!!!! 15740.871429443): 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 (!!!!! 7493.9727783203): SELECT fid FROM jos_deeppockets WHERE id=294734827 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294734827 AND published='1' LIMIT 1

63 (!!!!! 7931.9477081299): 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 (!!!!! 5231.8572998047): select jos_twitters.link from jos_twitters where cat=10

65 (129.93812561035): select jos_facebook.link from jos_facebook where cat=10

66 (822.06726074219): select jos_google_plus.link from jos_google_plus where cat=10

67 (316.85829162598): select jos_linkedin.link from jos_linkedin where cat=10

68 (549.0779876709): SELECT fid FROM jos_deeppockets WHERE id=294734827 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294734827 AND published='1' LIMIT 1

69 (272.03559875488): 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 (!!!!! 3857.8510284424): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294734827 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 8208.9900970459): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294734827 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 7951.9748687744): 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 (!!!!! 4717.8268432617): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (515.93780517578): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (76.055526733398): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (224.11346435547): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (197.17216491699): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (169.03877258301): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (341.89224243164): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (225.06713867188): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (277.04238891602): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (685.9302520752): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294734827 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (248.19374084473): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294734827 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (38.862228393555): 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 (!!!!! 2333.1642150879): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (!!!!! 3071.0697174072): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (!!!!! 1499.1760253906): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (!!!!! 2369.8806762695): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (70.095062255859): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (336.88545227051): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (315.90461730957): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (354.05158996582): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 1890.8977508545): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

105 (!!!!! 5107.1643829346): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

106 (!!!!! 2432.8231811523): 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=294734827 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (835.89553833008): 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=294734827 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 5645.9903717041): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

109 (!!!!! 1184.2250823975): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

110 (!!!!! 1060.0090026855): 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=294734827 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (754.83322143555): 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=294734827 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1593.1129455566): 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 (578.16505432129): 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 (!!!!! 1075.0293731689): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

115 (!!!!! 1097.9175567627): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

116 (!!!!! 3268.9571380615): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

117 (339.03121948242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

118 (!!!!! 3364.086151123): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

119 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

120 (!!!!! 1189.9471282959): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

121 (190.01960754395): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

122 (!!!!! 1079.0824890137): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 52782.05871582): 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 (772.95303344727): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294734827 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294734827 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 18397.092819214): ( 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 (59.843063354492): ( 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 (!!!!! 1151.0848999023): 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 (81.062316894531): 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 (780.10559082031): 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 (212.9077911377): 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 (468.96934509277): 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 (313.04359436035): 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 (!!!!! 1080.0361633301): 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 (54.121017456055): 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 (916.95785522461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (611.0668182373): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (897.88436889648): SELECT name FROM jos_deeppockets WHERE id=211

138 (59.127807617188): SELECT name FROM jos_deeppockets WHERE id=211

139 (767.23098754883): 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 (!!!!! 1255.989074707): 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 (854.0153503418): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

142 (!!!!! 1687.0498657227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

143 (!!!!! 18730.878829956): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 8243.0839538574): 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=294734827 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (110.14938354492): 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=294734827 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (573.15826416016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

149 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

150 (!!!!! 1555.9196472168): 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 (122.0703125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

152 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

153 (69.856643676758): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294734827 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294734827 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (422.00088500977): 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 (!!!!! 2720.1175689697): 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 (263.21411132812): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (199.0795135498): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

158 (!!!!! 1210.9279632568): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734827 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734827 AND published='1' LIMIT 1

159 (880.00297546387): select jos_twitters.link from jos_twitters where cat=10

160 (41.007995605469): select jos_facebook.link from jos_facebook where cat=10

161 (40.054321289062): select jos_google_plus.link from jos_google_plus where cat=10

162 (33.855438232422): select jos_linkedin.link from jos_linkedin where cat=10

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