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Newer Techniques Are Making Cardiac CT Safer for Children

By MedImaging International staff writers
Posted on 03 Aug 2011

Coronary computed tomography angiography (CTA) has excellent image quality and diagnostic effectiveness for the complete range of pediatric patients, with significant reduction of risk with recent technologic developments, according to a new study.

The study’s findings were presented at the sixth annual scientific meeting of the Society of Cardiovascular Computed Tomography (SCCT) in Denver, July 14-17, 2011. “Traditionally, pediatric patients who require coronary artery imaging have undergone a cardiac catheterization, which is an invasive procedure with a significant radiation dose, requiring sedation or anesthesia for all patients,” explained B. Kelly Han, MD, a pediatric cardiologist at Minneapolis Heart Institute at Abbott Northwestern Hospital (MN, USA) and the Children’s Heart Clinic and Children’s Hospitals and Clinics (Minneapolis, MN, USA). “The newer CT scanners deliver far less radiation than both previous generation CT scanners and catheter based angiography. Also, CTA is noninvasive and has different protocols that can be tailored to decrease the risk for each individual patient. One barrier to applying coronary CTA in children has been their relatively high heart rates. Using a combination of medication to slow the heart rate and the new scanner technology, we have been able to obtain excellent images of the coronary arteries in patients as young as five months of age.”

Dr. Han and colleagues conducted a retrospective review of all coronary CTAs performed on patients less than 18 years of age at Minneapolis Heart Institute from June 2007 through February 2011. The researchers examined the heart rate control with beta blockade, and the radiation dose with the varied scan modes, with the goal of comparing the image quality and the radiation dose.

Patients were separated by scan mode into three groups: (1) group one: first-generation, dual-source CT scanner with retrospective electrocardiographic (ECG) gating (spiral scan mode); (2) group two: second-generation, dual-source CT scanner with prospective ECG gating (sequential scan mode); and (3) group three: second-generation, dual-source CT using prospective ECG gating with high pitch (flash-scan mode). The researchers compared the age, heart rate, body surface area, radiation dose estimates, and image quality between the three groups. They performed 76 scans in patients from three days to 18 years of age.

The differences in radiation dose between the three scan groups were statistically significant, according to the authors, and high image quality was maintained between groups despite the decreased radiation exposure, Dr. Han and colleagues reported. A high percentage of the patients had coronary artery pathology including anomaly, stenosis, or aneurysm. Overall, 17 patients underwent subsequent surgical intervention and surgical findings correlated with coronary CTA in all cases.

“We found that the newer imaging modes decrease the radiation dose between four-fold and seven-fold, without loss in diagnostic accuracy or image quality,” Dr. Han said. “The estimated radiation dose reduction over traditional angiography is even greater. The aggressive use of beta-blockade to slow the heart rate, in combination with the newer scan modes allows for a very low radiation dose in this young patient population.”

This technology also will considerably decrease the anesthesia and invasive access risk of coronary imaging, according to Dr. Han, because the images are acquired without having to access the heart, and all patients age seven or older did not require sedation.

Related Links:
Minneapolis Heart Institute at Abbott Northwestern Hospital
Children’s Heart Clinic and Children’s Hospitals and Clinics

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63 (381.9465637207): 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 (96.08268737793): select jos_twitters.link from jos_twitters where cat=10

65 (31.948089599609): select jos_facebook.link from jos_facebook where cat=10

66 (32.186508178711): select jos_google_plus.link from jos_google_plus where cat=10

67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (39.100646972656): SELECT fid FROM jos_deeppockets WHERE id=294736431 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294736431 AND published='1' LIMIT 1

69 (32.901763916016): 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 (264.16778564453): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (218.15299987793): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 1012.0868682861): 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 (97.036361694336): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (46.968460083008): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (29.087066650391): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (30.994415283203): 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 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (64.13459777832): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (123.02398681641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

105 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

106 (83.92333984375): 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=294736431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (75.101852416992): 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=294736431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (116.10984802246): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

109 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

110 (49.829483032227): 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=294736431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (568.86672973633): 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=294736431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (816.10679626465): 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 (607.96737670898): 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 (203.13262939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

115 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

116 (101.08947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

117 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

118 (91.075897216797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

119 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

120 (105.14259338379): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

121 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

122 (414.84832763672): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 28075.933456421): 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 (740.05126953125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736431 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736431 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 11254.072189331): ( 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 (92.029571533203): ( 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 (398.87428283691): 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 (119.92454528809): 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 (342.13066101074): 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 (66.995620727539): 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 (317.09671020508): 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 (51.975250244141): 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 (269.17457580566): 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 (46.968460083008): 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 (572.91984558105): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (553.84635925293): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (319.9577331543): SELECT name FROM jos_deeppockets WHERE id=211

138 (63.896179199219): SELECT name FROM jos_deeppockets WHERE id=211

139 (813.00735473633): 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 (783.20503234863): 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 (122.0703125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

142 (83.208084106445): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

143 (!!!!! 10314.94140625): TRUNCATE TABLE jos_trademed_module

144 (136.13700866699): 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=294736431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (66.995620727539): 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=294736431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (643.01490783691): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (123.02398681641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

149 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

150 (!!!!! 1409.0538024902): 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 (98.943710327148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

152 (78.201293945312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

153 (69.856643676758): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736431 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736431 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (48.87580871582): 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 (42.915344238281): 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 (58.889389038086): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (95.129013061523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

158 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736431 AND published='1' LIMIT 1

159 (106.0962677002): select jos_twitters.link from jos_twitters where cat=10

160 (50.067901611328): select jos_facebook.link from jos_facebook where cat=10

161 (37.908554077148): select jos_google_plus.link from jos_google_plus where cat=10

162 (47.206878662109): select jos_linkedin.link from jos_linkedin where cat=10

163 (296.83113098145): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1169.9199676514): insert into jos_banners_delta values (14615,'2025-08-20 01:45:59','216.73.216.0','view'),(14202,'2025-08-20 01:45:59','216.73.216.0','view'),(14203,'2025-08-20 01:45:59','216.73.216.0','view')

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