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Cardiologists Urged to Lessen Patient Radiation Exposure

By MedImaging International staff writers
Posted on 23 Jan 2014

Image: Cardiologists are being urged to reduce radiations from cardiology procedures that equals more than 50 chest X-rays per person each year (Photo courtesy of Siemens Healthcare).

Recent findings show that radiation from cardiologic imaging equals more than 50 chest X-rays per person annually.

Cardiologists are being urged to reduce patient radiation exposure in a European Society of Cardiology (ESC; Sophia Antipolis, France) position paper that outlined doses and risks of common cardiology imaging for the first time. The study’s findings were published January 9, 2014, in the European Heart Journal. Lead author, Dr. Eugenio Picano, from the Fellowship of the European Society of Cardiology (FESC), said, “Cardiologists today, are the true contemporary radiologists. Cardiology accounts for 40% of patient radiology exposure and equals more than 50 chest X-rays per person per year. Unfortunately, radiation risks are not widely known to all cardiologists and patients and this creates a potential for unwanted damage that will appear as cancers, decades down the line. We need the entire cardiology community to be proactive in minimizing the radiological friendly fire in our imaging labs.”

Tor the first time, this position paper lists doses and risks of the most common cardiology examinations. Computed tomography (CT), percutaneous coronary intervention (PCI), cardiac electrophysiology, and nuclear cardiology imaging deliver a dose equivalent to 750 chest X-rays (with wide variation from 100 to 2,000 chest X-rays) per procedure. These procedures are performed daily in all cardiology in- and out-patient departments, usually more than one procedure per admission. They are used for all forms of cardiac disease, from congenital to heart failure, but more intensively and frequently for ischemic heart disease.

PCI for dilation of coronary artery stenosis totals nearly one million procedures per year in Europe. Risks are 1.38 times higher in women and four times higher in children. Children’s higher risk is because their cells divide more rapidly and they have more years in which to develop cancer.

Dr. Picano stressed, “Even in the best centers, and even when the income of doctors is not related to number of examinations performed, 30%–50% of examinations are totally or partially inappropriate according to specialty recommendations. When examinations are appropriate, the dose is often not systematically audited and therefore not optimized, with values, which are two to 10 times higher than the reference, expected dose.”

The study’s goal was to reduce the unacceptably high rate of inappropriate examinations and reduce excessive doses in appropriate examinations. Dr. Picano said, “In these hard economic times, 50% of the costly and risky advanced imaging examinations we do are for inappropriate indications. Politicians’ top priority should be to audit and cut down on useless and dangerous examinations. Decreased doses can best be accomplished by working with industry and many companies are now successfully fighting a ‘dose war.’ Companies who develop better ways of reducing doses will win in the future global competition. Radiological sustainability is becoming a competitive marketing advantage.”

The paper says that patients should be given the estimated dose before a procedure and the actual dose in writing afterwards if they request it. This could become a legal requirement through the European Directive Euratom law 97/43 but application of the law is being delayed by technical and practical difficulties.

Dr. Picano said, “Patients can protect themselves by not self-prescribing screening examinations promoted by irresponsible advertisers. Second, before any testing they should ask their doctor what is the likely radiation dose they will get from that examination. After the exam, they should receive the true delivered dose in a written report, which may differ by a factor of 10 from the theoretical reference dose. The smart patient, and the smart cardiologist, cannot be afraid of radiation since it is essential and often lifesaving. But they must be very afraid of radiation negligence or unawareness. This paper will help to make cardiology wards and laboratories a safer place for patients and doctors through an increase of radiation awareness and knowledge.”

Prof. Patrizio Lancellotti, FESC, president of the European Association of Cardiovascular Imaging (EACVI) of the ESC, said, “The radiation issue was first brought to the attention of the international cardiology community by European cardiologists and now it is right and fitting that the ESC delivers this paper.”

Related Links:
European Society of Cardiology

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60 (!!!!! 4880.1898956299): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

61 (!!!!! 4472.017288208): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

62 (379.08554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

63 (!!!!! 2508.8787078857): 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 (!!!!! 1060.0090026855): SELECT fid FROM jos_deeppockets WHERE id=294750332 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294750332 AND published='1' LIMIT 1

65 (!!!!! 1211.1663818359): 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 (392.19856262207): select jos_twitters.link from jos_twitters where cat=10

67 (675.91667175293): select jos_facebook.link from jos_facebook where cat=10

68 (!!!!! 4163.0268096924): select jos_google_plus.link from jos_google_plus where cat=10

69 (884.05609130859): select jos_linkedin.link from jos_linkedin where cat=10

70 (284.91020202637): SELECT fid FROM jos_deeppockets WHERE id=294750332 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294750332 AND published='1' LIMIT 1

71 (307.08312988281): 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 (905.99060058594): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294750332 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (!!!!! 1374.0062713623): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294750332 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (791.07284545898): 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 (529.05082702637): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (513.07678222656): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (!!!!! 4163.9804840088): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (466.82357788086): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (257.96890258789): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (!!!!! 3162.8608703613): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (98.943710327148): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (!!!!! 1933.8130950928): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294750332 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (58.889389038086): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294750332 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (52.213668823242): 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 (61.988830566406): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (375.98609924316): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (653.98216247559): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

107 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

108 (58.889389038086): 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=294750332 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (56.982040405273): 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=294750332 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (174.99923706055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

111 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

112 (54.121017456055): 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=294750332 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (538.11073303223): 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=294750332 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (792.9801940918): 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

115 (512.12310791016): 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

116 (138.99803161621): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

117 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

118 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

119 (54.836273193359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

120 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

121 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

122 (60.796737670898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

123 (54.836273193359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

124 (367.87986755371): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 125103.95050049): 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

126 (!!!!! 2985.0006103516): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294750332 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294750332 AND type='deeppockets_item' AND published='1' LIMIT 1

127 (!!!!! 44553.04145813): ( 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

128 (185.01281738281): ( 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

129 (75.817108154297): 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

130 (50.067901611328): 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

131 (72.002410888672): 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

132 (46.014785766602): 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

133 (!!!!! 2782.1063995361): 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

134 (134.94491577148): 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

135 (70.095062255859): 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

136 (46.014785766602): 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

137 (!!!!! 9809.0171813965): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (!!!!! 2386.0931396484): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (!!!!! 2388.0004882812): SELECT name FROM jos_deeppockets WHERE id=211

140 (!!!!! 6489.9921417236): SELECT name FROM jos_deeppockets WHERE id=211

141 (!!!!! 1438.1408691406): 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

142 (!!!!! 11086.940765381): 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

143 (!!!!! 1832.9620361328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

144 (!!!!! 1220.9415435791): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

145 (!!!!! 23626.089096069): TRUNCATE TABLE jos_trademed_module

146 (!!!!! 3416.0614013672): 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=294750332 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (!!!!! 4029.9892425537): 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=294750332 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (501.87110900879): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (711.91787719727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (!!!!! 1371.8605041504): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

151 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

152 (!!!!! 3432.9891204834): 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

153 (!!!!! 6246.0899353027): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

154 (91.075897216797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

155 (87.976455688477): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294750332 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294750332 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (82.015991210938): 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)

157 (49.114227294922): 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)

158 (51.021575927734): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (!!!!! 3538.1317138672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

160 (386.95335388184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750332 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750332 AND published='1' LIMIT 1

161 (673.05564880371): select jos_twitters.link from jos_twitters where cat=10

162 (614.88151550293): select jos_facebook.link from jos_facebook where cat=10

163 (54.836273193359): select jos_google_plus.link from jos_google_plus where cat=10

164 (51.021575927734): select jos_linkedin.link from jos_linkedin where cat=10

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