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MR-Guided, Focused Ultrasound Targeted at Bone Metastases Helps Ease Pain

By MedImaging International staff writers
Posted on 13 Jun 2013

A high-dose of ultrasound targeted to painful bone metastases appears to rapidly bring patients relief, and with largely bearable side effects.

The new study’s findings were presented by Fox Chase Cancer Center (Philadelphia, PA, USA) scientists at the 49th annual meeting of the American Society of Clinical Oncology (ASCO), on June 3, 2013, held in Chicago (IL, USA). During the procedure, known as magnetic resonance (MR)-guided, focused ultrasound, doctors direct a concentrated beam of energy to certain nerve endings that are causing pain in bone metastases. These patients typically have a significant amount of discomfort—50% of study participants rated their pain at least a 7 out of 10—but within several days, most reported they felt substantial relief.

Although Fox Chase patients received local anesthesia during the procedure, the most typically reported side effect was pain, which can often be lessened with additional anesthesia, according to study author Joshua Meyer, MD, attending physician in the radiation oncology department at Fox Chase. “That’s temporary pain, which is gone as soon as the procedure is over,” he said. “The whole reason we’re doing the procedure is for the pain relief that comes afterwards. And that’s relatively quick—we see a response by a day or so, and within three days of the procedure most patients are reporting a significant improvement.”

Specifically, 67% of the 107 treated patients said their pain was “much improved” after the treatment, and that relief continued through the end of the three-month study. In comparison, among a group of 35 patients that received a placebo (sham) treatment only 20% reported some pain relief, Dr. Meyer and his colleagues reported.

Patients enter into an MRI unit during the procedure, which allows clinicians to direct a cone of ultrasound energy at specific, targeted bone sites that are causing pain. The MRI also acts as a thermometer to gauge the temperature deep within the body created by the high dose of energy, which generates enough heat to burn the nerve endings that are causing pain. Although pain relief was sustained until the end of the study at 90 days, it’s not clear how much longer the pain relief lasts, reported Dr. Meyer. “We’ve had reports of patients experiencing pain relief up to a year or more outside of the study.”

Typically, patients with bone metastases are treated with radiation, which shrinks the bone cancer that is putting pressure on nerve endings, causing pain. This technique also treats the cancer (MR-guided focused ultrasound may not), but typically takes weeks before patients experience pain relief, and not all will respond, stated Dr. Meyer. Moreover, others may not be eligible to receive further radiation, if they have limited bone marrow function, for instance, he noted. The latest studies did not compare the effectiveness of the ultrasound technique to radiation, but the response to ultrasound appears “within the same ballpark of that in previous studies with radiation.”

MR-guided focused ultrasound has been approved by the US Food and Drug Administration (FDA), and is available at Fox Chase Cancer Center, as well as a handful of other facilities around the country.

Related Links:
Fox Chase Cancer Center

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58 (!!!!! 4035.9497070312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

59 (130.89179992676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

60 (!!!!! 1770.01953125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

61 (!!!!! 1800.0602722168): 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 (339.03121948242): SELECT fid FROM jos_deeppockets WHERE id=294746733 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294746733 AND published='1' LIMIT 1

63 (!!!!! 1169.2047119141): 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=214 ORDER BY `ordering`

64 (!!!!! 2930.8795928955): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 5213.0222320557): select jos_facebook.link from jos_facebook where cat=10

66 (937.93869018555): select jos_google_plus.link from jos_google_plus where cat=10

67 (56.028366088867): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 1336.0977172852): SELECT fid FROM jos_deeppockets WHERE id=294746733 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294746733 AND published='1' LIMIT 1

69 (87.976455688477): 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=214 ORDER BY `ordering`

70 (!!!!! 3957.0331573486): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746733 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 3216.028213501): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746733 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 2864.1223907471): 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 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (153.0647277832): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (642.06123352051): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (677.10876464844): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (235.08071899414): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (180.00602722168): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (92.983245849609): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (202.89421081543): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (92.983245849609): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (627.04086303711): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (168.0850982666): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (444.88906860352): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746733 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (912.90473937988): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746733 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (!!!!! 5555.1528930664): 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 (77.962875366211): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (63.896179199219): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (63.896179199219): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (158.07151794434): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 4405.9753417969): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

105 (148.05793762207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

106 (127.07710266113): 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=294746733 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (82.969665527344): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_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=294746733 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 9227.0374298096): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

109 (!!!!! 5296.9455718994): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

110 (293.97010803223): 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=294746733 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (655.8895111084): 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=294746733 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 7252.9315948486): 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 (!!!!! 8342.981338501): 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 (!!!!! 7848.9780426025): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

115 (!!!!! 8630.0373077393): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

116 (!!!!! 9199.1424560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

117 (!!!!! 7779.8366546631): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

118 (!!!!! 8092.1649932861): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

119 (!!!!! 7675.8861541748): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

120 (!!!!! 7942.9149627686): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

121 (!!!!! 7816.0762786865): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

122 (!!!!! 4236.9365692139): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 191646.09909058): 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 (!!!!! 7672.0714569092): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746733 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746733 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 51888.942718506): ( 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 (!!!!! 4153.9669036865): ( 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 (808.9542388916): 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 (!!!!! 7403.1352996826): 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 (!!!!! 3839.0159606934): 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 (221.01402282715): 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 (!!!!! 7125.8544921875): 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 (!!!!! 2099.0371704102): 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 (960.8268737793): 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 (293.01643371582): 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 (!!!!! 2416.8491363525): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (!!!!! 2427.8163909912): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (948.19068908691): SELECT name FROM jos_deeppockets WHERE id=214

138 (!!!!! 1649.8565673828): SELECT name FROM jos_deeppockets WHERE id=214

139 (!!!!! 1439.094543457): 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 '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (!!!!! 3471.851348877): 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 '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (!!!!! 2965.9271240234): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

142 (!!!!! 4093.1701660156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

143 (!!!!! 19423.961639404): TRUNCATE TABLE jos_trademed_module

144 (519.99092102051): 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=294746733 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 5160.8085632324): 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=294746733 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (383.85391235352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (!!!!! 1924.0379333496): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (809.90791320801): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

149 (499.96376037598): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

150 (!!!!! 4333.0192565918): 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 (!!!!! 7236.9575500488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

152 (!!!!! 16054.86869812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

153 (!!!!! 6385.0879669189): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746733 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746733 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (!!!!! 11790.990829468): 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=214 or channel_id is null)

155 (!!!!! 6985.9027862549): 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=214 or channel_id is null)

156 (!!!!! 8585.9298706055): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 14984.846115112): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

158 (!!!!! 8271.9326019287): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746733 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746733 AND published='1' LIMIT 1

159 (533.8191986084): select jos_twitters.link from jos_twitters where cat=10

160 (93.936920166016): select jos_facebook.link from jos_facebook where cat=10

161 (328.77922058105): select jos_google_plus.link from jos_google_plus where cat=10

162 (151.8726348877): select jos_linkedin.link from jos_linkedin where cat=10

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