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Lymph Node Ultrasound Imaging Most Effective for Obese Breast Cancer Patients

By MedImaging International staff writers
Posted on 14 May 2014

Image: Ultrasound imaging used to identify breast cancer in underarm lymph nodes in obese women has generated an unexpected finding: Fat did not obscure the images, and ultrasound imaging showing no suspicious lymph nodes actually was shown to be more accurate in overweight and obese patients than in women with a normal body mass index (Photo courtesy of the Mayo Clinic).

New research into whether ultrasound imaging used to identify breast cancer in underarm lymph nodes is less effective in obese women, has generated an unexpected finding. Fat did not obscure the images and ultrasound imaging showing no suspicious lymph nodes actually was shown to be more accurate in overweight and obese patients than in women with a normal body mass index.

The research was among several Mayo Clinic (Rochester, MN, USA) studies presented at the American Society of Breast Surgeons annual meeting, held April 30–May 4, 2014, in Las Vegas (NV, USA).

Researchers studied 1,331 breast cancer patients who received ultrasounds of their axillary lymph nodes, the lymph nodes in the armpits, to check for cancer before surgery. Of those patients, 36% were considered obese, with a body mass index of 30 or more. Body mass index is a formula that uses weight and height to estimate body fat. Of the other women evaluated, 33% were of normal weight and 31% were overweight but not obese.

Obesity can change lymph nodes, including the way they look in imaging studies, and make physical exam of underarm lymph nodes more challenging. The Mayo study discovered that higher body weight did not cloud ultrasound images of the axillary lymph nodes in overweight or obese cancer patients, and that their ultrasound scans had better specificity and accuracy than those of thinner women, meaning that when ultrasound showed no suspicious lymph nodes, it was likelier to be correct. “I think we were surprised at these results,” noted senior author Tina Hieken, MD, a breast cancer surgeon at Mayo Clinic. “It should be very reassuring that regardless of the weight of the patient, axillary ultrasound is helpful.”

Potential reasons for the findings, Dr. Hieken hypothesizes: Soft fatty tissue can be compressed during ultrasound scanning, and physicians now have more experience in knowing what lymph nodes may look like in overweight and obese patients. In some thin patients, ultrasounds may not yield as much information because underarm lymph nodes can be so close to the surface, it may be difficult to get good images, she reported.

Surgeons do not rely on ultrasound by itself to determine whether or not breast cancer has spread; it is one of several sources of information used to guide treatment. “For most patients with invasive breast cancer, if the axillary ultrasound is negative, we perform a sentinel lymph node biopsy at the time of the breast operation to make sure cancer has not spread. When the preoperative axillary ultrasound shows suspicious lymph nodes, we then do a fine-needle aspiration of the lymph nodes. If that shows cancer, we may discuss other strategies with the patient such as giving chemotherapy before surgery,” Dr. Hieken said.

More research is planned, including evaluating at different techniques of lymph node ultrasound to improve accuracy and perhaps to avoid axillary lymph node surgery altogether in some breast cancer patients with small tumors and negative axillary ultrasounds, Dr. Hieken reported.

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58 (!!!!! 7483.959197998): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

59 (!!!!! 7368.0877685547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

60 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

61 (!!!!! 13826.131820679): 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 (!!!!! 3555.0594329834): SELECT fid FROM jos_deeppockets WHERE id=294752417 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294752417 AND published='1' LIMIT 1

63 (995.87440490723): 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 (56.028366088867): select jos_twitters.link from jos_twitters where cat=10

65 (37.193298339844): select jos_facebook.link from jos_facebook where cat=10

66 (46.014785766602): select jos_google_plus.link from jos_google_plus where cat=10

67 (39.100646972656): select jos_linkedin.link from jos_linkedin where cat=10

68 (45.061111450195): SELECT fid FROM jos_deeppockets WHERE id=294752417 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294752417 AND published='1' LIMIT 1

69 (46.014785766602): 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 (!!!!! 1978.1589508057): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294752417 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (478.98292541504): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294752417 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (44.107437133789): 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 (!!!!! 5807.8765869141): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (114.91775512695): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 2676.0101318359): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294752417 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (87.976455688477): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294752417 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (41.007995605469): 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 (!!!!! 3134.01222229): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (98.228454589844): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (80.82389831543): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (!!!!! 2373.9337921143): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (87.976455688477): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (!!!!! 1031.8756103516): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (59.127807617188): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (264.88304138184): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 3015.9950256348): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

105 (!!!!! 6698.8468170166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

106 (!!!!! 2913.9518737793): 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=294752417 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 2722.0249176025): 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=294752417 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1367.0921325684): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

109 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

110 (565.0520324707): 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=294752417 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (582.93342590332): 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=294752417 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (868.79730224609): 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 (447.98851013184): 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 (298.97689819336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

115 (303.98368835449): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

116 (391.00646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

117 (!!!!! 1447.9160308838): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

118 (659.94262695312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

119 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

120 (571.01249694824): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

121 (586.03286743164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

122 (395.05958557129): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 54430.961608887): 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 (849.96223449707): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294752417 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294752417 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 17056.941986084): ( 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 (77.962875366211): ( 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 (480.89027404785): 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 (60.081481933594): 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 (340.93856811523): 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 (52.928924560547): 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 (66.041946411133): 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 (34.093856811523): 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 (252.96211242676): 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 (36.001205444336): 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 (!!!!! 4061.9373321533): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (402.92739868164): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (!!!!! 4357.0995330811): SELECT name FROM jos_deeppockets WHERE id=214

138 (83.92333984375): SELECT name FROM jos_deeppockets WHERE id=214

139 (781.05926513672): 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 (!!!!! 1478.910446167): 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 (370.97930908203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

142 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

143 (!!!!! 6639.0037536621): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 1837.9688262939): 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=294752417 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (566.00570678711): 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=294752417 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 1466.9895172119): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (365.01884460449): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 5293.8461303711): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

149 (611.0668182373): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

150 (!!!!! 2852.201461792): 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 (!!!!! 4820.8236694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

152 (108.95729064941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

153 (!!!!! 2635.0021362305): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294752417 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294752417 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (380.9928894043): 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 (474.92980957031): 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 (!!!!! 2623.0812072754): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (108.95729064941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

158 (235.79597473145): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752417 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752417 AND published='1' LIMIT 1

159 (!!!!! 1588.1061553955): select jos_twitters.link from jos_twitters where cat=10

160 (213.8614654541): select jos_facebook.link from jos_facebook where cat=10

161 (54.836273193359): select jos_google_plus.link from jos_google_plus where cat=10

162 (370.97930908203): select jos_linkedin.link from jos_linkedin where cat=10

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