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Wider Use of Ultrasound Screening in Asymptomatic People Recommended to Treat Vascular Disease

By MedImaging International staff writers
Posted on 25 Aug 2014

Data presented at a recent international angiology congress emphasized the benefits of ultrasound screening in identifying early signs of vascular disease in otherwise low- to moderate-risk asymptomatic individuals, with the potential to cut in half the incidence of stroke and heart attacks.

Research has shown that one-in-three people developing myocardial infarction (MI) will not exhibit any of the traditional risk factors, and 80% of strokes occur without warning in asymptomatic patients.

Early signs of vascular disease such as atherosclerotic plaques and narrowing of the arteries are indicators of risk and can be easily detected using ultrasound. Research and analysis presented at the IUA by several leading cardiovascular specialists, shows identifying asymptomatic individuals at risk as early as possible, and targeting them for aggressive risk factor modification, can dramatically reduce morbidity and mortality from myocardial infarction and stroke by 50%.

Research presented at the 26th World Congress of the International Union of Angiology (IUA), held August 2014, in Sydney (NSW, Australia) also revealed that a significant proportion of the population may have early signs of vascular disease. Study findings presented from a screening study in Australia showed the general prevalence of significant carotid vessel disease was 1.7%, and the prevalence of abdominal aortic aneurysm (AAA; where the dilatation of artery is > 3 cm) was 2% with some having a large (> 5 cm) life-threatening aneurysm that carries more than 20% risk of rupture in the next 12 months. The prevalence of 2% exceeds the 1% threshold typically used as a guideline to provide cost-effective screening in the general population, and supports unrestricted use of ultrasound screening to detect AAA and other cardiovascular diseases.

Data were also presented at the meeting from an epidemiologic study performed by Imperial College London (UK) and Life Line Screening UK (London) looking at demographics and risk factors in 2,419 patients with AAA detected by ultrasound screening. Carotid artery disease, history of MI, diabetes, hyperlipidemia, smoking and family history were shown to be independent risk factors for AAA in men.

A significant percentage of AAAs were found among males younger than 65. This suggests limitations in the current screening recommendations where males in the United Kingdom over the age of 65 are invited for screening by the UK National Health Service (NHS). Using the 1% threshold or greater to provide cost-effective screening, all women aged over 80 and women aged 70–79 who have two or more risk factors would benefit from being invited for screening (prevalence 0.98%–1.25%).

“Atherosclerotic arterial disease which is responsible for heart attacks and strokes, develops slowly and silently for many years before it becomes manifest as disease,” said Prof. Andrew Nicolaides, emeritus professor of vascular surgery at Imperial College London. “Its detection and silent progression can be recorded accurately with ultrasound scans. The presence of such deposits places an individual at high risk yet intervention with modern medical therapy can reduce the risk of heart attacks and strokes by 50%.”

According to Dr. Mohsen Chabok, medical research physician, Life Line Screening UK, “Arterial imaging of the carotid peripheral circulation can be used to further refine risk based on Framingham Risk Scoring. More accurate diagnosis allows more targeted treatment. I think it is time to seriously consider the value of ultrasound screening for vascular disease in asymptomatic patients.”

Other key data presented at the IUA meeting showed that patients with asymptomatic carotid artery disease are at 200% greater risk of developing chronic kidney disease (CKD). High blood pressure, carotid artery disease, peripheral artery disease, and history of stroke or heart disease double the risk of developing CKD.

Related Links:
Imperial College London
Life Line Screening UK

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59 (!!!!! 10766.02935791): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

60 (!!!!! 7866.1441802979): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

61 (!!!!! 8788.1088256836): 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 (!!!!! 7848.9780426025): SELECT fid FROM jos_deeppockets WHERE id=294754149 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294754149 AND published='1' LIMIT 1

63 (!!!!! 4336.1186981201): 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 (!!!!! 7300.1384735107): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 7931.9477081299): select jos_facebook.link from jos_facebook where cat=10

66 (!!!!! 6446.8383789062): select jos_google_plus.link from jos_google_plus where cat=10

67 (863.07525634766): select jos_linkedin.link from jos_linkedin where cat=10

68 (138.0443572998): SELECT fid FROM jos_deeppockets WHERE id=294754149 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294754149 AND published='1' LIMIT 1

69 (!!!!! 4283.9050292969): 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 (!!!!! 4256.010055542): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294754149 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 7171.8692779541): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294754149 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 4405.0216674805): 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 (333.07075500488): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (151.8726348877): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (!!!!! 1783.1325531006): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (215.05355834961): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (176.90658569336): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (156.16416931152): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (173.09188842773): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (488.0428314209): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294754149 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (164.98565673828): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294754149 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (44.822692871094): 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 (!!!!! 3723.8597869873): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (145.91217041016): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (151.15737915039): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (180.00602722168): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (!!!!! 2998.1136322021): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (294.92378234863): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (200.03318786621): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (195.02639770508): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (658.03527832031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

105 (171.89979553223): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

106 (71.048736572266): 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=294754149 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (676.87034606934): 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=294754149 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1013.9942169189): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

109 (!!!!! 2732.9921722412): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

110 (840.18707275391): 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=294754149 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (550.0316619873): 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=294754149 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (746.01173400879): 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 (400.06637573242): 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 (!!!!! 1059.0553283691): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

115 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

116 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

117 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

118 (186.92016601562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

119 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

120 (138.99803161621): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

121 (129.93812561035): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

122 (327.82554626465): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 49751.996994019): 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 (892.87757873535): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294754149 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294754149 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (200.98686218262): ( 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 (45.061111450195): ( 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 (394.10591125488): 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 (42.200088500977): 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 (254.86946105957): 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 (39.100646972656): 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 (35.04753112793): 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 (350.9521484375): 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 (38.862228393555): 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 (30.040740966797): 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 (656.1279296875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (391.00646972656): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (225.06713867188): SELECT name FROM jos_deeppockets WHERE id=214

138 (35.04753112793): SELECT name FROM jos_deeppockets WHERE id=214

139 (536.20338439941): 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 (452.99530029297): 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 (679.01611328125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

142 (90.837478637695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

143 (!!!!! 10182.857513428): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 7470.8461761475): 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=294754149 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 6839.0369415283): 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=294754149 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (751.97219848633): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (388.14544677734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (218.15299987793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

149 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

150 (!!!!! 5784.9884033203): 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 (236.98806762695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

152 (96.797943115234): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

153 (943.89915466309): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294754149 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294754149 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (40.054321289062): 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 (30.994415283203): 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 (41.961669921875): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 1044.0349578857): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

158 (!!!!! 4362.1063232422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294754149 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294754149 AND published='1' LIMIT 1

159 (!!!!! 2202.9876708984): select jos_twitters.link from jos_twitters where cat=10

160 (65.088272094727): select jos_facebook.link from jos_facebook where cat=10

161 (35.04753112793): select jos_google_plus.link from jos_google_plus where cat=10

162 (31.948089599609): select jos_linkedin.link from jos_linkedin where cat=10

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