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Echocardiography Helps Predict Pulmonary Embolism Outcomes

By MedImaging International staff writers
Posted on 12 Sep 2018

A new study suggests that transthoracic echocardiography (TTE) can help clinicians calculate short-term mortality outcomes for patients with acute pulmonary embolism (PE).

For the study, researchers at New York-Presbyterian Hospital/Columbia University Medical Center (NYP; New York, NY, USA), University Hospital Lausanne (CHUV; Switzerland), and other institutions extracted data for the years 2001-2017 from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a 179 collaborating centers registry of consecutive patients with acute PE in the Americas, Asia, and Europe. More...

An analysis was then conducted in order to determine contemporary utilization of early TTE and explore the association between TTE findings and PE‐related mortality.

The results revealed that among 35,935 enrollees with acute PE, 42.8% underwent early TTE, with an evident increase in early TTE utilization rate over time. Younger age, female sex, history of coronary disease, heart failure (HD), atrial fibrillation (AF), tachycardia, and hypotension were the main predictors of early TTE. In multivariable analyses, right atrial enlargement, right ventricular hypokinesis, and right heart thrombi were associated with increased odds for PE‐related mortality. The study was published on August 26, 2018, in the Journal of the American Heart Association.

“Acute pulmonary embolism is a serious thromboembolic condition accounting for thousands of hospitalizations and associated with high short-term mortality rates. Some studies suggest that TTE could help in the early risk stratification of patients with acute PE,” concluded lead author Behnood Bikdeli, MD, of NYP, and colleagues. “Early TTE was performed in over one-third of patients, and the proportion increased over time. History of prior cardiovascular disease and clinical markers of PE severity were among the main predictors of early TTE.”

TTE is the most common type of echocardiogram, involving an ultrasonic transducer placed non-invasively on the chest or abdomen to assess the overall health of the heart, including evaluation of all four chambers, the condition of the heart valves, the endocardium, and the aorta. It can be used to detect a heart attack, enlargement or hypertrophy of the heart, infiltrations, cardiac tumors and a variety of other findings. The images are displayed on-screen for real-time viewing, and then recorded.

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New York-Presbyterian Hospital
University Hospital Lausanne

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60 (!!!!! 5294.0845489502): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

61 (!!!!! 3470.8976745605): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

62 (535.01129150391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

63 (632.04765319824): 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 (525.95138549805): SELECT fid FROM jos_deeppockets WHERE id=294774856 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294774856 AND published='1' LIMIT 1

65 (543.11752319336): 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`

66 (46.968460083008): select jos_twitters.link from jos_twitters where cat=10

67 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

68 (175.95291137695): select jos_google_plus.link from jos_google_plus where cat=10

69 (36.954879760742): select jos_linkedin.link from jos_linkedin where cat=10

70 (283.95652770996): SELECT fid FROM jos_deeppockets WHERE id=294774856 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294774856 AND published='1' LIMIT 1

71 (45.061111450195): 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`

72 (!!!!! 1094.8181152344): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774856 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (475.16822814941): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774856 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (66.041946411133): 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 (!!!!! 3865.0035858154): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (101.80473327637): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (342.84591674805): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (409.12628173828): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774856 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (143.05114746094): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774856 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (45.061111450195): 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 (514.98413085938): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (211.00044250488): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (216.00723266602): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (221.01402282715): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (193.11904907227): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (141.85905456543): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (146.86584472656): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (624.8950958252): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

107 (186.92016601562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

108 (231.02760314941): 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=294774856 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (573.87351989746): 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=294774856 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (770.09201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

111 (276.08871459961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

112 (155.92575073242): 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=294774856 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (694.99015808105): 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=294774856 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (!!!!! 2197.9808807373): 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 (!!!!! 3824.9492645264): 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 (345.94535827637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

117 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

118 (308.03680419922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

119 (179.05235290527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

120 (293.01643371582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

121 (174.04556274414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

122 (217.91458129883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

123 (215.05355834961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

124 (741.95861816406): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 66978.931427002): 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 (!!!!! 1850.1281738281): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774856 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774856 AND type='deeppockets_item' AND published='1' LIMIT 1

127 (!!!!! 68682.909011841): ( 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 (78.916549682617): ( 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 (53.882598876953): 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 (46.014785766602): 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 (!!!!! 1900.1960754395): 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 (66.995620727539): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

133 (364.06517028809): 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 (48.87580871582): 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 (48.160552978516): 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 (40.054321289062): 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 (516.17622375488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (350.9521484375): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (79.870223999023): SELECT name FROM jos_deeppockets WHERE id=214

140 (37.908554077148): SELECT name FROM jos_deeppockets WHERE id=214

141 (833.98818969727): 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

142 (902.89115905762): 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

143 (115.15617370605): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

144 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

145 (!!!!! 12797.832489014): TRUNCATE TABLE jos_trademed_module

146 (!!!!! 2907.0377349854): 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=294774856 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (164.03198242188): 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=294774856 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (669.00253295898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (185.01281738281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (180.95970153809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

151 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

152 (!!!!! 1721.1437225342): 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 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

154 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

155 (47.922134399414): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774856 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774856 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (39.100646972656): 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)

157 (36.954879760742): 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)

158 (320.1961517334): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

160 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774856 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774856 AND published='1' LIMIT 1

161 (66.041946411133): select jos_twitters.link from jos_twitters where cat=10

162 (38.862228393555): select jos_facebook.link from jos_facebook where cat=10

163 (36.001205444336): select jos_google_plus.link from jos_google_plus where cat=10

164 (37.908554077148): select jos_linkedin.link from jos_linkedin where cat=10

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