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Ultrasound-Guided Surgery More Effective for Treating Early Form of Breast Cancer

By MedImaging International staff writers
Posted on 21 Nov 2022

Image: Surgeon using IOUS to guide breast surgery (Photo courtesy of Clinica Universidad de Navarra)

Using ultrasound to guide surgery for patients with ductal carcinoma in situ (DCIS) gives better results than the standard technique of using a wire inserted into the breast, according to new research. The technique, known as intraoperative ultrasound, or IOUS, enables surgeons to remove a smaller quantity of breast tissue, while still removing all the of DCIS tissue. Using IOUS improves the chance of having no cancer cells at the outer edge of the tissue that was removed (known as positive margins), reducing the risk of patients needing a second operation. Because IOUS negates the need for inserting a guide wire, this technique could also reduce pain and preoperative stress for patients and save time for medical staff.

The research carried out by a team at Clinica Universidad de Navarra (Madrid, Spain) involved 108 people who were diagnosed with DCIS and treated between February 2018 and December 2021. Forty-one were treated with IOUS-guided surgery while 67 were treated with surgery guided by wire localization (WL). Following each operation, the tissue removed was analyzed to see how much was removed and whether there were ‘positive margins’. This means that DCIS cells were found at the edge of the tissue removed, suggesting some DCIS cells could have been left behind and patients would probably need a second operation.

Among those treated using WL, seven (10.4%) had positive margins and needed a second operation while in those treated using IOUS, there were only two patients (4.8%) with positive margins who needed a second operation. The patients have been followed up for a year and half so far and cancer has only recurred in one (who was treated with WL). The researchers plan to continue gathering information about patients having surgery for DCIS in the hopes of seeing long-term benefits of using IOUS.

“DCIS is a common form of early breast cancer that can develop into a more serious, invasive cancer. To ensure it does not progress, patients are usually offered surgery. Because DCIS does not usually create lumps in the breast, we need a good technique to guide surgery and make it accurate as possible,” said Dr. Antonio J. Esgueva at Clinica Universidad de Navarra. “As breast surgeons, we want to perform the very best oncological surgery in terms of removing any trace of DCIS but also removing as little of the breast tissue as possible in order to have the best cosmetic result possible. At the same time, we also want to improve patients' experience during treatment by using less invasive techniques and reducing their anxiety. Our research suggests that using intraoperative ultrasound, a quicker and less invasive technique, is effective for guiding DCIS surgery.”

“Once intervention is planned, the standard treatment for patients diagnosed with DCIS is surgery. The need for a second operation due to positive margins can be an issue. This research is promising because it shows that a kinder technique can help guide surgeons to effectively remove DCIS from the breast while minimising unwanted side-effects,” added Dr. Laura Biganzoli, Co-Chair of the European Breast Cancer Conference and Director of the Breast Centre at Santo Stefano Hospital, Prato, Italy, who was not involved in the research.

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61 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

62 (142.09747314453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

63 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

64 (!!!!! 5637.1688842773): 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

65 (878.09562683105): SELECT fid FROM jos_deeppockets WHERE id=294795406 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294795406 AND published='1' LIMIT 1

66 (80.82389831543): 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`

67 (68.902969360352): select jos_twitters.link from jos_twitters where cat=10

68 (51.975250244141): select jos_facebook.link from jos_facebook where cat=10

69 (35.04753112793): select jos_google_plus.link from jos_google_plus where cat=10

70 (37.908554077148): select jos_linkedin.link from jos_linkedin where cat=10

71 (61.988830566406): SELECT fid FROM jos_deeppockets WHERE id=294795406 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294795406 AND published='1' LIMIT 1

72 (41.007995605469): 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`

73 (338.07754516602): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795406 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (229.83551025391): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795406 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (36.954879760742): 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`

76 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (71.048736572266): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (!!!!! 5288.83934021): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795406 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (89.168548583984): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795406 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (38.862228393555): 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`

93 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (315.90461730957): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (114.91775512695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

108 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

109 (53.882598876953): 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=294795406 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (547.88589477539): 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=294795406 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

112 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

113 (93.221664428711): 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=294795406 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (563.14468383789): 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=294795406 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (715.01731872559): 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 (406.02684020996): 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

117 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

118 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

119 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

120 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

121 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

122 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

123 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

124 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

125 (325.91819763184): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 40482.997894287): 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

127 (475.88348388672): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795406 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795406 AND type='deeppockets_item' AND published='1' LIMIT 1

128 (51.021575927734): ( 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 (33.855438232422): ( 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

130 (71.048736572266): 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 (44.107437133789): 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

132 (49.829483032227): 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 (30.040740966797): 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

134 (29.802322387695): 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 (30.040740966797): 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

136 (31.948089599609): 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 (29.802322387695): 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

138 (559.09156799316): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (442.0280456543): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (46.968460083008): SELECT name FROM jos_deeppockets WHERE id=214

141 (29.802322387695): SELECT name FROM jos_deeppockets WHERE id=214

142 (512.12310791016): 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 (428.91502380371): 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

144 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

145 (106.0962677002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

146 (!!!!! 24723.052978516): TRUNCATE TABLE jos_trademed_module

147 (108.00361633301): 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=294795406 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (68.902969360352): 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=294795406 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (799.17907714844): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (68.187713623047): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

152 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

153 (!!!!! 1116.9910430908): 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

154 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

155 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

156 (37.193298339844): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795406 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795406 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (31.948089599609): 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 (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)

159 (47.922134399414): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (91.791152954102): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

161 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795406 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795406 AND published='1' LIMIT 1

162 (35.04753112793): select jos_twitters.link from jos_twitters where cat=10

163 (49.114227294922): select jos_facebook.link from jos_facebook where cat=10

164 (32.901763916016): select jos_google_plus.link from jos_google_plus where cat=10

165 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

166 (226.02081298828): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14202,14203)

167 (!!!!! 1371.1452484131): insert into jos_banners_delta values (14202,'2025-08-04 04:29:36','216.73.216.210','view'),(14203,'2025-08-04 04:29:36','216.73.216.210','view')

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