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Focused Ultrasound Device Helps Treat Essential Tremor

By MedImaging International staff writers
Posted on 27 Jul 2016

An innovative device uses magnetic resonance imaging (MRI) guidance to deliver focused ultrasound into the thalamus, the area of the brain thought to be responsible for tremor.

The ExAblate Neuro device is designed to deliver precise high-intensity focused ultrasound (HIFU) waves to target a focal point in the Vim nucleus of the thalamus, a part of the brain thought to be responsible for causing tremors. The proprietary ultrasound transducer consists of 1,024 beams that generate heat at a focal point of up to 85○C to ablate targeted tissue the frequencies used for therapeutic ultrasound are in the range of 220-680 MHz. The result is an immediate and significant reduction of tremor for patients.

During planning and treatment for essential tremor, the patient is fully conscious and lying on the treatment bed in a proprietary MR guided focused ultrasound (MRgFUS) system. The MRI provides high-resolution visualization, patient-specific treatment planning, and continuous monitoring of the procedure. Real-time thermal feedback allows the physician to control and adjust the treatment, ensuring that the targeted tissue is completely ablated without impacting adjacent healthy tissue. The ExAblate Neuro device is a product of InSightec (Dallas, TX, USA), and has been approved by the U.S. Food and Drug Administration (FDA).

“I am confident that we have arrived at a tipping point for non-invasive medical treatment,” said Maurice Ferré, MD, CEO and chairman of the board of InSightec. “Focused ultrasound has the unique ability to precisely ablate target tissue deep within the body. With Exablate Neuro, InSightec expands its Exablate product line with a system that signifies a new era for functional neurosurgery.”

“Patients with essential tremor who have not seen improvement with medication now have a new treatment option that could help them to avoid more invasive surgical treatments,” said Carlos Peña, PhD, director of the division of neurological and physical medicine devices at the FDA Center for Devices and Radiological Health (CDRH). “As with other treatments for essential tremor, this new device is not a cure but could help patients enjoy a better quality of life.”

HIFU technology is based on nonlinear acoustic mathematical optimization methods to analyze and simulate the propagation of sound in material. The information is then used to enhance the shape of an acoustic lens in such a way that that ultrasound pressure is focused precisely on the location of the tissue to be ablated, while the surrounding tissue retains as little damage as possible.

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65 (124.21607971191): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

66 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

67 (73.19450378418): 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

68 (526.90505981445): SELECT fid FROM jos_deeppockets WHERE id=294765294 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294765294 AND published='1' LIMIT 1

69 (47.922134399414): 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=212 ORDER BY `ordering`

70 (41.961669921875): select jos_twitters.link from jos_twitters where cat=10

71 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

72 (29.087066650391): select jos_google_plus.link from jos_google_plus where cat=10

73 (28.133392333984): select jos_linkedin.link from jos_linkedin where cat=10

74 (30.040740966797): SELECT fid FROM jos_deeppockets WHERE id=294765294 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294765294 AND published='1' LIMIT 1

75 (31.948089599609): 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=212 ORDER BY `ordering`

76 (334.02442932129): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294765294 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

77 (223.15979003906): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294765294 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

78 (43.153762817383): 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`

79 (57.93571472168): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (902.17590332031): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (45.061111450195): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294765294 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

94 (29.087066650391): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294765294 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

95 (31.948089599609): 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`

96 (65.088272094727): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (24.080276489258): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

109 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

110 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

111 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

112 (48.87580871582): 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=294765294 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (41.007995605469): 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=294765294 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (!!!!! 1635.0746154785): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

115 (76.770782470703): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

116 (46.968460083008): 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=294765294 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

117 (405.07316589355): 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=294765294 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

118 (616.07360839844): 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

119 (431.06079101562): 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

120 (98.943710327148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

121 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

122 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

123 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

124 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

125 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

126 (261.78359985352): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

127 (!!!!! 39646.863937378): 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

128 (90.837478637695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

129 (44.822692871094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

130 (376.93977355957): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294765294 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294765294 AND type='deeppockets_item' AND published='1' LIMIT 1

131 (!!!!! 472802.87742615): ( 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

132 (104.90417480469): ( 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

133 (50.067901611328): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

134 (36.954879760742): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

135 (37.193298339844): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

136 (34.809112548828): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

137 (35.04753112793): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

138 (33.855438232422): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

139 (524.99771118164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (515.93780517578): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

141 (49.829483032227): SELECT name FROM jos_deeppockets WHERE id=212

142 (36.001205444336): SELECT name FROM jos_deeppockets WHERE id=212

143 (576.97296142578): 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 '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (503.0632019043): 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 '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

145 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

146 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

147 (!!!!! 10470.151901245): TRUNCATE TABLE jos_trademed_module

148 (125.88500976562): 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=294765294 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (82.015991210938): 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=294765294 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

150 (!!!!! 1065.9694671631): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

152 (90.837478637695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

153 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

154 (!!!!! 1537.0845794678): 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

155 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

156 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

157 (61.988830566406): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294765294 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294765294 AND type='deeppockets_item' AND published='1' LIMIT 1

158 (47.922134399414): 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=212 or channel_id is null)

159 (41.007995605469): 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=212 or channel_id is null)

160 (56.982040405273): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

161 (90.122222900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

162 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765294 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765294 AND published='1' LIMIT 1

163 (59.127807617188): select jos_twitters.link from jos_twitters where cat=10

164 (31.948089599609): select jos_facebook.link from jos_facebook where cat=10

165 (29.087066650391): select jos_google_plus.link from jos_google_plus where cat=10

166 (28.133392333984): select jos_linkedin.link from jos_linkedin where cat=10

167 (299.93057250977): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

168 (!!!!! 1180.88722229): insert into jos_banners_delta values (14615,'2025-04-29 22:04:40','18.223.172.149','view'),(14202,'2025-04-29 22:04:40','18.223.172.149','view'),(14203,'2025-04-29 22:04:40','18.223.172.149','view')

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