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Sepsis, som er den tredjehyppigste dødsårsag, registreres ikke i Danmark

- og mangel på D-vitamin øger risikoen

Sepsis, som er den tredjehyppigste dødsårsag, registreres ikke i DanmarkDe færreste tænker på faren ved at få sepsis, som er en alvorlig blodforgiftning. Men ifølge WHO er sepsis meget udbredt og den tredje hyppigste dødsårsag, næst efter hjertekarsygdomme og kræft. Ifølge Ugeskrift for Læger er det derfor et paradoks, at der i Danmark ikke findes nogen samlet registrering af forekomsten og den høje dødelighed. Det viser sig desuden, at risikoen for at få sepsis og dø af sygdommen øges gevaldigt, hvis man mangler D-vitamin. Det fremgår af et iransk studie, der er publiceret i Archives of Academic Emergency Medicine. Derfor trænger vi til meget mere fokus på sepsis, inklusive diagnose, hurtig behandling og ikke mindst forebyggelse af den livstruende sygdom.

Sepsis udgår som regel fra infektioner i andre organer som lungebetændelse, urinvejsinfektion eller sårinfektion. Inden for få timer kan sepsis påvirke kredsløbet, lunger og flere indre organer. Dødeligheden er op til 50 procent, hvis patienterne får septisk chock. Det er en livstruende tilstand, som skyldes, at immunforsvaret reagerer for voldsomt på infektionen i blodbanen med cytokinstorm og hyperinflammation. Derved angriber immunforsvaret sundt væv. Symptomerne, der ofte overses eller fejldiagnosticeres, inkluderer høj feber, hjertebanken, vejrtrækningsbesvær, forvirring, sløvhed og sløret udtale. Mange af symptomerne skyldes dehydrering. Sepsis kræver øjeblikkelig behandling, og det er især i form af kortison (binyrebarkhormoner), der hæmmer det overaktive immunforsvar. Men behandlingen er ofte utilstrækkelig, og ifølge WHO er sygdommen den tredje hyppigste dødsårsag næst efter hjertekarsygdomme og kræft. Derfor er det langt bedre at forebygge sygdommens komplikationer, hvor D-vitamin spiller en afgørende rolle.

  • Ifølge 2016-definitionen er sepsis en tilstand med livstruende organdysfunktioner på grund af en dysreguleret respons på infektion.
  • Når danske patienter har infektionssygdomme og dør af ledsagende sepsis, registrerer man typisk infektionen og ikke sepsis som dødsårsag.
  • Det estimeres, at 56.000 danskere hvert år rammes af sepsis, og at dødsfald på grund af sepsis udgør 15 procent af alle dødsfald.
  • På verdensplan er der årligt mere end 31 millioner tilfælde af sepsis, og det estimeres, at 5,1 million dør af sygdommen

D-vitamin aktiverer immunforsvaret og modvirker livstruende inflammationer

De fleste af kroppens celler har receptorer for D-vitamin, som aktiverer og regulerer en række gener og et utal af biokemiske processer i kroppen. D-vitamin har således afgørende betydning for aktivering af immunforsvarets hvide blodlegemer, der skal angribe virus og bakterier målrettet og effektivt. Hvis vi mangler D-vitamin, forbliver immunforsvaret passivt med fare for, at infektionen tager overhånd. D-vitamin hæmmer samtidig dannelsen af proinflammatoriske cytokiner, som er afgørende for, at immunforsvaret ikke går amok og forårsager vævsskader.

  • Sommersolen er den primære kilde til D-vitamin
  • Mange kommer i underskud i løbet af vinterhalvåret
  • Indendørs livsførelse, mørk hud, overvægt og aldringsprocesser øger risikoen for kronisk mangel
  • Det estimeres, at én milliard mennesker på verdensplan mangler D-vitamin

Større risiko for at dø af sepsis ved mangel på D-vitamin

Forskerne bag det iranske studie ville se nærmere på sammenhængen mellem blodets indhold af D-vitamin og risikoen for at dø af sepsis. I studiet deltog der 168 patienter med sepsis. Patienterne var over 18 år med en gennemsnitsalder på 70.8 år, og der var en jævn fordeling mellem mænd og kvinder. Alle patienterne fik målt blodets indhold af D-vitamin, hvor 20-50 nmol/L blev vurderet som normal. Det viste sig, at 61,6 procent af patienterne manglede D-vitamin. Denne mangel øgede signifikant risikoen for at dø af sepsis. Det samme gjorde en høj alder.
I henhold til studiet antager forskerne derfor, at tilskud med D-vitamin kan være en god hjælp i forebyggelsen af infektioner i blodet, og at de udvikler sig til livstruende sepsis. Det gælder ikke mindst for de ældre.

  • I Danmark opdeles blodet indhold af D-vitamin i regulær mangel (under 30 nmol/L), utilstrækkelig (30-50 nmol/L) og tilstrækkelig (over 50 nmol/L).
  • I lande som Iran ligger den nedre grænse lavere og på 20 nmol/L.
  • Ifølge flere danske og internationale studier, skal værdierne gerne ligge over 75 mol/L.

RI og reelle behov for D-vitamin

Referenceindtag, RI, for hvide voksne under 70 år er 5 mikrogram. Den danske sundhedsstyrelse anbefaler tilskud med 10 mikrogram til gravide, småbørn, personer med mørk hud og personer, der ikke får direkte sollys. Tilskud med 20 mikrogram anbefales til plejehjemsbeboere og personer over 70 år. Mange forskere hævder nu, at det reelle behov for D-vitamin ligger meget højere, hvis vi skal opnå et optimalt niveau i blodet.
På markedet findes der stærke tilskud med 20-80 mikrogram, og det reelle behov afhænger af alder, hudtype, BMI, kroniske sygdomme og indtagelse af kolesterolsænkende medicin, statiner.
Da D-vitaminet er et fedtopløseligt vitamin, får vi den bedste udnyttelse i tilskud som kapsler, hvor D-vitaminet er bundet til olie.

Hvilke ligheder er der mellem livstruende sepsis, COVID-19 og influenza?

Når sepsis, COVID-19 og influenza bliver livstruende, skyldes det i alle tre tilfælde, at immunforsvaret overreagerer med cytokinstorm og hyperinflammation, der angriber sundt væv. Det er altså ikke de pågældende bakterier eller virus som sådan, der bliver livstruende, men vores eget immunforsvar, der går amok, fordi det blandt andet mangler livsvigtige næringsstoffer som D-vitamin.

Referencer:

Majid Shojaei et al. The Correlation between Serum Level of Vitamin D Outcome of Sepsis Patients; a Cross-sectional Study. Archives of Academic Emergency Medicine 2019

Palle Toft og Thomas Strøm. Sepsis, den tredjehyppigste dødsårsag, registreres ikke i Danmark. Ugeskrift for Læger 2018

Essen MR et al. Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nat Immunol 2010

University of Copenhagen. Vitamin D crucial to activating immune Defences. 2010

Eamon Laird, Rose Anne Kenny. Vitamin D deficiency in Ireland – implications for COVID 19. Results from the Irish Longitudinal Study on Ageing (TILDA) April 2020

https://www.sundhed.dk/sundhedsfaglig/laegehaandbogen/endokrinologi/tilstande-og-sygdomme/knoglevaev-og-vitamin-d/d-vitamin-mangel/

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  • SELECT `a`.`id`,`a`.`asset_id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`state`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`version`,`a`.`ordering`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`metadata`,`a`.`featured`,`a`.`language`,`fp`.`featured_up`,`fp`.`featured_down`,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`language` AS `category_language`,`fp`.`ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1) AS `rating`,`v`.`rating_count` AS `rating_count` FROM `has_content` AS `a` INNER JOIN `has_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `has_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `has_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `has_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `has_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE ( (`a`.`id` = :pk AND `c`.`published` > 0 AND `a`.`language` IN (:preparedArray1,:preparedArray2)) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp)) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`state` IN (:preparedArray3,:preparedArray4)349μs22.19KBParams/components/com_content/src/Model/ArticleModel.php:215Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `has_categories` AS `s` INNER JOIN `has_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`656μs3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `has_contentitem_tag_map` AS `m` INNER JOIN `has_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2) AND `language` IN (:preparedArray3,:preparedArray4)21.93ms4.08KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `has_categories` AS `s` INNER JOIN `has_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`1.62ms3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT DISTINCT a.id, a.title, a.name, a.checked_out, a.checked_out_time, a.note, a.state, a.access, a.created_time, a.created_user_id, a.ordering, a.language, a.fieldparams, a.params, a.type, a.default_value, a.context, a.group_id, a.label, a.description, a.required, a.only_use_in_subform,l.title AS language_title, l.image AS language_image,uc.name AS editor,ag.title AS access_level,ua.name AS author_name,g.title AS group_title, g.access as group_access, g.state AS group_state, g.note as group_note FROM has_fields AS a LEFT JOIN `has_languages` AS l ON l.lang_code = a.language LEFT JOIN has_users AS uc ON uc.id=a.checked_out LEFT JOIN has_viewlevels AS ag ON ag.id = a.access LEFT JOIN has_users AS ua ON ua.id = a.created_user_id LEFT JOIN has_fields_groups AS g ON g.id = a.group_id LEFT JOIN `has_fields_categories` AS fc ON fc.field_id = a.id WHERE ( (`a`.`context` = :context AND (`fc`.`category_id` IS NULL OR `fc`.`category_id` IN (:preparedArray1,:preparedArray2,:preparedArray3)) AND `a`.`access` IN (:preparedArray4,:preparedArray5)) AND (`a`.`group_id` = 0 OR `g`.`access` IN (:preparedArray6,:preparedArray7)) AND `a`.`state` = :state) AND (`a`.`group_id` = 0 OR `g`.`state` = :gstate) AND `a`.`only_use_in_subform` = :only_use_in_subform AND `a`.`language` IN (:preparedArray8,:preparedArray9) ORDER BY a.ordering ASC515μs4.81KBParams/libraries/src/MVC/Model/BaseDatabaseModel.php:166Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id1.04ms1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id1.04ms1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `m`.`id`,`m`.`title`,`m`.`module`,`m`.`position`,`m`.`content`,`m`.`showtitle`,`m`.`params`,`mm`.`menuid` FROM `has_modules` AS `m` LEFT JOIN `has_modules_menu` AS `mm` ON `mm`.`moduleid` = `m`.`id` LEFT JOIN `has_extensions` AS `e` ON `e`.`element` = `m`.`module` AND `e`.`client_id` = `m`.`client_id` WHERE ( ( (`m`.`published` = 1 AND `e`.`enabled` = 1 AND `m`.`client_id` = :clientId AND `m`.`access` IN (:preparedArray1,:preparedArray2)) AND (`m`.`publish_up` IS NULL OR `m`.`publish_up` <= :publishUp)) AND (`m`.`publish_down` IS NULL OR `m`.`publish_down` >= :publishDown)) AND (`mm`.`menuid` = :itemId OR `mm`.`menuid` <= 0) AND `m`.`language` IN (:preparedArray3,:preparedArray4) ORDER BY `m`.`position`,`m`.`ordering`13.3ms261.84KBParams/libraries/src/Cache/Controller/CallbackController.php:51Copy
  • SELECT `a`.`id`,`a`.`title`,`a`.`catid`,`a`.`language`, CASE WHEN CHAR_LENGTH(`a`.`alias`) != 0 THEN CONCAT_WS(':', `a`.`id`, `a`.`alias`) ELSE a.id END AS `slug`, CASE WHEN CHAR_LENGTH(`cc`.`alias`) != 0 THEN CONCAT_WS(':', `cc`.`id`, `cc`.`alias`) ELSE cc.id END AS `catslug` FROM `has_content` AS `a` LEFT JOIN `has_categories` AS `cc` ON `cc`.`id` = `a`.`catid` WHERE `a`.`catid` = :catid AND `a`.`state` = :state AND `a`.`access` IN (:preparedArray1,:preparedArray2) AND (`publish_up` IS NULL OR `publish_up` <= :nowDate1) AND (`publish_down` IS NULL OR `publish_down` >= :nowDate2) AND `a`.`language` IN (:preparedArray3,:preparedArray4) ORDER BY CASE WHEN `a`.`publish_up` IS NULL THEN `a`.`created` ELSE `a`.`publish_up` END DESC38.72ms161.75KBParams/plugins/content/pagenavigation/src/Extension/PageNavigation.php:188Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `has_categories` AS `s` INNER JOIN `has_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`3.54ms3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT custom_data FROM has_extensions WHERE element = 'yootheme' AND folder = 'system' LIMIT 13.88ms536B/templates/yootheme/packages/platform-joomla/src/Storage.php:30Copy
  • SELECT `language`,`id` FROM `has_menu` WHERE `home` = '1' AND `published` = 1 AND `client_id` = 0280μs704B/libraries/src/Language/Multilanguage.php:123Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id2.13ms1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id2.75ms1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `c2`.`language`,CONCAT_WS(':', `c2`.`id`, `c2`.`alias`) AS `id`,CONCAT_WS(':', `ca`.`id`, `ca`.`alias`) AS `catid` FROM `has_content` AS `c` INNER JOIN `has_associations` AS `a` ON `a`.`id` = `c`.`id` AND `a`.`context` = :context INNER JOIN `has_associations` AS `a2` ON `a`.`key` = `a2`.`key` INNER JOIN `has_content` AS `c2` ON `a2`.`id` = `c2`.`id` INNER JOIN `has_categories` AS `ca` ON `c2`.`catid` = `ca`.`id` AND `ca`.`extension` = :extension2 WHERE `c`.`id` = :id AND c2.access IN (1,5) AND c2.language != 'da-DK' AND (c2.publish_up IS NULL OR c2.publish_up <= '2025-01-30 22:17:34') AND (c2.publish_down IS NULL OR c2.publish_down >= '2025-01-30 22:17:34') AND c2.state = 11.86ms3.97KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug`,( SELECT COUNT(`i`.`id`) FROM `has_content` AS `i` WHERE `i`.`catid` = `c`.`id` AND `i`.`state` = 1 AND `i`.`language` IN (:preparedArray5,:preparedArray6)) AS `numitems` FROM `has_categories` AS `s` INNER JOIN `has_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`43.17ms4.05KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `a`.`id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,CASE WHEN `a`.`publish_up` IS NULL THEN `a`.`created` ELSE `a`.`publish_up` END AS `publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`metadata`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`featured`,`a`.`language`,LENGTH(`a`.`fulltext`) AS `readmore`,`a`.`ordering`,`fp`.`featured_up`,`fp`.`featured_down`,CASE WHEN `c`.`published` = 2 AND `a`.`state` > 0 THEN 2 WHEN `c`.`published` != 1 THEN 0 ELSE `a`.`state` END AS `state`,`c`.`title` AS `category_title`,`c`.`path` AS `category_route`,`c`.`access` AS `category_access`,`c`.`alias` AS `category_alias`,`c`.`language` AS `category_language`,`c`.`published`,`c`.`published` AS `parents_published`,`c`.`lft`,CASE WHEN `a`.`created_by_alias` > ' ' THEN `a`.`created_by_alias` ELSE `ua`.`name` END AS `author`,`ua`.`email` AS `author_email`,`uam`.`name` AS `modified_by_name`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,COALESCE(NULLIF(ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1), 0), 0) AS `rating`,COALESCE(NULLIF(`v`.`rating_count`, 0), 0) AS `rating_count` FROM `has_content` AS `a` LEFT JOIN `has_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `has_users` AS `ua` ON `ua`.`id` = `a`.`created_by` LEFT JOIN `has_users` AS `uam` ON `uam`.`id` = `a`.`modified_by` LEFT JOIN `has_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `has_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `has_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE `a`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`access` IN (:preparedArray3,:preparedArray4) AND `c`.`published` = 1 AND `a`.`state` = :condition AND `a`.`catid` IN (:preparedArray5) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`language` IN (:preparedArray6,:preparedArray7) ORDER BY RAND() ASC LIMIT 15255ms199.28KBParams/libraries/src/MVC/Model/BaseDatabaseModel.php:166Copy
  • SELECT MAX(`tag_id`) AS `tag_id`,COUNT(*) AS `count`,MAX(`t`.`title`) AS `title`,MAX(`t`.`access`) AS `access`,MAX(`t`.`alias`) AS `alias`,MAX(`t`.`params`) AS `params`,MAX(`t`.`language`) AS `language` FROM `has_contentitem_tag_map` AS `m` INNER JOIN `has_ucm_content` AS `ucm` ON `m`.`content_item_id` = `ucm`.`core_content_item_id` AND `m`.`type_id` = `ucm`.`core_type_id` INNER JOIN `has_categories` AS `cat` ON `ucm`.`core_catid` = `cat`.`id` INNER JOIN `has_tags` AS `t` ON `tag_id` = `t`.`id` INNER JOIN `has_ucm_content` AS `c` ON `m`.`core_content_id` = `c`.`core_content_id` WHERE `t`.`access` IN (:preparedArray1,:preparedArray2) AND `t`.`published` = 1 AND `cat`.`published` > 0 AND `t`.`language` IN (:preparedArray3,:preparedArray4) AND `m`.`type_alias` = `c`.`core_type_alias` AND `c`.`core_state` = 1 AND (`c`.`core_access` IN (:preparedArray5,:preparedArray6) OR `c`.`core_access` = 0) AND (`c`.`core_publish_up` IS NULL OR `c`.`core_publish_up` = :nullDate2 OR `c`.`core_publish_up` <= :nowDate2) AND (`c`.`core_publish_down` IS NULL OR `c`.`core_publish_down` = :nullDate3 OR `c`.`core_publish_down` >= :nowDate3) GROUP BY `tag_id`,`t`.`title`,`t`.`access`,`t`.`alias` ORDER BY RAND() LIMIT 15365ms2.75KBParams/modules/mod_tags_popular/src/Helper/TagsPopularHelper.php:183Copy
  • SELECT `c2`.`language`,`c2`.`id` FROM `has_menu` AS `c` INNER JOIN `has_associations` AS `a` ON `a`.`id` = `c`.`id` AND `a`.`context` = :context INNER JOIN `has_associations` AS `a2` ON `a`.`key` = `a2`.`key` INNER JOIN `has_menu` AS `c2` ON `a2`.`id` = `c2`.`id` WHERE `c`.`id` = :id213μs1.44KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT `name`,`element` FROM `has_extensions` WHERE `type` = 'plugin' AND `folder` = 'finder' AND `enabled` = 1412μs640B/administrator/components/com_finder/src/Helper/LanguageHelper.php:135Copy
  • SELECT `title` FROM `has_finder_taxonomy` WHERE `parent_id` = 1 AND `state` = 1 AND `access` IN (1,5)127μs584B/administrator/components/com_finder/src/Indexer/Taxonomy.php:314Copy
  • SELECT DISTINCT a.id, a.title, a.name, a.checked_out, a.checked_out_time, a.note, a.state, a.access, a.created_time, a.created_user_id, a.ordering, a.language, a.fieldparams, a.params, a.type, a.default_value, a.context, a.group_id, a.label, a.description, a.required, a.only_use_in_subform,l.title AS language_title, l.image AS language_image,uc.name AS editor,ag.title AS access_level,ua.name AS author_name,g.title AS group_title, g.access as group_access, g.state AS group_state, g.note as group_note FROM has_fields AS a LEFT JOIN `has_languages` AS l ON l.lang_code = a.language LEFT JOIN has_users AS uc ON uc.id=a.checked_out LEFT JOIN has_viewlevels AS ag ON ag.id = a.access LEFT JOIN has_users AS ua ON ua.id = a.created_user_id LEFT JOIN has_fields_groups AS g ON g.id = a.group_id WHERE ( (`a`.`context` = :context AND `a`.`access` IN (:preparedArray1,:preparedArray2)) AND (`a`.`group_id` = 0 OR `g`.`access` IN (:preparedArray3,:preparedArray4)) AND `a`.`state` = :state) AND (`a`.`group_id` = 0 OR `g`.`state` = :gstate) AND `a`.`only_use_in_subform` = :only_use_in_subform AND `a`.`language` IN (:preparedArray5,:preparedArray6) ORDER BY a.ordering ASC310μs4.75KBParams/libraries/src/MVC/Model/BaseDatabaseModel.php:166Copy
  • SELECT `title` FROM `has_finder_taxonomy` WHERE `parent_id` = 1 AND `state` = 1 AND `access` IN (1,5)139μs584B/administrator/components/com_finder/src/Indexer/Taxonomy.php:314Copy
  • SELECT SUM(CASE WHEN `a`.`next_execution` <= :now THEN 1 ELSE 0 END) AS due_count,SUM(CASE WHEN `a`.`locked` IS NULL THEN 0 ELSE 1 END) AS locked_count FROM `has_scheduler_tasks` AS `a` WHERE `a`.`state` = 1119μs1.37KBParams/administrator/components/com_scheduler/src/Model/TasksModel.php:466Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `has_categories` AS `s` INNER JOIN `has_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`424μs4KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `session_id` FROM `has_session` WHERE `session_id` = ?2.2ms1KBParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:291Copy
  • UPDATE `has_session` SET `data` = ? , `time` = ? WHERE `session_id` = ?839μs592BParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:318Copy