{"id":10646,"date":"2024-03-16T14:37:19","date_gmt":"2024-03-16T07:37:19","guid":{"rendered":"https:\/\/43hr.com\/?p=10646"},"modified":"2024-03-16T14:37:19","modified_gmt":"2024-03-16T07:37:19","slug":"nhung-dieu-can-biet-khi-dung-thuoc-tri-viem-mui-di-ung","status":"publish","type":"post","link":"https:\/\/43hr.com\/nhung-dieu-can-biet-khi-dung-thuoc-tri-viem-mui-di-ung\/","title":{"rendered":"Nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft khi d\u00f9ng thu\u1ed1c tr\u1ecb vi\u00eam m\u0169i d\u1ecb \u1ee9ng"},"content":{"rendered":"
Vi\u00eam m\u0169i d\u1ecb \u1ee9ng l\u00e0 b\u1ec7nh th\u01b0\u1eddng g\u1eb7p, \u0111\u1eb7c bi\u1ec7t l\u00e0 khi th\u1eddi ti\u1ebft giao m\u00f9a. Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh r\u1ea5t kh\u00f3 ch\u1ecbu n\u00ean ng\u01b0\u1eddi b\u1ec7nh c\u00f3 xu h\u01b0\u1edbng l\u1ea1m d\u1ee5ng thu\u1ed1c. Tuy nhi\u00ean n\u1ebfu kh\u00f4ng d\u00f9ng thu\u1ed1c \u0111\u00fang c\u00e1ch s\u1ebd khi\u1ebfn b\u1ec7nh c\u00e0ng tr\u1edf n\u00ean kh\u00f3 \u0111i\u1ec1u tr\u1ecb h\u01a1n.<\/p>\n
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1. Bi\u1ec3u hi\u1ec7n c\u1ee7a\u00a0vi\u00eam m\u0169i d\u1ecb \u1ee9ng<\/strong><\/p>\n C\u00e1c tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh c\u1ee7a vi\u00eam m\u0169i d\u1ecb \u1ee9ng bao g\u1ed3m:<\/p>\n – Ng\u1ee9a m\u0169i, h\u1eaft x\u00ec:<\/em>\u00a0\u0110\u00e2y l\u00e0 bi\u1ec3u hi\u1ec7n ph\u1ed5 bi\u1ebfn nh\u1ea5t v\u00e0 r\u1ea5t kh\u00f3 ch\u1ecbu. Ng\u1ee9a m\u0169i, h\u1eaft x\u00ec khi th\u1eddi ti\u1ebft thay \u0111\u1ed5i \u0111\u1ed9t ng\u1ed9t, k\u00e8m theo \u0111\u00f3 s\u1ebd th\u1ea5y co th\u1eaft c\u01a1 hay \u0111au \u0111\u1ea7u m\u1ed7i khi h\u1eaft h\u01a1i; ng\u1ee9a da v\u00f9ng c\u1ed5, v\u00f9ng m\u1eaft, h\u1ecdng hay \u1ed1ng tai ngo\u00e0i.<\/p>\n – Ch\u1ea3y n\u01b0\u1edbc m\u0169i,\u00a0ngh\u1eb9t m\u0169i:<\/em>\u00a0Khi b\u1ecb vi\u00eam m\u0169i d\u1ecb \u1ee9ng, ni\u00eam m\u1ea1c m\u0169i b\u1ecb ph\u00f9 n\u1ec1 v\u00e0 ch\u1ea3y nhi\u1ec1u n\u01b0\u1edbc d\u1eabn \u0111\u1ebfn ngh\u1eb9t m\u0169i kh\u00f3 th\u1edf. N\u01b0\u1edbc m\u0169i ban \u0111\u1ea7u trong su\u1ed1t, lo\u00e3ng, sau \u0111\u00f3 \u0111\u1eb7c d\u1ea7n. Tr\u01b0\u1eddng h\u1ee3p b\u1ed9i nhi\u1ec5m, d\u1ecbch m\u0169i s\u1ebd b\u1ecb \u0111\u1ee5c l\u1ea1i v\u00e0 ng\u1ea3 sang m\u00e0u xanh ho\u1eb7c v\u00e0ng. T\u00ecnh tr\u1ea1ng kh\u00f3 th\u1edf khi\u1ebfn b\u1ec7nh nh\u00e2n ph\u1ea3i th\u1edf b\u1eb1ng mi\u1ec7ng d\u1eabn \u0111\u1ebfn kh\u00f4 mi\u1ec7ng, h\u1ecdng. M\u0169i b\u1ecb ngh\u1eb9t khi\u1ebfn d\u1ecbch m\u0169i b\u1ecb ch\u1ea3y ng\u01b0\u1ee3c. Qu\u00e1 tr\u00ecnh n\u00e0y s\u1ebd d\u1eabn \u0111\u1ebfn ph\u1ea3n x\u1ea1 ho, th\u1eadm ch\u00ed l\u00e0 ho nhi\u1ec1u…<\/p>\n – M\u1ec7t m\u1ecfi:<\/em>\u00a0C\u00f9ng v\u1edbi c\u00e1c bi\u1ec3u hi\u1ec7n tr\u00ean th\u00ec b\u1ec7nh nh\u00e2n hay b\u1ecb \u0111au nh\u1ee9c m\u1ecfi ng\u01b0\u1eddi, c\u1ea3m gi\u00e1c u\u1ec3 o\u1ea3i.<\/p>\n 2. C\u00e1c\u00a0thu\u1ed1c tr\u1ecb vi\u00eam m\u0169i d\u1ecb \u1ee9ng\u00a0v\u00e0 l\u01b0u \u00fd khi d\u00f9ng<\/strong><\/p>\n Vi\u00eam m\u0169i d\u1ecb \u1ee9ng hi\u1ec7n nay ch\u01b0a c\u00f3 thu\u1ed1c \u0111\u1eb7c tr\u1ecb m\u00e0 ch\u1ee7 y\u1ebfu l\u00e0 d\u00f9ng thu\u1ed1c l\u00e0m d\u1ecbu c\u00e1c tri\u1ec7u ch\u1ee9ng. Trong \u0111\u00f3 c\u00e1c thu\u1ed1c \u0111\u01b0\u1ee3c d\u00f9ng ph\u1ed5 bi\u1ebfn bao g\u1ed3m:<\/p>\n – Thu\u1ed1c\u00a0v\u1ec7 sinh m\u0169i:<\/em>\u00a0Tr\u01b0\u1edbc khi d\u00f9ng \u0111\u1ebfn c\u00e1c thu\u1ed1c kh\u00e1c, bi\u1ec7n ph\u00e1p \u0111\u1ea7u ti\u00ean l\u00e0 c\u1ea7n v\u1ec7 sinh gi\u00fap m\u0169i th\u00f4ng tho\u00e1ng, gi\u1ea3m kh\u00f4 ng\u1ee9a. Trong \u0111\u00f3 n\u01b0\u1edbc mu\u1ed1i sinh l\u00fd NaCl 0,9% l\u00e0 s\u1ea3n ph\u1ea9m th\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng. NaCl 0,9% \u0111\u01b0\u1ee3c b\u00e0o ch\u1ebf d\u01b0\u1edbi d\u1ea1ng dung d\u1ecbch nh\u1ecf m\u0169i, d\u1ea1ng x\u1ecbt. Thu\u1ed1c c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m lo\u00e3ng d\u1ecbch m\u0169i, gi\u00fap n\u01b0\u1edbc m\u0169i ch\u1ea3y ra ngo\u00e0i d\u1ec5 d\u00e0ng h\u01a1n v\u00e0 xoa d\u1ecbu ni\u00eam m\u1ea1c m\u0169i.<\/p>\n NaCl 0,9% c\u00f3 \u0111\u1ed9 an to\u00e0n cao, \u00edt g\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5, c\u00f3 th\u1ec3 d\u00f9ng \u0111\u01b0\u1ee3c cho ph\u1ee5 n\u1eef mang thai, tr\u1ebb s\u01a1 sinh, ng\u01b0\u1eddi cao tu\u1ed5i… \u0110\u1ed1i v\u1edbi tr\u1ebb em, khi v\u1ec7 sinh m\u0169i th\u00ec cha m\u1eb9 c\u1ea7n c\u1ea9n th\u1eadn \u0111\u1ec3 tr\u00e1nh l\u1ef1c t\u00e1c \u0111\u1ed9ng m\u1ea1nh khi\u1ebfn tr\u1ebb b\u1ecb t\u1ed5n th\u01b0\u01a1ng ni\u00eam m\u1ea1c m\u0169i.<\/p>\n – Thu\u1ed1c\u00a0kh\u00e1ng histamin:\u00a0<\/em>Histamin l\u00e0 m\u1ed9t ch\u1ea5t h\u00f3a h\u1ecdc do c\u01a1 th\u1ec3 s\u1ea3n sinh ra d\u1eabn \u0111\u1ebfn ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng. Khi b\u1ecb vi\u00eam m\u0169i d\u1ecb \u1ee9ng, histamin \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng v\u00e0 k\u00edch th\u00edch c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 ch\u1ea3y n\u01b0\u1edbc m\u0169i, ng\u1ee9a m\u1eaft, h\u1eaft h\u01a1i, ng\u1ee9a m\u0169i…<\/p>\n Trong \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u0169i d\u1ecb \u1ee9ng, thu\u1ed1c kh\u00e1ng histamin t\u1ea1i c\u00e1c th\u1ee5 th\u1ec3 H1 (kh\u00e1ng histamin H1), th\u1ebf h\u1ec7 1 th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh nh\u01b0 promethazin, chlorpheniramine, diphenhydramin c\u00f3 hi\u1ec7u qu\u1ea3 ch\u1ed1ng d\u1ecb \u1ee9ng cao. Tuy nhi\u00ean c\u00e1c thu\u1ed1c n\u00e0y l\u1ea1i c\u00f3 nh\u01b0\u1ee3c \u0111i\u1ec3m l\u00e0 c\u00f3 th\u1ec3 g\u00e2y kh\u00f4 m\u1eaft, bu\u1ed3n ng\u1ee7, nh\u00ecn m\u1edd, kh\u00f4 mi\u1ec7ng, t\u00e1o b\u00f3n…<\/p>\n Thu\u1ed1c kh\u00e1ng histamin th\u1ebf h\u1ec7 2 c\u00f3 th\u1ec3 kh\u1eafc ph\u1ee5c nh\u1eefng t\u00e1c d\u1ee5ng ph\u1ee5 n\u00eau tr\u00ean bao g\u1ed3m loratadin, astemizol, fexofenadine, cetirizin… Do \u0111\u00f3 ng\u00e0y nay thu\u1ed1c kh\u00e1ng histamin th\u1ebf h\u1ec7 2 \u0111\u01b0\u1ee3c d\u00f9ng r\u1ed9ng r\u00e3i h\u01a1n so v\u1edbi thu\u1ed1c th\u1ebf h\u1ec7 1.<\/p>\n Tuy nhi\u00ean c\u0169ng t\u00f9y tr\u01b0\u1eddng h\u1ee3p m\u00e0 s\u1eed d\u1ee5ng lo\u1ea1i n\u00e0o cho hi\u1ec7u qu\u1ea3. H\u01a1n n\u1eefa kh\u00e1ng histamin s\u1ebd c\u00f3 l\u1ee3i h\u01a1n khi s\u1eed d\u1ee5ng ch\u00fang l\u00fac m\u1edbi b\u1eaft \u0111\u1ea7u b\u1ecb d\u1ecb \u1ee9ng. N\u1ebfu t\u00ecnh tr\u1ea1ng d\u1ecb \u1ee9ng \u0111\u00e3 k\u00e9o d\u00e0i th\u00ec kh\u00e1ng histamin s\u1ebd kh\u00f4ng mang l\u1ea1i hi\u1ec7u qu\u1ea3 cao.<\/p>\n –\u00a0Thu\u1ed1c th\u00f4ng m\u0169i:\u00a0<\/em>Ngh\u1eb9t m\u0169i l\u00e0 tri\u1ec7u ch\u1ee9ng kh\u00f3 ch\u1ecbu nh\u1ea5t c\u1ee7a vi\u00eam m\u0169i d\u1ecb \u1ee9ng. Do \u0111\u00f3 c\u00e1c thu\u1ed1c th\u00f4ng m\u0169i th\u01b0\u1eddng \u0111\u01b0\u1ee3c b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng nhi\u1ec1u nh\u1ea5t. Thu\u1ed1c th\u00f4ng m\u0169i \u0111\u01b0\u1ee3c b\u00e0o ch\u1ebf theo dung d\u1ecbch nh\u1ecf m\u0169i, d\u1ea1ng x\u1ecbt hay d\u1ea1ng u\u1ed1ng.<\/p>\n M\u1ed9t s\u1ed1 thu\u1ed1c th\u01b0\u1eddng d\u00f9ng nh\u1ecf\/x\u1ecbt nh\u01b0: Ephedrin, naphazolin, oxymetazolin… c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m co c\u00e1c m\u1ea1ch m\u00e1u trong ni\u00eam m\u1ea1c m\u0169i, gi\u00fap gi\u1ea3m s\u01b0ng n\u1ec1, t\u1eeb \u0111\u00f3 gi\u00fap th\u00f4ng tho\u00e1ng, gi\u1ea3m ngh\u1eb9t m\u0169i.<\/p>\n Do thu\u1ed1c th\u00f4ng m\u0169i mang l\u1ea1i hi\u1ec7u qu\u1ea3 nhanh, d\u1ec5 th\u1edf ngay sau khi nh\u1ecf\/x\u1ecbt, n\u00ean b\u1ec7nh nh\u00e2n c\u00f3 xu h\u01b0\u1edbng l\u1ea1m d\u1ee5ng. Tuy nhi\u00ean c\u00e1c thu\u1ed1c x\u1ecbt\/nh\u1ecf th\u00f4ng m\u0169i n\u1ebfu d\u00f9ng k\u00e9o d\u00e0i qu\u00e1 7 ng\u00e0y, l\u1ea1m d\u1ee5ng th\u01b0\u1eddng xuy\u00ean s\u1ebd mang l\u1ea1i hi\u1ec7u \u1ee9ng ng\u01b0\u1ee3c nh\u01b0 nh\u1eddn thu\u1ed1c, nghi\u1ec7n thu\u1ed1c, t\u00e1i ph\u00e1t b\u1ec7nh nhi\u1ec1u l\u1ea7n v\u00e0 kh\u00f3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh d\u1ee9t \u0111i\u1ec3m do ni\u00eam m\u1ea1c m\u0169i b\u1ecb x\u01a1.<\/p>\n Thu\u1ed1c d\u1ea1ng u\u1ed1ng ch\u1ee9a phenylpropanolamine, ho\u1ea1t \u0111\u1ed9ng theo c\u01a1 ch\u1ebf l\u00e0m co m\u1ea1ch m\u00e1u, gi\u1ea3m s\u01b0ng n\u1ec1 ni\u00eam m\u1ea1c v\u00e0 gi\u00fap tho\u00e1t d\u1ecbch, gi\u1ea3m ng\u1ea1t m\u0169i m\u1ed9t c\u00e1ch nhanh ch\u00f3ng. Thu\u1ed1c ch\u1ec9 n\u00ean d\u00f9ng sau khi tham kh\u1ea3o \u00fd ki\u1ebfn c\u1ee7a b\u00e1c s\u0129. T\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c th\u01b0\u1eddng l\u00e0 h\u1ed3i h\u1ed9p, run tay ch\u00e2n, b\u00ed ti\u1ec3u v\u00e0 \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c.<\/p>\n C\u00e1c ph\u1ea3n \u1ee9ng n\u1eb7ng h\u01a1n c\u00f3 th\u1ec3 g\u1eb7p nh\u01b0 kh\u00f3 th\u1edf, ngh\u1eb9t c\u1ed5 h\u1ecdng, s\u01b0ng m\u00f4i, l\u01b0\u1ee1i\/m\u1eb7t, ph\u00e1t ban, co gi\u1eadt, \u1ea3o gi\u00e1c; nh\u1ecbp tim b\u1ea5t th\u01b0\u1eddng, ch\u00f3ng m\u1eb7t, \u0111au \u0111\u1ea7u, lo \u00e2u; b\u1ed3n ch\u1ed3n, bu\u1ed3n n\u00f4n, n\u00f4n m\u1eeda, v\u00e3 m\u1ed5 m\u1ed3 h\u00f4i… Khi g\u1eb7p ph\u1ea3i m\u1ed9t trong c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0y c\u1ea7n th\u00f4ng b\u00e1o cho b\u00e1c s\u0129 bi\u1ebft \u0111\u1ec3 \u0111\u01b0\u1ee3c x\u1eed l\u00fd k\u1ecbp th\u1eddi.<\/p>\n – Corticoid:\u00a0<\/em>C\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m vi\u00eam, \u1ee9c ch\u1ebf gi\u1ea3i ph\u00f3ng c\u00e1c cytokine, do \u0111\u00f3 gi\u00fap gi\u1ea3m tri\u1ec7u ch\u1ee9ng vi\u00eam m\u0169i d\u1ecb \u1ee9ng. T\u00f9y t\u00ecnh tr\u1ea1ng b\u1ec7nh c\u00f3 th\u1ec3 d\u00f9ng corticoid d\u1ea1ng x\u1ecbt ho\u1eb7c d\u1ea1ng u\u1ed1ng.<\/p>\n + Corticoid d\u1ea1ng x\u1ecbt: Thu\u1ed1c x\u1ecbt c\u00f3 ch\u1ee9a corticoid gi\u00fap gi\u1ea3m nhanh c\u00e1c t\u00ecnh tr\u1ea1ng vi\u00eam c\u1ee7a ni\u00eam m\u1ea1c m\u0169i v\u00e0 c\u1ea3i thi\u1ec7n b\u1ec7nh th\u00f4ng qua c\u01a1 ch\u1ebf kh\u00e1ng vi\u00eam. Thu\u1ed1c corticoid d\u1ea1ng x\u1ecbt \u00edt t\u00e1c d\u1ee5ng ph\u1ee5 h\u01a1n d\u1ea1ng u\u1ed1ng. Thu\u1ed1c \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u0169i d\u1ecb \u1ee9ng cho tr\u1ebb t\u1eeb 2 tu\u1ed5i tr\u1edf l\u00ean (t\u00f9y lo\u1ea1i thu\u1ed1c).<\/p>\n Tuy nhi\u00ean ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng n\u00ean l\u1ea1m d\u1ee5ng thu\u1ed1c m\u00e0 c\u1ea7n d\u00f9ng theo h\u01b0\u1edbng d\u1eabn c\u1ee7a b\u00e1c s\u0129.<\/p>\n + Corticoid d\u1ea1ng u\u1ed1ng: Th\u01b0\u1eddng \u00edt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng h\u01a1n trong \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u0169i d\u1ecb \u1ee9ng do \u1ea9n ch\u1ee9a nhi\u1ec1u t\u00e1c d\u1ee5ng ph\u1ee5 nguy hi\u1ec3m. Corticoid \u0111\u01b0\u1eddng u\u1ed1ng n\u1ebfu d\u00f9ng li\u1ec1u cao c\u00f3 th\u1ec3 g\u00e2y lo\u00e3ng x\u01b0\u01a1ng, vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y, t\u0103ng c\u01b0\u1eddng h\u00e0m l\u01b0\u1ee3ng \u0111\u01b0\u1eddng trong m\u00e1u, suy tuy\u1ebfn th\u01b0\u1ee3ng th\u1eadn…<\/p>\n B\u00e1c s\u0129 s\u1ebd c\u00e2n nh\u1eafc gi\u1eefa r\u1ee7i ro v\u00e0 l\u1ee3i \u00edch tr\u01b0\u1edbc khi k\u00ea \u0111\u01a1n tr\u1ecb vi\u00eam m\u0169i d\u1ecb \u1ee9ng \u0111\u01b0\u1eddng u\u1ed1ng c\u00f3 corticoid cho b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam m\u0169i n\u1eb7ng.<\/p>\n – Kh\u00e1ng sinh:\u00a0<\/em>Ch\u1ec9 s\u1eed d\u1ee5ng khi vi\u00eam m\u0169i d\u1ecb \u1ee9ng xu\u1ea5t hi\u1ec7n b\u1ed9i nhi\u1ec5m vi khu\u1ea9n. Kh\u00e1ng sinh \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng g\u1ed3m nh\u00f3m cephalosporin, penicillin… Trong qu\u00e1 tr\u00ecnh s\u1eed d\u1ee5ng thu\u1ed1c, b\u1ec7nh nh\u00e2n c\u1ea7n tu\u00e2n th\u1ee7 tuy\u1ec7t \u0111\u1ed1i li\u1ec7u tr\u00ecnh \u0111\u1ec3 tr\u00e1nh nguy c\u01a1 kh\u00e1ng kh\u00e1ng sinh v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng kh\u00e1c.<\/p>\n B\u1ec7nh vi\u00eam m\u0169i d\u1ecb \u1ee9ng kh\u00f4ng g\u00e2y nguy hi\u1ec3m nh\u01b0ng \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. Vi\u1ec7c d\u00f9ng thu\u1ed1c \u0111\u00fang k\u1ebft h\u1ee3p ch\u1ebf \u0111\u1ed9 \u0103n v\u00e0 h\u1ea1n ch\u1ebf ti\u1ebfp x\u00fac y\u1ebfu t\u1ed1 nguy c\u01a1 s\u1ebd gi\u00fap b\u1ec7nh nh\u00e2n ph\u00f2ng tr\u00e1nh b\u1ec7nh t\u00e1i ph\u00e1t.<\/p>\n","protected":false},"excerpt":{"rendered":" Vi\u00eam m\u0169i d\u1ecb \u1ee9ng l\u00e0 b\u1ec7nh th\u01b0\u1eddng g\u1eb7p, \u0111\u1eb7c bi\u1ec7t l\u00e0 khi th\u1eddi ti\u1ebft giao m\u00f9a. Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh r\u1ea5t kh\u00f3 ch\u1ecbu n\u00ean ng\u01b0\u1eddi b\u1ec7nh c\u00f3 xu h\u01b0\u1edbng l\u1ea1m d\u1ee5ng thu\u1ed1c. Tuy nhi\u00ean n\u1ebfu kh\u00f4ng d\u00f9ng thu\u1ed1c \u0111\u00fang c\u00e1ch…<\/p>\n","protected":false},"author":11,"featured_media":10647,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[25],"tags":[],"yoast_head":"\n