{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T11:34:57Z","timestamp":1789385697067,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,8,11]],"date-time":"2019-08-11T00:00:00Z","timestamp":1565481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Increasing viscosity with thickening agents is a valid therapeutic strategy for oropharyngeal dysphagia (OD). To assess the therapeutic effect of a xanthan gum\u2010based thickener (Nutilis Clear<jats:sup>\u00ae<\/jats:sup>) at six viscosities compared with thin liquid in poststroke OD (PSOD) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 120 patients with PSOD were studied in this controlled, multiple\u2010dose, fixed\u2010order, and single\u2010blind study using videofluoroscopy (VFSS). A series of boluses of 10\u00a0mL thin liquid and 2000, 1400, 800, 450, 250, and 150\u00a0mPa\u00a0s viscosities were given in duplicate, interrupted in case of aspiration. We assessed the safety and efficacy of swallow and the kinematics of the swallow response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>A total of 41.2% patients had safe swallow at thin liquid which significantly increased for all viscosities from 71.9% at 150\u00a0mPa\u00a0s to 95.6% at 1400\u00a0mPa\u00a0s (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). PAS score (3.7\u00a0\u00b1\u00a02.3) at thin liquid was also reduced by increasing bolus viscosity (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). The prevalence of patients with aspiration at thin liquid was 17.5% and decreased at all viscosities (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01), except at 150\u00a0mPa\u00a0s. Increasing viscosity shortened time to laryngeal vestibule closure (LVC) at all viscosities (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01) and reduced bolus velocity at \u2265450\u00a0mPa\u00a0s (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). The prevalence of patients with pharyngeal residue at each viscosity 37.7%\u201044.7% was similar to that at thin liquid (41.2%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>The prevalence of unsafe swallow with thin liquids is very high in PSOD. Increasing shear bolus viscosity with this xanthan gum\u2010based thickener significantly increased the safety of swallow in patients with PSOD in a viscosity\u2010dependent manner without increasing the prevalence of pharyngeal residue.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13695","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T02:19:30Z","timestamp":1565576370000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["Effect of a gum\u2010based thickener on the safety of swallowing in patients with poststroke oropharyngeal dysphagia"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8896-1150","authenticated-orcid":false,"given":"Mireia","family":"Bolivar\u2010Prados","sequence":"first","affiliation":[{"name":"Gastrointestinal Physiology Laboratory Hospital de Matar\u00f3, Universitat Aut\u00f2noma de Barcelona Matar\u00f3 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laia","family":"Rofes","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (Ciberehd) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3913-317X","authenticated-orcid":false,"given":"Viridiana","family":"Arreola","sequence":"additional","affiliation":[{"name":"Gastrointestinal Physiology Laboratory Hospital de Matar\u00f3, Universitat Aut\u00f2noma de Barcelona Matar\u00f3 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Guida","sequence":"additional","affiliation":[{"name":"Danone Nutricia Research Nutricia Advanced Medical Nutrition Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1267-3475","authenticated-orcid":false,"given":"Weslania V.","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Gastrointestinal Physiology Laboratory Hospital de Matar\u00f3, Universitat Aut\u00f2noma de Barcelona Matar\u00f3 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6805-764X","authenticated-orcid":false,"given":"Alberto","family":"Martin","sequence":"additional","affiliation":[{"name":"Gastrointestinal Physiology Laboratory Hospital de Matar\u00f3, Universitat Aut\u00f2noma de Barcelona Matar\u00f3 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1357-9889","authenticated-orcid":false,"given":"Nat\u00e0lia","family":"Vilardell","sequence":"additional","affiliation":[{"name":"Gastrointestinal Physiology Laboratory Hospital de Matar\u00f3, Universitat Aut\u00f2noma de Barcelona Matar\u00f3 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6178-3748","authenticated-orcid":false,"given":"Omar","family":"Ortega Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Gastrointestinal Physiology Laboratory Hospital de Matar\u00f3, Universitat Aut\u00f2noma de Barcelona Matar\u00f3 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"Ripken","sequence":"additional","affiliation":[{"name":"Danone Nutricia Research Nutricia Advanced Medical Nutrition Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirian","family":"Lansink","sequence":"additional","affiliation":[{"name":"Danone Nutricia Research Nutricia Advanced Medical Nutrition Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0696-8560","authenticated-orcid":false,"given":"Pere","family":"Clav\u00e9","sequence":"additional","affiliation":[{"name":"Gastrointestinal Physiology Laboratory Hospital de Matar\u00f3, Universitat Aut\u00f2noma de Barcelona Matar\u00f3 Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (Ciberehd) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2015.49"},{"key":"e_1_2_9_3_1","unstructured":"World Health Organization.International Statistical Classification of Diseases and Related Health Problems 10th Revision. 2016. 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