cad6d8c01db2f8b14d8579b170d7419d nutrients-18-01138-v3.pdf 30eb4c9d85f52002a0468bef55ec80a24815f553 nutrients-18-01138-v3.pdf 65eb070b985fd854dd921d4b36e735908da1e5eadcb1120148461b12bbf27d5f nutrients-18-01138-v3.pdf Title: Effect of Fluid Thickening with a Gum-Based Thickening Product in Older Patients with Structural or Mild Oropharyngeal Dysphagia Subject: Background: The effect of fluid thickening in older patients with oropharyngeal dysphagia (OD) is not settled in the case of mild OD or OD caused by structural abnormalities. Objective: To assess the therapeutic effect and mechanism of action of the xanthan-gum-based thickener Tsururinko Quickly in older patients with structural OD and those with mild OD (Penetration–Aspiration Score < 3). Patients and Methods: We included 25 participants in each group (81.8 7.1 vs. 77.4 7.2 yr, respectively). Participants underwent videofluoroscopy (VFS) while swallowing 10 mL boluses at <50 mPas, 100, 200, 400, 800, and 1600 mPas to evaluate the safety and efficacy of swallowing and the biomechanics of the swallowing response at each viscosity level. After 30 s oral incubation, the effect of salivary -amylase on shear viscosity was assessed using viscometer measurements. Results: (a) For the <50 mPas liquid series, no aspirations occurred in either group; however, 44% of patients with structural OD and 30% of patients with mild OD showed PAS 2 penetrations. (b) Fluid thickening reduced prevalence of penetrations with a maximal effect at 800 mPas and without affecting oral or pharyngeal residue in either group. (c) Increasing shear viscosity did not affect timing of airway protection mechanisms nor bolus kinematics. (d) Oral incubation decreased viscosity by 1.7–1.8% at 800 mPas. Conclusions: Fluid thickening with TQ enhances swallowing safety in older patients with structural causes of OD and those with mild OD through compensatory mechanisms and without a consistent increase in pharyngeal residue across the tested viscosity range. Keywords: structural dysphagia; mild dysphagia; thickening product; swallowing safety; swallowing efficacy; shear viscosity Author: Johana Muchová, Mireia Bolívar-Prados, Adrián Núñez-Lara, Noemí Tomsen and Pere Clavé Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Sat Apr 4 07:20:30 2026 CEST ModDate: Sat Apr 4 07:25:17 2026 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 19 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1556656 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- CVTVAM+URWPalladioL-Ital Type 1 Custom yes yes yes 134 0 CKBPVA+EURM10 Type 1 Builtin yes yes yes 135 0 BVKSVL+CMSY10 Type 1 Builtin yes yes yes 136 0 ECQJMB+URWPalladioL-Bold Type 1 Custom yes yes yes 137 0 MIKRSI+VnURWPalladioL Type 1 Custom yes yes yes 138 0 PLOHGP+URWPalladioL-Roma Type 1 Custom yes yes yes 139 0 EKDJPJ+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 223 0 EKDJNI+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 224 0 EKDJOJ+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 225 0 EKDMLO+ArialMT TrueType WinAnsi yes yes no 226 0 EKDJPJ+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 288 0 EKDJNI+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 289 0 EKDJOJ+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 290 0 EKDJPJ+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 328 0 EKDJNI+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 329 0 EKDJOJ+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 330 0 EKDPCD+Cambria TrueType WinAnsi yes yes no 331 0 EKDJPJ+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 337 0 EKDJNI+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 338 0 EKDJOJ+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 339 0 EKDJPJ+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 373 0 EKDJNI+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 374 0 EKDJOJ+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 375 0 EKDPCD+Cambria TrueType WinAnsi yes yes no 376 0 EKDJPJ+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 428 0 EKDJNI+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 429 0 EKDJOJ+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 430 0 EKDPCD+Cambria TrueType WinAnsi yes yes no 431 0 EKDJPJ+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 528 0 EKDJNI+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 529 0 EKDJOJ+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 530 0 EKDJPJ+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 535 0 EKDJNI+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 536 0 EKDJOJ+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 537 0 EKDMLO+ArialMT TrueType WinAnsi yes yes no 538 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-04-30 03:09:12 CEST RepresentationInformation: nutrients-18-01138-v3.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-04-29 16:50:35 CEST Size: 1556656 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 676 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Patients, Materials and Methods Children: Item: Title: Experimental Design and Study Population Item: Title: Products Item: Title: Equipment Item: Title: Videofluoroscopy Item: Title: Hedonic Scale Item: Title: Adverse Events Item: Title: Outcome Parameters Item: Title: Statistics and Data Analysis Item: Title: Results Children: Item: Title: Demographics and Patient’s Clinical Characteristics Item: Title: Therapeutic Effect of Increasing Shear Viscosity Children: Item: Title: Safety and Efficacy of Swallowing Item: Title: Oropharyngeal Swallowing Response Item: Title: Hedonic Scale Item: Title: Rheological Characterization After Oral Incubation Item: Title: Discussion Item: Title: Conclusions Item: Title: Appendix A Item: Title: References Info: Title: Effect of Fluid Thickening with a Gum-Based Thickening Product in Older Patients with Structural or Mild Oropharyngeal Dysphagia Author: Johana Muchová, Mireia Bolívar-Prados, Adrián Núñez-Lara, Noemí Tomsen and Pere Clavé Subject: Background: The effect of fluid thickening in older patients with oropharyngeal dysphagia (OD) is not settled in the case of mild OD or OD caused by structural abnormalities. Objective: To assess the therapeutic effect and mechanism of action of the xanthan-gum-based thickener Tsururinko Quickly in older patients with structural OD and those with mild OD (Penetration–Aspiration Score < 3). Patients and Methods: We included 25 participants in each group (81.8 7.1 vs. 77.4 7.2 yr, respectively). Participants underwent videofluoroscopy (VFS) while swallowing 10 mL boluses at <50 mPas, 100, 200, 400, 800, and 1600 mPas to evaluate the safety and efficacy of swallowing and the biomechanics of the swallowing response at each viscosity level. After 30 s oral incubation, the effect of salivary -amylase on shear viscosity was assessed using viscometer measurements. Results: (a) For the <50 mPas liquid series, no aspirations occurred in either group; however, 44% of patients with structural OD and 30% of patients with mild OD showed PAS 2 penetrations. (b) Fluid thickening reduced prevalence of penetrations with a maximal effect at 800 mPas and without affecting oral or pharyngeal residue in either group. (c) Increasing shear viscosity did not affect timing of airway protection mechanisms nor bolus kinematics. (d) Oral incubation decreased viscosity by 1.7–1.8% at 800 mPas. Conclusions: Fluid thickening with TQ enhances swallowing safety in older patients with structural causes of OD and those with mild OD through compensatory mechanisms and without a consistent increase in pharyngeal residue across the tested viscosity range. 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