SUMMARY Treatment-refractory hypothyroidism is a common clinical finding. Substantial causes include poor compliance and intake failure as well as gastrointestinal diseases, such as inflammatory bowel disease and short bowel syndromes. Increasing oral dosage of levothyroxine (LT4) is not always effective. Therefore, alternative routes of administration are necessary. In this report, we evaluate alternative treatment modalities for refractory hypothyroidism and present a 28-year-old woman with intestinal drug malabsorption successfully treated by subcutaneous LT4 administration. In this patient, a parenteral form of LT4, 500 μg/5 ml, was administered subcutaneously in a split dosage regimen. Blood hormone levels returned to normal within a few days and remained stable over an 8-month follow-up period.

Objectives: Obesity during adolescence is an increasing health problem in industrial countries. The comorbidities associated with obesity include important metabolic diseases. Methods: To analyze the effect of a weight-loss program, we recruited 12 obese, male adolescents before entering this program. We determined body weight measures at baseline, 6-week and 36-month follow-up. Also, the long-term changes of blood pressure, HbAlc, and CRP were evaluated. Twenty healthy age-matched adolescents served as controls. Results: Within the intervention group ((body mass index [BMI, kg/m²] > 95th percentile for age and sex, age 13-17 years) the BMI and BMI-standard deviation score [SDS] were significantly reduced in the 6-week follow-up after completing the weight loss program. However, the significant weight-reduction effect was not persistent until the 36-month follow-up. Conclusion: The 6-week weight-loss program had beneficial short-term effects on body weight, BMI, and BMI-SDS in obese adolescents, but these effects could not be maintained until the 36-month follow-up.

Objetivos: La obesidad durante la adolescencia es un problema de salud creciente en los países industriales. Las comorbilidades asociadas a la obesidad conllevan importantes enfermedades metabólicas. Métodos: Para analizar el efecto de un programa de pérdida de peso, seleccionamos a 12 adolescentes varones obesos antes de entrar en este programa. Determinamos las mediciones de peso corporal al inicio del programa y en los seguimientos a las 6 semanas y a los 36 meses. También se evaluaron los cambios a largo plazo de tensión arterial, HbAlc y PCR. Igualmente se seleccionó a veinte adolescentes sanos de la misma edad que sirvieron como grupo de control. Resultados: Dentro del grupo de intervención ((índice de masa corporal [IMC, kg/m²] > percentil 95 para edad y sexo, 13-17 años) el IMC y la puntuación de la desviación estándar sobre el IMC [SDS] se vieron significativamente reducidos en el seguimiento de 6 semanas tras completar el programa de pérdida de peso. Sin embargo, el efecto de reducción de peso significativa no fue persistente hasta el seguimiento a los 36 meses. Conclusión: El programa de pérdida de peso de 6 semanas tuvo efectos beneficiosos a corto plazo en el peso corporal, IMC y en el IMC-SDS en adolescentes obesos, pero estos efectos no se pudieron mantener hasta el seguimiento a los 36 meses.