Description: Segment 1 Footage of unhealthy activities is seen (e.g. walking next to heavy traffic, smoking, fatty foods), as well as related medical footage (taking blood pressure, measuring body fat). Dr Krikler introduces the lecture and explains that it will be about the treatment of hyperlipidaemias (raised or abnormal lipids in the blood). He explains why hyperlipidaemias must be treated, who is treated, how they are treated and when patients should be treated. He introduces Dr Barry Lewis, who outlines therapeutic classifications and schemas. Lewis explains how to sort patients into therapeutic categories, involving identifying patients with secondary hyperlipidaemias. He also explains about the treatment of secondary hyperlipidaemias. Time start: 00:00:00:00 Time end: 00:05:01:00 Length: 00:05:01:00 Segment 2 Lewis goes on to explain how to treat primary hyperlipidaemias. Both primary and secondary are treated with a reduced diet in the first instance. Graphs show the cholesterol and triglyceride response to a changed diet in a patient with type 2b hyperlipoproteinaemia the patient responded well. A graph of a patient who did not respond well is also seen. Another graph of a patient with the rare disease chylomicronaemia of type 1 hyperlipoproteinaemia is also seen. Dr Krikler then describes and shows the kinds of foods that patients should eat. Both unsatisfactory and healthy food are seen. Time start: 00:05:01:00 Time end: 00:10:22:11 Length: 00:05:21:11 Segment 3 Photographs of unsuitable and suitable meals are seen, including a roast dinner (bad) and chicken a l'orange (good). Krikler then says that a change in diet may sometimes not be enough, so asks Dr Lewis to discuss medication. A list of common drugs in treating hyperbetalipoproteinaemia is seen. He also mentions clofibrate, used to treat patients with endogenous hypertriglyceridaemia. He next introduces Dr Gilbert Thompson, who speaks about drugs that act at an intestinal level. He explains that these drugs are used to treat patients with increased levels of low-density lipoprotein in their plasma. He first explains bile-acid-binding resins (Questran and Secholex). Time start: 00:10:22:11 Time end: 00:14:38:11 Length: 00:04:16:00 Segment 4 Thompson explains the enterohepatic circulation of bile acids using diagrams. He next explains another group of drugs, compounds that lower the level of serum cholesterol by blocking its absorption. He describes the physicochemical processes involved in fat absorption as well as a case study of a patient with familial hypercholesterolaemia. He hands back to Barry Lewis, who discusses the drug clofibrate. Time start: 00:14:38:11 Time end: 00:20:04:22 Length: 00:05:26:11 Segment 6 Thompson continues to discuss surgical treatments, including a portacaval shunt. He also describes plasma exchange - exchanging the plasma of two homozygous patients with a cholesterol-free fraction of human plasma. Footage of a female patient receiving plasma exchange is shown, and Thompson describes the process. The results of the process are seen in a chart. Dr Krikler asks Dr Lewis to talk about what levels doctors should consider instituting treatment at, and what targets they should aim for. Dr Lewis provides some figures for cholesterol levels. Krikler asks Thompson to provide evidence that all these procedures work. Time start: 00:25:05:00 Time end: 00:29:57:00 Length: 00:04:52:00. Segment 7 Dr Thompson provides some data but also says that more evidence is probably forthcoming and more research is needed. Krikler concludes the lecture. Time start: 00:29:57:00 Time end: 00:32:34:16 Length: 00:02:37:16