The criteria of cure and indications for taking off the record completely cured patients

Patients who have completed antisyphilitic treatment are kept under dispensary care. The term of control is determined by the period of syphilis in which treatment was begun. Individuals who completed preventive treatment, for example, are taken off the record after a follow-up period of three months, those treated for primary seronegative syphilis after six months. All patients who was ill with syphilis not over then six months are taken off the record after a follow-up period of 12-18 months, those who was ill from six months to one year after a period of 18-24 months, and those one who was ill more then one year are removed from the register after a follow-up period of 24-30 months. Patients treated for seroresistant syphilis are removed from the register after a follow-up period of 36-48 and more months.

During the control period, the patient visits the physician once in three or six months for medical examination and serological tests. When the term of control ends the question of taking off the record is decided.

Taking the patient off the record, the physician proceeds from the premise that syphilis can undoubtedly be cured. Evidence of this are cases of reinfection, the results of animal experiments, absence of any manifestations of syphilis throughout the life in most patients who had been subject to proper treatment, and statistical data of postmortem data of the last decades.

The absence of absolute criteria of complete cure, however, obliges us to weigh the sum total of criteria for taking patients off the record. These criteria are as follows: (1) the stage of the disease in which treatment was begun (the earlier treatment was applied, the better the prognosis); (2) the time of the disappearance of the syphilids (epithelization or cicatrization of the chancre, disappearance of the rose-coloured spots, resolution of papules and condylomata lata, etc.); a delay in the disappearance of syphilids may be regarded as resistance to specific therapy and may lead to a less favourable prognosis; (3) terms of negative reversal of the serological reaction (the earlier this occurs, the better the prognosis); (4) the quality of treatment (in accordance with the instruction); (5) the results of clinical and X-ray examination; the results of examination of the nervous system, internal organs, fundus oculi and the cardiovascular system are particularly important; (6) the results of laboratory examination. The reversal of positive TPI to negative in properly treated patients in the absence of syphilitic changes in the internal organs and nervous system may testify to complete cure from syphilis. On the other hand, the TPI may remain positive throughout life in individuals who began treatment late, which is no impediment to being taken off the record if the results of all other types of examination are favourable.

Materials for self-checking:

А. Tasks for self-checking: