Local Health Authority of Ravenna

Introduction We aimed to evaluate the diagnostic stability of a large spectrum of psychiatric diagnoses in adolescents and young adult patients attending specialised facilities in the Lazio Region (Italy). Methods A total of 3871 subjects (11–35 years) at their first hospitalisation with a psychiatric diagnosis were selected and followed up for 10 years on subsequent hospital admissions to psychiatric care. Results A total of 1145 patients were readmitted to a hospital for a psychiatric disorder in the following 10 years. Among these subjects, the concordance between the first and last diagnosis was 57.8% with a weighted kappa of 0.47 (95% CI: 0.42–0.51); the repeated stability (the same diagnosis in at least 75% of admissions) was 31.2%. The diagnostic categories with the highest values of prospective concordance and kappa were schizophrenia spectrum and other functional psychoses (70%, kappa 0.53), substance use disorders (54%, kappa 0.57), and eating disorders (80.9%, kappa 0.76). Conclusions In a population study, the stability over time of the first psychiatric diagnosis in a hospital varied according to the specific diagnostic categories, and overall, it was lower than previously reported. The trajectories were disorder‐specific, and the stability was influenced by several factors, including the individuals' characteristics, the disorder's severity, and the diagnostic setting.

Purpose Breast cancer screening programs often encounter challenges related to high costs and limited accessibility, particularly in rural areas. Mobile mammography units (MMUs) have emerged as a potential solution to address these barriers. This study aimed to compare the outcomes of mammography screenings conducted in fixed units and MMUs, focusing on recall rates, follow-up adherence, and screen-detected breast cancer (BC) rates. Patients and Methods This retrospective study analyzed data from 790 women aged 50–69 years who underwent mammography screening between January and February 2023. Participants were divided into two groups: group A (525 women, screened at fixed units) and group B (265 women, screened at MMUs). Key metrics included recall rates, biopsy rates, screen-detected BC rates, and refusal rates for follow-up evaluations. Statistical comparisons were made between the two groups to assess differences in outcomes. Results In group A (mean age 58.8 ± 5.7 years), the recall rate was 6.1%, with 32 recalls, 8 biopsies, and 7 confirmed BC cases, yielding a screen-detected BC rate of 1.33%. In group B (mean age 59.6 ± 5.8 years), the recall rate was higher at 10.6%, with 28 recalls, 5 biopsies, and 3 BC cases, resulting in a screen-detected BC rate of 1.13%. Notably, refusal rates for follow-up evaluations were significantly higher in group B (42.9%) compared to group A (9%). Conclusion While MMUs improve accessibility to underserved areas, they face challenges such as higher refusal rates for follow-up evaluations. The comparable screen-detected BC rates between MMUs and fixed units underscore the potential of combining both approaches in breast cancer screening programs. These findings highlight the importance of awareness campaigns to improve follow-up adherence and suggest that future research should focus on cost-effectiveness and sociocultural factors to optimize breast cancer prevention strategies.

Background : Digital communication is increasingly influencing the way medical knowledge is accessed and shared, particularly in pediatrics. Among various platforms, YouTube has emerged as a major source of health-related information, not only for healthcare professionals but also for the general population. However, the open nature of social media raises concerns about the consistency, reliability, and educational quality of the content shared. Pediatric ultrasound (PedUS) is a highly specialized topic that requires accurate representation to ensure safe and effective knowledge transfer. Objective : Our research evaluates the quality and accuracy of PedUS content shared on social media platforms, with a focus on YouTube. We analyzed over 50 hours of video produced by various contributors including radiologists, pediatricians, and patient associations. This diversity enriches the platform but also introduces variability in content quality. The primary aim was to assess the educational value and dissemination potential of pediatric ultrasound content on social media. Through detailed analysis, we identified features that capture viewer interest and recurring patterns across PedUS categories, offering insights that could help content creators develop more consistent and effective educational materials.

Borderline personality disorder (BPD) is is a type B personality disorder primarily characterized by a pattern of unstable interpersonal relationships, a distorted self-concept, and intense emotional reactions, associated with extreme and opposing mental and behavioral states, which coexist and lead to destructive behaviors such as self-harm, commonly recurring over time.. The Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition (PID-5) provides a dimensional assessment of maladaptive domains associated with personality disorders, improving the understanding of their complex clinical presentations. While altered brain functional connectivity (FC) has been reported in BPD, neurobiological-clinical correlations remain debated. This study explores the relationship between the personality dimensions of BPD and resting-state fMRI (rs-fMRI) FC. Twenty-eight patients with BPD (6M/22F, 23.7 ± 3.4 years) and twenty-eight matched healthy controls (6M/22F, 24.3 ± 2.8 years) underwent a psychiatric assessment, including the PID-5, and an MRI protocol including rs-fMRI. Functional data were analyzed via graph theory to derive network properties at global and nodal levels, which were correlated with the PID-5 subdomains. The results revealed impairments across all personality trait facets. Patients had lower global connectivity and compromised centrality of several limbic structures and frontotemporal regions. Significant correlations were found between separation insecurity and global efficiency (R = 0.60, adjusted-p = 0.035) and between depressivity and the degree of the left middle temporal gyrus (R = 0.69, adjusted-p = 0.023) in females. These findings suggest links between negative affectivity traits, in particular separation insecurity and depressivity, and specific brain network dysfunctions in BPD.

Background Population risk stratification (RS) tools have been proposed to tailor interventions, prioritize resources, and proactively manage high-risk individuals with chronic diseases in primary care settings. This study aims to explore the available evidence on the use of population RS tools in primary care settings, specifically evaluating the impact of targeted interventions based on RS tools on selected chronic patients and healthcare utilization outcomes. Methods A systematic literature review was conducted across multiple electronic databases to identify relevant articles assessing the impact of targeted interventions based on RS tools in the management of chronic disease patients within primary care settings. We included studies meeting the following inclusion criteria: randomized controlled trials (RCTs), controlled clinical trials (CCTs) or before-after studies (BAs); adults with heart failure, chronic kidney disease, type 2 diabetes mellitus, chronic obstructive pulmonary disease, or dementia; interventions relying on RS tools; comparators with or without RS tools; and outcomes including Emergency Department (ED) visits, outpatient visits, hospitalizations, mortality, and costs. Results A total of seven studies met the inclusion criteria, comprising one RCT, two CCTs, and four controlled BAs. The findings revealed mixed effects of interventions on patients identified using RS tools. Among the included studies, four reported significant reductions in ED visits. Two studies reported an increase in outpatient visits. Hospitalization rates were reduced in three studies, and two studies reported significant reductions in overall mortality. However, the impact on healthcare costs was inconclusive. Conclusions The evidence on the effectiveness of RS tools for chronic disease management in primary care settings remains limited. While some studies demonstrated positive outcomes in reducing hospitalizations, ED visits, and mortality, the overall impact on outpatient service use and healthcare costs varied. Further high-quality studies are needed to evaluate the long-term benefits and cost-effectiveness of RS tools in chronic disease management within primary care.

Background: It has been observed that women vaccinated against coronavirus disease 2019 (COVID-19) may show axillary lymphadenopathy at screening mammogram, which may become suspicious for malignancy, leading to an increased recall rate for further diagnostic evaluations and a higher number of false-positive results, as well as considerable emotional distress for the women involved. Study design: The study aimed to assess the incidence of doubt/positive results in the 1st level mammogram among women who received a COVID-19 vaccine within 4 weeks before mammogram, compared to unvaccinated women. Further aims included the analysis of the distribution of doubt/positive 1st level screening mammogram results according to different women-related and diagnostic work-up-related characteristics, and the evaluation of the incidence of false-positive results observed at the 2nd level. Methods: The cohort study was carried out by retrospectively reviewing electronic data records related to the breast screening program of the Local Health Authority of Bologna in 2021 concerning women between 45 and 74 years old. Excluded were the women outside the age range, with prior breast cancer history, or receiving COVID-19 vaccination more than 4 weeks before the mammogram. Results: A total of 43,856 (mean age 56.6 ± 8.7) women met the study's inclusion criteria. Among all enrolled women, the recall rate was 5.5% (N=2,394). There were no statistically significant differences in doubt/positive results between vaccinated within 4 weeks before the mammogram and unvaccinated women (5.5% versus 5.4%, p=0.649). However, those who received the Pfizer vaccine showed a significantly higher rate of doubt/positive results. Conclusions: Healthcare professionals' awareness of vaccine records and educating patients about rare adverse effects can help prevent unnecessary biopsies, interventions, and changes in patient management. Further research is needed to confirm our findings.

Introduction Vaccination rates in Italian children must be substantially increased to control the transmission of seasonal influenza and mitigate the associated socio-economic burden. This work aimed to describe strategies to improve the effectiveness and reach of pediatric influenza vaccination campaigns in Italy. Areas covered Based on a literature review, influencing factors and potential strategies to enhance vaccination coverage were explored, focusing on settings, logistics, and communication aspects. Expert opinion School-based interventions should be deeply implemented in Italy by offering a cost-effective and safe approach to vaccination and successfully overcoming socio-economic and cultural challenges. Scheduled educational programs and institution-supported childhood influenza vaccination awareness campaigns that thoroughly inform about the risk of influenza and its socio-economic consequences, counter vaccine hesitancy, and discuss the benefits of vaccination are desirable, thus concretely prompting all children, families, and healthcare professionals to get vaccinated. Digitalizing procedures could lead to improved adherence by healthcare professionals to immunization programs. Nationwide implementation of these strategies would establish a robust, sustainable system for pediatric influenza vaccination. This would significantly increase childhood vaccination rates, leading to improved disease control and substantially reducing the overall national burden of influenza.

Background/Objectives: As life expectancy rises and the epidemiological landscape of chronic diseases evolves, the necessity to assess and improve the overall health status of the population becomes increasingly fundamental. Therefore, evaluating health gains is a crucial challenge for modern health systems, particularly in the context of limited resources and increasing demand for services. The aim of this study is to assess health gains and their costs, with data provided by a private Italian clinic. Methods: We conducted a retrospective study on 129 patients admitted between June 2020 and August 2023 in a solvent ward for short-term planned hospitalization. The patients completed the EQ-5D-5L questionnaire at both admission and discharge. Quality-Adjusted Life Years (QALYs) were estimated based on the difference in EQ-5D-5L scores between discharge and admission, assuming that health gains persist up to two years post-discharge. Through QALYs value and hospitalization cost, a cost–utility analysis was performed. Descriptive and statistical analyses were carried out using STATA SE/14.0 software. Results: Of the studied sample, 55% was female, the median age was 81 [11] years old, and the median length of stay (LoS) was 16 [16] days. The patients gained, in median, 0.33 [0.38] in QALY, which was higher for males (0.35 [0.34]) than females (0.29 [0.45]). The QALY gained was greater for the non-geriatric patients (0.41 [0.42]) than geriatric ones (0.32 [0.38]) (p > 0.05). Those with a longer LoS showed a higher gain in QALY (0.35 [0.42]) than those with a shorter one (0.23 [0.29]) (p < 0.05). The cost per QALY gained was, in median, EUR 14,337, which was lower in males (EUR 13,803), in non-geriatric patients (EUR 13,743), and in patients with a shorter LoS (EUR 10,670) (p > 0.05). Conclusions: Although QALY gains differed among the groups, the median cost per QALY remained consistent. These results highlight the need for targeted interventions to optimize resource allocation, both by integrating data into allocation strategies and by employing a multidisciplinary approach to tailor interventions.

Introduction We report a population-based, competing risk-adjusted analysis of the risk and timing of true recurrences and second primaries in women with breast cancer (BC), that are still ill-defined. Methods We performed a manual review of medical charts of 1988 BC patients from a cancer registry in northern Italy (2000–2013). The occurrence and timing of true recurrences (TRs, including local, regional and distant recurrences) and second BCs (SBCs, including ipsilateral and contralateral SBC) during 10 years of follow-up were evaluated. The prognostic factors for TRs and SBCs were identified using the Fine and Gray model. Results The cumulative incidence was 13.7 % (95 % confidence interval (CI), 12.2–15.3 %) for TRs and 4.6 % (95 % CI, 3.7–5.7 %) for SBCs. The median time to detection varied between 3.4 (TRs) and 5.1 (SBCs) years. The risk of TRs had two peaks, one between the 2nd and the 3rd year of follow-up and another between the 7th and the 8th year. The subhazard of SBCs fluctuated for five years, had a drop between the 6th and the 7th year and a marked peak between the 8th and the 9th year. Prognostic factors for TRs (tumour stage and grade, lymph node status and residual disease) and SBCs (patient age and –inverse association– hormone therapy) were different. In the 9th-10th year of follow-up, the excess incidence of total BC episodes as compared with the expected incidence of BC was no longer significant (standardised incidence ratio, 1.15; 95 % CI, 0.86–1.53). Conclusions The multifaceted results of this study warrant further research into the risk and timing of all types of BC recurrence.

Background: The Mediterranean diet has long been associated with better cardiovascular health, with evidence suggesting that it may play a key role in reducing arterial stiffness. This research aims to systematically review existing evidence on the association between a Mediterranean diet pattern and arterial stiffness in the general population. Methods: The literature was examined in six electronic databases up until December 2024. The evaluation of the 128 publications based on inclusion criteria resulted in the selection of 16 observational and randomized controlled trials that aligned with the research question. Two researchers simultaneously extracted the data, employing inter-rater reliability (IRR) to assess coder agreement, followed by the κ statistic to evaluate accuracy and precision. According to the PRISMA principles and quality evaluation procedures, all data extraction phases achieved a k coefficient of no less than 0.9. All publications, with the exception of randomized controlled trials (RCTs), were evaluated for bias risk utilizing the NIH Quality Assessment Toolkit. The study protocol was registered with PROSPERO (CRD42024597173). Results: Most studies were observational (ten cross-sectional, three longitudinal), with three RCTs. Studies were primarily conducted in Europe (82%), followed by America (12%) and Australia (6%), with a total of 13,680 participants. The evidence showed an inverse relationship between adherence to the Mediterranean diet and arterial stiffness, with a focus on pulse wave velocity (PWV) and the Augmentation Index (AIx) as outcome measures. Lower but consistent and statistically significant evidence was also found in the cross-tabulation of adherence to the Mediterranean diet and the cardiovascular ankle index (CAVI), a proxy of the overall stiffness of the artery from the origin of the aorta to the ankle. Study quality ranged from moderate to high. Conclusions: The available evidence consistently shows that people who follow a Mediterranean diet may have less stiff arteries and, therefore, a lower cardiovascular risk. However, multifactorial biological pathways still need to be corroborated.

Sinusitis is an inflammation of the mucous membrane of the paranasal sinuses. Bacterial sinusitis usually occurs as a complication of viral infections of the upper respiratory tract and is a frequent cause of medical consultation. The clinical presentation of acute bacterial sinusitis can vary. It most commonly manifests as an upper respiratory tract infection (nasal congestion, postnasal drip, cough) that persists for more than 10 days without clinical improvement. Unfortunately, updated guidelines in paediatric age are not currently available. The purpose of this consensus is to provide guidelines for the therapeutic management of previous healthy paediatric patients with sinusitis. A systematic review was conducted to identify the most recent and relevant evidence. Embase, Scopus, PubMed, and Cochrane databases were systematically screened, combining the terms “children” and “sinusitis” and “antibiotics” and “rhinosinusitis” with a date restriction from 2012 to April 2024, but without language limitations. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methods. The final recommendations were obtained through a Delphi consensus of an expert panel. In children with a diagnosis of uncomplicated acute bacterial sinusitis, made according to strict clinical criteria, systemic empiric antibiotic therapy with amoxicillin or amoxicillin-clavulanic acid is indicated at a high dose (90 mg/kg/day, calculated based on amoxicillin, preferably in 3 daily doses) and for at least 10 days. In children with chronic sinusitis, systemic antibiotic treatment is not recommended, and it is not possible to make any specific recommendation regarding antibiotic agents due to the scarcity of scientific evidence supporting treatment. In conclusion, the diagnosis of sinusitis is primarily clinical, and despite acute sinusitis generally having a favourable course, some cases can present orbital and intracranial complications. The misuse of antibiotics in managing upper respiratory tract infections, including acute sinusitis, and the challenges posed by antibiotic resistance are a current issue in paediatric care. Due to the scarcity, heterogeneity, and poor quality of available evidence either supporting or opposing the use of systemic antibiotic therapy in children with sinusitis prospective studies on larger and more homogeneous cohort are needed.

Background: The COVID-19 pandemic disproportionately affected vulnerable populations in terms of comorbidity and socioeconomic disadvantage, both between and within countries. This retrospective population-based cohort study is part of the Horizon 2020 ORCHESTRA project, was conducted in the Emilia-Romagna (E-R) Region, and aimed to investigate the risk of hospitalization, disease severity and all-cause mortality during the 30 days following SARS-CoV-2 infection. Methods: All adult positive cases notified in E-R from 2020 to 2022 were included. Poisson regression with robust standard error was used to estimate risk ratios for the three outcomes, stratified by sex, pandemic period and adjusted for age, citizenship, deprivation index, risk of hospitalization and death score (RHDS), and vaccination status. Data sources were regional healthcare databases. Supplementary analyses considered citizenship in relation to duration of residency in E-R or aggregated in areas of origin. Results: During the first two years of the pandemic 859,653 E-R residents tested positive for SARS-CoV-2 (47.8% males); 9.6% of them were citizens from high migratory pressure countries (HMPCs). The risk of severe outcomes increased steeply with age, especially in males. RHDS predicted worse outcomes in both sexes while vaccination showed a strong protective effect against all outcomes of acute infection (i.e., recent vaccination was 85% more protective against in-hospital severe disease in both sexes). Immigrants from HPMCs, especially females, showed a higher risk of hospitalization and in-hospital severe disease, in particular those who arrived within 5 years ago from the infection (RR for hospitalization = 1.92, 95%CI = 1.76-2.00 for males, and RR = 2.40, 95%CI = 2.23-2.59 for females), whereas the risk of all-cause mortality was lower compared to residents from low migratory pressure countries (LMPCs) that showed a RR for females of 0.73 (95%CI = 0.59-0.90). Conclusions: The results provided an overall view of course of acute COVID-19 outcomes in E-R and allowed the risk associated with clinical, demographic, and social characteristics to be measured. The findings suggest that, although national and regional public health policies have helped to mitigate the impact of the pandemic in the general population, inequalities in outcomes among persons with comorbidities and social disadvantages remain. Improvements in the appropriateness, effectiveness and equity of public health strategies are needed.

Purpose To present the prevalence screening results of the RIsk-Based Breast Screening (RIBBS) study (ClinicalTrials.gov NCT05675085), a quasi-experimental population-based study evaluating a personalized screening model for women aged 45–49. This model uses digital breast tomosynthesis (DBT) and stratifies participants by risk and breast density, incorporating tailored screening intervals with or without supplemental imaging (ultrasound, US, and breast MRI), with the goal of reducing advanced breast cancer (BC) incidence compared to annual digital mammography (DM). Materials and methods An interventional cohort of 10,269 women aged 45 was enrolled (January 2020–December 2021. Participants underwent DBT and completed a BC risk questionnaire. Volumetric breast density and lifetime risk were used to assign five subgroups to tailored screening regimens: low-risk low-density (LR–LD), low-risk high-density (LR–HD), intermediate-risk low-density (IR–LD), intermediate-risk high-density (IR–HD), and high-risk (HR). Screening performance was compared with an observational control cohort of 43,838 women undergoing annual DM. Results Compared to LR–LD, intermediate-risk groups showed a 4.9- (IR–LD) and 4.6-fold (IR–HD) higher prevalence of BC, driven by a 7.1- and 7.1-fold higher prevalence of pT1c tumors. The interventional cohort had lower recall rate (rate ratio, 0.5), higher surgery rate (1.9) and increased prevalence of DCIS (2.9), pT1c (2.3) and grade 3 tumors (2.4), compared to controls. Conclusion The prevalence screening demonstrated the feasibility of using DBT and —in high-density subgroups— supplemental US. The stratification criteria effectively identified subpopulations with different BC prevalence. Increasing the detection rate of pT1c tumors is not sufficient but necessary to achieve a reduction in advanced BC incidence.

Introduction In the 1940s, Henricus Cornelius Rümke introduced the concept of Praecox Feeling (PF), a multifaceted clinician’s intuition about the nuclear essence of schizophrenia that may play a role in the diagnostic process. Many classical and contemporary psychopathologists have devoted attention to this concept and the issue of intuitive diagnosis of schizophrenia. However, so far very little empirical research was carried out on this topic. This study aimed at testing the hypothesis that the empathic failure described by Rümke as a major experiential dimension underlying the PF as measured by the ACSE Difficulty in Attunement scale can discriminate between schizophrenia and the other psychotic conditions. Methods The study involved 49 clinicians and 326 patients (schizophrenia N = 161, schizoaffective disorder N = 47, delusional disorder N = 35, psychotic mood disorder N = 83) in several psychiatric inpatient and outpatient units. When they saw a new patient, the clinicians completed the Assessment of Clinician’s Subjective Experience questionnaire (ACSE) and the 24-item Brief Psychiatric Rating Scale (BPRS). Results While no significant finding was observed in outpatients, several significant between-group differences in ACSE scores were found in inpatients. In multivariate analysis controlling for patient’s sex, age, educational level, and clinical severity as measured by BPRS total score, we found that clinicians reported higher levels of Impotence with patients affected by schizoaffective disorder and schizophrenia than with patients affected by psychotic mood disorder, and that clinicians reported higher levels of Difficulty in Attunement with patients affected by schizophrenia than with patients affected by delusional disorder and psychotic mood disorder. Discussion Although our findings should be interpreted with caution due some study limitations, they corroborate the notion that the clinician’s feelings, and in particular empathic attunement and its disruptions, play a role in the diagnosis of schizophrenia. They provide preliminary support for Rümke’s hypothesis that the PF may help distinguishing between clinically overlapping psychotic conditions. Overall, this study highlights the importance for psychiatry to embrace the relational dimension of the clinical encounter, and to recognize the value of the clinician’s subjective participation within the clinical relationship itself.

The aim of our three-year retrospective observational study on 6000 healthcare workers, all subjected to mandatory health surveillance, is to determine the risk factors and prevalence of cardiovascular diseases (CVDs) and to analyze the results of an ad hoc designated preventive health surveillance protocol. A risk assessment was performed and a preventive health surveillance protocol was implemented, including clinical-instrumental and laboratory tests aimed at the early detection of any sign of CVD. As a result, n = 442 new diagnoses of CVDs were made and the prevalence of CVDs increased from 12 to 16.1%. The higher prevalence was observed in physicians (P = 57.8%; p < 0.0001). The main risk factors for CVDs were age, male sex and family history of CVDs. The analysis of CVDs determinants highlighted an unexpected protective role of shift work (aOR = 0.64; p < 0.0001). Our preventive health surveillance protocol allowed to reveal a high prevalence of undiagnosed CVDs, laying the foundations for future primary prevention and counseling interventions as part of the health promotion and TOTAL WORKER HEALTH programs. Further studies are needed to create solid scientific evidence that can guide public health decisions regarding new prevention models and health promotion programs also in the general population.

The standard induction treatment for acute myeloid leukemia (AML) has limited efficacy for patients with non-low-risk AML. We conducted a multicenter study phase 1b/2, GIMEMA AML1718, to investigate the safety and efficacy of venetoclax (VEN) combined with fludarabine, cytarabine, and idarubicin (V-FLAI) as an induction therapy for non-low-risk AML patients younger than 65 years and at intermediate or high ELN risk. After a safety run-in, patients were randomly allocated to VEN 400 mg or VEN 600 mg cohorts. The primary objectives were safety and composite complete remission (bone marrow blasts <5% with any recovery). We report a predefined interim analysis after 57 patients. Median exposure to VEN during induction was 22 days. Effectiveness and safety were similar between VEN 400 mg and VEN 600 mg cohorts. 60-days mortality was 5.8%. Prolonged aplasia was observed in patients receiving high doses of cytarabine during consolidation. cCR, was achieved in 84% of patients. With a median follow-up of 20.6 months, 1-year overall survival was 71%, 1-year disease free survival was 66.2%, 1-year cumulative incidence of relapse was 24%. V-FLAI is an effective induction therapy for young and fit patients. Fifty-five more patients will be enrolled in part 2; they will receive VEN 400 mg-FLAI as predefined and will be centrally evaluated for measurable residual disease. NCT03455504

Background The main treatment for Celiac Disease (CD) is the gluten-free diet (GFD). However, in some CD patients, iron deficiency anemia can be persistent despite a GFD. Aim In this study, we aim to evaluate the prevalence of anemia in both adults and children with CD at the diagnosis and during the GFD. Methods In this cross-sectional study including both adults and children with CD, the demographic characteristics and hemoglobin, iron, folate and vitamin B12 levels were retrospectively retrieved from patients’ medical records at the time of diagnosis (T0); after 3–5 years (T1) and after 8–10 years (T2) of GFD. Results 311 CD patients (184 adults and 127 pediatric patients) were included in the study. No difference was observed in the prevalence of anemia in the overall population after 3–5 years of GFD in both adult and pediatric patients compared to the diagnosis. At 8–10 years, in the adult patient’s group, a significant reduction in the prevalence of anemia was observed (24% vs. 17.8% p = 0.043). Conclusions Despite the GFD and a very long observational period the diagnosis of anemia persists in 17.8% and 4.4% of adult and pediatric patients, respectively. The diagnostic delay (longer in adult patients) and a more pronounced ultrastructural mucosal injury could play a role in the persistence of anemia despite the GFD.