Supercritical Gallium Trichloride in Oxidative Metal Recycling: Ga2Cl6 Dimers vs GaCl3 Monomers and Rheological Behavior.

Oxidative recycling of metals is crucial for a circular economy, encompassing the preservation of natural resources, the reduction of energy consumption, and the mitigation of environmental impacts and greenhouse gas emissions associated with traditional mining and processing. Low-melting gallium trichloride appears to be a promising oxidative solvent for rare-earth metals, transuranium elements, platinum, pnictogens, and chalcogens. Typically, oxidative dissolution with GaCl3 occurs at relatively low temperatures over a few days, assuming the presence of tetrahedral Ga-Cl entities. While supercritical gallium trichloride holds the potential for advanced recycling, little is known about its structure and viscosity. Using high-energy X-ray diffraction and multiscale modeling, which includes first-principles simulations, we have revealed a dual molecular nature of supercritical gallium trichloride, consisting of tetrahedral dimers and flat trigonal monomers. The molecular geometry can be precisely tuned by adjusting the temperature and pressure, optimizing the recycling process for specific metals. The derived viscosity, consistent with the reported results in the vicinity of melting, decreases by a factor of 100 above the critical temperature, enabling fast molecular diffusion, and efficient recycling kinetics.

Gallium Trichloride Fluid: Dimer Dissociation Mechanism, Local Structure, and Atomic Dynamics.

Molten gallium trichloride emerges as a promising solvent for oxidative metal recycling. The use of supercritical fluid enhances the performance and kinetics of metal dissolution due to significantly lower viscosity in the reaction media. Additionally, the dual molecular nature of gallium trichloride, existing as edge-sharing ES-Ga2Cl6 dimers at low temperatures and high pressure, or flat trigonal GaCl3 monomers in the vicinity of the critical point and low pressures, creates the possibility to tailor the chemical geometry to a particular metallic species. Nevertheless, the mechanism of dimer dissociation, local structure, and atomic dynamics in supercritical gallium trichloride fluids are not known. Using first-principles molecular dynamics, validated by comparison with our high-energy X-ray diffraction results, we illustrate the elementary steps in dimer dissociation. These include the formation of intermediate corner-sharing CS-Ga2Cl6 dimers, the partial disproportionation of GaCl3 monomers at high temperatures and low pressures, changes in the local environment of molecular entities, and unusual atomic dynamics in supercritical fluids.

Decoding the Atomic Structure of Ga2Te5 Pulsed Laser Deposition Films for Memory Applications Using Diffraction and First-Principles Simulations.

Neuromorphic computing, reconfigurable optical metamaterials that are operational over a wide spectral range, holographic and nonvolatile displays of extremely high resolution, integrated smart photonics, and many other applications need next-generation phase-change materials (PCMs) with better energy efficiency and wider temperature and spectral ranges to increase reliability compared to current flagship PCMs, such as Ge2Sb2Te5 or doped Sb2Te. Gallium tellurides are favorable compounds to achieve the necessary requirements because of their higher melting and crystallization temperatures, combined with low switching power and fast switching rate. Ga2Te3 and non-stoichiometric alloys appear to be atypical PCMs; they are characterized by regular tetrahedral structures and the absence of metavalent bonding. The sp3 gallium hybridization in cubic and amorphous Ga2Te3 is also different from conventional p-bonding in flagship PCMs, raising questions about its phase-change mechanism. Furthermore, gallium tellurides exhibit a number of unexpected and highly unusual phenomena, such as nanotectonic compression and viscosity anomalies just above their melting points. Using high-energy X-ray diffraction, supported by first-principles simulations, we will elucidate the atomic structure of amorphous Ga2Te5 PLD films, compare it with the crystal structure of tetragonal gallium pentatelluride, and investigate the electrical, optical, and thermal properties of these two materials to assess their potential for memory applications, among others.

Potentiometric Chemical Sensors Based on Metal Halide Doped Chalcogenide Glasses for Sodium Detection.

Chalcogenide glasses are widely used as sensitive membranes in the chemical sensors for heavy metal ions detection. The lack of research work on sodium ion-selective electrodes (Na+-ISEs) based on chalcogenide glasses is due to the high hygroscopicity of alkali dopes chalcogenides. However, sodium halide doped Ga2S3-GeS2 glasses are more chemically stable in water and could be used as Na+-sensitive membranes for the ISEs. In this work we have studied the physico-chemical properties of mixed cation (AgI)x(NaI)30-x(Ga2S3)26(GeS2)44 chalcogenide glasses (where x = 0, 7.5, 15, 22.5 and 30 mol.% AgI) using density, DSC, and conductivity measurements. The mixed cation effect with shallow conductivity and glass transition temperature minimum was found for silver fraction r = Ag/(Na + Ag) ≈ 0.5. Silver addition decreases the moisture resistance of the glasses. Only (AgI)22.5(NaI)7.5(Ga2S3)26(GeS2)44 composition was suitable for chemical sensors application, contrary to the single cation sodium halide doped Ga2S3-GeS2 glasses, where 15 mol.% sodium-halide-containing vitreous alloys are stable in water solutions. The analytical parameters of (NaCl)15(Ga2S3)23(GeS2)62; (NaI)15(Ga2S3)23(GeS2)62 and (AgI)22.5(NaI)7.5(Ga2S3)26(GeS2)44 glass compositions as active membranes in Na+-ISEs were investigated, including detection limit, sensitivity, linearity, ionic selectivity (in the presence of K+, Mg2+, Ca2+, Ba2+, and Zn2+ interfering cations), reproducibility and optimal pH-range.

Transient Mesoscopic Immiscibility, Viscosity Anomaly, and High Internal Pressure at the Semiconductor-Metal Transition in Liquid Ga2Te3.

Gallium tellurides appear to be promising phase-change materials (PCMs) of the next generation for brain-inspired computing and reconfigurable optical metasurfaces. They are different from the benchmark PCMs because of sp3 gallium hybridization in both cubic Ga2Te3 and amorphous pulsed laser deposition (PLD) films. Liquid Ga2Te3 also shows a viscosity η(T) anomaly just above melting when η(T) first increases and only then starts decreasing. We used high-energy X-ray diffraction to observe a transient mesoscopic immiscibility that suggested dense metallic liquid droplets in a semiconducting melt. The η(T) shape was consistent with this finding. A vanishing first sharp diffraction peak that also shifts to a higher Q indicates a high internal pressure in the metallic melt, which produces a remarkable asymmetry of the Ga-Te nearest neighbor distances and is reminiscent of high-pressure rhombohedral Ga2Te3. The observed phenomena provide a realistic scenario for a fast, multilevel SET-RESET response, which also unravels similar trends in the purported density-driven liquid polyamorphism of water, phosphorus, sulfur, and other materials.

Reperfusion Without Functional Independence in Late Presentation of Stroke With Large Vessel Occlusion.

BACKGROUND: Reperfusion without functional independence (RFI) is an undesired outcome following thrombectomy in acute ischemic stroke. The primary objective was to evaluate, in patients presenting with proximal anterior circulation occlusion stroke in the extended time window, whether selection with computed tomography (CT) perfusion or magnetic resonance imaging is associated with RFI, mortality, or symptomatic intracranial hemorrhage (sICH) compared with noncontrast CT selected patients. METHODS: The CLEAR study (CT for Late Endovascular Reperfusion) was a multicenter, retrospective cohort study of stroke patients undergoing thrombectomy in the extended time window. Inclusion criteria for this analysis were baseline National Institutes of Health Stroke Scale score ≥6, internal carotid artery, M1 or M2 segment occlusion, prestroke modified Rankin Scale score of 0 to 2, time-last-seen-well to treatment 6 to 24 hours, and successful reperfusion (modified Thrombolysis in Cerebral Infarction 2c-3). RESULTS: Of 2304 patients in the CLEAR study, 715 patients met inclusion criteria. Of these, 364 patients (50.9%) showed RFI (ie, mRS score of 3-6 at 90 days despite successful reperfusion), 37 patients (5.2%) suffered sICH, and 127 patients (17.8%) died within 90 days. Neither imaging selection modality for thrombectomy candidacy (noncontrast CT versus CT perfusion versus magnetic resonance imaging) was associated with RFI, sICH, or mortality. Older age, higher baseline National Institutes of Health Stroke Scale, higher prestroke disability, transfer to a comprehensive stroke center, and a longer interval to puncture were associated with RFI. The presence of M2 occlusion and higher baseline Alberta Stroke Program Early CT Score were inversely associated with RFI. Hypertension was associated with sICH. CONCLUSIONS: RFI is a frequent phenomenon in the extended time window. Neither magnetic resonance imaging nor CT perfusion selection for mechanical thrombectomy was associated with RFI, sICH, and mortality compared to noncontrast CT selection alone. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT04096248.

Deciphering Fast Ion Transport in Glasses: A Case Study of Sodium and Silver Vitreous Sulfides.

High-capacity solid-state batteries are promising future products for large-scale energy storage and conversion. Sodium fast ion conductors including glasses and glass ceramics are unparalleled materials for these applications. Rational design and tuning of advanced sodium sulfide electrolytes need a deep insight into the atomic structure and dynamics in relation with ion-transport properties. Using pulsed neutron diffraction and Raman spectroscopy supported by first-principles simulations, we show that preferential diffusion pathways in vitreous sodium and silver sulfides are related to isolated sulfur Siso, that is, the sulfur species surrounded exclusively by mobile cations with a typical stoichiometry of M/Siso ≈ 2. The Siso/Stot fraction appears to be a reliable descriptor of fast ion transport in glassy sulfide systems over a wide range of ionic conductivities and cation diffusivities. The Siso fraction increases with mobile cation content x, tetrahedral coordination of the network former and, in case of thiogermanate systems, with germanium disulfide metastability and partial disproportionation, GeS2 → GeS + S, leading to the formation of additional sulfur, transforming into Siso. A research strategy enabling to achieve extended and interconnected pathways based on isolated sulfur would lead to glassy electrolytes with superior ionic diffusion.

Noncontrast Computed Tomography vs Computed Tomography Perfusion or Magnetic Resonance Imaging Selection in Late Presentation of Stroke With Large-Vessel Occlusion.

Importance: Advanced imaging for patient selection in mechanical thrombectomy is not widely available. Objective: To compare the clinical outcomes of patients selected for mechanical thrombectomy by noncontrast computed tomography (CT) vs those selected by computed tomography perfusion (CTP) or magnetic resonance imaging (MRI) in the extended time window. Design, Setting, and Participants: This multinational cohort study included consecutive patients with proximal anterior circulation occlusion stroke presenting within 6 to 24 hours of time last seen well from January 2014 to December 2020. This study was conducted at 15 sites across 5 countries in Europe and North America. The duration of follow-up was 90 days from stroke onset. Exposures: Computed tomography with Alberta Stroke Program Early CT Score, CTP, or MRI. Main Outcomes and Measures: The primary end point was the distribution of modified Rankin Scale (mRS) scores at 90 days (ordinal shift). Secondary outcomes included the rates of 90-day functional independence (mRS scores of 0-2), symptomatic intracranial hemorrhage, and 90-day mortality. Results: Of 2304 patients screened for eligibility, 1604 patients were included, with a median (IQR) age of 70 (59-80) years; 848 (52.9%) were women. A total of 534 patients were selected to undergo mechanical thrombectomy by CT, 752 by CTP, and 318 by MRI. After adjustment of confounders, there was no difference in 90-day ordinal mRS shift between patients selected by CT vs CTP (adjusted odds ratio [aOR], 0.95 [95% CI, 0.77-1.17]; P = .64) or CT vs MRI (aOR, 0.95 [95% CI, 0.8-1.13]; P = .55). The rates of 90-day functional independence (mRS scores 0-2 vs 3-6) were similar between patients selected by CT vs CTP (aOR, 0.90 [95% CI, 0.7-1.16]; P = .42) but lower in patients selected by MRI than CT (aOR, 0.79 [95% CI, 0.64-0.98]; P = .03). Successful reperfusion was more common in the CT and CTP groups compared with the MRI group (474 [88.9%] and 670 [89.5%] vs 250 [78.9%]; P < .001). No significant differences in symptomatic intracranial hemorrhage (CT, 42 [8.1%]; CTP, 43 [5.8%]; MRI, 15 [4.7%]; P = .11) or 90-day mortality (CT, 125 [23.4%]; CTP, 159 [21.1%]; MRI, 62 [19.5%]; P = .38) were observed. Conclusions and Relevance: In patients undergoing proximal anterior circulation mechanical thrombectomy in the extended time window, there were no significant differences in the clinical outcomes of patients selected with noncontrast CT compared with those selected with CTP or MRI. These findings have the potential to widen the indication for treating patients in the extended window using a simpler and more widespread noncontrast CT-only paradigm.

Unraveling the Atomic Structure of Bulk Binary Ga-Te Glasses with Surprising Nanotectonic Features for Phase-Change Memory Applications.

Binary Ge-Te and ternary Ge-Sb-Te systems belong to flagship phase-change materials (PCMs) and are used in nonvolatile memory applications and neuromorphic computing. The working temperatures of these PCMs are limited by low-T glass transition and crystallization phenomena. Promising high-T PCMs may include gallium tellurides; however, the atomic structure and transformation processes for amorphous Ga-Te binaries are simply missing. Using high-energy X-ray diffraction and Raman spectroscopy supported by first-principles simulations, we elucidate the short- and intermediate-range order in bulk glassy GaxTe1-x, 0.17 ≤ x ≤ 0.25, following their thermal, electric, and optical properties, revealing a semiconductor-metal transition above melting. We also show that a phase change in binary Ga-Te is characterized by a very unusual nanotectonic compression with the high internal transition pressure reaching 4-8 GPa, which appears to be beneficial for PCM applications increasing optical and electrical contrast between the SET and RESET states and decreasing power consumption.

Chemical and Structural Variety in Sodium Thioarsenate Glasses Studied by Neutron Diffraction and Supported by First-Principles Simulations.

Sodium-conducting sulfide glasses are promising materials for the next generation of solid-state batteries. Deep insight into the glass structure is required to ensure a functional design and tailoring of vitreous alloys for energy applications. Using pulsed neutron diffraction supported by first-principles molecular dynamics, we show a structural diversity of Na2S-As2S3 sodium thioarsenate glasses, consisting of long corner-sharing (CS) pyramidal chains CS-(AsSS2/2)k, small AspSq rings (p + q ≤ 11), mixed corner- and edge-sharing oligomers, edge-sharing (ES) dimers ES-As2S4, and isolated (ISO) pyramids ISO-AsS3, entirely or partially connected by sodium species. Polysulfide S-S bridges and structural units with homopolar As-As bonds complete the glass structure, which is basically different from structural motifs predicted by the equilibrium phase diagram. In contrast to superionic silver and sodium sulfide glasses, characterized by a significant population of isolated sulfur species Siso (0.20 < Siso/Stot < 0.28), that is, sulfur connected to only mobile cations M+ with a usual M/Siso stoichiometry of 2, poorly conducting Na2S-As2S3 alloys exhibit a modest Siso fraction of 6.2%.

Mercury Thiogermanate Glasses HgS-GeS2: Vibrational, Macroscopic, and Electric Properties.

Glasses in the pseudo-binary system (HgS)x (GeS2)1-x were synthesized over the concentration range of 0.0 ≤ x ≤ 0.5. The fundamental glass properties (macroscopic, electric, and vibrational) were studied using differential scanning calorimetry (DSC), direct current (dc) electrical measurements, Raman spectroscopy supported by DFT modeling, and X-ray diffraction. Mercury species in thiogermanate glasses essentially form chain-like (HgS2/2) fragments substituting bridging sulfur between corner- and edge-sharing GeS4/2 tetrahedra. This structural evolution results in a significant monotonic decrease of the glass transition temperatures from 480 to 270 °C. The room-temperature dc conductivity changes non-monotonically with increasing HgS content x over a limited range of 4 × 10-15 to 7 × 10-13 S cm-1. The electronic transport in insulating HgS-GeS2 glasses occurs via extended electronic states. Tetrahedral HgS4/4 fragments also appear in the glass network with increasing x. Their exact population needs further advanced structural studies using diffraction techniques.

Giant Adult Mesenteric Lipoma: A Rare Cause of Chronic Abdominal Distention and Discomfort.

Solitary or multiple lipomas are considered common tumors that can occur anywhere in the body; however, mesenteric lipoma is a rare entity that is well known to present with signs and symptoms of small bowel volvulus. Hereby, we present a case of a 54-year-old male patient with multiple comorbidities who was suffering from chronic abdominal discomfort and gradual increase of his abdominal distention over many years without seeking any medical attention. The patient was seen by a general practitioner after complaining of an inflated abdomen, as he described his condition. After several imaging studies, he was diagnosed with one of the largest mesenteric lipomas in the literature. Mesenteric lipoma should be present in the differential diagnosis of any abdominal tumor. Magnetic resonance imaging plays a major role in differentiating benign from malignant lipomas.

Dimeric Molecular Structure of Molten Gallium Trichloride and a Hidden Evolution toward a Possible Liquid-Liquid Transition.

Group 13 trihalides MY3 (M = Al, Ga, and In; Y = Cl, Br, and I) mostly having a dimeric M2Y6 molecular structure in the solid state and a mixture of M2Y6 dimers and MY3 monomers in the vapor phase are potential candidates for entropy-driven liquid-liquid transition M2Y6 ⇄ 2MY3 at elevated temperatures. Using pulsed neutron diffraction and high-energy X-ray scattering supported by structural modeling, we show a dimer molecular structure of liquid GaCl3 above the melting point at 351 K and midway between the boiling point (474 K) and the critical temperature (694 K) with almost hidden characteristic evolution toward a possible liquid-liquid transition. In contrast to edge-sharing (ES) dimers in solid and vapor of D2h symmetry, the ES Ga2Cl6 molecules in the melt have a puckered structure of the central four-membered ring with shorter Cl-Cl (2.90-3.09 Å) and longer Ga-Ga (3.20-3.26 Å) second-neighbor correlations. The elongation of Ga-Ga intramolecular distances with increasing temperature simultaneously with diminished Cl-Cl nearest neighbor contacts destabilizes the ES dimers, indicating the first step toward dimer dissociation.

Ventriculo-humeral shunt: a cadaveric feasibility study with application to treating hydrocephalus.

PURPOSE: Intraosseous vascular access is often used when vascular access is difficult. However, the use of this space for a receptacle for cerebrospinal fluid (CSF) diversion has been scantly considered. MATERIALS AND METHODS: Six upper limbs of fresh frozen cadavers were used for this study. In the supine position, a small hole was drilled through the outer cortex of the proximal humerus and into the medullary cavity. A 16-gauge needle was placed into the hole in the humerus and 150 cc of saline infused. Next, the adjacent axillary vein and tributaries were dissected to observe dilation or the presence of the blue-colored saline. For part two of the study, shunt tubing was passed subcutaneously from a supraclavicular incision to the hole made in the humerus. Range of motion of the shoulder was then performed. RESULTS: On all sides, all 150 cc of fluid was easily infused into the humerus. No specimen was found to have leakage from the drill hole site or into the extravascular soft tissues. With dissection of the axillary vein and its tributaries, all sides were found to have engorgement of these vessels. No tension was placed on the distal shunt tubing with full range of motion of the shoulder. CONCLUSION: Based on our study, the humerus is another option available to the neurosurgeon for CSF diversion.

Constriction of the Stomach by an Unusual Peritoneal Band.

Compression of intraabdominal contents can occur due to anomalous congenital bands. Herein, we describe, to our knowledge, the first case of compression of the stomach by an anomalous band extending from the lesser omentum to the greater omentum. Relevant literature is reviewed and the clinical implications of such a case are described.

Imaging Characteristics of Dural Arteriovenous Fistulas Involving the Vein of Galen: A Comprehensive Review.

Vein of Galen aneurysmal malformation (VGAM) is a rare angiopathy, which most commonly presents in infancy. Although very rare, it is associated with high morbidity and mortality rates. In order to minimize such morbid rates, a prompt diagnosis followed by a timely initiation of management is crucial. Multiple antenatal and postnatal imaging techniques for the diagnosis have been described and discussed in the literature. However, to our knowledge, a comprehensive review exploring such a list of imaging options for VGAM has never been established. We aim to review the diagnostic tools to aid in better understanding of the investigative modalities physicians may choose from when treating patients with a VGAM.

Accessory neuropathy after sternotomy: Clinico-anatomical correlation supporting an inflammatory cause.

Inflammatory etiologies are becoming increasingly recognized as explanations of some neuropathies, especially those occurring in the perioperative period. Although "brachial neuritis" is known to affect extraplexal nerves, accessory nerve palsy following median sternotomy has been attributed to stretch on the nerve. To better elucidate stretch as a potential cause, a cadaveric study was performed. Two patients who developed accessory nerve palsy following median sternotomy are presented to illustrate features consistent with the diagnosis of a perioperative inflammatory neuropathy. Five adult unembalmed cadavers underwent exposure of the bilateral accessory nerves in the posterior cervical triangle. A median sternotomy was performed and self-retaining retractors positioned. With the head in neutral, left rotation and right rotation, retractors were opened as during surgery while observing and recording any accessory nerve movements. The self-retaining sternal retractors were fully opened to a mean inter-blade distance of 13 cm. Regardless of head position, from the initial retractor click to maximal opening there was no gross movement of the accessory nerve on the left or right sides. Opening self-retaining sternal retractors does not appear to stretch the accessory nerve in the posterior cervical triangle. Based on our clinical experience and cadaveric results, we believe that inflammatory conditions, (i.e., idiopathic brachial plexitis) can involve the accessory nerve, and might be triggered by surgical procedures. Clin. Anat. 31:417-421, 2018. © 2017 Wiley Periodicals, Inc.

Anterior Inferior Cerebellar Arteries Juxtaposed with the Internal Acoustic Meatus and Their Relationship to the Cranial Nerve VII/VIII Complex.

Vascular loops in the cerebellopontine angle (CPA) and their relationship to cranial nerves have been used to explain neurological symptoms. The anterior inferior cerebellar artery (AICA) has variable branches producing vascular loops that can compress the facial cranial nerve (CN) VII and vestibulocochlear (CN VIII) nerves. AICA compression of the facial-vestibulocochlear nerve complex can lead to various clinical presentations, including hemifacial spasm (HFS), tinnitus, and hemiataxia. The formation of arterial loops inside or outside of the internal auditory meatus (IAM) can cause abutment or compression of CN VII and CN VIII. Twenty-five (50 sides) fresh adult cadavers underwent dissection of the cerebellopontine angle in the supine position. In regard to relationships between the AICA and the nerves of the facial/vestibulocochlear complex, 33 arteries (66%) traveled in a plane between the facial/nervus intermedius nerves and the cochlear and vestibular nerves. Five arteries (10%) traveled below the CN VII/VIII complex, six (12%) traveled posterior to the nerve complex, four (8%) formed a semi-circle around the upper half of the nerve complex, and two (4%) traveled between and partially separated the nervus intermedius and facial nerve proper. Our study found that the majority of AICA will travel in a plane between the facial/nervus intermedius nerves and the cochlear and vestibular nerves. Although the relationship between the AICA and porus acusticus and AICA and the nerves of the CN VII/VIII complex are variable, based on our findings, some themes exist. Surgeons should consider these with approaches to the cerebellopontine angle.

Intramedullary placement of ventricular shunts: a review of using bone as a distal cerebrospinal absorption site in treating hydrocephalus.

PURPOSE: Intraosseous (IO) vascular access has been used since the Second World War and is warranted when there is an emergency and/or urgent need to replenish the vascular pool. Despite long-term and satisfactory results from delivering large quantities of intravenous fluid via the medullary space of bone, use of this space for a distant receptacle for cerebrospinal fluid (CSF) diversion has seldom been considered. METHODS: The current paper reviews the literature regarding the bony medullary space as a receptacle for intravenous fluid and CSF. RESULTS: Previous authors have demonstrated the potential of the diploic space of the calvaria for CSF shunting. Pugh and colleagues tested the ability of the cranium to receive and absorb a small amount of tracer fluid. CONCLUSION: The literature suggests that intraosseous placement of ventricular diversionary shunts is an alternative to more traditional sites such as the pleural cavity and peritoneum. When these latter locations are not available or are contraindicated, placement in the medullary space of bone is another option available to the surgeon.

Prescription Patterns for Tigecycline in Severely Ill Patients for Non-FDA Approved Indications in a Developing Country: A Compromised Outcome.

Introduction: With the rise in antibiotic resistance, tigecycline has been used frequently in off-label indications, based on its in-vitro activity against multidrug-resistant organisms. In this study, our aim was to assess its use in approved and unapproved indications. Materials and Methods: This is a retrospective chart review evaluating a 2-year experience of tigecycline use for > 72 h in 153 adult patients inside and outside critical care unit from January 2012 to December 2013 in a Lebanese tertiary-care hospital. Results: Tigecycline was mostly used in off-label indications (81%) and prescribed inside the critical care area, where the number of tigecycline cycles was 16/1,000 patient days. Clinical success was achieved in 43.4% of the patients. In the critically ill group, it was significantly higher in patients with a SOFA score <7 using multivariate analysis (Odds Ratio (OR) = 12.51 [4.29-36.51], P < 0.0001). Microbiological success was achieved in 43.3% of patients. Yet, the univariate and adjusted multivariate models failed to show a significant difference in this outcome between patients inside vs. outside critical care area, those with SOFA score <7 vs. ≥ 7, and in FDA-approved vs. off-label indications. Total mortality reached ~45%. It was significantly higher in critically ill patients with SOFA score ≥7 (OR = 5.17 [2.43-11.01], P < 0.0001) and in off-label indications (OR = 4.00 [1.30-12.31], P = 0.01) using an adjusted multivariate model. Gram-negative bacteria represented the majority of the clinical isolates (81%) and Acinetobacter baumannii predominated (28%). Carbapenem resistance was present in 85% of the recovered Acinetobacter, yet, more than two third of the carbapenem-resistant Acinetobacter species were still susceptible to tigecycline. Conclusion: In our series, tigecycline has been mostly used in off-label indications, specifically in severely ill patients. The outcome of such infections was not inferior to that of FDA-approved indications, especially inside critical care area. The use of this last resort antibiotic in complicated clinical scenarios with baseline microbiological epidemiology predominated by extensively-drug resistant pathogens ought to be organized.