A small number of pRCCs have indeterminate enhancement when renal protocol CT is used. Heterogeneity, irregular margins, and calcification are suggestive diagnostic features; however, quantitative and qualitative CE-MRI can accurately differentiate hemorrhagic/proteinaceous cysts from pRCC.

A minority of solid RCCs have attenuation similar to that of water on unenhanced CT. In this study, all such tumors were of the clear cell subtype and qualitatively heterogeneous, suggesting they can be distinguished from simple cysts on unenhanced CT.

The twinkling artifact has a high PPV for detecting renal and urinary tract calculi. Evaluation for the twinkling artifact is a complementary technique to standard gray-scale shadowing of calculi and improves detection of urolithiasis on sonography.

Background: Adherence to hand hygiene (HH) by health care professional (HCP) is crucial to prevent nosocomial infections; adequate knowledge and a positive attitude are needed for optimal compliance. Objectives: The current study aimed to assess the knowledge and the attitudes of the HCPs regarding HH. Materials and Methods: Questionnaires were distributed to HCPs in two university affiliated hospitals. After completion, members of the study team analyzed the collected data. Results: Two-hundred fifty-five personnel completed the questionnaires; 143 (56.1%) physicians and 112 (43.9%) nursing personnel. Hands of health care personnel were named as the major source of transmission of infection and hand washing as the most effective way to prevent transmission by 88.6% and 94.5% of participants respectively. Hand washing was recognized as HH by 81.6% of the HCP, alcohol hand rubs by 64.3% and disposable gloves by 23.9%. Reasons to perform HH included prevention of nosocomial infection by 85.1% along with selfprotection by 64.3%; 25.9% had received formal training. Lack of knowledge, poor accessibility to alcohol hand rubs and concerns about skin damage were regarded as barriers to HH by 71.4%, 54.1% and 41.2% of participants, respectively. Suggestions for improving compliance to hand hygiene: continued education, 67.1%; increasing number/accessibility to hand rubs, 63.5%; putting up posters 54.5% and camera control, 15.7%. Conclusions:The findings indicate that hand hygiene should be included in the formal curriculum, continuous education and supervision are necessary to ensure compliance.