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La cultura de seguridad del paciente se fundamenta en el aprendizaje a partir de los eventos adversos, en el desarrollo de estrategias preventivas para evitar su ocurrencia y en reconocer y acompañar a los que han sufrido un daño innecesario e involuntario derivado de la atención sanitaria recibida. Avanzar en la cultura de seguridad del paciente lleva consigo facilitar la implantación de estos comportamientos en los profesionales sanitarios con normativas acordes. El objetivo fue escribir las normativas de algunas comunidades autónomas y proponer cambios normativos a nivel nacional.

We give a birational reduction of singularities for one dimensional foliations in ambient spaces of dimension three. To do this, we first prove the existence of a Local Uniformization in the sense of Zariski. The reduction of singularities is then obtained by a gluing procedure for Local Uniformizations similar to the one used by Zariski.

Increases or decreases in the contractile response of smooth muscle underlie important pathological conditions such as hypertension, incontinence and altered gastrointestinal transit. These disorders are also frequently encountered in the aged population. Oxidative stress and inflammation are key features in the initiation, progression, and clinical manifestations of smooth muscle disorders. Melatonin, the major secretory product of the pineal gland, has free radical scavenging and antioxidative properties and protects against oxidative insult. Recently, widespread interest has grown regarding the apparent protective effects of melatonin on smooth muscle dysfunction. “In vitro” studies have shown that melatonin decreased vascular tone of vascular beds from control, hypertensive or aged animals, through the reduction of adrenergic contraction and the increase in acetylcholine-induced relaxation. “In vivo”, melatonin also attenuates sympathetic tone by direct activation of melatonin receptors, scavenging free radicals or increasing NO availability in the central nervous system. In the gastrointestinal tract, melatonin treatment improves age-related impairments in gallbladder contractility and prevents deleterious effects of cholecystitis on smooth muscle and the enteric nervous system through suppression of oxidative stress. In addition, melatonin improves colonic transit time in constipation-predominant IBS patients. Melatonin is also able to restore impaired contractility of the detrusor muscle from old animals through normalization of Ca2 dependent and independent contraction, mitochondrial polarity, neuromuscular function and oxidative stress, which would explain the effects of melatonin counteracting cystometric changes in senescent animals. It also reverses bladder damage following ischemia/reperfusion. In conclusion, melatonin may be a promising candidate for future research of agents that modulate smooth muscle motility.

Isoniazid is one of the most useful drugs for the treatment of tuberculosis. However, in the last few years treatment with this drug has become long, complicated, and occasionally inefficient because of the increasing number of cases with resistance. The aim of our work was to know the isoniazid resistance level of 1,496 Mycobacterium tuberculosis strains that were submitted to the Mycobacteria Reference Center, Córdoba, during the years 1993-2000. A total of 1,186 strains were from pulmonary sources and 196 from extrapulmonary sources; no source was provided for 114 strains. All M. tuberculosis strains were previously identified by different methods. For sensitivity testing, the BACTEC 460 TB system was used initially and then the ESP II system was also used. The control strains used in this study were ATCC27294 (sensitive to SM, RP, EB, and INH) and ATCC35822, resistant to INH. The overall resistance rate obtained was 14.8%, of which 2.3% and 1.4% accounted for primary and secondary resistance types, respectively. Ninety-six out of the 221 resistant strains were resistant to INH only, and 8 strains were resistant to INH plus SM. A total of 117 multiresistant strains were found. An apparent increase in the resistance rate to INH in the last few years was observed. Secondary resistance has decreased, whereas primary resistance has increased. A continuous surveillance of resistance is required and, therefore, any patient with tuberculosis should undergo sensitivity testing to confirm therapy to be used.

In this work we propose the use of a neural network to predict the crystal mode of packing of small organic molecules from just their 3-D molecular structure. A sample of 31 molecules, of quite different chemical characters and known crystal structures, has been employed. These molecules, encoded by the 1-D Fourier transform of their 3-D point charge distributions, are used as input in a Kohonen neural network. Although no molecular packing information is given, the resulting similarity output maps self-classify the molecules after the type of H-bonding pattern they present, or according to their observed molecular packing mode, when no H-bonds exist. The corresponding crystal packings of these molecules were encoded similarly by the Fourier transform of a finite cluster of molecules sought from their known crystal structures. The self-classification of these encoded packings, on the Kohonen map, presents good correlation with the classification found for the isolated molecules, and both correlate well also with the visually observed types of packings in the crystal structure. Thus, it seems that the Fourier transform of an isolated molecule includes enough packing information to allow its classification into packing modes. Finally, the same neural network, trained with part of the set of 31 molecules, supervised with their crystal packing, is used to predict the encoded packing of molecules not included in the training, in order to classify them into a mode of packing.

Three new diterpenoids, a neoclerodane and two labdane derivatives, have been isolated from an acetone extract of Plectranthus ornatus. The structures of these compounds (plectrornatins A−C, 1−3, respectively) were established mainly by spectroscopic means, particularly by 1D and 2D NMR studies and, in the case of the neoclerodane 1, by an X-ray diffraction analysis. Compounds 1 and 3 showed moderate antimicrobial activity against five Candida species and selected Gram negative and Gram positive bacteria strains.

We study the effects of the |qqqqq̄〉component of the hadronic wave function on the description of the electromagnetic structure of the nucleon. Starting with a 3qbaryonic wave function which describes the baryonic and mesonic low-energy spectrum, the extra qq̄pair is generated through a relativistic version of the 3P0model. It is shown that this model leads to a renormalization of the quark mass that allows one to construct a conserved electromagnetic current. We conclude that these dynamical relativistic corrections play an important role in reproducing the Q2dependence of the electromagnetic form factors at low Q2.

Mackey and Ornstein proved that if R is a semi-simple ring then the ring of row and column finite matrices over R (RCFMΓ(R)) is a Baer ring for any infinite set Γ. A ring with identity is a Baer ring if every left (equivalent every right) annihilator is generated by an idempotent. This result is discussed in Kaplansky's book, “Rings of Operators.” This result is of course decades old. Here we prove that the converse is true. The proof is long and we develop techniques which allow us to obtain results of a more modern flavor about RCFMΓ(R), where R is a perfect or semi-primary ring. Finally, we obtain good enough results on annihilators in RCFM(Z) to show that this ring is coherent.

The pimarane-type structures previously suggested for leucophleol (1) and leucophleoxol (2), two diterpenoids isolated from Acacia leucophloea, must be amended to the isopimarane-type derivatives 5 and 6, respectively. These corrections were supported on NMR spectroscopic studies and, in the case of 6, by an X-ray diffraction analysis. Moreover, the unpublished complete and unambiguous ¹H and ¹³C NMR assignments of 5 and 6 together with those of leucoxol (3), another diterpenoid from the same plant, are also reported.

Abstract.:  The nucleon form factors are calculated using a non-relativistic description in terms of constituent quarks. The emphasis is put on present numerical methods used to solve the three-body problem in order to reliably predict the expected asymptotic behaviour of form factors. Nucleon wave functions obtained in the hyperspherical formalism or employing Faddeev equations have been considered. While a q −8 behaviour is expected at high q for a quark-quark force behaving like 1/r at short distances, it is found that the hypercentral approximation in the hyperspherical formalism leads to a q −7 behaviour. An infinite set of waves would be required to get the correct behaviour. Solutions of the Faddeev equations lead to the q −8 behaviour. The coefficient of the corresponding term, however, depends on the number of partial waves retained in the Faddeev amplitude. The convergence to the asymptotic behaviour has also been studied. Approximate expressions characterizing this one have been derived. From the comparison with the most complete Faddeev calculation, a validity range is inferred for restricted calculations.

La dynamique oscillante d'un champ de vecteurs analytique en dimension trois s'organise autour d'un nombre fini d'axes de tourbillonnement lorsqu'elle ne se délocalise pas par des éclatements de point.

Mono- and bimetallic allylic palladium complexes (1L−5L) with L being chiral bidentate oxazoline ligands (from pyridine (a−d), quinoline (e−g), and piperazine (h)), containing different kinds of allyl groups (1−5), were easily obtained, and their structures in solution were elucidated by NMR spectroscopy. Complex 1d was also characterized by X-ray diffraction. The activity of these complexes in palladium-catalyzed allylic alkylation for acyclic and cyclic substrates was tested. For catalytic systems with ligands a−g, the activity was very high, although the enantioselectivity was low for pyridine derivatives and moderate for quinolino-oxazoline ligands, showing the beneficial effect of chelate size in the latter case. In contrast, the palladium tetraaza catalytic system (Pd/h) exhibited a low activity and a low asymmetric induction. Allylic complexes 1a, 1d, and 1e were also active in the Pd-catalyzed allylic amination, but the activity of these systems was lower than for the alkylations. Under in situ catalytic conditions, the coordination competition of the benzylamine with the bidentate ligand led to different results than using previously isolated precursors.

A series of esters derived from syn‐ and anti‐2‐methyl‐2‐azabicyclo[2.2.2]octan‐6‐ols were synthesized and studied by NMR spectroscopy. The unambiguous assignment of all bicyclic proton and carbon resonances was achieved by the combined analysis of the COSY, 1H–13C correlation spectra and double resonance experiments (spin decoupling). The crystal structure of 6‐anti‐(2‐chlorobenzoyloxy)‐2‐methyl‐2‐azabicyclo[2.2.2]octane hydrochloride, was determined by x‐ray diffraction, which confirmed the configurational assignment. Copyright © 1999 John Wiley & Sons, Ltd.

Lack of reliable data about street vendors, who are difficult to survey, has hampered efforts to improve the safety of street-vended food. A two-phase method for sampling vendors, surveying first in areas of concentrated vending activity identified by local authorities and second in randomly selected areas, was developed and implemented in two Guatemalan cities where street-vended food had been implicated in cholera transmission. In a 4-day survey in Escuintla, 59 vendors (42 from phase 1, 17 from phase 2) were interviewed. They demonstrated good knowledge of food safety and cholera but unsafe practices, implying that more effective, practical training was needed. In a 6-day survey in Guatemala City, 78 vendors (77 from phase 1, 1 from phase 2) were interviewed. Sixty-eight (87%) vendors stored water, usually in wide-mouthed vessels prone to contamination; this led to a field test of a new system for safe water storage. Useful information for public health planning and intervention can be gathered rapidly with this new method for surveying street vendors.

A series of esters derived from syn- and anti-2-methyl-2-azabicyclo[2.2.2]octan-6-ols were synthesized and studied by NMR spectroscopy. The unambiguous assignment of all bicyclic proton and carbon resonances was achieved by the combined analysis of the COSY, ¹H–¹³C correlation spectra and double resonance experiments (spin decoupling). The crystal structure of 6-anti-(2-chlorobenzoyloxy)-2-methyl-2-azabicyclo[2.2.2]octane hydrochloride, was determined by x-ray diffraction, which confirmed the configurational assignment. Copyright © 1999 John Wiley & Sons, Ltd.

The variance in the geometry of pentafluorophenyl rings bonded to metals of the fourth, fifth and sixth rows of the Periodic Table has been analyzed from the data present in the literature. The application of univariate and bivariate analysis to internal coordinates shows that the major variation corresponds to bond angles, specially to those near to the substitution. This effect (“ipso” effect) seems to be related to the Pauling's electronegativity of the metals. Multivariate analysis of these coordinates reveals the existence of three principle effects, the main one of them corresponding to the “ipso” effect and the other two being related with the thermal vibration of the molecule and with the inhomogeneity of the sample. The application of bivariate analysis to symmetry coordinates does not give any correlation between the two orthogonal components describing fully the angular variance.

The objective of this study was to optimize, in terms of endometrial receptivity (embryo implantation), the limits of unopposed administration of oestrogens beyond 35 days in an in-vitro fertilization (IVF) and ovum donation programme. Oocytes donated by 182 women undergoing IVF were distributed among 186 women treated by ovum donation. Five groups of recipients were established according to the duration of oestradiol valerate administration, in a 'prolonged follicular phase' protocol, before embryo replacement, employing oestradiol valerate at increasing doses up to 6 mg/day. Gonadotrophin-releasing hormone analogues (GnRHa) were simultaneously administered in ovulatory patients. The dosage of oestradiol valerate was maintained until oocytes were available for insemination and subsequent transfer. Donors and recipients were equally distributed among groups in terms of age and cause of infertility. There was no difference among groups in serum oestradiol concentration the day in which progesterone was added to obtain a secretory transformation of the endometrium. An analysis of the ovum donation cycles showed no difference among groups in pregnancy and implantation rates after the replacement of a similar number of embryos. Successful implantation was observed even after 100 days of unopposed oestradiol valerate administration. Break-through bleeding increasingly appeared according to the duration of oestrogen replacement. These clinical observations provide evidence that the concept of 'prolonged follicular phase' oestrogen replacement for ovum donation can be maintained, at least as long as 15 weeks. However, because of the high (> 44%) incidence of break-through bleeding after 9 weeks, it is advisable to stop oestrogen treatment at this point.(ABSTRACT TRUNCATED AT 250 WORDS)

The attenuated phenotype of Sabin 3 poliovirus compared with its neurovirulent progenitor strain has been largely accounted for by mutations in the genome at positions 472 and 2034 (G. D. Westrop, K. A. Wareham, D. M. A. Evans, G. Dunn, P. D. Minor, D. I. Magrath, F. Taffs, S. Marsden, M. A. Skinner, G. C. Schild, and J. W. Almond, J. Virol. 63:1338-1344, 1989). By sequencing vaccine virus RNA, we recently identified another Sabin 3-specific mutation at position 2493 (U----C), which predicts an Ile----Thr change at the sixth residue of VP1 (C. Weeks-Levy, J. M. Tatem, S. J. DiMichele, W. Waterfield, A. F. Georgiu, and S. J. Mento, Virology 185:934-937, 1991). Viruses generated by using cDNAs which represent the vaccine sequence (LED3) and a derivative (VR318) possessing a single base change to the wild-type nucleotide (U) at 2493 were used to determine the impact of the 2493 mutation on virus phenotype. The VP1 proteins of LED3 and VR318 viruses were distinguishable by denaturing electrophoretic analysis. LED3 produced smaller plaques in Vero cells than VR318 virus did. Neurovirulence testing of these cDNA-derived viruses in monkeys demonstrated that the 2493 mutation in LED3 virus is attenuating.

Abstract: This is an analysis of the scientific production of the Spanish research community compiled by the Institute for Scientific Information (ISI) during the period 1983–1989 through indicators of publications (scientific output) that have been accepted, more and more frequently, as tools for decision-making. The percentages of the total number of articles per year are defined and the temporal evolution is shown of the orders of quality of the hypothetical journals that represent the whole production. A new indicator is used for comparisons between scientific subjects and thematic areas. Finally, mention is made of the spectacular growth of the Spanish scientific production in the period referred to, not only in quantity but also in quality through the indicators considered.

The x-ray single crystal structures of NH4MnCl3 at 343, 295 and 128 K. have been determined. No crystallographic differences have been found between the samples at the two highest temperatures, showing the Pmim perovskite structure. Below 258 K a crystallographic transition, occurring per domains, twins the crystal and doubles the lattice constants. This distorted perovskite structure is described in the space group Cmcm. The results, together with some observations on Mössbauer spectra, suggest the existence of two phase transitions of 1st and 2nd order around 258 K.

Strong pionic decays of baryons are studied in a non—relativistic quark model framework via a convergent (p/E) expansion of the transition operator. Results are compared to the ones obtained within a more conventional (p/m) expansion.

Factory automation is a job that intends to map all the cooperative and competitive relationships that happen among the elements existing in a factory into the software domain. The goal of this paper is to show an important phase when a software system of this kind is to be built. This is the design phase. We have chosen an object oriented methodology. We think several concepts belonging to this methodology are applicable on the industrial environment to be controlled. We think it is very important to build a conceptual model of the system which will control the factory. The final software system will depend on the consistency of this model. The main feature of the model is to consider the factory as a set of different classes of components. The components belonging to each class have the same behavior.

Diastereoselectivity of allylations of enantiopure 3- and 4-substituted η⁴-(1Z)-(sulfinyldienal)iron(0) tricarbonyl complexes is dependent on the nature of the alkyl substituent. For 1-sulfinyl-1,3-pentadien-5-al iron complexes (11a−d), the aldehyde predominately reacts through the s-cis conformer, with diastereoselectivites as high as 95:5 (for homoallylic alcohol 13d). For 3-formyl-1-sulfinyl-1,3-butadiene iron complexes (12a,b), the aldehyde predominately reacts through the s-trans conformer (diastereomer ratio for homoallylic alcohol, 14b, 89:11).

C24H21N3O2 is orthorhombic,P212121,a = 15.1342(3),b = 14.1692(3),c = 9.6533(3) Å,Z = 4,Dm = 1.23 g cm-3. The structure was solved by direct methods, and refined to anR of 0.048 (Rw = 0.068) for 1831 observed reflections. An intramolecular hydrogen bond is present. The conformation of the seven membered ring is boatlike with a quasi-mirror plane through N(1).

The title compound crystallizes in space groupP21/c witha = 17.988(5),b = 9.504(1),c = 14.811(4)Å, β = 106.90(2) °,Z = 4, andDx = 1.441 g cm−3. The structure was solved by Patterson and electron density syntheses. The finalR andRw values for all reflections were 0.089 and 0.095 respectively. The molecule has an erythro configuration around C(3) and C(3′). Intramolecular distances, up to 4 Å, within the two halves of the molecule have been studied by half-normal probability methods.

Molecules of C36H28N2O2S2 crystallize in the monoclinic space groupP21/c with cell dimensionsa = 8.9326(3),b = 20.0197(11),c = 17.0349(8) Å, and ß = 92.20(1) °,Z = 4,Dx = 1.276 g cm-3, µ (CuKa) = 18.16 cm-1. The structure was solved by Patterson methods and refined by least-squares calculations to anR of 0.057 andRw = 0.066 for all reflections. The main differences in the two halves of the dimer are due to the different torsion angles in the propenyl chain.

Crystals of 1,4-dichloro-7-methylpyrrolo[3,2-d]pyridazine,·C7H3N3Cl2, are monoclinic:a = 18.7465(9),b = 9.3031(3),c = 9.5363(3) Å, ß = 104.755(3) °,Z = 8,P21/n,Dx = 1.667 g cm-3, µ(MoKa) = 7.4 cm-1. The structure was solved by Fourier techniques and refined toR = 0.042 for the observed reflections, and 0.060 for all data measured. The two independent molecules in the asymmetric unit have similar geometry. The packing in the crystal is due to van der Waals' forces and two hydrogen interactions of type N-H ? N.

Crystals of C20H16N2O2 are orthorombic:P212121,a = 28.1364(21),b = 7.6474(2),c = 7.5376(2) Å,Z = 4, µ = 6.4 cm-1 (CuKa radiation), andM = 316.36. The structure has been solved by direct methods and refined by two-block least-squares toR = Rw = 0.042. The conformation of ringB is a distorted envelope at N(10), and the phenyl rings have acis configuration with respect to the pyridazine ring. Thermal motion of the molecule has been analyzed in terms of the rigid-body TLS model.

This study was undertaken to investigate an empirical observation that 'high responder patients have poorer in-vitro fertilization (IVF) outcome than normal responder patients'. The aim of our study was to analyse the effect of high serum oestradiol and progesterone concentrations at the day of human chorionic gonadotrophin (HCG) administration on endometrial receptivity and oocyte-embryo quality in high and normal responder patients. The IVF patients were divided into two groups: 59 high responder patients who voluntarily donated some of their oocytes, and a control group consisting of 105 normal responder patients. Both groups were compared in terms of the number and quality of oocytes retrieved, embryos transferred, fertilization, implantation and gestation rates, serum oestradiol and progesterone concentrations and the oestradiol:progesterone ratio on the day of HCG injection. To ascertain oocyte-embryo quality, a second control group of 96 women undergoing oocyte donation (receiving oocytes from high responder patients) was considered. To assess the impact of steroid concentrations on endometrial receptivity, high responder patients were divided into two subgroups according to oestradiol concentration, above or below the minimal oestradiol and progesterone concentrations (mean--SD) in this group. The normal responder patients were divided into two subgroups according to oestradiol concentration, above or below the maximal oestradiol and progesterone concentrations (mean+SD) in this group. To assess further the relevance of oestradiol concentration on endometrial receptivity, patients were divided into different subgroups according to increasing oestradiol concentration, regardless of whether they were high or normal responders. High responder patients had significantly decreased implantation and pregnancy rates per cycle compared with normal responder patients (33.3 versus 16.3 and 11.1 versus 5.4% respectively; P < 0.05). The results of 108 embryo transfers in 91 recipients who received oocytes from the high responder group showed normal embryo quality. Implantation rates and pregnancies per cycle were significantly lower in high responder patients with serum oestradiol concentrations > 1700 pg/ml compared with those having oestradiol concentrations < or = 1700 pg/ml, as well as in normal responder patients with serum oestradiol concentrations > 2200 pg/ml compared with those having oestradiol concentrations < or = 2200 pg/ml. Considering all the patients together, significant decreases in pregnancy and implantation rates were observed when oestradiol concentrations were > 2500 pg/ml compared with patients having lower oestradiol concentrations. Our clinical results demonstrate that high serum oestradiol concentrations on the day of HCG injection in high and normal responder patients, regardless of the number of oocytes retrieved and the serum progesterone concentration, are detrimental to uterine receptivity without affecting embryo quality.

The singularities of a plane vector field can be reduced under quadratic blowing ups. We describe a control method for the singularities of the vector field which works for ground fields of any characteristic and which has no essential obstruction for generalizing to higher dimensional cases.

The crystal structure of the title compound has been determined from single-crystal x-ray diffraction data. The crystals are tetragonal, space group P42212, withz=2 in a unit cell of dimensionsa=b=9.575(2),c=16.135(5) Å. The structure was solved by the usual Patterson and Fourier techniques, and was refined by least-squares analysis to an R value of 0.057 for 545 observed reflexions. Two mepirizole molecules are arranged in a flattened tetrahedral manner (average Cu-N, 1.974 Å) around Cu, and coordinated through N atoms. The dihedral angle between N-Cu-N planes of the two ligands is 53.6+°. This geometry seems to result from steric interaction between the ligands.

Fecal excretion of astroviruses was monitored in 321 children, 0 to 3 years old, living in the rural highlands of Guatemala. During the longitudinal study, from February 1987 to February 1989, we examined 5,000 stool specimens, including 1,805 collected during 1,369 episodes of diarrhea, 830 collected during the convalescent week, and 216 and 244 collected 2 weeks and 1 week, respectively, before the onset of diarrhea. Routine specimens were taken once a month from every child who had been free from diarrhea for at least three consecutive weeks. Of the children, 124 (38.6%) excreted astroviruses during the study. In total, we identified 184 infections by astroviruses. Of the samples collected 2 weeks and 1 week before the initiation of symptoms, 0.9 and 4.9%, respectively, were positive, while 7.3% of the diarrhea episodes were associated with astroviruses. Of the convalescent specimens, 3.4% were shown to be positive; 2.4% of the 1,905 specimens taken in diarrhea-free periods contained astroviruses. Infections by other potential enteropathogens were documented in 54 and 65% of the asymptomatic and symptomatic astrovirus infections, respectively. Diarrhea associated with astroviruses alone had a median duration of 5 days and was associated with vomiting in 8.6%, with fever in 17.1%, with dehydration in 5.7%, and with loss of appetite in 34.3% of the episodes. Diarrhea due to astroviruses was accompanied by negative changes in weight gain. Astrovirus diarrhea contributes to the high morbidity observed in young children living under poor conditions and has a deleterious effect on their nutritional status.

During July 1985 to June 1986, fecal excretion of Cryptosporidium oocysts was determined prospectively in a cohort of 130 infants, aged 0 to 11 months, living in a marginal urban area of Guatemala City, Guatemala. A total of 1,280 stool specimens were examined; 158 of them were collected during episodes of diarrhea, and 1,122 were collected during symptom-free periods, every 2 to 3 weeks, from every child. Of the children, 20 (15.4%) excreted Cryptosporidium oocysts during the observation period. Of the diarrheal episodes, 13 (8.3%) were associated with Cryptosporidium sp. Of the control specimens, seven (0.6%) were positive for oocysts. Most of the infections were documented during the months of February to May, at the end of the dry season. Cryptosporidium infections are very common among Guatemalan infants and are an important cause of diarrhea and weight loss. The introduction of liquid or solid foods in the diets of the children, the presence of domestic animals (dogs, cats, or poultry), and the absence of toilet facilities in the house seem to be important risk factors for infection; also, deficient nutritional status may predispose the infected child to Cryptosporidium-associated illness.

From March 1987 to February 1988, fecal excretion of adenovirus types 40 and 41 and rotavirus serotypes in 194 children (age, 0 to 3 years) from a rural community of Guatemala was monitored. In total, 458 samples taken during 385 episodes of diarrhea and 191 specimens obtained during symptom-free periods were examined by enzyme-linked immunosorbent assay. Fifty-seven children hospitalized because of diarrhea were also studied. Among the rural children, 43 (22.2%) excreted adenovirus types 40 and 41 and 20 (10.3%) shed rotaviruses. Adenovirus types 40 and 41 were associated with 54 (14.0%) illnesses, and rotaviruses were associated with 18 (4.7%) illnesses. Asymptomatic infections with adenovirus types 40 and 41 were documented in nine children and with rotaviruses in two children. Fifteen typeable rotaviruses were identified as serotype 2. In the hospital population, 36 (63.2%) children had viral infections. Rotaviruses were identified in 29 (50.9%) and adenovirus types 40 and 41 were identified in 15 (31.2%) of 48 subjects tested. Dual infections by these viruses were found in eight children. Of 22 typeable strains of rotaviruses, 9 (34.6%) were serotype 1, 12 (46.1%) were serotype 2, and 1 (3.8%) was serotype 3. All the children infected with serotype 2 rotavirus were coinfected with other enteric pathogens, while only three (37.5%) of those infected with rotavirus serotype 1 excreted another pathogen. Adenovirus types 40 and 41 are an important cause of gastroenteritis in both ambulatory and hospitalized Guatemalan children. There seems to be a difference in the pathogenicity among rotavirus serotypes.