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Admadol (Tramadol)

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Admadol is an opioid (narcotic) pain reliever. It works by binding to mu-opiate receptors in the brain and changes how you feel and respond to pain. Admadol is usually started at 25 mg per day. After slowly raising the dose over several days, a typical dose would be 50 to 100 mg by mouth every 4 to 6 hours as needed for pain.

Other names for this medication:
Anazac, Cadol, Cosdol, Dolomed, Dolotram, Dolstar, Esgiypyrin, Euphodol, Jpdol, Kevtram, Mandol, Meridol, Movon, Nopidol, Pentazen, Rybix, Spasteez, Tramaflam, Tramagesic, Tramasol, Tramex, Tramoflex, Tranat, Trandol, Trapain, Tromar, Typhon, Urogendo, Vintram, Zytram

Similar Products:
Zudena, Duricef, Arcoxia, Ceftin, Daklinza, Cozaar

Also known as: Tramadol


{name} ER is an pain medicine similar to an opioid. This medicine is used to treat moderate to severe pain.

The extended-release form of tramadol is for around-the-clock treatment of pain. This form of tramadol is not for use on an as-needed basis for pain.


Usual Adult Dose for Pain:

Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain -For patients not requiring rapid onset of analgesic effect: Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days Maximum dose: 400 mg per day.

Usual Adult Dose for Chronic Pain:

Extended-Release (ER): 18 years or older (tramadol-naive): 100 mg orally once a day -Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions -Maximum Dose: 300 mg/day For patients CURRENTLY receiving Immediate-Release (IR) Admadol: Initial Dose: Calculate 24-hour IR requirement and initiate with a total daily ER dose rounded down to the next lowest 100 mg increment orally once a day Conversion from OTHER Opioids: Discontinue all other around the clock opioid drugs prior to initiating therapy -Initial dose: 100 mg ER orally once a day -Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions -Maximum Dose: 300 mg/day.

Usual Geriatric Dose for Pain:

Dose selection should be cautious generally starting at the low end of the dose range Over 75 years: Maximum dose of Immediate-release: 300 mg per day.

Usual Geriatric Dose for Chronic Pain:

Dose selection should be cautious generally starting at the low end of the dose range Over 75 years: Maximum dose of Immediate-release: 300 mg per day.

Usual Pediatric Dose for Pain:

Admadol is not recommended for use in pediatric patients 17 years or older: See Adult Dose.

Detailed Admadol dosage information


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.

Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don't wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.

Anyone can buy naloxone from a pharmacy or local health department. Make sure any person caring for you knows where you keep naloxone and how to use it.


Store at room temperature below 25 degrees C (77 degrees F) away from moisture and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Admadol are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


You should not take Admadol if you are allergic to tramadol, or if you have:

severe asthma or breathing problems; a stomach or bowel obstruction (including paralytic ileus); if you have recently used alcohol, sedatives, tranquilizers, or narcotic medications; or if you have used an MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine).

Admadol should not be given to a child younger than 12 years old. Admadol ER should not be given to anyone younger than 18 years old.

Do not give Admadol to anyone younger than 18 years old who recently had surgery to remove the tonsils or adenoids.

Seizures have occurred in some people taking Admadol. Your seizure risk may be higher if you have ever had:

a head injury, epilepsy or other seizure disorder; drug or alcohol addiction; or a metabolic disorder.

To make sure Admadol is safe for you, tell your doctor if you have ever had:

breathing problems, sleep apnea; liver or kidney disease; urination problems; problems with your gallbladder, pancreas, or thyroid; a stomach disorder; or mental illness, or suicide attempt.

If you use tramadol during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

Ask a doctor before using tramadol if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

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Thermoluminescence dosimeters were used for measuring the dose to the distal part of the anus in 10 patients, and in a prostate phantom to measure the radiation dose during the transport of the radiation source. Most Cochrane reviews of drug interventions considered adverse events. Future studies should focus on this insufficiently analyzed clinical feature and put to better use more specific QoL questionnaires. We hypothesised that the latter effect will be more pronounced when DHA/EPA is supplemented as phospholipids rather than as triglycerides. To understand the changes and trend of child growth during the period in fast economic development in China. Computed tomography showed anteriorly displaced fibula at syndesmosis level. The primary findings essentially consist of occlusion of the circle of Willis and collateral formation, including moyamoya vessel formation. We discuss several of these and describe how they have led to novel insights into tumor genesis, growth, apoptosis, vascularization and therapy. Such a mechanism requires the presence of translational machinery and associated mRNAs in circuit-integrated brain axons. In case of warning signs of complications or emergency symptoms, medical care is required, and antiviral treatment, hospitalization might be needed.

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Fragmentation was not observed in ICR27TK.3 cells containing mutant glucocorticoid receptors (L753F) that are activation-deficient but retain the ability to repress AP-1 activity. Our data suggest a regulatory role of MARCKS during endothelial cell proliferation. Superior parietal cortex is critical for the manipulation of information in working memory. It has been demonstrated that therapy with proton pump inhibitors reduces recurrence of bleeding following initial endoscopic treatment of bleeding peptic ulcers. Presenting symptoms are often common complaints in general practice or the emergency department, such as leg weakness or numbness. Anterior OV gave rise to cells in nasal retina and posterior OV became temporal retina.

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These specimens were tested by means of both single-sided and through-transmission techniques using planar transducers. Dibromoacetic acid does not adversely affect early pregnancy in rats. An observational investigation of poker style and the five-factor personality model. Immunohistochemical consistency between primary tumors and lymph node metastases of gastric neuroendocrine carcinoma. In vitro and in vivo data showed that the treatment with the mood stabilizing drugs had no effect on basal cAMP levels in vitro, but had differential effects in vivo. Clinical outcomes of MTC patients in our series were better than those in Western countries, a result that might have resulted in part because of our routine MND regardless of whether clinically apparent node metastasis was detected. Isoform-specific PKC inhibitors for PKC-delta and PKC-epsilon reduced supraphysiological caerulein-induced zymogen activation. Therefore, endogenous genomic damage may be produced in Drosophila development, and RecQ5 would be involved in the maintenance of genomic stability by suppressing the accumulation of DNA damage. Also, the remnant hepatocytes demonstrated an immature phenotype as indicated by high nuclear to cytoplasmic ratio, poor cell polarity, absent glycogen, and decreased expression of key liver-enriched transcription factors: CCAAT-enhancer binding protein-alpha and hepatocyte nuclear factor-4alpha.

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Distribution of 131I-labeled Bothrops erythromelas venom in mice. Genes and proteins determining species specificity of avian influenza viruses as well as possible emergence of influenza pandemic caused by H5N1 strain are discussed. Following surgery, pathologic findings of the tumor demonstrated pure choriocarcinoma without combination of other germ cell tumor elements. In randomized trials, the treatment assignment mechanism is independent of the outcome of interest and other covariates thought to be relevant in determining this outcome. No long-term study found any evidence that surgery would prevent knee osteoarthritis. These additions are incorporated in a new version of the SHIFTS program. For the retrospective arm, preoperative CT images of all cases were reviewed electronically in a blinded fashion by the senior author and a prediction was made for the site of attachment. For the infinite allele model, the analysis shows that more precise estimates of the frequency of ancestral alleles can greatly improve the reliability of the estimate of genetic identity in the case of ITL. Recurrent ischemic stroke in a patient with idiopathic thrombocytopenic purpura. The patient was successfully treated by endovascular embolization at the orifice of the pseudoaneurysm followed by the total ICA trapping technique using electrolytically Guglielmi detachable coils (GDCs) and injection of N-butyl-2-cyanoacrylate (n-BCA).

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This type of research, however, has not been examined extensively in regards to labels for mental disorders. Long-term benzimidazole therapy benefits patients with non-resectable alveolar echinococcosis (AE). Methamphetamine (Meth) dependence and depression are common comorbid conditions with HIV and may complicate diagnosis of HIV-associated neurobehavioral syndromes. The experimental data allow us to discriminate the transport systems by the physicochemical parameter that is sensed, which can be a change in external osmotic pressure, turgor pressure, membrane strain, internal osmolality and/or concentration of specific signal molecule. We present a 75 years old diabetic patient with emphysematous cystitis that develops into an urosepsis treated in a conservative management.

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In this context, the present review examines the effects of cannabinoids and of the pharmacological manipulation of the endocannabinoid system, in cardiovascular pathophysiology. Additional experimental data also support the diffusion of FADH(2) between TftC and TftD without direct physical interaction between the two enzymes. Results were compared to hormone receptor expression and proliferation index. The repertoire of virulence determinants promoting EHEC disease is encoded on both the main chromosome and virulence plasmid. Furthermore, the HIV-1 Gag precursor is generally inefficiently processed and is poorly secreted from mouse and rat cells in a largely noninfectious form. Chemical control against this species is difficult because of its cryptic habits and is mainly based on the repeated application of large quantities of synthetic insecticides. Healthy participants wore two lower intra-oral appliances retaining four dentine samples for four treatment days for each period of the study. We performed a population-based retrospective cohort study to determine the morbidity of SE. The impact of matrix loading and protein molecular weight was assessed with the model proteins lysozyme, BSA, alcohol dehydrogenase and thyroglobulin. To describe the implementation of the European Foundation for Quality Management (EFQM) model as a quality framework for improving a psychiatric hospital ward.

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Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. The magnitude of these DOR-2 vagolytic effects was small compared to controls and repeated MEAP challenges rapidly eroded vagolytic responses further. As these results are somewhat at odds with results from published RCTs, we will examine the level of evidence from the observational setting that is the ANZDATA Registry and contrast it against the level of evidence from RCTs, particularly the ADEMEX trial. The dynamics of adsorption and competition are incorporated using expanding zones within the carbon bed, taking into account vapor and water displacements. In this study we examine global regulator half-sites, where a half-site, which we shall call a binding motif (BM), is one half of a palindromic TFBS. To the greatest extent possible, any course of action for this group should be built into integrated, coordinated plans that take a broad approach to the main issues involved.

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Subsequent 48-trial testing sessions were then used to test for detection of each stimulus in presented pairs, and test discrimination between the member stimuli of each pair. The activity of the transporters was determined electrophysiologically using the whole cell configuration of the patch-clamp recording technique. Drug efficacy analysis showed that ATA nanoparticles were as effective as free ATA against estrogen receptor positive breast cancer cells, but much less toxic towards human endothelial cells. Management of incomplete regional anaesthesia in Germany: results of a nation-wide survey. Quantitative regulation of intracellular endothelial nitric-oxide synthase (eNOS) coupling by both tetrahydrobiopterin-eNOS stoichiometry and biopterin redox status: insights from cells with tet-regulated GTP cyclohydrolase I expression. However, very little information is available on how efficiently external carbon is utilized by microorganisms and transported to consumers of higher trophic levels. From June 2009 through May 2010, 61 prospectively identified families completed a cost diary, documenting the numbers of missed school days for the child and missed employment days for the adult caregiver(s) over the treatment course. Elevated levels of c-reactive protein (CRP) are known to be associated with insulin resistance and metabolic syndrome in adults. Most dentulous unilateral cleft lip and palate patients show a tendency toward lingualized occlusion in lateral segment teeth. We suggest that the prevalence of the metabolic syndrome in cohort studies should be based on two consecutive measurements of the laboratory components in the syndrome definition.

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Transgenic plants showed markedly increased accumulation of transcripts and higher cysteine content compared with the wild-type. Diffuse liver diseases in neonatal and pediatric liver transplant candidates: a pictorial essay. The study design was ecological, with the urban areas of a medium-size municipality in Minas Gerais State, Brazil, as the units of analysis. Staff performance was evaluated before and after access to the resources using self-administered Likert scales, observation and a focus group. There is no close connection between either underlying disease or symptoms and cause of the complication.

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Partial bladder outlet obstruction successfully created a hyperactive (unstable) bladder, typified by increased BC, RV, frequency of SA and a marked decrease in compliance. These results are consistent with a strong electronic coupling or Dexter-type energy transfer as the dominating mechanism. The other concept is that accelerated repopulation of tumor cells occurs in a later period of radiation therapy. A case-control study of GST polymorphisms and arsenic related skin lesions. Sulindac treatment in hereditary non-polyposis colorectal cancer. In a defined population aged 65 years or older, baseline interviews captured self- or proxy-reported history of cardiovascular illness. Faster, simpler, more-specific methods for improved molecular detection of Phytophthora ramorum in the field. In the meantime, almost all large statutory health insurance providers in Germany have joined this healthcare project. Additionally, the effect of HO-1 on osteoblasts appears different to that seen in adipocyte stem cells.

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Effect of IGF-II (insulin-like growth factor-II) genotype on the quality of dry-cured hams and shoulders. A consideration of recent advances leads to a packaging principle for gene regulation. The collection included approximately 100 strains of Gram-positive (Firmicutes, Arthrobacter) and Gram-negative bacteria (Bacteroidetes, gamma-Proteobacteria, and alpha-Proteobacteria) resistant to aminoglycoside antibiotics (gentamycin, kanamycin, and streptomycin), chloramphenicol and tetracycline. Humanistic outcomes included the mental and physical components of the 12-Item Short-Form Health Survey (SF-12) and patient satisfaction with health services related to their diabetes care. Little is known about how Indigenous adolescence differs from mainstream adolescence, or how Indigenous adolescents manage chronic conditions. Literature concerning the indications for, and therapeutic levels of, lithium and the associated acute and chronic risks of therapy was scrutinized as part of updating clinical practice guidelines. Many patients have been identified with good graft function despite the presence of circulating donor-specific HLA antibody. The aim of the present study was to assess predictive abilities of carboxypeptidase-B activation peptide (CAPAP-B) and soluble L-selectin (sL-selectin) using samples collected on admission to hospital.

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The fraction that remained after the EDTA/CaCl(2) wash was considered to be strongly bound in the cell. RevNeurol Programme: the Lilly Foundation Prize for the Best Publishing Initiative 2008. Masticatory performance in postmaxillectomy patients with edentulous maxillae fitted with obturator prostheses. The 9-aminotetrahydroacridine analogues were tested as acetylcholinesterase (AChE) inhibitors. Randomly selected rheumatology outpatients were asked to complete questionnaires about CAM usage, diagnoses, medication, quality of life (using the 36-item Short Form Health Survey, SF-36), fatigue (using the 20-item Multiple Fatigue Inventory, MFI-20), the Health Assessment Questionnaire (HAQ), and visual analogue scales (VAS) for global health, pain, and fatigue. The result of the simple linear regression showed that the recognition of facial emotions, compared to the performances of working memory and executive functioning, was the best predictor of the performances in the theory of mind stories. We aimed to comparatively assess the vascular response to paclitaxel-eluting (PES) and everolimus-eluting (EES) stents in a porcine coronary model of streptozotocin (STZ)-induced type I diabetes. Highly sensitive analysis of cholesterol and sitosterol in foods and human biosamples by liquid chromatography with fluorescence detection. Taken together, these results suggest that H5N8 viruses spread efficiently in mandarin ducks.

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We introduced and validated an improvement of the Bland-Altman method to assess agreement between INR measures. The Composite International Diagnostic Interview - Short Form consists of short form scales for evaluating psychiatric disorders. Such boundaries occur when differently oriented MoS2 grains merge during growth, whereas the overlap of grains leads to boundaries with bilayer areas. In this study it was adapted for very young children by deleting paid/unpaid work and household management categories and having parents act as proxies to rate child performance and their own satisfaction. The exceptional rigidity and stability allow the use of SFTI derivatives as scaffolds for the introduction of tumor-specific peptide motifs which could be used to increase cell-binding affinities and thus their use as diagnostic and/or therapeutic tools. To evaluate and estimate the effect of psychosocial interventions on improving the quality of life (QoL) of adult cancer caregivers. Children aged less than 16 years were recruited after obtaining consent.

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Consistent with its prominent antiproliferative effect, PD98059 induced a remarkable G(1) cell cycle arrest, followed by a modest apoptotic response, in these tumor cells. Murine neutrophils were isolated from bone marrow and incubated with the neutrophil-targeted near-infrared imaging agent Neutrophil Elastase 680 FAST for proof of principle experiments, verifying that the elastase-targeted fluorescent agent is specifically cleaved and activated by neutrophil content after lysis or cell stimulation. Myocardial triglyceride content and myocardial function were measured in 38 T2DM patients and 28 healthy volunteers in the same range of age and BMI by proton magnetic resonance (MR) spectroscopy and MR imaging, respectively. Statistically insignificant but marginally higher reduction in PUSH 3.0 scores and ulcer size were seen with topical phenytoin treatment. It was found in this study that stable expression of small hepatitis B surface antigen (SHBs) in HepG2 and Huh7 cells increased susceptibility to apoptosis. Unlike what is seen for SDHWT and SDHY236F, the catalytic turnover rates of SDH R55M and SDHH57A are relatively insensitive to pH (approximately 60 and 200 s(-1), respectively). In digital subtraction radiography, image registration is one of the important prerequisites to match the reference and subsequent images. This leads to new possibilities for prevention and therapy of diseases, mainly of the gastrointestinal organs. Recurrence patterns of intraductal papillary mucinous neoplasms of the pancreas on enhanced computed tomography.

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Secretory phospholipase A2 (sPLA2) represents a family of small water-soluble enzymes that catalyze the hydrolysis of phospholipids in the sn-2 position liberating free fatty acids and lysophospholipids. Epiaortic ultrasound and transesophageal echocardiography screening are more accurate and more accessible to the operative team than any other available modality to diagnose atherosclerosis of the aorta. No standard treatment guidelines exist for late acute aortic dissection after CABG. The nail-bone constructs were submitted to axial distraction to test compression, four-point bending and torsion. Patients were followed for 3 to 96 months with a mean of 43 months. A total of 100 working dies for fixed partial denture (FPD) abutments were prepared to fit 50 three-unit fixed-fixed conventional FPDs. Protective efficacy of crude virus-like particle vaccine against HPAI H5N1 in chickens and its application on DIVA strategy. The contribution of D1 to this appeared to be small in AKR/J and SAMR1, but substantial in SAMP6. Eleven patients underwent mitral valve plasty and valve replacement was carried out in seven.

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Experimental results showed that the efficiency of gene transfection with an attracting-electric field become much higher than that without an attracting-electric field. K(ATP) channel activation reduces the severity of postresuscitation myocardial dysfunction. Our results suggest that Nursing Managers should create a supportive working environment where the LPN would feel encouraged to carry out the nursing role, thereby creating a positive image of nursing in general which would lead to career motivation and pursuing RN status. The area of thin-film photovoltaics has been overwhelmed by organometal halide perovskites. In conclusion, those changes occurred in microtubules and microfilaments might be closely related to the re-organization of the genetic material during the oocyte maturation and early embryo development. The optimised ELRA assay is a fast, cost-effective, reliable and highly reproducible tool that can be used for high-throughput screening in a microplate format in detecting both estrogenic and anti-estrogenic effects.

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The temporal course of the dominant motion percept generated by the iterative interplay between motion and form pathway is in line with data of ocular following responses in primates and humans. The fraction of cells surviving after the combination treatment with 2 Gy of radiation (SF2) was compared with that of the fraction of cells surviving after treatment with irradiation alone. The ADL section of Tamai score and the one we used correlated well with each other and patient satisfaction. To address the issue in SVDD methodology, we propose a new SVDD by introducing new distance measurements based on the notion of a relative density degree for each data point in order to reflect the distribution of a given data set. Changes in body temperature influence the scaling of VO2max and aerobic scope in mammals. In all cases the results showed the effectiveness of the GRID-FLAP method and its potential use in applications such as identifying selectivity targets and tools/hits for new targets via the identification of other proteins with pharmacophorically similar binding sites. Massive copper and what drug class is claritin selenium losses cause life-threatening deficiencies during prolonged continuous renal replacement.

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According to Barrow one can distinguish between direct (high flow) and indirect (low flow) fistulas, whereby direct fistulas are often traumatic while indirect fistulas more frequently occur spontaneously in postmenopausal women. Bombyx mori nucleopolyhedrovirus SNF2 global transactivator homologue (Bm33) enhances viral pathogenicity in B. Psychogeriatric patients often have complex health care needs, requiring specific nursing interventions. This article describes different forms of Doppler ultrasound, including color Doppler (CD), power Doppler (PD), and spectral Doppler (SD), as well as 3-dimensional (3D) ultrasound and ultrasound contrast media. The results obtained show promise for future studies that can increase both the accuracy of feature extraction and pragmatism of machine monitoring for at-risk elders. Diffusion tensor imaging of normal white matter maturation from late childhood to young adulthood: voxel-wise evaluation of mean diffusivity, fractional anisotropy, radial and axial diffusivities, and correlation with reading development. State-of-the-art techniques for surgical data analysis report promising results for automated skill assessment and action recognition. Patients with bipolar disorder were identified zyrtec child dose using computerized records of inpatient diagnoses, outpatient visit diagnoses, and outpatient prescriptions of mood stabilizers.

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Some of the effects of individual macronutrients such as fat, refined sugars and alcohol in promoting abnormalities in glucose/insulin system are presented. (2007) Am J Med Genet 143: 2662-2667 Alpha-cardiac actin mutations produce atrial septal defects Matsson et al. Acupuncture and electroacupuncture were applied simultaneously in the acu-points, ST36 (Zusanli) and GV20 (Baihui), once a day for 3 weeks. Cultural messages of blame and shame are associated with obesity, but also spreading from body weight to the very scene of life. Myocardial ischaemia occurs during routine colonoscopy, but with a lower incidence than previously reported during upper endoscopy. The EPR evidence is consistent with the hypothesis that this Mn-binding site is located in the N-terminal domain, in agreement with predictions based on depakote dr 250 mg a recent X-ray structure of the enzyme. Eight patients with Type I (aged 23-61 years, mean 40.4 years) and nine patients with Type II ADO (aged 20-49 years, mean 32.8 years) were compared with 10 normal controls (aged 22-54 years, mean 35.4 years). Familial DZ twinning is clearly present in mothers of spontaneous DZ twins. Pentax-AWS improves laryngeal view compared with Macintosh blade during laryngoscopy and facilitates easier intubation. In contrast, the epithelial surfaces of the pharynx, trachea, bronchus, and bronchiole of chickens contained mainly SAalpha2,3Gal, a well-recognized receptor for avian influenza viruses including H5N1 HPAIV.

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Different histologies within the same mass have been reported, although, to our knowledge, there have been no reports of different tumors at distinct locations. Targeting CD4 using sequential treatments with a humanized monoclonal antibody (OKTcdr4a) may offer another therapeutic option for the treatment of moderate to severe psoriasis. Body mass index and waist circumference in persons aging with muscular dystrophy, multiple sclerosis, post-polio syndrome, and spinal cord injury. Our results suggest that with the advent of the clinical portability of typical nonlinear optical endoscopy, the NLOM technique has the potential to be applied in vivo to the clinical diagnosis and monitoring of bronchial disease. Patients with depression show abnormalities in the neural circuitry supporting working memory. Based on a data pool of 136 empirical papers that reported framing experiments with nearly 30,000 participants, we calculated 230 effect sizes. The obtained results correlated well with the ELISA used in the clinic for assaying glucose-stimulated insulin release from donor islets. Rickia wasmannii is an ectoparasitic fungal symbiont in Myrmica ants that covers the whole body surface of the host and reduces its bactrim cost without insurance lifespan. These combined approaches show that the molecular heterogeneity of breast ductal carcinomas exists already in in situ lesions and further indicate that DCIS and invasive ductal carcinomas share genomic alterations with a similar effect on gene expression profile.

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