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Acute liver failure – Symptoms and causes

Overview

Acute liver failure is loss of liver function that occurs rapidly — in days or weeks — usually in a person who has no preexisting liver disease. It’s most commonly caused by a hepatitis virus or drugs, such as acetaminophen. Acute liver failure is less common than chronic liver failure, which develops more slowly.

Acute liver failure, also known as fulminant hepatic failure, can cause serious complications, including excessive bleeding and increasing pressure in the brain. It’s a medical emergency that requires hospitalization.

Depending on the cause, acute liver failure can sometimes be reversed with treatment. In many situations, though, a liver transplant may be the only cure.

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Symptoms

Signs and symptoms of acute liver failure may include:

  • Yellowing of your skin and eyeballs (jaundice)
  • Pain in your upper right abdomen
  • Abdominal swelling (ascites)
  • Nausea
  • Vomiting
  • A general sense of feeling unwell (malaise)
  • Disorientation or confusion
  • Sleepiness
  • Breath may have a musty or sweet odor
  • Tremors

When to see a doctor

Acute liver failure can develop quickly in an otherwise healthy person, and it is life-threatening. If you or someone you know suddenly develops a yellowing of the eyes or skin; tenderness in the upper abdomen; or any unusual changes in mental state, personality or behavior, seek medical attention right away.

Causes

Acute liver failure occurs when liver cells are damaged significantly and are no longer able to function. Potential causes include:

  • Acetaminophen overdose. Taking too much acetaminophen (Tylenol, others) is the most common cause of acute liver failure in the United States. Outside of the United States, acetaminophen is known as paracetamol. Acute liver failure can occur after one very large dose of acetaminophen, or after higher than recommended doses every day for several days.

    If you or someone you know has taken an overdose of acetaminophen, seek medical attention as quickly as possible. Treatment may prevent liver failure. Don’t wait for the signs of liver failure.

  • Prescription medications. Some prescription medications, including antibiotics, nonsteroidal anti-inflammatory drugs and anticonvulsants, can cause acute liver failure.
  • Herbal supplements. Herbal drugs and supplements, including kava, ephedra, skullcap and pennyroyal, have been linked to acute liver failure.
  • Hepatitis and other viruses. Hepatitis A, hepatitis B and hepatitis E can cause acute liver failure. Other viruses that can cause acute liver failure include Epstein-Barr virus, cytomegalovirus and herpes simplex virus.
  • Toxins. Toxins that can cause acute liver failure include the poisonous wild mushroom Amanita phalloides, which is sometimes mistaken for one that is safe to eat. Carbon tetrachloride is another toxin that can cause acute liver failure. It is an industrial chemical found in refrigerants and solvents for waxes, varnishes and other materials.
  • Autoimmune disease. Liver failure can be caused by autoimmune hepatitis — a disease in which your immune system attacks liver cells, causing inflammation and injury.
  • Diseases of the veins in the liver. Vascular diseases, such as Budd-Chiari syndrome, can cause blockages in the veins of the liver and lead to acute liver failure.
  • Metabolic disease. Rare metabolic diseases, such as Wilson’s disease and acute fatty liver of pregnancy, infrequently cause acute liver failure.
  • Cancer. Cancer that either begins in or spreads to your liver can cause your liver to fail.
  • Shock. Overwhelming infection (sepsis) and shock can severely impair blood flow to the liver, causing liver failure.
  • Heat stroke. Extreme physical activity in a hot environment can trigger acute liver failure.

Some cases of acute liver failure have no apparent cause.

Complications

Acute liver failure often causes complications, including:

  • Excessive fluid in the brain (cerebral edema). Too much fluid causes pressure to build up in your brain, which can lead to disorientation, severe mental confusion and seizures.
  • Bleeding and bleeding disorders. A failing liver cannot make enough clotting factors, which help blood to clot. Bleeding in the gastrointestinal tract is common with this condition. It may be difficult to control.
  • Infections. People with acute liver failure are more likely to develop infections, particularly in the blood and in the respiratory and urinary tracts.
  • Kidney failure. Kidney failure often occurs after liver failure, especially if you had an acetaminophen overdose, which damages both your liver and your kidneys.

Prevention

Reduce your risk of acute liver failure by taking care of your liver.

  • Follow instructions on medications. If you take acetaminophen or other medications, check the package insert for the recommended dosage, and don’t take more than that. If you already have liver disease, ask your doctor if it is safe to take any amount of acetaminophen.
  • Tell your doctor about all your medicines. Even over-the-counter and herbal medicines can interfere with prescription drugs you’re taking.
  • Drink alcohol in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
  • Avoid risky behavior. Get help if you use illicit intravenous drugs. Don’t share needles. Use condoms during sex. If you get tattoos or body piercings, make sure the shop you choose is clean and safe. Don’t smoke.
  • Get vaccinated. If you have chronic liver disease, a history of any type of hepatitis infection or an increased risk of hepatitis, talk to your doctor about getting the hepatitis B vaccine. A vaccine also is available for hepatitis A.
  • Avoid contact with other people’s blood and body fluids. Accidental needle sticks or improper cleanup of blood or body fluids can spread hepatitis viruses. Sharing razor blades or toothbrushes also can spread infection.
  • Don’t eat wild mushrooms. It can be difficult to tell the difference between a poisonous mushroom and one that is safe to eat.
  • Take care with aerosol sprays. When you use an aerosol cleaner, make sure the room is ventilated, or wear a mask. Take similar protective measures when spraying insecticides, fungicides, paint and other toxic chemicals. Follow product instructions carefully.
  • Watch what gets on your skin. When using insecticides and other toxic chemicals, cover your skin with gloves, long sleeves, a hat and a mask.
  • Maintain a healthy weight. Obesity can cause a condition called nonalcoholic fatty liver disease, which may include fatty liver, hepatitis and cirrhosis.


Oct. 21, 2020

Show references

  1. Feldman M, et al., eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Sept. 4, 2020.
  2. Acute liver failure. Merck Manual Professional Version. https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/approach-to-the-patient-with-liver-disease/acute-liver-failure#. Accessed Sept. 4, 2020.
  3. Stravitz RT, et al. Acute liver failure. The Lancet. 2019; doi:10.1016/S0140-6736(19)31894-X.
  4. Goldberg E, et al. Acute liver failure in adults: Management and prognosis. https://www.uptodate.com/contents/search. Accessed Sept. 4, 2020.
  5. Bezinover D, et al., eds. Liver assist systems for bridging to transplantation: Devices and concepts. In: Critical Care for Potential Liver Transplant Candidates. Springer; 2019.
  6. 13 ways to a healthy liver. American Liver Foundation. https://liverfoundation.org/13-ways-to-a-healthy-liver/. Accessed Sept. 4, 2020.
  7. Picco MF (expert opinion). Mayo Clinic. Oct. 6, 2020.

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Overview of ALT and AST Liver Enzymes

Liver enzymes are substances produced by the liver that can be measured with a blood test. Any elevation in an enzyme level may be a sign of a liver problem, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are two of the enzymes central to such an investigation. When used comparatively, AST and ALT can help identify liver toxicity, liver disease, or liver damage.

Verywell / Elise Degarmo

Roles of AST and ALT

Aminotransferases are chemicals that the liver uses to make glycogen. Glycogen is the stored form of glucose, a sugar that the body uses for energy. Any glucose not immediately used will be converted into glycogen and stored in cells for future use. Most will be stored in the liver, while the remainder will be warehoused in skeletal muscles, glial cells of the brain, and other organs.

Aspartate aminotransferase (AST) is found in a variety of tissues, including the liver, brain, pancreas, heart, kidneys, lungs, and skeletal muscles. If any of these tissues are damaged, AST will be released into the bloodstream. While increased AST levels are indicative of a tissue injury, it is not specific to the liver per se.

By contrast, alanine aminotransferase (ALT) is found primarily in the liver. Any elevation of the ALT is a direct indication of a liver injury, whether minor or severe. Occasional increases may occur in association with a short-term infection or illness. Sustained increases are more problematic as they suggest an underlying disease and a greater likelihood of liver damage.

Normal Lab Values

AST and ALT are measured in international units per liter (IU/L). The normal levels vary based on a person’s body mass index (BMI) as well as the individual lab’s reference value. Generally speaking, the normal reference value for adults is:

  • AST: 8 to 48 IU/L
  • ALT: 7 to 55 IU/L

The high end of the reference range is referred to as the upper limit of normal (ULN). This number is used to establish how elevated your liver enzymes are.

Mild elevations are generally considered to be two to three times the ULN. With some liver diseases, the level can exceed 50 times the ULN. Levels this high are described as deranged.

AST/ALT Ratio

While it may seem that a high ALT is all that is needed to diagnose liver disease, its relationship to AST can provide valuable clues as to what exactly is going on and whether the issue is acute (occurring suddenly and progressing rapidly) or chronic (long-standing or persistent).

If the liver sustains an acute injury, you can expect to see a sudden spike in the ALT. On the other hand, if a liver disease is slowly progressing, the damage incurred by the liver will gradually affect other organs as well. As these organs are damaged, the AST will begin to rise.

This occurs with diseases like hepatitis C in which long-term liver damage will trigger an ever-expanding array of symptoms involving the kidneys, brain, eyes, skin, and joints (referred to as extra-hepatic symptoms).

This enzyme relationship can be described diagnostically with the AST/ALT ratio. This is a calculation that compares the levels of AST and ALT in your blood. Depending on which value is elevated and the extent of that elevation, doctors can often get a pretty strong indication as to what disease is involved.

What the AST/ALT Ratio Reveals

The AST/ALT ratio is important insofar as the pattern of elevation can tell a lot about the condition involved. Among the general guidelines used to diagnose liver disease:

  • An AST/ALT ratio of less than one (where the ALT is significantly higher than the AST) is suggestive of non-alcoholic fatty liver disease.
  • An AST/ALT ratio equal to one (where the ALT is equal to the AST) is suggestive of acute viral hepatitis or drug-related liver toxicity.
  • An AST/ALT ratio higher than one (where the AST is higher than ALT) is suggestive of cirrhosis.
  • An AST/ALT ratio higher than 2:1 (where the AST is more than twice as high as the ALT) is suggestive of alcoholic liver disease.

However, a disease cannot be diagnosed by the pattern of elevation alone. The magnitude of elevation described in multiples of the ULN also needs to be evaluated. It is only when the magnitude is above a certain threshold that the ratio can be considered diagnostic.

When Testing Is Recommended

AST and AST are part of a comprehensive testing panel known as the liver function test (LFT). An LFT may be ordered:

  • If you have symptoms of liver disease, including jaundice, dark urine, nausea, vomiting, and fatigue
  • To monitor the progression of a liver disease
  • To determine when certain drug treatments should be started
  • To assess your response to a liver treatment

Even beyond the scope of liver disease, an LFT can assess whether a drug (prescription or over-the-counter) or an herbal remedy is causing liver injury.

If the lab test is processed on-site, the results can be returned within hours. Otherwise, your doctor will usually receive the results in anywhere from one to three days.

Tips From Other Journals – American Family Physician

Tips

From Other Journals

 

Am Fam Physician. 2002 Nov 15;66(10):1991-1992.

Serum alanine aminotransferase (ALT) levels have been used to evaluate liver disease, but they may fail to identify patents with chronic hepatitis C virus (HCV) who have low levels of liver inflammation. Presently, the normal range for ALT is identified as 40 U per L, with a range from 30 to 50 U per L. The populations used to determine this normal level in the 1980s probably included patients with nonal-coholic fatty liver, which is now acknowledged to be a common cause of chronic liver disease. The prevalence of chronic liver disease may be underestimated if this normal range is used. Prati and associates used the results of a four-year study of first-time blood donors to update the acceptable ALT range and identify a healthy range.

This newly identified range was then tested for sensitivity and specificity among anti-HCV–positive persons with and without documented liver disease. More than 6,000 healthy blood donors and 209 persons with confirmed anti-HCV were included. The median ALT level in the entire group was 12 U per L, with men having a slightly higher range than women. The sex-specific 95th percentile for ALT among the healthy blood donors was 30 U per L in men and 19 U per L in women, and these were suggested as healthy ALT levels.

When the old normal ALT range was compared with the new healthy range to detect ALT abnormalities among anti-HCV–positive persons, the sensitivity for liver disease of the new range’s gender-specific levels was significantly higher, while the specificity was slightly lower. Persons with a greater body mass index (BMI), glucose intolerance, or hyperlipidemia tended to have higher ALT levels.

The authors conclude that updated normal or healthy guidelines would better identify persons at risk for liver disease. These patients should probably be investigated for liver disease. Flexibility is appropriate considering the impact of other factors that may cause slight elevations of ALT, including obesity and hyperlipidemia.

In an editorial in the same journal, Kaplan legitimizes the findings of this study but puzzles over the implications. He discusses three courses of action: accepting the new lower ALT range, adjusting the current ALT range for effects of BMI and sex, and leaving the current standards alone. He suggests that combining the last two options would be appropriate because adapting the new ALT range would greatly increase the number of persons with ALT elevations who would require evaluation and impose anxiety on many otherwise healthy persons. Although additional patients with chronic HCV infection might be discovered, these patients with minimally elevated ALT levels generally have a more benign disease course that has not been documented to improve with treatment.

ALT Blood Test: What Is It & Normal Range

ALT test, also known as alanine aminotransferase test or SGPT blood test, is a type of exam that helps to identify damage and diseases of the liver, due to the elevated presence of this enzyme in the blood.

Alanine aminotransferase (ALT) is a type of enzyme that is found inside the liver cells and, so, when there is damage to the liver, it is normal for large amounts of the enzyme to be released into the bloodstream, leading to an increase in the ALT blood test results.

When to do an ALT blood test

The ALT blood test is used to detect liver damage and, so, it can be recommended for people who have a fatty liver or that are overweight. It is also recommended when there are symptoms such as:

  • Excessive tiredness;
  • Loss of appetite; 
  • Nausea;
  • Vomiting;
  • Swelling of the belly;
  • Dark urine;
  • Yellow skin and eyes.

An ALT blood test is a great tool to diagnose liver problems early on. Therefore an ALT test can also be requested when there is history of exposure to some type of hepatitis virus or excessive consumption of alcohol.

Normal range results

ALT levels are considered normal between 7 – 56 UI/L. If the test result shows a higher value, it can be indicative of:

High levels of ALT

  •  4x higher than normal: is normally a sign of chronic hepatitis caused by cirrhosis or cancer.

Very high levels of ALT

  • 10x higher than normal: is usually a change caused by acute hepatitis due to viruses or the use of drugs;
  • 100x higher than normal: is very common in people who use drugs, alcohol or other substances that cause severe liver damage.

Despite being a very specific marker for liver damage, ALT can also be found in muscles and in the heart tissue. Therefore an increase in the concentration of this enzyme can also be seen after intense physical exercises.

To assess liver function and identify any damage, the doctor may also request other types of blood test to check for other enzymes, such as lactate dehydrogenase (LDH) and AST (or SGOT). 

What to do if ALT levels are high

When ALT levels are high it is recommended to consult with a hepatologist to assess your clinical history and identify what may be causing damage to the liver. The doctor may also request other more specific tests such as hepatitis tests or a liver biopsy, to confirm a diagnostic hypothesis.

Furthermore, in cases of high ALT, it is also recommended to follow an adequate diet for the liver, which should be low in fats and giving preference to boiled foods. 

Alanine Aminotransferase (ALT) | HealthLink BC

Test Overview

An alanine aminotransferase (ALT) test measures the amount of this enzyme in the blood. ALT is found mainly in the liver, but also in smaller amounts in the kidneys, heart, muscles, and pancreas. ALT was formerly called serum glutamic pyruvic transaminase (SGPT).

ALT is measured to see if the liver is damaged or diseased. Low levels of ALT are normally found in the blood. But when the liver is damaged or diseased, it releases ALT into the bloodstream, which makes ALT levels go up. Most increases in ALT levels are caused by liver damage.

The ALT test is often done along with other tests that check for liver damage, including aspartate aminotransferase (AST), alkaline phosphatase, lactate dehydrogenase (LDH), and bilirubin. Both ALT and AST levels are reliable tests for liver damage.

Why It Is Done

The alanine aminotransferase (ALT) test is done to:

  • Identify liver disease, especially cirrhosis and hepatitis caused by alcohol, drugs, or viruses.
  • Help check for liver damage.
  • Find out whether jaundice was caused by a blood disorder or liver disease.
  • Keep track of the effects of cholesterol-lowering medicines and other medicines that can damage the liver.

How To Prepare

Avoid strenuous exercise just before having an ALT test.

Tell your doctor:

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may mean. To help you understand the importance of this test, fill out the medical test information form .

How It Is Done

The health professional taking a sample of your blood will:

  • Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
  • Clean the needle site with alcohol.
  • Put the needle into the vein. More than one needle stick may be needed.
  • Attach a tube to the needle to fill it with blood.
  • Remove the band from your arm when enough blood is collected.
  • Put a gauze pad or cotton ball over the needle site as the needle is removed.
  • Put pressure on the site and then put on a bandage.

How It Feels

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch.

Risks

There is very little chance of a problem from having blood sample taken from a vein.

  • You may get a small bruise at the site. You can lower the chance of bruising by keeping pressure on the site for several minutes.
  • In rare cases, the vein may become swollen after the blood sample is taken. This problem is called phlebitis. A warm compress can be used several times a day to treat this.

Results

An alanine aminotransferase (ALT) test measures the amount of this enzyme in the blood. Results are usually available within 12 hours.

Normal

The normal values listed here—called a reference range—are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what’s normal. Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab.

High values

High levels of ALT may be caused by:

  • Liver damage from conditions such as hepatitis or cirrhosis.
  • Lead poisoning.
  • Very strenuous exercise or severe injury to a muscle.
  • Exposure to carbon tetrachloride.
  • Decay of a large tumour (necrosis).
  • Many medicines, such as statins, antibiotics, chemotherapy, aspirin, opioids, and barbiturates.
  • Mononucleosis.
  • Growth spurts, especially in young children. Rapid growth can cause mildly elevated levels of ALT.

What Affects the Test

You may not be able to have the test, or the results may not be helpful, if:

  • You take some natural health products, such as echinacea and valerian.
  • You recently had cardiac catheterization or surgery.

What To Think About

  • The alanine aminotransferase (ALT) value is often used along with the results of the aspartate aminotransferase (AST) test to obtain the AST to ALT ratio. This value can often help determine whether there is damage to the liver related to heavy alcohol use. For more information, see the topic Aspartate Aminotransferase (AST).
  • The gamma glutamyl transferase (GGT) test is sometimes done along with other liver enzyme tests.
  • In children with acute lymphocytic leukemia (ALL), very high ALT levels may mean that the disease is likely to progress rapidly.
  • Many different conditions can raise ALT blood levels, so other testing is usually needed to interpret an abnormal ALT result.

References

Citations

  1. Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

Other Works Consulted

  • Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
  • Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.

Credits

Current as of:
December 9, 2019

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD – Internal Medicine
Anne C. Poinier MD – Internal Medicine
Adam Husney MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Kathleen Romito MD – Family Medicine
Jerome B. Simon MD, FRCPC, FACP – Gastroenterology

Current as of: December 9, 2019

Author: Healthwise Staff

Medical Review:E. Gregory Thompson MD – Internal Medicine & Anne C. Poinier MD – Internal Medicine & Adam Husney MD – Family Medicine & Martin J. Gabica MD – Family Medicine & Kathleen Romito MD – Family Medicine & Jerome B. Simon MD, FRCPC, FACP – Gastroenterology

Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

Liver Function Blood Tests Explained

Liver Blood Tests Explained

Blood tests and Investigations for Liver Function              

Some of the standard or routine blood tests that your doctor will order to check “liver function” are in reality only able to detect liver damage. These tests may not be sensitive enough to accurately reflect whether your liver is functioning at its optimum level. These tests will usually be abnormal in significant liver disease or liver distress; however, they can still give normal readings in some cases of mild liver disease.  

Healthy ranges for Blood tests for Liver Function

ALT 0 – 45 U/L

GGT 0 – 45 U/L

AST 0 – 45 U/L

ALP 30 – 120 U/L

BILIRUBIN 0 – 20 U/L or 0. 174 to 1.04 mg/dL

ALBUMIN 38 – 55 g/L or 3.8 to 5.5g/dL 

AFP 20 – 32 g/L or 2 to 3.2g/dL

ALT
(alanine aminotransferase), sometimes called SPGT just to confuse us,  is elevated showing inflammation of the liver.

Our ALT shows up high whenever our liver is dealing with any infection or poison or even a hard to digest food such as fried meat. It is common for them to be high in people who have recently had alcohol or paracetamol. With infections, and these can be other diseases like flu or an septic wound they go up as the liver fights back. If they are constantly in the 50 to 200 range we term the hepatitis B infection active. ALT’s range from 0 up to 3000 or so in many acute hepatitis cases. They change with every meal so it is important not to panic if they go from 20 to 45 after a few months. All scores below 45 indicate a perfectly healthy score.

GGT
(gamma glutamyl transpeptidase) is elevated in those who use alcohol or toxins.

Our GST shows up high between 50 and 200 if we are often taking paracetamol or using alcohol a lot. It is often a sign of alcoholism or longer term liver damage, but can be reversed by adopting a alcohol free or toxin free lifestyle.

BILIRUBIN 

If our Bilirubin is elevated, the patient may have a yellow colour skin and eyes, jaundice. Bilirubin is a bile product made by the liver to digest food and it often is overproduced when we first get Hepatitis B or C, then it back fires into the blood stream causing the yellow effect to eyes and skin. It can cause itching and skin irritation as it is sweated out. If it goes up during chronic Hepatitis B or C infection it is a sign of poor food and drink or liver disease. Milk thistle herbal pills are proven to help lower Bilirubin scores so many Hepatitis patients take it.

AFP
(Alpha Feta Globulin Protein). If our AFP is elevated it usually mean excessive inflammation in the liver and/or immune system. Very high levels may be seen in some types of cancers. It is important the many women diagnosed during pregnancy remember it goes up sometimes because of Pregnancy, a score of 40 g/l is not a sign of liver cancer, scores that may indicate a cancer tend to be in the hundreds

AST
(aspartate aminotransferase) also called SGOT, is elevated in heart, muscle and liver diseases.

ALP
(alkaline phosphatase) is elevated in many types of liver and non liver disease.

ALBUMIN
falling levels of blood albumin show deteriorating liver function.

Up to 80% of Hepatitis B and C patients usually have normal, perfectly healthy scores for liver function, these are termed inactive or healthy patients.

Viral Hepatitis Liver Tests – the 4 main Results and Stages

Viral Hepatitis Patients tend to present with 4 types of LFT Result, 3 factors most affect the liver results 

Viral Load, Time Infected and Toxins

Stage 1 – All Normal 

Means hepatitis is having little effect and you are best monitored yearly for activity

Stage 2 – ALT is persistently above 50
but your LFT’s are Normal

Means you have an active hepatitis infection which over decades can cause 

Fibrosis without additional toxins like alcohol or being overweight and is best treated at some point and slowed with a liver friendly diet

Your Liver Team should provide a Personalised Care Plan if

Stage 3 – ALT/AST/GGT are 50 to 200 

Usually means you have taken liver toxins that worsen viral hepatitis eg alcohol, barbiturates, 

benzodiazepines, anticonvulsants, warfarin, antidepressants, paracetamol, 

or you may also have fatty liver from obesity

Stage 4 – GGT /ALT are 50 to 200 and ALP is above 200

Liver cells are damaged Cirrhosis and Fibrosis have occurred, liver functions 

can fall, tumours can occur. The author of this site was diagnosed in this stage 12 years ago,

point being a liver friendly diet, treatment and he is fine now.

ALT Blood Test (SGPT) for Liver

What Is ALT?

ALT is an enzyme found in many parts of the body, but the liver contains the highest concentration. This enzyme, formerly known by the name serum glutamic-pyruvic transaminase, or SGPT, is used by the body to break down food into energy. ALT levels normally remain fairly low, but rise when your liver is damaged. Because of this, a high ALT level are usually a straightforward indication that there is something wrong with your liver.


How Does an ALT Test Work?

Alanine transaminase, also known as ALT or SGPT, is an enzyme made by the liver to metabolize proteins. ALT is released into the bloodstream when liver cells are damaged. An ALT test measures the amount of ALT in the blood to assess if the liver is damaged. The most common reason to take an ALT test is to detect liver injury and to screen for/or help diagnose liver disease, as it is considered to be one of the best methods to identify liver issues.


Why take an ALT Test?

ALT blood tests are often part of liver function testing. The main reason to take an ALT test is if you or your doctor identify signs of liver damage or failure. It can also be taken to monitor the progression of liver diseases or to evaluate the effectiveness of treatment.


Signs of Liver Damage or Failure

Onset symptoms of liver failure include:

  • Nausea
  • Loss of appetite
  • Fatigue
  • Diarrhea

As you can see, the initial symptoms of liver failure are so broad that it can be difficult, if not impossible, to diagnose without testing.

The following are symptoms of liver failure that indicate the disease has progressed to the point of requiring immediate treatment or hospitalization:

  • Jaundice (yellow skin)
  • Bleeding easily
  • Swollen abdomen
  • Hepatic encephalopathy (mental disorientation/confusion)
  • Sleepiness
  • Coma

What can cause ALT levels to rise?

There are many things may increase the ALT levels in the blood. Some of these include:

  • Alcohol abuse
  • Hepatitis – an inflammatory condition of the liver
  • Cirrhosis – severe scarring and poor overall performance of the liver caused by high exposure to toxins like alcohol or viral infection
  • Death of liver tissue
  • A tumor in the liver
  • Poor blood flow to the liver
  • Hemochromatosis – a disorder that causes iron build up
  • Mononucleosis – an infection usually caused by the Epstein-Barr virus
  • Pancreatitis – pancreas inflammation
  • Diabetes

Things to Know Beforehand

You should tell your doctor about any drugs you are taking, as some prescription and over-the-counter medications can affect ALT levels. Acetaminophen (Tylenol) is a notable example. Your doctor may tell you to avoid taking some medications for a period of time prior to taking the test. Otherwise, there are not any precautions necessary to taking the test.


How Is the Test Taken?

Testing with Healthlabs. com is simple, quick, and easy. After you have purchased an ALT test and traveled to the lab you selected using our lab finder, a lab technician will perform a simple blood test. The technician inspects your arm for vein visibility first, chooses a spot to draw the blood, cleans the area with antiseptic, and wraps an elastic band around your upper arm in preparation for collection. The lab technician then carefully injects a sterile needle into the vein and draws blood. The entire process, depending on how busy the lab is, should take about 5-10 minutes.


What your ALT Test Results mean

The normal value of an ALT test depends on gender:

~29 to 33 U/L (units per liter) for men and ~19 to 25 U/L for women.

ALT levels typically fall somewhere within the 7 to 55 U/L range. Certain factors like age and gender can affect this range, but doctors should be able to recognize abnormal values regardless.

Both excessively high and low ALT levels are considered to be unhealthy, but higher-than-normal levels are the most likely to indicate liver damage.

How to Determine Voice Range – SAMESOUND

Knowing your own voice range is useful for every musician. It’s not just about vocalists, but about all people involved in music – composers, guitarists, pianists. Knowing the range helps to write music in comfortable keys (or choose minus in the right keys), as well as to process vocals in such a way as not to break the ligaments. SAMESOUND.RU explains how to determine the range of a voice in order to correctly tell about your own vocals.


How to describe your own voice?

Imagine that a musician responded to an ad from a local band looking for a guitarist with a good voice. The band members ask the musician what his voice is. How do you answer this question?

There are three ways to describe your vocals:

  1. Compare your voice with another vocalist. The method is known to be a failure, since no one will believe that you sing the same way as Robert Plant;
  2. Give a general description of your vocals. For example, say that you are a lyric baritone, rock tenor, or rock alto. This description is easier to understand, but does not provide useful information;
  3. Explain the range of your voice, noting the lowest and highest note you can sing. This is the most informative and normal way of describing vocals.

Despite the clarity of the third method, musicians often give incomplete information about the vocal range. Many students who come to me say that they can sing all notes from lower C to B flat, but they do not specify which octaves are in question.

How to determine the range of a voice?

To accurately determine the range of your voice, it is enough to turn to music theory and the octave system of grouping notes. All sounds that we can use in music and which are distinguishable by the human ear are divided into 9 octaves. A number is attached to each note of C, indicating the octave to which it belongs.

Digit Octave Name
0 Subcontractava
1 Controctava
2 Large octave
3 Small octave
4 First octave
5 Second octave
6 Third octave
7 Fourth octave
8 Fifth Octave

Thus, Before the subcontroctave will be denoted as C0, Before the contractave – C1, and so on. All other notes within the octave are also indicated by the corresponding number: F of the controctave – F1, G of the first octave – G4, E of the fifth octave – E8. The C note of the first octave is in the middle of the 88-key keyboard and is often taken as the starting point (also called Middle C in Western musical tradition).

The range of the voice can be determined using the piano or the Piano Roll in the DAW. Start your search for sounds you can sing from C4.If you can sing this sound cleanly, move down and then up, checking the notes available to your voice. The last sounds from above and below that you were able to sing cleanly and without discomfort for yourself and your vocal cords are the boundaries of the vocal range.

Most voices refer to the common border from C2 to F3 octave (F6). At the same time, a number of sub-bands have been introduced within the C2-F6 range, which make it possible to more accurately characterize the vocals.

Minor octave A and B notes (A3, B3) and first octave Do and Re notes (C4-D4) are available to all people. Men and women with any voice sing these notes cleanly.

Despite tight sound delineation, you can play notes above or below a certain range without difficulty. However, the range of the voice includes only those notes that you can sing with ease and without discomfort in any situation.

Name Accessory Notation Notation decoding
Bass Male E2-D4 From E large octave to D first octave
Baritone Male F2-G4 Large Octave F to 1st Octave Sol
Tenor Male A2-C5 From A to the second octave
Viola Female E3-G5 Minor E to Second Octave Sol
Mezzo-soprano Female E3-B ♭ 5 E minor octave to B flat second octave
Soprano Female G3-C6 Minor Salt to 3rd Octave

Each voice has many subtypes that refine the range of notes available (for example, baritone is subdivided into lyric, dramatic, and tenor-baritone), but such refinements are not practical for ordinary musicians.

90,000 Special qualities in children’s choral singing

Bibliographic description:


Khasanova, Kh.S. Special qualities in children’s choral singing / Kh.S. Khasanova. – Text: direct // Young scientist. – 2017. – No. 24 (158). – S. 403-406. – URL: https://moluch.ru/archive/158/44440/ (date of access: 27.07.2021).

In the meantime, there is no need to know about it. ”

The article talks about the development of children’s choral singing and the difference in children’s voices, as well as what needs to be paid attention to so that the children’s choir can achieve a high level and great success.

Key words: choir, choirmaster, octave, choral singing, children’s voices, chanting, voice staging, chest breathing.

Choral singing is a popular cultural genre. It is known that choral singing is not a typical genre for Uzbek traditional music, but in the 1930s – 1940s, the choir attracted the interest of Uzbek composers and art critics. Since that time, they began to search for and introduce a number of methods for the formation of Uzbek choral art.Having an understanding of each voice in a choir and creating new works, taking into account the capabilities of these voices, is the most important quality of a composer or choirmaster. In the development of children’s choral singing, the voice and its characteristics are the most important criterion. Children’s voices are acoustically similar to female voices, but still they differ from each other. First, the range of a child’s voice is much smaller and the character of the sound is more special. Secondly, children’s voices differ from female voices in brightness and transparency.Thirdly, a sonorous and very clear tone is characteristic of children’s voices. In terms of anatomical aspects, children’s vocal cords differ from women’s vocal cords in their elasticity, and, thanks to this, children’s voices sound more loudly in high notes. Children’s voices are distinguished by soprano or treble (the highest voice of boys) and alto. Soprano or treble is the highest children’s voice. It is very light, can change its directions and is heard very softly. The same qualities give the chances to perform in the main melodic direction at a professional level.The soprano range is counted from the first octave “C” to the second octave “G”. And the range of the children’s viola is counted from the minor octave “la” to the second octave “re”.

Rice. one.

Children’s voices can be conditionally divided into 3 groups:

  1. A group of young ages, that is, from the smallest to 10-11 years. At this age, the range of the voice does not exceed one octave. For example, it is counted from the first octave “C” to the second octave “C”, or from the first octave “D” to the second octave “D”.At this age, the voice of boys and girls does not differ. The choir’s repertoire consists of 2-3 simple children’s songs. This group is the most important stage in the development of hearing, the ability to listen to each other and maintain a clear voice while singing.
  2. Middle-aged group. This group includes children from 11-12 to 13-14 years old. In children of this age, ringing in the chest appears, the range of the voice expands. Their voice range can be counted from the first octave “do” to the second octave “mi”, “fa”. At the age of 13-14, the voice of children is enriched with strength and fulfillment.In boys, a chest voice appears and gradually increases. And girls have a timbre of a woman’s voice. Soprano from the first octave “C”, “D” to the second octave “F”, “G”. Alto from the first minor octave “la” to the second octave “re”, “mi”. At this age, the sound of the voice of children expands and begins to have many more variations. The repertoire can include harmonic and easily polyphonic pieces. You can also teach to sing 2-3 voice songs.
  3. A group of adult children. The choir is attended by 14-16-year-old children. At this age, the voice of children is in the period of formation and development. The sound of the voice is similar to the sound of a mature female voice. The range expands by 1.5-2 octaves. In boys, the chest sound is clearly distinguished. They have a “mutation” of the voice, that is, at this time the vocal cords change their shape and properties. In order to preserve the brightness and beauty of the voice, special, small parts of the works are selected for boys. In girls, the formation of the voice ends and is considered a developed voice. The repertoire of the choir group of adult children can include works by composers from different times.It should be noted that the range of each batch can be expanded. For example, soprano from the second octave “la”, “si” to the third octave “c”. Alto to minor octave “G”.

Rice. 2.

In the process of working with a choral group of young ages, the choirmaster must determine the primary territory of the children’s voices and, as far as possible, must find a piece with a convenient range for children. This is very important, because the correct choice of the piece can become the basis for the success of the choir group in the future and is considered an important factor, clearly showing the work of the choir master.

Until the mutational age of children’s voices, the primary point is considered “fa”, “salt”, “la” in the first octave, and it is advisable to start chanting with these sounds. Many music teachers consider the primary point to be lower, and as a result, the voices of children quickly get tired. It should not be forgotten that the primary territory before the mutation period of the voice can be between different sounds.

A correctly composed chant for novice little singers helps them develop pitch hearing, better know the range of their voice, learn to listen to themselves and correctly intonate songs in the future.A chant is a set of vocal exercises. These vocal exercises not only warm up the muscles and vocal apparatus, but can also solve various vocal tasks. 10-15 minutes are allotted for chanting, and such exercises while standing give good results. During the chanting of the scale, you can determine the voice of the child, that is, the timbre of the voice is determined and the alto and soprano are highlighted.

Rice. 3.

Many experts believe that children should use chest breathing while singing.The choirmaster in each lesson should check if the student is breathing correctly during chanting and singing. Of course, it will be more effective if he shows the correct breathing on himself. When the student is breathing through the nose, the shoulders should not rise and the arms should be free. And this is considered the correct position of the student during chanting and chanting. It is with the correct breathing that the performance of the song begins, because this is the support on which all vocal technique rests.

Voice training is also central to the development of children’s singing skills. The teaching process can be divided into two parts:

  1. Chanting the voice and bringing it into working condition.
  2. To develop choral singing – vocal skills, achieving a high-quality and beautiful performance of the work.

There are problems in every job. And what are the problems in children’s choral singing? Incorrect voice formation, improper diction, improper singing breathing and a number of such problems are encountered in the work of choirmasters or music teachers.But working on mistakes, developing professionalism, developing new techniques will help us achieve high goals. Every choirmaster and music teacher should not miss the slightest detail in the development of the voice and singing art of children.

Literature

  1. Asafiev, B.V.On choral art M .: Muzyka, 1980.
  2. Bogdanova, T. S. Fundamentals of Choral Studies. Tutorial. – Minsk. 2009.
  3. Struve, G.A. School Choir. Book for the teacher. – M.: Enlightenment, 1981.

Key Terms (automatically generated) : Voice, Choir Singing, Secondary, Children’s, Voice Range, Singing Timing, Children’s Voice, Chest breathing, Children’s Choir Singing, Correct Breathing.

Alt. Guide to the orchestra and its backyards

Viola

– How many jokes about violists are there?

– Two.

– And the rest?

– And the rest is true.

Viola and violists occupy a special position in the musical world.The viola is still, in spite of everything, considered a musical instrument, and violists have become the same symbol of oral culture as the Gabrovo, Chukchi, conductors and many others.

Now, in order.

What is it, why is it and where did it come from

The old people say that the viola was born at the moment when Stradivari, collecting another violin in a terribly screwy state, pulled the strings on the violin case.

Some clarification is needed here. The inquisitive psychology of musical masters in an effort to expand the range of any instrument has always indicated the same evolutionary and technological recipe.A hedgehog, who has not even studied acoustics, understands that with a constructive increase in the size of a sounding object, it will reproduce lower sounds, and with a decrease, higher sounds. This is true for everything from organ pipes to tin buckets. And then the logic is simple. If you have a clarinet in your hands and you really like its sound, but would like to go down beyond its range, you simply make the clarinet bigger and get the desired result with the sound of a vacuum cleaner and call it a bass clarinet.If it is up, you make a reduced model, and you have in your hands an esque clarinet (clarinet in Es) with the voice of a hysterical midget. The same thing, with the inevitable appearance of a lump after a blow to the forehead, was done with all instruments – from the flute to the bass trombone. And from violin to double bass, it’s just a little different historically in terms of evolution.

With one small no.

A Victim of Compromise, or You Can’t Trample Against Science

– When Does Alto Sound Best?

– Quiet crackling in the fireplace.

Those who have dealt with a sampled sound (this is a pre-recorded sample of a sound with a specific timbre) are well aware that when a sample is assigned to another note, the timbre remains the same in a rather narrow range. Further, it begins to change, and the further from its original height, the more. The same thing happens in acoustic non-digital life. Therefore, the alto saxophone differs by ear from the tenor, and the violin from the double bass, even if they play the same notes. Which, in principle, is possible.

Schnittke has a very interesting piece for two violins called Moz-art and subtitled “Project for the reconstruction of a half-lost work 1783/1976”. At the end of the piece, for complete happiness and achievement of an artistic result, Alfred Garrievich did not have enough violin range down, and there it is suggested that the second violinist lower the G string. I am not going to judge the acoustic result (I saw only the notes), but here the violin climbs into the working area of ​​the viola. This is the area of ​​his work – the sector between violin and cello.This is especially noticeable in quartet music, when you realize that without the viola your hands are noticeably tied. You can do without it: the sector overlaps in the range both from above and from below, but you begin to understand that this overgrown violin is not eating its musical bread for nothing.

The viola as an instrument has one design feature that determines its certain sonic prematurity. The fact is that, in accordance with the laws of acoustics, an instrument operating in this range should have a slightly larger resonator box (body).But the acoustically perfect size does not allow you to play comfortably on it.

I can’t help it, but the containers of the familiar bottles are very convenient for describing musical instruments. If only by virtue of the fact that they are some conceptual Esperanto. If the size of the violin is taken as the basic half-liter, then the size of the viola corresponds not to 0.7, as would naturally be expected, but only to 0.66, which is certainly not enough if you want to play for real. Anyone who understands will say that the difference is small, but certainly offensive.You will laugh, but I, as a person with a scientific mindset, counted – the proportion matches quite accurately. Instruments made for solo playing will indeed be larger, reaching the optimal 0.7. But the performer has to pay for this by stretching his fingers even more. And without that, considerable.

Usually the alto sounds quite close in timbre to the Stradivarius product described above. There are astonishing exceptions, though. The divine sound of a real musical instrument was played by the wonderful violist Lenya Kaplan, with whom I was lucky to meet in this life.And the frivolously talented Yuri Bashmet, with whom Schnittke’s Alto Concerto was assembled and performed in an hour and a half. And, by the way, the spectacle was extremely expressive when, before leaving for a concert in some hole near Tours in France, sitting on the hood of a rented rattletrap with a viola, he looked at a completely new piece for himself, which in a little over an hour he was going to perform in front of the public.

All people are like people

Orchestra competition. Violists play concerts: Hoffmeister – Stamitz, Stamitz – Hoffmeister.

Members of the selection committee – accompanists of the groups, are already swollen.

Finally, the accompanist of the second violins can’t stand it:

– Don’t you have other concerts ?!

Concertmaster of Violas:

– Tell me at least one concerto for the second violin.

All normal instruments play in the treble clef and bass clef. Usually.

Actually, the key is a pretty smart invention. This is a sign that indicates a starting point on the staff.Like the prime meridian. Or as zero on the coordinate axis. Violin (G), showing that G is on the second ruler, or bass (F), indicating that the minor octave F is on the fourth. The idea of ​​choosing a key for the situation is that the range involved would mostly fit within the basic five rulers, plus or minus a little bit. Once upon a time there were a lot of keys. The trend towards standardization and common sense has basically reduced this number to two – treble and bass. From time to time, the parts of the cellos and bassoons are written in the tenor key.And only the viola is iotated in the alto. What is technologically optimal, but nobody but them understands.

How to get into violists

– What should a violist do if an elephant, a giraffe and a hippopotamus are chasing him?

– Get off the carousel!

Okay, I’ll tell you. There is nothing offensive in this. First, the child is flogged for playing the violin. Causal relationships there are built somehow differently, but the result is a constant. For it is said in the Scripture: “Be like children, and you will definitely be flogged.”Upon reaching a certain critical value of the frequency and amplitude of the whipping of the youth, if he has big hands, he is transferred from the Spivakovs to Bashmets, already having an approximate idea of ​​what he will have to do for the rest of his life.

Illustration and explanation of this thesis:

An old violist is dying. His son comes up to him: “Dad, dad!” He opens his eyes and corrects: “Um-pa-pa, um-pa-pa “.

Yes, this is their fate and karma. Violins and flutes play a tune, a tuba with double basses plays a downbeat, and violas with French horns are all that remains.Moreover, the French horns suffer greatly from this physically, because after the marches and waltzes of Strauss, the whole apparatus endures it, and the violists – morally. Although they are strong. I saw it myself. In Tver.

Actually, I went into the store. At the store – a cafe in which they pour. A string quartet was sitting at the table. Apparently after the concert, albeit in the afternoon. Of course, I wouldn’t have guessed by their faces, but they were with cases. The quartet has already been optimized to the maximum for the surrounding reality. The conversation was about the need to catch up a little.The only problem was to nominate from their ranks whoever could walk to the counter and back. At that stage, only the violist could.

So. In essence, a violist is a defrocked violinist. There is nothing horrible about that. He himself was demoted from pianists to oboists. And later he voluntarily left the theorists. But this was already a free choice of a free person who realized that the wind form of shaking the air pays better than the theoretical one.

The same, only better, was the defrocked oboist and, moreover, the deserter William Herschel, whom we know not from two dozen symphonies that he managed to roll out of inertia, but from the fact that he discovered Uranus.Well, and also on little things – all sorts of satellites and infrared radiation.

So it’s okay. Someone also needs to be a violist.

Viola in the orchestra

The concertmaster of violas fell ill with foot and mouth disease. I had to burn the whole group.

During the intermission the inspector approaches the conductor:

– Maestro, during the first part the violin accompanist died. What to do?

– I don’t even know, yet transfer to the second remote control.

There is relatively little solo music for viola in the orchestra.These are the famous solo episodes in Giselle and Coppelia. And in the symphonic repertoire – the “poster” solo in “Don Quixote” by Richard Strauss and the concert symphony for viola and orchestra “Harold in Italy” by G. Berlioz.

Coming to composing a symphony based on the plot of Byron’s Child-Harold, Berlioz felt that the mysterious, melancholic and slightly dull timbre of the viola perfectly matched the character of his chosen hero …

(pseudoscientific)

In operatic music, violas, with their harsh, rustling sound, are used to depict ominous and potentially unpleasant situations for the heroes.I noticed this in both Tchaikovsky and Verdi.

I asked the violist where the group of violas is brightly used in symphonic music. Within the limits of a smoked cigarette, he listed Bruckner’s Fourth, Mahler’s Tenth, Tchaikovsky’s First and Fifth (the First actually begins with viola) and almost all of Shostakovich’s symphonies. Then he stubbed out his cigarette, sighed and added: “The saddest instrument.”

Composers have two stupid habits. Writing the same part to the English horn and French horns, because they are all transpose instruments in F, and even in the 19th century it was most convenient to copy and paste them.

And do the same with the horn and violas. Apparently, because they play in the same range and you can, without thinking too much, once again copy-paste and pass off as a mixed timbre. Moreover, every even conductor in these cases says that this is a horn solo, and the odd one, on the contrary, that the violas are the main ones here, and the horn, like, paint. This is me, in particular, about Tchaikovsky’s Romeo and Juliet and Rachmaninoff’s Second Symphony. Well, okay, I’m not sorry.

In reality

If a violist and a conductor are in a burning house, and you can save only one, what will you choose: drink coffee or go to the cinema?

The best show in the world I missed.But I heard about him from eyewitnesses. My former classmate, and at that time the accompanist of the viola group in the Ponkin’s orchestra, and the maestro himself, with good sadistic pleasure, told each other anecdotes. One about conductors, the other about violists.

In life, everything looks less scary. All the same, any professional folklore is rather cruel. Every day I meet with these cute creatures and I can responsibly declare that they can be safely ranked as Homo sapiens. Almost everyone.

Why are the jokes about violists so stupid and short?

Because they are composed by violinists …

Still, they were offended. You will be offended here when …

The viola wolf fell into a trap. He bit off three of his legs, but never got out of the trap.

In the restaurant there is a cellist and two violists. The waiter takes the order.

Cellist: “For me, please, red wine and meat.”

Waiter: “And vegetables ?”

Cellist: “The vegetables will be the same.”

And so on. For what? They are kind and good …

This text is an introductory fragment.

Continuation for liters

Contralto

Today, I want to talk about the lowest and most amazing female voice. This voice is CONTRALTO (Italian Contralto – below the viola).This voice is simply unique and stands out for its low chest, velvety, enveloping and mesmerizing timbre. Often, composers wrote works using this voice in the form of boys, young boys, mothers-heroines, mothers with a tragic cruel fate. The fact is that the contralto has the most tragic tone of voice, sometimes reminiscent of a high male voice in a low tessiture.

The range of the contralto voice, like all voices, is individual, but often it is a FA of a small octave – FA2 octave or MI of a small octave – MI of 2 octaves.

Here is an example of contralto in an academic school:

And an example of cootralto in a pop manner of singing:

Personally, I generally admire all the singing voices when they are in the hands of trained experienced singers, but for some reason low voices cause more admiration, because low voices naturally sound more naturally from the beginning. I want to say that if people with low voices by nature are already half-singing, then for example a tenor who has not gone through a good music school and a couple of notes will not be able to sing normally.Like this! I don’t want to offend anyone, as proof I will say that I have a central lyricist-dramatic tenor.

Related articles

90,000 alt-tab-macos 🚀 – Trigger key behaves as if it was being held down even if it was pressed just recently

You said: “demonstrates the same ignorance …”.

This is what I was trying to show in the gif at the bottom of this post. After playing around with EventTaps over the past few weeks, I was vaguely familiar with how key events are reported by the system, i.e. a tap, a few taps with a retry flag on hold, and then a release.You mentioned the behavior at the end of the list and this part actually always works (including when I ran into the OP’s problem). I am guessing that these OS level replays are what KeyCastr actually shows, so I made a video to hopefully illustrate better.

Oddly enough, updating the SysPrefs GUI Key Repeat setting to any value other than Off works correctly. Setting it to Off works for direct switching, but retains the previous value for the reverse.In this case, the system does not actually affect the defaults KeyRepeat value: instead, it updates the defaults InitialKeyRepeat value to 30000 and keeps the current Delay Until Repeat value from the SysPrefs (this time as an integer 1-6 representing the notches on the slider , just to add some extra fun to the complexity) in a separate defaults "InitialKeyRepeat_Level_Saved" . You probably already know all this, sorry for piecing it together as I type.

Oddly enough, by clearing all three corresponding global defaults with defaults delete… , the forward AltTab loop reverts to the global KeyRepeat default ( standard? Original? Custom? ). from (I think) 5 and InitialKeyRepeat out of 35 (4 on the GUI slider) – obviously after removing them there is nothing to ask for and confirm this. However, the reverse loop still retains what was the last value.Although in this case for both KeyRepeat and InitialKeyRepeat .

The behavior is even more difficult and difficult to describe clearly when I start setting default values ​​for each application for AltTabs. It feels like I’m running into edge cases where checking for one default is missing when the other is updated, but I have a headache trying to work out the full logic behind this :). As for why this is only for the return trip, I am completely puzzled.

I think maybe the particular shortcut or keyboard you are using could be the cause of this particular edge case as well as the OP’s problem.

I had the same thought regarding the bluetooth keyboard I usually use (Logitech K380), or perhaps some strange interaction with BTT on, or even my choice of keys. However, I’ve tested many different combinations of all of these factors, and this recurring error seems to keep occurring regardless of any of them – even with the Apple A1243 wired keyboard.The only exception to this is if I change to using the modifier + modifier shortcut for Select previous window then it behaves correctly.

TL; DR – For me and only ever for the reverse shortcut after the AltTab UI appears, it seems to be:

  • using the previous global KeyRepeat when Key Repeat is off via the GUI
  • using the previous global KeyRepeat and InitialKeyRepeat when global defaults have been removed and no per application defaults have been set
  • using the current global KeyRepeat and InitialKeyRepeat when per application defaults are set / updated / removed and the global setting is not equals Off

Obviously there are many other combinations that I haven’t tested (or at least got too confused about doing so) and very few of them will reflect real-world use.Does AltTab update the reading of both values ​​when either of them changes? It would also be helpful to describe all this if Apple called the tool defaults literally something else 😂.

Update: I’m not inclined to use the arrow keys with the UI, so I didn’t think about testing them before, but they show the same symptoms of erroneous repetition that I described here for switching back. So hide (⌘H) and minimize (⌘M).The latter also seemed to be causing the UI to crash (spinning beach ball and no response to keys or mouse) as it constantly tried to minimize and minimize the same windows. I had to killall from the terminal, but AltTab didn’t ask if I wanted to send a crash report on reopening.

I checked again and the repetition happens regardless of their replacement with non-standard keys. I’ve already changed the exit and close labels to include the extra ⌥ and stop triggering them accidentally, you know if I’m not eager to test them!

I’m wondering if it’s better from a UX perspective to completely eliminate the repetition of these 4 “windowing” shortcuts, regardless of speed.Although, if the problem is specific to my installation, chances are you already assumed that this is how it works.

Quick search in Excel keys

Working in various fields of activity, we almost never do without using Excel to solve problems. We’ve prepared 39 of the most useful keyboard shortcuts for you to improve your speed and efficiency in Excel.

F2: Edit Selected Cell

Pressing the F2 key on the keyboard will instantly switch to the editing mode of the selected cell.

F4: repeat the last command or action, if possible

When a cell or range reference is selected in a formula, pressing F4 iterates over all combinations of absolute and relative references.

CTRL + ALT + F9: Calculates all cells in file

When you press this keyboard shortcut, all cells with formulas in the Excel file will be recalculated.

F11: Create Chart

Perhaps the fastest way to create a chart in Excel is to press the F11 key.If you have previously selected the data range on which you want to build a chart, then after pressing the F11 key, a chart based on the values ​​you need will appear in a new tab in the Excel file.

ALT: Display KeyTips on Ribbon

Press the ALT key on your keyboard and letters appear above the menu items in the Excel tool ribbon. By pressing these letters on the keyboard, you instantly activate the ribbon menu item you need.

ALT +: Sum of the selected range with data

If you have a data range that you want to sum, press the ALT + key combination and the sum of the values ​​you have selected will appear in the next cell after the range.

ALT + Enter: start a new line inside cell

This keyboard shortcut is useful for those who write a lot of text within one cell. For greater clarity of the text – it should be broken into paragraphs or start on new lines. Use the keyboard shortcut ALT + Enter and you will be able to create lines with text inside one cell.

CTRL + Page Up: Move to next Excel sheet

Pressing this key combination will take you to the next sheet in the Excel file (to the right).

CTRL + Page Down: Move to previous Excel sheet

Pressing this key combination will take you to the previous sheet in the Excel file (to the left).

CTRL + ‘: demo formula

Using this combination in a cell with a formula, you will be clearly shown the range of cells involved in the formula.

CTRL + Backspace: Demo active cell

In the event that you are lost in the file and cannot find on which cell the cursor is located, press this key combination and the system will return you to the area of ​​the file with the selected cell.

CTRL + Shift + #: Change cell format to date format “day, month, year”

This keyboard shortcut instantly changes the cell format to the standard date format.

CTRL + K: Insert hyperlink

Now you know how to quickly insert a hyperlink.

CTRL + Shift + $: Change cell format to currency

Press CTRL + Shift + $ on any cell and it will be displayed in financial format.

CTRL + Shift + &: Add outer borders of cell

With this combination, you can instantly set the outer boundaries of the selected cell or range.

CTRL + B: bold

This will quickly highlight the cells you want in bold.

CTRL + I: Italicize

And so quickly select the cells in italics.

CTRL + U: Make underline

With CTRL + U you can make an underline in the selected cells.

CTRL + S: quick save

Use this combination to quickly save changes to your Excel file.

CTRL + C: Copy data

Select the data range and press CTRL + C – this will allow you to copy the selected data.

CTRL + V: Paste data

Select a cell to insert data and press CTRL + V

CTRL + X: Cut data

Use CTRL + X to cut data.

CTRL + Shift +

: assign general format to cell

This way you can assign the general format of the selected cell.

CTRL + Shift +%: Set the percentage format of cell

Use this combination to convert the cell values ​​to a percentage.: assign exponential format to cell

Pressing these keys will assign an exponential format to the highlighted cell.

CTRL + Shift + @: Style date with time

These keys allow you to assign the time format to the date.

CTRL + Shift +!: Assign numeric format to cell

This way you can assign a number format to any cell.

CTRL + F12: Open file

If you suddenly need to open another Excel file, just press this key combination.

CTRL + Space: Select data in entire column

With this keyboard shortcut, you can select all the cells in a column.

CTRL +]: Select cells with formulas

Sometimes, when working with data, it is important to calculate cells with formulas that refer to other cells. To do this, select a range of cells and press the keyboard shortcut. The system will highlight cells that refer to other cells in formulas.

CTRL +;: Insert current date

With this keyboard shortcut, you can insert the current date into any cell.

CTRL + Shift + ;; insert current time

So, you add the current time to the cell.

CTRL + A: Select all cells

If you want to select all cells on the sheet – just press CTRL + A.

CTRL + D: copy equation down

In cases where you want to duplicate a formula with calculation one cell down, use this combination.

CTRL + F: Search

Search for data in a sheet.

CTRL + H Search and Replace

Find and replace data in an Excel sheet.

Shift + Space: Select the entire line

Press Shift + Space to select the entire sheet line.

CTRL + Shift + Down Arrow (Right, Left, Up): Select cells with shift down

Use this keyboard shortcut to select a range of cells. The peculiarity of this selection is that it occurs instantly before the first data gap.

CTRL + Down Arrow (Right, Left, Up): Fast move through data

With these hotkeys, you will quickly move through the data range.

When working with Excel, use keyboard shortcuts instead of the mouse. Using keyboard shortcuts, you can open and close documents and sheets, move around the document, perform various actions on cells, perform calculations, etc. Using keyboard shortcuts will make it easier and faster to work with the program.

Ctrl + N – Create a new document

Ctrl + S, Shift + F12 – Save document

F12 – Saving the document under a different name (in a different directory)

Ctrl + O, Ctrl + F12 – Open document

Ctrl + F4, Ctrl + W – Close Document

Alt + F4 – Close Excel

Ctrl + F6, Ctrl + Shitt + F6, Ctrl + Tab, Ctrl + Shift + Tab – Switch between document windows

Alt + Tab – Switching document windows (if the window switch on the taskbar is enabled)

Ctrl + F10 – Transfer of all document windows from normal to maximized state, and back

Ctrl + F5 – Transfer all document windows to normal view

F6, Shift + F6 – Jump between parts of the table after splitting

Shift + F10 – Calling the context menu of the object

F7 – Spell Checker

Ctrl + P, Ctrl + Shift + F12 – Print document

Shift + F11, Alt + Shitt + F1 – Create a table sheet

F11, Alt + F1 – Create chart sheet

Ctrl + Page Down – Next sheet

Ctrl + Page Up – Previous Sheet

Ctrl + Shift + Page Down – Select next sheet

Ctrl + Shift + Page Up – Select the previous sheet

Alt + Enter – Enter text in multiple lines

Ctrl + Enter – Entering the same data into the cells of the selected block

Ctrl + R (Ctrl + D) – Entering the same data in the cells to the right (bottom)

Ctrl +; – Insert current date

Ctrl + Shift +; – Insert current time

Shitt + F3 – Calling the function wizard

Ctrl + Sbitt + A – Calling the function wizard after dialing the function name

Ctrl + A – Entering function argument names after typing the function name

Ctrl + Z, Alt + Back Space – Undo the last operation

F4, Ctrl + Y – Redo the undone action (or redo the last action)

F4 (when editing) – Change relative / absolute addresses

Ctrl + 1 – Calls the Format Cells dialog box

Ctrl + B, Ctrl + 2 – Bold

Ctrl + I, Ctrl + 3 – Italic font

Ctrl + U, Ctrl + 4 – Underlined font

Ctrl + 5 – Strikethrough font

Ctrl + Shift + P – Activate the Dimension tool

Ctrl + Shift + F – Activation of the Font tool

Ctrl + Shift ± – Format Normal (default)

Ctrl + Shift + 1 – Number format 0.00 with group separator

Ctrl + Shift + 2 – Time format h.mm

Ctrl + Shift + 3 – Date format DD.MMM.YY

Ctrl + Shift + 4 – Number format Currency

Ctrl + Shift + 5 – Number format Percentage

Ctrl + Shift + 6 – Number format OOOE + 00

Ctrl + Shift + 7 – Framing the outer contour with a thin solid line

Ctrl + Shift ± – Cancel the border of all lines

Alt + ‘ – Call window Style

Shift + Space – Selection of line

Ctrl + Space – Column selection

Ctrl + A – Select the entire table

Ctrl + Shift + 8, Ctrl + * (digits.key.) – Selection of the area of ​​filled cells

Shift + navigation keys, F8 and navigation keys – Select a single block

Shift + F8 & F8 and navigation keys – Selection of a piece block

Ctrl + C, Ctrl + lnsert – Copy to clipboard

Ctrl + X, Shitt + Delete – Cut to clipboard

Ctrl + V, Shift + lnsert – Paste from clipboard

Ctrl ± – Delete cells

Ctrl + Shift + = – Insert new cells

Ctrl + 9, Ctrl + Shift + 9 – Hide (show) lines

Ctrl + 0, Ctrl + Shift + 0 – Hide (show) columns

Alt +; – Deselecting hidden cells (highlighting visible)

Ctrl + 6 – Hide / show graphic objects

Ctrl + G, F5 – Transition and selection of cells

Ctrl + F, Shift + F5 – Search

Shift + F4 – Repeat search

Ctrl + H – Search and Replace

Ctrl + F3 – Assign name

Ctrl + Shift + F3 – Create names from existing headers

F3 – Insert name into formula

Shift + F2 – Add / edit cell note

Ctrl + Shift + O – Select all cells with notes

F9, Ctrl + = – Manual calculation of formulas in all open workbooks

Shift + F9 – Manual calculation of formulas in the current table

Ctrl + ‘ – Enabling / disabling the mode of displaying formulas

Ctrl + [, Ctrl +] – Selection of influencing (dependent) cells

Ctrl + Shift + [, Ctrl + Shift +] – Selection of indirectly influencing (dependent) cells

Ctrl + Shift + C – Copy (memorize) the parameters of the graphic object

Ctrl + Shift + V – Inserting (assigning) parameters of a graphic object

Ctrl + Shift + Space – Select all graphic objects on sheet

Keyboard shortcuts for editing the contents of cells

No. – Start of line

End – At the end of line

Ctrl + Right Arrow – One Word Right

Ctrl + Left Arrow – One Word Left

Ctrl + ‘ – Copy all data from the top cell

to the current cell

Ctrl + Shift + ’ – Copies to the current cell from the top cell of all values ​​entered or calculated by the formula

Delete (Back Space) – Deleting a character to the right (left) of the cursor

Ctrl + Oelete – Delete to end of line

Keyboard shortcuts for moving according to the table

Tab – Per cell to the right

Shift + Tab – One cell to the left

Ctrl + Home – To the first first cell of the table (A1)

Ctrl + End, End and Home – To the lower right corner of the active area

Alt + Page Up – Screen Left

Alt + Page Down – Screen Right

Ctrl + Back Space – Return to the current cell (if it is not visible)

Ctrl + Right Arrow, End and Right Arrow – Right along the line to the border of the filled area

Ctrl + Left Arrow, End and Left Arrow – Left along the line to the border of the filled area

Ctrl + Down Arrow, End and Down Arrow – Down a column to the border of the filled area

Ctrl + Up Arrow, End and Up Arrow – Up a column to the border of the filled area

Keyboard shortcuts for moving around the selected block

Enter – Top to bottom left to right

Shift + Enter – From bottom to top right to left

Tab – From left to right, top to bottom

Shift + Tab – Right to left from bottom to top

Ctrl + Alt + Right Arrow – To the next part of the piece block

Ctrl + Alt + Left Arrow – Go to the previous part of the piece block

Ctrl +. – Clockwise to the corners of the selected block

Keyboard shortcuts for navigating the database

Down arrow, Enter – To next record

Up arrow, Shift + Enter – To the previous record

Page Up – 10 records forward

Page Down – 10 records back

Ctrl + Down Arrow, Ctrl + Page Down -To the last empty record

Ctrl + Up Arrow, Ctrl + Page Up – Go to first record

Even if you are familiar with Microsoft Excel, you may be surprised at the number and variety of keyboard shortcuts you can use to speed up your work and generally make things more convenient.

So no one expects you to memorize all these keyboard shortcuts? Of course not! Every need is different, so some will be more beneficial to you than others. And even if you choose a few new combinations, it’s worth it.

General program hotkeys

First, let’s take a look at some common keyboard shortcuts for managing books.

  • Ctrl + N : Create New Workbook
  • Ctrl + O: open existing workbook
  • Ctrl + S: save workbook
  • F12: Open Save As Dialog
  • Ctrl + W: close workbook
  • Ctrl + F4: Close Excel
  • F4: Repeat the last command or action.
  • Shift + F11: add new sheet
  • Ctrl + Z: undo
  • Ctrl + Y: repeat action
  • Ctrl + F2: switch to preview mode
  • F1: open the help panel
  • Alt + Q: go to the field “Tell me what you want to do”
  • F7: spell check
  • F9: Calculate all sheets in all open workbooks
  • Shift + F9: Calculate Active Worksheets
  • Alt or F10: enable or disable prompts
  • Ctrl + F1: show or hide ribbon
  • Ctrl + Shift + U: Expand or Collapse Formula Bar
  • Ctrl + F9: Minimize workbook window
  • F11 : Create a bar chart based on the selected data (on a separate sheet)
  • Alt + F1: Create inline histogram based on selected data (same sheet)
  • Ctrl + F: search spreadsheet or find and replace
  • Alt + F: Open the File Tab Menu
  • Alt + H: go to the Home tab
  • Alt + N: open the “Insert” tab
  • Alt + P: Switch to Page Layout tab
  • Alt + M: go to Formulas tab
  • Alt + A: go to Data tab
  • Alt + R: go to the Overview tab
  • Alt + W: go to the “View” tab
  • Alt + X: Go to add-ins tab
  • Alt + Y: go to Help tab
  • Ctrl + Tab: switch between open books
  • Shift + F3: insert function
  • Alt + F8: create, run, edit or delete a macro
  • Alt + F11: Open Microsoft Visual Basic for Applications Editor

Move in worksheet or cell

You can use keyboard shortcuts to easily navigate an entire worksheet, within a cell, or throughout your workbook.

  • Left / Right Arrow: Move one cell to the left or right
  • Ctrl + Left / Right Arrow: Move to the farthest cell to the left or right in line
  • Up / Down Arrow: Move one cell up or down
  • Ctrl + Up / Down Arrow: Move to the top or bottom cell in column
  • Tab: Move to next cell
  • Shift + Tab: Move to previous cell
  • Ctrl + End: Move to the lowest-right cell
  • F5: Go to any cell by pressing F5 and typing the cell coordinate or cell name.
  • Home: go to the leftmost cell in the current row (or go to the beginning of a cell when editing a cell)
  • Ctrl + Home: Go to start of worksheet
  • Page Up / Down: Move one screen up or down on a sheet
  • Alt + Page Up / Down: Move one screen right or left on sheet
  • Ctrl + Page Up / Down: Move to previous or next worksheet

Select cells

You may have noticed from the previous section that you use the arrow keys to move between cells and the Ctrl key to change this movement.Using the Shift key to change the arrow keys expands the selected cells. There are also several other combos to speed up the selection.

  • Shift + Left / Right Arrow: Expand the selection cell to the left or right
  • Shift + Space: select the whole line
  • Ctrl + Space: select the entire column
  • Ctrl + Shift + Space: select entire worksheet

Edit cells

Excel also provides some keyboard shortcuts for editing cells.

  • F2: edit cell
  • Shift + F2: Add or edit cell comment
  • Ctrl + X: Cut cell content, selected data, or selected range of cells
  • Ctrl + C or Ctrl + Insert: Copy cell contents, selected data, or selected range of cells
  • Ctrl + V or Shift + Insert: Paste content of cell, selected data, or selected range of cells
  • Ctrl + Alt + V: Open Special Attachment Dialog
  • Delete: Delete cell contents, selected data, or selected range of cells
  • Alt + Enter: Insert hard return inside cell (while editing cell)
  • F3: Insert cell name (if cells are specified on the sheet)
  • Alt + H + D + C: Delete column
  • Esc: Cancel an entry in a cell or Formula Bar
  • Enter: Fill in a cell or formula bar

Cell formatting

Are you ready to format some cells? These keyboard shortcuts make your work easier!

  • Ctrl + B: Add or remove bold font to cell content, selected data, or selected range of cells
  • Ctrl + I: Add or remove italics to cell content, selected data, or selected range of cells
  • Ctrl + U: Add or remove underline of cell content, selected data, or selected range of cells
  • Alt + H + H: select fill color
  • Alt + H + B: add border
  • Ctrl + Shift + &: Apply outline border
  • Ctrl + Shift + _ (underline): Delete outline border
  • Ctrl + 9: Hide Selected Rows
  • Ctrl + 0: Hide Selected Columns
  • Ctrl + 1: Open Format Cells Dialog
  • Ctrl + 5: Apply or Remove Strikethrough Text
  • Ctrl + Shift + $: Apply Currency Format
  • Ctrl + Shift +%: Apply percent format

The more you use keyboard shortcuts, the easier it is to remember them.And no one expects you to remember them. Hopefully you’ve found some new ones that you can use to make your Excel life a little better.

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Command line to return to GUI after Ctrl-Alt-F1?

I cannot return to the GUI with Ctrl-Alt-F7 (or any of the 12 function keys).I have some unsaved jobs and I don’t want to lose them. Are there other keyboard shortcuts that will allow me to go back?

Here’s what I did:

  1. I pressed Ctrl-Alt-F1 and it showed the login text screen as usual
  2. Then I pressed Ctrl-Alt-F7 and it showed a screen full of text (I can’t remember what they were)
  3. Then I pressed Ctrl-Alt-F8 and it showed log messages that are similar / var / log / messages .Some entries are from automount , some from sendmail , and none are errors.
  4. Pressing any of the Ctrl-Alt-Fn combinations now has no effect. The cap-lock and num-lock LEDs no longer respond to the corresponding keys. I can use my mouse to select text on the screen, but nothing else.

Any idea what happened?

I can still log in via SSH. The GUI applications I have used (eg opera ) still work and consume a small amount of CPU resources as usual. top . Can I switch back to the GUI from the command line? If possible, I don’t want to restart X because that will kill all GUI applications.

System Information:

  Red Hat Enterprise Linux Client release 5.7
 Linux 2.6.18-238.12.1.el5 SMP x86_64
 gnome-desktop: 2.16.0-1.fc6
 xorg-x11-server-Xorg: 1.1.1-48.76.el5_7.5
  

Thanks to Sean, I was able to revert to using chvt 9 .

Further experiments show that if I go to the 8th virtual terminal (either via, Ctrl-Alt-F8 or chvt 8 ), I cannot switch to other terminals with the Ctrl-Alt-Fx keys .