Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison to the prior radiograph , the patient is positioned differently . The patient is upright as opposed to semi-upright previously and more rotated to the right . There is increased atelectasis at the left base . Increased diffuse opacification of the right lung may represent a layering effusion or increased edema within that lung . A moderate right pleural effusion has redistributed but probably stable in size . Tracheostomy tube and right PICC are unchanged in position . Heart size is difficult to evaluate
    OUTPUT:
    
Comparison is difficult due to changes in positioning . Left lower lung atelectasis has increased . Diffuse opacification of the right hemothorax may be related to an increased layering effusion or new parenchymal process .