Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparision to the prior radiograph , there appears to be an increase in the left - sided pleural effusion . Cardiac and mediastinal silhouettes remain unchanged . Coronary stent and left PICC which abuts the confluence of the brachiocephalic vein and ends in the SVC . No new opacities concerning for infectious process are seen . The trahceostomy appears to be impinging upon the chest wall and could be reposistioned for better alignment .
    OUTPUT:
    
1 ) Slightly increased left - sided pleural effusion . 2 ) The trahceostomy appears to be impinging upon the chest wall and could be reposistioned for better alignment .