Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The tracheostomy is in place . The tip of the right - sided PICC line is not well visualized , but is likely unchanged in vascular level , overlying the distal SVC / RA junction . There is improved visualization of the right lung base , likely reflecting significant improvement in a previously seen right pleural effusion . Some residual atelectasis is noted at the right lung base . A small to moderate left effusion with underlying left lower lobe collapse and / or consolidation remains present , slightly improved . There is upper zone redistribution and vascular plethora , probably similar to the prior study . The cardiomediastinal silhouette is better defined on the right and there appears to be some leftward shift of the mediastinum , consistent with left - sided volume loss . Cervical fixation hardware is again noted .
    OUTPUT:
    
1 . Improvement in right - sided effusion . Residual right base atelectasis noted . 2 . Small to moderate left effusion and underlying collapse and / or consolidation may be minimally improved . 3 . Probable leftward shift of the mediastinum consistent with left - sided volume loss . This may have increased in the interim , based on subtle change in the course of the PICC line . 4 . CHF is grossly unchanged .