Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Endotracheal tube terminates 6 .6 cm above the carina , and advancement is recommended . Tip of the enteric tube extends to the proximal fundus of the body , but the sidehole is at the GE junction , and advancement is also recommended . Lungs are hyperinflated , with moderate to severe emphysema . No focal consolidation to suggest pneumonia . Ill - defined opacities are noted in the right upper lobe and left lower lobe , which are of unclear clinical significance . No pleural effusion or pneumothorax . Heart size is normal . There are multiple old bilateral rib fractures .
    OUTPUT:
    
1 . Endotracheal tube terminates 6 .6 cm above the carina . Recommend advancement of both the endotracheal and enteric tubes . 2 . Moderate to severe emphysema . 3 . Ill - defined opacities in the right upper and left lower lung , of unclear clinical significance . Close interval follow - up is recommended , with consideration for a repeat PA and lateral chest radiograph if appropriate .