Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A frontal chest radiograph again demonstrates a right central catheter with the tip in the upper SVC and the endotracheal tube and nasogastric tubes in proper position . The cardiomediastinal silhouette is unchanged . Bilateral layering pleural effusions are noted . Given the change in patient position , it is difficult to tell if these effusions are new or increased . The area of pneumonia is substantially covered by the layering fluid and difficult to evaluate . There is no pneumothorax .
    OUTPUT:
    
1 . Bilateral layering pleural effusions ; it is difficult to tell if these are new or increased , versus unchanged and more prominent due to change in position . 2 . The area of pneumonia is substantially covered by layering fluid , making it difficult to evaluate for interval change . Upright and / or lateral views , if possible , would be helpful with evaluation .