Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral upright views of the chest were reviewed and compared to the prior studies . The patient is markedly rotated to the right which distorts the mediastinal and cardiac silhouettes that are likely unchanged . Accounting for patient rotation , the large right pleural effusion is relatively unchanged and the small left pleural effusion is slightly increased . A left PICC ends in the upper superior vena cava . Right middle lobe , right lower lobe collapse and left basilar atelectasis are relatively unchanged there is no vascular engorgement , pulmonary edema , or pneumothorax . Median sternotomy wire are intact and aligned .
    OUTPUT:
    
Accounting for patient rotation , the large right pleural effusion is relatively unchanged in the small left pleural effusion has slightly increased .