Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right PICC tip terminates within the right atrium , similar compared to the previous exam . There is continued elevation of the right hemidiaphragm with leftward shift of mediastinal structures . Atelectatic changes are noted in the lung bases , and small bilateral pleural effusions appear relatively unchanged . No pulmonary vascular congestion or pneumothorax is identified . The heart size is unchanged and within normal limits . There are calcifications of the aortic knob . Biliary stents and clips are again demonstrated in the right upper quadrant of the abdomen . No acute osseous abnormalities are visualized .
    OUTPUT:
    
Little interval change compared to the previous exam . Continued marked elevation of the right hemidiaphragm with small bilateral pleural effusions and bibasilar atelectasis . Right PICC tip terminates in the right atrium , and should be withdrawn slightly for optimal positioning .