Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Rotated positioning . In addition , there is apparent marked volume loss on the left , with leftward shift of the mediastinum and apparent leftward hyper inflation of the right lung . As result , the carina is not well delineated . The tip of the ET tube lies at the upper edge of the medial clavicular heads . An NG tube is present . The sideport overlies the lower mediastinum and likely lies proximal to the GE junction . The NG tube tip overlies the upper abdomen . A left subclavian PICC line is also displaced leftward with the mediastinal structures , possibly at the level of the distal SVC . In the left hemithorax , there is opacification along lung apex and in the left mid and lower zones , with obscuration left hemidiaphragm and left costophrenic angle as well as the cardiomediastinal silhouette . In the right hemithorax chest tube is present . No definite pneumothorax is identified . Aside from some crowded markings at the right lung base , no focal infiltrate is identified on the right . Possible small right effusion . Doubt CHF . Compared with ___ allowing for differences in positioning no definite interval change on the left . Minimal atelectasis a small right effusion are new .
    OUTPUT:
    
Marked left - sided volume loss of left ward shift of the mediastinum is probably unchanged . Atelectasis at the right lung base and small right effusion are new . Right chest tube again seen . No obvious pneumothorax .