Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A tracheostomy tube is appropriately positioned . A left PICC ends in the upper SVC . A surgical clip is seen in the right upper abdominal quadrant . There is a moderate left pleural effusion with marked volume loss of the left lower lobe , not significantly changed . There is minimal right lower lung atelectasis . The heart size is difficult to assess given the marked volume loss at the left lung base , but it is likely mildly enlarged , not significantly changed . There is no pneumothorax .
    OUTPUT:
    
No significant interval change including a moderate left pleural effusion and marked volume loss at the left lung base .