Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Markedly rotated and lordotic positioning , which makes comparison to the prior film challenging . Inspiratory volumes are slightly low . An ET tube is present , the tip lies approximately 3 .7 cm above the carina . An NG tube is present , the tip extends beneath the diaphragm and overlies the gastric fundus . A right IJ sheath is seen . Allowing for rotation , this probably similar to the prior study . No pneumothorax is detected . The cardiac silhouette is quite difficult to assess due to extreme differences in positioning . Likely vascular plethora and scattered parenchymal opacities . On the right , the appearance is probably similar to the prior study . No gross right effusion . On left , comparison to the prior study is quite difficult due to differences in positioning . No definite interval change on the left . No gross left effusion . Right and left hemidiaphragms remain well defined .
    OUTPUT:
    
Lines and tubes as described . No pneumothorax detected . Likely vascular plethora and scattered parenchymal opacities . Comparison to the prior film is quite limited due to differences in position and technique . No definite worsening . Possible slight improvement in the left upper zone . Hemidiaphragms remain well - defined . No gross effusion detected on either side .