Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views the chest were reviewed . There is a moderate left pleural effusion with likely associated atelectasis . Underlying consolidation can not be excluded . Small right effusion is noted on the lateral view . The right lung is clear . There is no pneumothorax . The cardiomediastinal and hilar contours are stable . Median sternotomy wires are again noted . Previously fractured inferior most sternotomy wire is noted , now with a second fracture of the same wire . Dextroscoliosis of the thoracic spine is again noted .
    OUTPUT:
    
1 . New left pleural effusion with associated atelectasis . Underlying consolidation not excluded . 2 . Fractured inferior median sternotomy wire , progressed since the prior radiograph with a second fracture of the same wire now present .