Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacemaker type device again seen with single lead overlying the right ventricle . No obvious pneumothorax is identified . Compared with the prior film , opacity at both bases is increased . This appears to reflect the presence of small bilateral effusions , with associated collapse and / or consolidation . Some of the lateral left mid zone patchy opacity appears improved . Otherwise , the overall appearance is similar prior . There is background hyperinflation , consistent with COPD . Upper zone redistribution noted . As before , there are background interstitial opacities in both lungs , which could be due to chronic lung disease or asymmetric pulmonary edema . However , a possible infectious etiology can not be excluded .
    OUTPUT:
    
Bilateral foot pleural effusions are larger , with underlying collapse and / or consolidation . Otherwise , doubt gross change .