Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is rotated to the right . There are probable bilateral pleural effusions . Degree of pulmonary edema , likely moderate is grossly unchanged for perhaps minimally improved . Cardiac silhouette is enlarged . Chronic changes noted at the shoulders . Included image of the distal left humerus is also notable for likely chronic appearing deformity , similar to scout from CT scan from ___ . Left upper extremity vascular access line seen terminating at the left brachial / lower axillary level .
    OUTPUT:
    
No significant interval change . Likely moderate pulmonary edema and suspected pleural effusions with cardiomegaly . Catheter projecting over the left upper extremity as above .