Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left sided dual lead pacemaker device a appears intact and unchanged with 1 lead in the right atrium and the other in the right ventricle . Enteric tube tip traverses the hemidiaphragm and tip projects over the mid abdomen , and expected region of the stomach . Edema has improved in the interim . Otherwise , no significant interval change . Persistent , right greater than left pleural effusions with compressive atelectasis , overall unchanged given positional differences . No pneumothorax . Cardiomediastinal contours are unchanged . Aortic knob calcifications are moderate . Extensive , broad dextroconvex scoliosis of the thoracic spine with marked distortion of thoracic cage is unchanged . Incompletely visualized cervical spine fixation hardware is noted .
    OUTPUT:
    
No significant change .