Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen and bilateral pleural effusions with platelike atelectasis of the left mid lung , relatively unchanged compared to previous radiographs . No vascular congestion . No pneumothorax is seen . The cardiac silhouette is enlarged but unchanged , and mediastinal silhouette is unchanged . Median sternotomy wires are again noted . Left pectoral pacer with leads in the right atrium and right ventricle . Right PICC tip in unchanged position .
    OUTPUT:
    
No significant change in the bilateral pleural effusions since ___ . Platelike atelectasis in the left mid lung again seen . Enlarged cardiac silhouette .