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<s>[INST] ap upright and lateral views of the chest provided. persistent perihilar and lower lung opacities are noted with slight improvement compared with prior recent exam could reflect persistent pneumonia. small pleural effusions are also present. no pneumothorax. heart size is unchanged. mild edema difficult to exclude. patient is known to have severe emphysema. bony structures are intact.What are the key findings of this report? [/INST] persistent lower lung and perihilar opacities remain concerning for pneumonia with slight improvement from prior recent exam. small bilateral pleural effusions. recommend followup to resolution. </s>
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<s>[INST] frontal and lateral views of the chest were obtained. new right picc terminates within the right atrium. the heart size and cardiomediastinal contours are normal. right lower lobe atelectasis is minimal and the lungs are otherwise clear. no focal consolidation, pleural effusion, or pneumothorax.What are the key findings of this report? [/INST] right picc terminates within the right atrium. </s>
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<s>[INST] cardiomediastinal contours are within normal limits for post-operative status of the patient. pulmonary vascularity is normal. partial atelectasis of the left lower lobe has slightly worsened in the interval. linear atelectasis in the left mid lung region is slightly improved, however. small bilateral pleural effusions are persistent, left greater than right, and note is made of persistent free intraperitoneal air.What are the key findings of this report? [/INST] <num>. worsening left lower lobe atelectasis. <num>. small pleural effusions, left greater than right. <num>. free intraperitoneal air. this finding has been communicated by telephone to <unk> at <time> p.m. on <unk> at the time of discovery. </s>
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<s>[INST] frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion or pneumothorax. there is no pulmonary edema. hilar and mediastinal silhouettes are unremarkable. heart size is normal. right lung base consolidation has resolved.What are the key findings of this report? [/INST] right lower lobe consolidation seen on <unk> ct exam has resolved. </s>
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<s>[INST] pa and lateral views of the chest are compared to previous exam from <unk>. the lungs are hyperinflated but are clear of consolidation. the cardiomediastinal silhouette is within normal limits. osseous and soft tissue structures are unremarkable.What are the key findings of this report? [/INST] hyperinflation, but no acute cardiopulmonary process. </s>
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<s>[INST] the lungs are clear of focal consolidation, pleural effusion or pneumothorax. there is mild left lower lobe atelectasis. the heart is normal in size.What are the key findings of this report? [/INST] left basilar atelectasis. </s>
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<s>[INST] pa and lateral views of the chest were obtained. suture material is again noted in the right mid to upper lung. there is mild pulmonary edema without large pleural effusions or pneumothorax. the heart is within normal limits for size. mediastinal contour is normal. hilar vascular engorgement is noted. hardware partially visualized at the right proximal humerus. no free air below the right hemidiaphragm.What are the key findings of this report? [/INST] mild pulmonary edema. </s>
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<s>[INST] frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal contours. lungs are clear. as before, there is mild blunting of the right lateral costophrenic angle likely reflecting atelectasis or scarring given persistence since <unk>. no pleural effusion is definitively identified. no pneumothorax is present. no osseous abnormality present.What are the key findings of this report? [/INST] no acute intrathoracic pathology. </s>
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<s>[INST] interval decrease in heart size, now normal with stable tortuosity of the aorta. no focal consolidation, pleural effusion or pneumothorax. no pulmonary edema.What are the key findings of this report? [/INST] no acute process </s>
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<s>[INST] the lungs are well inflated and clear. no consolidation, effusion, or pneumothorax is present. the heart and mediastinal contours are normal. minimal aortic arch calcifications are present. there is a non-displaced fracture of the lateral left sixth rib.What are the key findings of this report? [/INST] non-displaced left lateral sixth rib fracture. findings were discussed via phone with dr <unk> at <unk> on <unk>. </s>
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<s>[INST] frontal and lateral views of the chest demonstrate stable moderate cardiomegaly and mildly unfolded thoracic aorta. again seen is mild perihilar vascular congestion. there is no large effusion or pneumothorax. multilevel mild thoracic spondylosis is present.What are the key findings of this report? [/INST] mild perihilar vascular congestion and stable cardiomegaly. </s>
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<s>[INST] ap upright and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is stable with top-normal heart size imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.What are the key findings of this report? [/INST] no acute intrathoracic process. top normal heart size. </s>
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<s>[INST] lung volumes are low. heart size is within normal limits. mediastinal and hilar contours are unremarkable. pulmonary vasculature is normal. minimal patchy opacities are seen in the lung bases, likely reflective of atelectasis without focal consolidation. no pleural effusion or pneumothorax is demonstrated. no acute osseous abnormalities seen.What are the key findings of this report? [/INST] low lung volumes with probable bibasilar atelectasis. </s>
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<s>[INST] frontal and lateral radiographs of the chest demonstrate hyperexpanded lungs. the small regions of peribronchial opacification at the right and left lung base are much less conspicuous on this exam. the heart size is normal. the cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion, pneumothorax, or pulmonary edema. again seen is a wedge-shaped deformity of the mid thoracic vertebral body, unchanged from prior.What are the key findings of this report? [/INST] peribronchial opacities at the bilateral bases are much less conspicuous on this exam. </s>
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<s>[INST] right picc has been repositioned since <unk> and now terminates at low svc. lung volume is low. pulmonary vascular congestion is similar to before. right lung base opacity is slightly increased compared to before. left lung base opacity is stable and consistent with atelectasis. there are probable small bilateral pleural effusions. enlarged cardiomediastinal silhouette is unchanged.What are the key findings of this report? [/INST] right lung base opacity is slightly increased compared to <unk> and may reflect aspiration, pneumonia, or worsening atelectasis. </s>
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<s>[INST] there is interval placement of an ng tube that is coiled in the stomach. right chest tube and et tube are unchanged in position. interstitial changes which are due to pre-existing interstitial lung disease, now appear slightly less prominent; the decreased prominence is likely due to decreased vascular congestion. no definite pleural effusion is seen. moderate cardiomegaly is seen.What are the key findings of this report? [/INST] interval placement of ng tube and side port is seen within the stomach. mild decrease in interstitial markings is seen. </s>
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<s>[INST] ap upright and lateral views the chest provided. midline sternotomy wires and mediastinal clips are again noted. there is persists and atelectasis in the left lower lung. no convincing signs of pneumonia. no pleural effusion or pneumothorax. cardiomediastinal silhouette appears stable. bony structures are intact.What are the key findings of this report? [/INST] persistent mild left basal atelectasis. no convincing signs of pneumonia. </s>
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<s>[INST] there is an increasing pleural effusion on the right, now at least moderate size, and probably a trace one on the left side. associated opacity can probably be explained by atelectasis in the right lower and middle lobes. projecting over the right mid lung is a rounded mass-like opacity measuring about <num> cm in diameter, possibly an increasing metastatic nodule. patchy opacity at the left lung base is probably due to minor atelectasis. compression deformities along the lower thoracic and upper lumbar spines are probably unchanged allowing for differences in technique. known metastases into the bones are not well demonstrated on this study.What are the key findings of this report? [/INST] increasing right-sided pleural effusion. right lung mass, probably increased substantially, although comparison of different modalities is not entirely reliable. ct may be helpful to evaluate further if needed clinically. </s>
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<s>[INST] there is a left-sided port-a-cath terminating in the mid svc. heart size is at the upper limits of normal. mild unfolding of the aorta. no chf, focal infiltrate, effusion, or pneumothorax is detecetd. within the limits of plain film radiography, no hilar or mediastinal lymphadenopathy is detected.What are the key findings of this report? [/INST] no evidence of pneumonia. </s>
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<s>[INST] the patient remains intubated. an orogastric tube courses into the stomach, its tip not imaged. an introducer catheter again resides in the left internal jugular vein. the patient is status post coronary artery bypass graft surgery. a left-sided chest tube is unchanged. a portion of the left lung base is excluded. hazy background opacification suggests mild vascular congestion. small layering pleural effusions are suspected. increasing retrocardiac opacification is non-specific but is most commonly due to atelectasis following cardiac surgery. there is no pneumothorax.What are the key findings of this report? [/INST] improvement in aeration of the right upper lobe, but increased left basilar opacification, commonly due to atelectasis. </s>
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<s>[INST] the lungs are clear. there is no pleural effusion, pneumothorax or focal airspace consolidation. heart is normal size. mediastinal and hilar contours are unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] interval withdrawal of right-sided picc line with tip terminating in the upper superior vena cava. no pneumothorax identified. nasogastric tube is seen coursing into stomach and out of view. there is a persistent right hemidiaphragm elevation with increased right lower lung consolidation, likely due to right middle lobe collapse. unchanged left retrocardiac opacity likely represents combination of atelectasis and effusion, though cannot exclude developing infectious process. pulmonary edema is unchanged. stable bilateral pleural effusions.What are the key findings of this report? [/INST] interval withdrawal of right picc line with tip in the upper superior vena cava. increased right middle lung collapse. stable bilateral pleural effusions and retrocardiac opacification. </s>
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<s>[INST] cardiomediastinal contours are stable in appearance. small right upper lobe nodular opacity at level of second anterior rib is similar compared to earlier radiographs. minimal bibasilar opacities are improved compared to prior radiographs. mild elevation of left hemidiaphragm is unchanged. no pleural effusion or acute skeletal findings.What are the key findings of this report? [/INST] no definite acute pneumonia, but ct would be more sensitive for detecting early signs of infection, especially considering the presence of chronic chest radiograph abnormalities in this patient. </s>
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<s>[INST] a small right apical and lateral pneumothorax is unchanged from <unk>. a right-sided chest tube remains. no left pneumothorax. right tenth rib fracture appears unchanged. mediastinal contours, hila, and cardiac silhouette are normal. no pleural effusion. subcutaneous emphysema is unchanged from <unk>.What are the key findings of this report? [/INST] small right apical pneumothorax unchanged from <unk>. </s>
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<s>[INST] right port-a-cath tip projects over the expected location of the low svc. bibasilar opacities is probably atelectasis in the setting of chronic severe pleural thickening move, although infection should be considered in the appropriate clinical setting. peripheral opacity at the right lung base adjacent to the fiducial marker reflects changes of radiation fibrosis. no pleural effusion or pneumothorax. extensive pleural calcification noted on the left. cardiac silhouette partially obscured by pleural thickening, top-normal size.What are the key findings of this report? [/INST] <num>. bibasilar opacities more likely atelectasis than infection. <num>. pleural thickening and chronic radiation changes in the peripheral right lower lobe adjacent to the fiducial marker. </s>
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<s>[INST] the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac silhouette is top-normal. coronary artery stenting is noted. mediastinal contours are unremarkable. the aortic knob is calcified. no evidence of free air is seen beneath the diaphragms.What are the key findings of this report? [/INST] no acute cardiopulmonary process. no evidence of free air beneath the diaphragms. </s>
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<s>[INST] moderate pulmonary vascular congestion with moderate associated pulmonary interstitial edema and mild cardiomegaly are new since <unk>. there is no pleural effusion, pneumothorax, or focal consolidation.What are the key findings of this report? [/INST] mild congestive heart failure. </s>
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<s>[INST] pa and lateral chest radiograph demonstrates clear lungs bilaterally. cardiomediastinal and hilar contours are within normal limits. there is no pleural effusion or pneumothorax. no evidence of pulmonary edema. an azygos fissure is noted. no free air under the right hemidiaphragm is present. degenerative changes involve bilateral acromioclavicular joints and left shoulder joint.What are the key findings of this report? [/INST] no evidence of pneumonia. </s>
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<s>[INST] pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>
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<s>[INST] bibasilar pleural effusions are again seen with compressive atelectasis at the lung bases, similar in appearance to the prior exam. a superimposed infectious process should be considered if there are clinical symptoms. the cardiomediastinal silhouette and hilar contours are unchanged. there is no evidence of pneumothorax.What are the key findings of this report? [/INST] bilateral effusions with compressive atelectasis at the bases. superimposed pneumonia should be considered if there are clinical symptoms. </s>
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<s>[INST] the lungs are clear. the cardiomediastinal silhouette and hila appear normal. there is no pleural effusion and no pneumothorax. intact sternotomy wires are seen.What are the key findings of this report? [/INST] no acute cardiothoracic process. </s>
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<s>[INST] frontal and lateral views of the chest were obtained. the cardiomediastinal silhouette is stable. the appearance of the lungs is grossly stable. no definite focal consolidation is seen. there is persistent blunting of the right costophrenic angle posteriorly, on the lateral view. no pneumothorax is seen.What are the key findings of this report? [/INST] no significant interval change. </s>
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<s>[INST] mild pulmonary edema is increased since the prior study. dilatation of the bilateral pulmonary arteries is compatible with pulmonary arterial hypertension. cardiac silhouette is moderately enlarged. no focal consolidation, pleural effusion, or pneumothorax is seen. a left chest pacemaker and leads are in unchanged positions. tricuspid and mitral valves replacements are again seen.What are the key findings of this report? [/INST] mild pulmonary edema and enlargement of the pulmonary arteries. </s>
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<s>[INST] evaluation is somewhat limited by rotation. however, the tip of the newly placed right-sided picc line projects over the low svc. there is no pneumothorax. the heart and mediastinum are suboptimally assessed due to patient positioning. regional bones and soft tissues are unremarkable.What are the key findings of this report? [/INST] satisfactory position of newly placed right picc line with no pneumothorax. </s>
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<s>[INST] pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>
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<s>[INST] compared to <unk> chest x-ray, there is new patchy opacity at the right lung base, slight blunting of the right costophrenic angle, and minimal, if any, atelectasis at the left lung base. no gross left effusion. no chf. cardiomediastinal silhouette unchanged. biventricular pacemaker again noted. no pneumothorax detected.What are the key findings of this report? [/INST] new or worsened right base patchy opacity. differential diagnosis includes aspiration or an early pneumonic infiltrate. atelectasis is in the differential, but considered less likely, as there also appears to be a small right effusion. </s>
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<s>[INST] the et tube is in more appropriate position at the level of the clavicles. the left picc line is visualized with tip terminating in the upper svc. the bilateral basilar atelectasis and pleural effusions are improved. the cardiomediastinal and hilar silhouettes are stable.What are the key findings of this report? [/INST] <num>. appropriate position of et tube with tip terminating at the level of the clavicles. <num>. improved bilateral atelectasis and pleural effusions. </s>
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<s>[INST] single semi-erect ap portable view of the chest was obtained. there is interval placement of a right internal jugular central venous catheter terminating in the low svc without findings to suggest pneumothorax. left base retrocardiac opacity appears increased, consistent with known left lower lobe collapse seen on preceding ct with small right pleural effusion. right basilar atelectasis/consolidation seen on preceding ct is not well appreciated on the current study. there is no large right pleural effusion. the cardiac and mediastinal silhouettes are stable.What are the key findings of this report? [/INST] interval placement of right internal jugular central venous catheter terminating in the low svc without evidence of pneumothorax. interval increase in left basilar/retrocardiac opacity which may be due to atelectasis/left lower lobe collapse. </s>
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<s>[INST] the lungs are moderately well inflated with bilateral lower lobe patchy opacities that may represent atelectasis versus consolidation. aspiration pneumonitis is a consideration in the right clinical setting. mild cardiomegaly and aortic knuckle calcification. no pleural effusions. ekg leads overlie the chest wall. visualized bones are unremarkable.What are the key findings of this report? [/INST] moderately well inflated lungs with bibasilar opacities compatible with subsegmental atelectasis versus consolidation including aspiration pneumonitis in the right clinical setting. </s>
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<s>[INST] dobbhoff tube tip terminates in the upper half of the esophagus. right picc tip terminates at the cavoatrial junction. lung volumes are hyperinflated. cardiac, mediastinal and hilar contours are unchanged. there is minimal streaky opacity in the retrocardiac region. no focal consolidation, pleural effusion or pneumothorax is visualized. there are no acute osseous abnormalities.What are the key findings of this report? [/INST] <num>. dobbhoff tube tip terminates in the upper esophagus and needs to be advanced by at least <num> cm. <num>. retrocardiac patchy opacity could reflect atelectasis. </s>
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<s>[INST] right chest tube is unchanged in position with interval removal of ng tube. patient is slightly rotated, resulting in increased visualization of the neoesophagus which is normal. no pneumothorax and decreased subcutaneous emphysema. unchanged bilateral pleural effusions, moderate-sized on left and small on right, with mild increase in left lower lobe atelectasis. heart size, mediastinal contour and hila are otherwise normal. no bony abnormality.What are the key findings of this report? [/INST] <num>. stable bilateral pleural effusions, moderate-sized on the left, small on the right, with mild interval increase in left lower lobe atelectasis. <num>. no pneumothorax. </s>
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<s>[INST] ap portable upright view of the chest. there has been interval intubation with the endotracheal tube positioned <num> cm above the carina. feeding tube remains in place and there is now <num> a nasogastric tube extending into the left upper abdomen. airspace consolidation in the right lower lobe is noted as well as probable consolidation in the left lower lobe. findings raise concern for pneumonia versus aspiration. no large effusion or pneumothorax. the heart size is unchanged. mediastinal contours unremarkable. coronary stents project over the left heart border. bony structures are intact. clips noted in the upper abdomen.What are the key findings of this report? [/INST] interval placement of endotracheal tube and nasogastric tube. feeding tube remains in place. lower lobe consolidations concerning for aspiration versus pneumonia. </s>
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<s>[INST] bilateral pulmonary effusions left greater than right which have slightly increased in size. atelectasis bilaterally has slightly increased as well. otherwise, cardiomediastinal is largely unchanged as compared to previous examination. no pneumothorax is seen.What are the key findings of this report? [/INST] slightly increased atelectasis and bilateral pulmonary effusions. </s>
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<s>[INST] pa and lateral views of the chest. the lungs are clear. there is no effusion or pneumothorax. the cardiomediastinal silhouette is within normal limits. osseous structures are unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] slight increase in opacity over the left mid lung is felt to most likely be due to overlying breast tissue. no definite focal consolidation is seen. there is no pleural effusion or pneumothorax. cardiac and mediastinal silhouettes are unremarkable. slight irregularity of the mid sternal body seen on the lateral view is of indeterminate age, but could be from prior trauma. correlate with site of point tenderness, history.What are the key findings of this report? [/INST] slight increase in opacity of the left mid lung is felt to most likely be due to overlying breast tissue. no definite focal consolidation. slight irregularity of the mid sternal body seen on the lateral view is of indeterminate age, but could be from prior trauma. correlate with point tenderness at this site and for history of trauma. </s>
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<s>[INST] frontal and lateral views of the chest were obtained. there is persistent mild bibasilar atelectasis. no focal consolidation is seen. there is no large pleural effusion. a large hiatal hernia with air-fluid levels again seen. the cardiac and mediastinal silhouettes are stable. there is mild biapical pleural thickening.What are the key findings of this report? [/INST] large hiatal hernia. mild bibasilar atelectasis. </s>
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<s>[INST] the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. no evidence of free air is seen beneath the diaphragms.What are the key findings of this report? [/INST] no acute cardiopulmonary process. no evidence of free air beneath the diaphragms. </s>
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<s>[INST] right lower lobe opacities abutting the right heart border are concerning for pneumonia. some cephalization of vessels on the right may indicate some fluid overload as well. the heart size is normal. there is no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] right middle lobe pneumonia. recommend followup chest x-ray in <unk> weeks after treatment to assure resolution </s>
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<s>[INST] heart size is normal. the aorta is diffusely calcified and tortuous. mediastinal contour is otherwise unchanged. there is crowding of the bronchovascular structures due to low lung volumes. small left pleural effusion appears chronic. patchy bibasilar airspace opacities may reflect atelectasis but infection or aspiration cannot be excluded. small right pleural effusion is new in the interval. no pneumothorax is present. there are mild degenerative changes noted diffusely within the imaged thoraco umbar spine.What are the key findings of this report? [/INST] low lung volumes with patchy bibasilar nonspecific airspace opacities, possibly atelectasis but infection or aspiration cannot be excluded. small bilateral pleural effusions, with the left pleural effusion appearing chronic. </s>
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<s>[INST] heart size remains mildly enlarged. the aorta is tortuous. mediastinal and hilar contours are unremarkable. pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is present. there are moderate multilevel degenerative changes throughout the thoracic spine.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] there are bibasilar opacities, more confluent on the right than on the left which are new since <unk> but perhaps mildly improved since <unk>. superiorly the lungs are clear. the cardiomediastinal silhouette is within normal limits. right chest wall dual lead pacing device is again noted. no acute osseous abnormalities.What are the key findings of this report? [/INST] persistent bibasilar opacities, right greater than left compatible with infection or aspiration. </s>
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<s>[INST] frontal and lateral radiographs of the chest demonstrate clear lungs. the cardiac and mediastinal contours are normal. no pleural abnormality is detected.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] the cardiac, mediastinal and hilar contours are normal. lungs are clear. the pulmonary vascularity is normal. no focal consolidation, pleural effusion or pneumothorax is identified. multiple clips are seen within the left and right upper quadrants of the abdomen.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] pa and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax. the cardiomediastinal silhouette is normal. a mild dextroscoliosis of the t-spine noted. bony structures appear intact.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>
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<s>[INST] small right pleural effusion persists. there has been interval resolution of the left pleural effusion. the amount of air within the right apical postsurgical air-fluid collection has decreased. no focal consolidation is seen. the left lung is both compensatorily and pathologically hyperinflated. heart and mediastinal contours are stable, with top normal heart size, aortic tortuosity and calcification. mid thoracic vertebral body compression deformity appears unchanged since at least <unk>.What are the key findings of this report? [/INST] interval decrease in amount of air within the right apical postsurgical air-fluid collection. interval resolution of small left pleural effusion with persistent small right basilar pleural effusion. </s>
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<s>[INST] cardiomediastinal contours are normal. lungs and pleural surfaces are clear except for a few scattered calcified granulomas in the left lung.What are the key findings of this report? [/INST] no evidence of pneumonia. </s>
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<s>[INST] the lungs are clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] pa and lateral views of the chest were obtained. right axillary clips are noted. right breast shadow is absent compatible with prior mastectomy. the lungs are hyperinflated with upper lobe lucency compatible with underlying emphysema. there is no sign of pneumonia or chf. no pleural effusion or pneumothorax. cardiomediastinal silhouette appears normal. bony structures are intact.What are the key findings of this report? [/INST] no acute intrathoracic process. emphysema. </s>
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<s>[INST] pacer is seen in the left anterior axillary position with intact leads along the expected course to the right atrium and right ventricle. there is a large hiatal hernia on the left, which includes a visible air-fluid level within the stomach. the lungs are well expanded and clear. there no pleural effusion. there is no pneumothorax or other related complication. cardiomediastinal silhouette is partially obscured by the hiatal hernia, but appears unchanged from prior exam.What are the key findings of this report? [/INST] pacer leads in appropriate position. large hiatal hernia on the left. </s>
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<s>[INST] t<num>he cardiac, mediastinal and hilar contours appear stable. there is no pleural effusion or pneumothorax. since the very recent prior studies, there is a substantial new opacity in the right lower lobe concerning for pneumonia. the bones appear demineralized. there is mild-to-moderate rightward convex curvature again centered along the lower thoracic spine with incompletely characterized lumbar compression deformities. moderate degenerative changes are again noted along lower thoracic levels.What are the key findings of this report? [/INST] findings consistent with pneumonia in the right lower lobe. depending on clinical circumstances, the possibility of aspiration could also be considered. </s>
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<s>[INST] the heart continues to be moderately enlarged. there is minimal pulmonary vascular redistribution. there small bilateral effusions have decreased compared to prior. overall the aeration is better but there still continues to be some volume loss in bilateral lower lobesWhat are the key findings of this report? [/INST] slight improvement in pulmonary edema </s>
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<s>[INST] frontal and lateral radiographs of the chest demonstrate diffuse bilateral pulmonary nodules which are unchanged from <unk>. there has been interval increase in the size of the large left pleural effusion, now with some adjacent atelectasis in the left upper lung zone. there is no pleural effusion in the right lung. again seen is a single-chamber pacemaker with tip terminating in the right ventricle, in the standard position. no pneumothorax. right-ward shift of the mediastinum is unchanged.What are the key findings of this report? [/INST] interval increase in size of large left-sided pleural effusion with adjacent atelectasis. </s>
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<s>[INST] there is small bilateral pleural effusions, increased in size compared to prior. <num> left upper lobe lesions measuring <num> and <num> cm respectively are again visualized. there are small areas of volume loss versus early infiltrate in both lower lungs. the heart continues to be moderately enlarged.What are the key findings of this report? [/INST] small bilateral effusions, increased in size compared to prior. </s>
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<s>[INST] heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen.What are the key findings of this report? [/INST] no evidence of pneumonia. if there is high clinical suspicion for obstructive lesion, recommend chest ct for further evaluation. </s>
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<s>[INST] the cardiac, mediastinal and hilar contours are normal. the pulmonary vascularity is normal. there is minimal subsegmental atelectasis within the left mid lung field. remainder of the lungs are clear. no pleural effusion or pneumothorax is visualized. no displaced rib fractures or other acute osseous abnormality is detected.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] single portable view of the chest. when compared to prior, there has been interval placement of a right central venous catheter with tip in the mid-to-lower svc. there is no pneumothorax. there are persistent linear bibasilar opacities and surgical chain sutures in the right mid and lower lung. interstitial markings throughout the lungs suggest interstitial edema. cardiomediastinal silhouette is unchanged, noting aortic valve replacement.What are the key findings of this report? [/INST] new right ij line in appropriate position. no pneumothorax. </s>
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<s>[INST] heart size is top-normal with stable cardiomediastinal and hilar contours. the aorta is tortuous with atherosclerotic mural calcifications. bibasilar linear densities are unchanged from <unk> and likely represent scarring given their chronicity. lungs are otherwise clear without focal consolidation. there is no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] stable bibasilar linear scarring without evidence of pneumonia. </s>
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<s>[INST] there are no significant changes since the prior cxr performed <unk>. unchanged appearance of neoesophagus. linear atelectasis is noted at the right lung base. stable appearance of small right pleural effusion. tiny left pleural effusion has largely resolved. the lungs are otherwise free of focal consolidations or pneumothorax. no pulmonary edema. cardiomediastinal silhouette is within normal limits. surgical clips are noted in the left upper quadrant.What are the key findings of this report? [/INST] stable small right pleural effusion. left effusion has largely resolved. no acute intrapulmonary process. </s>
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<s>[INST] pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>
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<s>[INST] the lungs remain relatively hyperinflated. mild biapical pleural thickening is again seen. no focal consolidation, pleural effusion, or evidence of pneumothorax is seen. the cardiac and mediastinal silhouettes are stable and unremarkable. overall, there has been no significant interval change.What are the key findings of this report? [/INST] no significant interval change. no acute cardiopulmonary process. </s>
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<s>[INST] pa and lateral views of the chest were provided. there is no focal consolidation, effusion, or pneumothorax. there is mild prominence of the central pulmonary hilar vasculature, which could indicate mild congestion. cardiomediastinal silhouette is stable. bony structures are intact.What are the key findings of this report? [/INST] possible mild central congestion. no signs of pneumonia. </s>
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<s>[INST] right infrahilar opacity with partial obscuring of the right heart border is perhaps similar to <unk> but slightly worse compared to <unk>, suggesting ongoing aspiration and and/or pneumonia. retrocardiac opacity with silhouetting of the lateral border of the thoracic aorta as well as left hemidiaphragm is overall unchanged to slightly improved compared to the prior exam and may reflect atelectasis and/or consolidation. the heart is top-normal in size, unchanged. lung volumes are slightly low and prominence of the pulmonary vessels may be secondary to crowding effect. the right hemidiaphragm is elevated and may suggest some component of right lower lung atelectasis. no pneumothorax. no pleural effusion.What are the key findings of this report? [/INST] increased infrahilar opacity concerning for ongoing aspiration pneumonia. </s>
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<s>[INST] the patient is status post median sternotomy. cardiac silhouette size remains mildly enlarged. the aorta is tortuous. moderate size hiatal hernia is again noted. hilar contours are within normal limits, and pulmonary vasculature is not engorged. streaky atelectasis is seen in the lung bases without focal consolidation. lungs are hyperinflated of suggestive of underlying copd. no pleural effusion or pneumothorax is present. compression deformity at the thoracolumbar junction is unchanged, and partially imaged is posterior fusion hardware within the lumbar spine.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. moderate size hiatal hernia. </s>
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<s>[INST] a left port-a-cath tip is in the mid svc. there is no pneumothorax or focal consolidation, pleural effusion. cardiomediastinal silhouette is normal. there are no acute skeletal abnormalities.What are the key findings of this report? [/INST] left chest port catheter tip in the mid svc. these findings were reported to <unk>, rn by dr. <unk> <unk> telephone at <time>pm. </s>
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<s>[INST] cardiac, mediastinal and hilar contours are normal. a patchy opacity is noted in the retrocardiac region, new in the interval, which may reflect an area of infection. the right lung is clear. no pleural effusion or pneumothorax is identified. no acute osseous abnormalities seen.What are the key findings of this report? [/INST] new patchy retrocardiac opacity concerning for infection. </s>
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<s>[INST] the patient is rotated. otherwise, no significant interval change. no focal consolidation, effusion, edema, or pneumothorax. the cardiomediastinal silhouette is unchanged. mild aortic knob calcifications are also unchanged.What are the key findings of this report? [/INST] no significant interval change. no evidence of pneumomediastinum or pneumothorax post bronchoscopy. </s>
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<s>[INST] there is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. blunting of the left costophrenic angle on the lateral view suggests chronic pleural thickening rather than small effusion. the cardiomediastinal silhouette is within normal limits.What are the key findings of this report? [/INST] no evidence of acute cardiopulmonary process. </s>
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<s>[INST] portable semi-upright frontal chest radiograph demonstrates an endotracheal tube tip located at least <num> cm from the level of the carina. a left subclavian central venous catheter tip is at the confluence of the svc and brachiocephalic vein, with its tip projecting laterally against the wall of the svc. an ng tube is in place, superimposed on the stomach, though the tip is not seen off the inferior margin of the film. low lung volumes are slightly decreased with bibasilar opacities and bilateral pleural effusions, right greater than left. mild edema is unchanged. calcified mitral valve annulus is again noted.What are the key findings of this report? [/INST] <num>. unchanged mild edema, bibasilar atelectasis and bilateral pleural effusion. <num>. left subclavian central venous catheter tip projects against the wall of the svc, and repositioning is suggested to prevent erosion of the catheter tip through the wall. </s>
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<s>[INST] et tube ends at <num> cm from carina. it can be withdrawn at least <num> cm. right ij catheter ends in lower svc. left lung base pigtail is unchanged since prior chest x-ray. as compared to yesterday, the bilateral pulmonary edema is unchanged in the right lung, but minimally improved in the left lung. there is no pleural effusion on the left, but small on the right. cardiomediastinal silhouette is unchanged and normal.What are the key findings of this report? [/INST] the bilateral pulmonary edema has slightly improved to the left, but is unchanged and severe to the right. there is no pleural effusion on the left, small to the right.the et tube should be withdrawn <num> cm. </s>
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<s>[INST] the lungs are clear. the hila and pulmonary vasculature are normal. no pleural abnormalities or pneumothorax. the cardiomediastinal silhouette is unchanged.What are the key findings of this report? [/INST] no pneumonia. </s>
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<s>[INST] the cardiomediastinal and hilar contours are within normal limits. lungs are clear. there is no focal consolidation, pleural effusion or pneumothorax.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] the cardiomediastinal silhouette and pulmonary vasculature are normal. the lungs are clear. apical scarring is noted, particularly on the left, which may be the sequela of prior infection. there is no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] no pneumothorax. </s>
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<s>[INST] heart size, mediastinal and hilar contours are normal. lungs and pleural surfaces are clear. no cervical rib is visualized.What are the key findings of this report? [/INST] normal chest radiograph. </s>
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<s>[INST] lung volumes are low. there is mild bibasilar atelectasis, but no focal consolidation is identified. mild-to-moderate cardiomegaly is present but not significantly changed from prior. otherwise, cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax. remote deformity of the left distal clavicle is again noted.What are the key findings of this report? [/INST] mild-to-moderate cardiomegaly. mild bibasilar atelectasis, but no focal consolidation to suggest pneumonia. </s>
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<s>[INST] compared with the prior study, lung volumes are slightly lower. diffusely increased interstitial lung markings are again seen, compatible with known history of chronic interstitial lung disease. evaluation of the ribs is limited by overlying structures, however there does not appear to be any evidence of acute rib fracture. cardiomediastinal silhouette is unchanged since the prior study. no large effusion or pneumothorax. degenerative changes of the glenohumeral and ac joints are similar. similar appearance of the rightward deviated trachea.What are the key findings of this report? [/INST] <num>. limited evaluation of the ribs due to overlying structures. however, no definite acute rib fracture detected. <num>. re demonstration of diffusely increased interstitial lung markings, compatible with progression of known chronic interstitial lung disease. again, in the appropriate clinical setting, this may also represent atypical infection or a component of interstitial edema. </s>
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<s>[INST] compared to the study done at <time> earlier today there has been an interval decrease in the amount of pleural air at the left base and at the left apex and partial re-expansion of the left lower lobe. no other significant change from the prior exam.What are the key findings of this report? [/INST] interval re-expansion of the left lower lobe and decrease in previously seen pleural air at the left base and left apex. </s>
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<s>[INST] the lungs are well expanded and clear. hila and cardiomediastinal contours are normal. trace apical scarring is unchanged from <unk>. no pneumothorax or pleural effusion.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] again seen is hyperinflation consistent with background copd. cardiomediastinal silhouette is unchanged at the upper limits of normal or slightly enlarged. there is upper zone redistribution. there is more focal hazy opacity in the right perihilar region, similar to the chest x-ray from <unk> and similar or slightly more pronounced compared with <unk>. there is subsegmental atelectasis in the retrocardiac region, increased. there is minimal blunting of the left costophrenic angle on the ap view and, on the lateral view, a small pleural effusion is present, new compared with a lateral film from <unk>. again seen is slight pleural thickening at the left chest wall inferiorly which appears to relate to an old healed rib fracture.What are the key findings of this report? [/INST] <num>. small left pleural effusion, new compared with <unk>. <num>. upper zone redistribution, without other findings pathognomic for chf. <num>. hazy focal perihilar right perihilar opacity is probably similar to the prior films. as before, this could represent residual chf, but superimposed infection is difficult to exclude. moreover, given persistence over time, the possibility of a chronic infiltrate should also be consider. followup imaging to confirm resolution is recommended. in the absence of resolution, further assessment with ct scan would be recommended. </s>
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<s>[INST] the lungs are well expanded and clear. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] the cardiomediastinal and hilar contours are normal. in comparison to the most recent prior study, the right pleural effusion has continued to decrease in size, now small. there is no pneumothorax. linear atelectasis present at the right lung base. previously seen left retrocardiac linear atelectasis has mostly resolved. new subtle focal opacities at the right upper and mid lung are present.What are the key findings of this report? [/INST] <num>. decreased right pleural effusion, now small. <num>. new focal opacities at the right upper and mid lung which are less likely to represent atelectasis. infection cannot be excluded. dr. <unk> <unk> impression point <num> into the critical results dashboard at <time> pm on <unk>. </s>
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<s>[INST] the heart size is normal. there is mild pulmonary vascular congestion, otherwise the hilar and mediastinal contours are unremarkable. small bilateral pleural effusions are new. right middle lobe atelectasis is unchanged compared to the prior ct from <unk>. an opacity is seen in the retrocardiac region. there is no evidence of a pneumothorax. the visualized osseous structures are unremarkable. abdominal aortic stent graft is re- demonstrated.What are the key findings of this report? [/INST] <num>. patchy bibasilar opacities, which could be due to clinically suspected aspiration, although the appearance overlaps with atelectasis and infectious pneumonia. <num>. complete right middle lobe collapse. <num>. new, small bilateral pleural effusions. recommendation(s): short-term followup radiographs to assess for resolution of pulmonary findings. </s>
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<s>[INST] portable upright chest film <unk> at <time> is submitted.What are the key findings of this report? [/INST] endotracheal tube, nasogastric tube and left internal jugular central line unchanged in position. overall cardiac and mediastinal contours are stable. overall, there continues to be a diffuse bilateral airspace process but it appears to be somewhat improved suggesting resolving edema and/or an improving pneumonia. clinical correlation is advised. there is likely a layering left effusion. no pneumothorax is appreciated. </s>
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<s>[INST] small to moderate right pneumothorax persists, with apical and basilar components. improved left lower lobe atelectasis and decreased left pleural effusion. unchanged small right effusion. the left central line and right hemodialysis catheter are stable in position. the gastric tube continues to coil in the stomach. the cardiac and mediastinal contours are unchanged.What are the key findings of this report? [/INST] moderate right pneumothorax with apical and basilar components is unchanged. </s>
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<s>[INST] cardiac silhouette size is top normal. the aorta remains unfolded. mediastinal contour remains unchanged. new focal consolidative opacity is seen in the left lower lobe concerning for pneumonia. linear opacities in the right mid lung and lung base are unchanged, likely reflective of areas of scarring. emphysematous changes are again noted with bilateral pleural parenchymal scarring in the lung apices. there is no pulmonary vascular congestion, pleural effusion or pneumothorax. no acute osseous abnormality is detected.What are the key findings of this report? [/INST] left lower lobe pneumonia. recommendation(s):followup radiographs after treatment are recommended to ensure resolution of this finding. </s>
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<s>[INST] left-sided pacemaker device with leads terminating in the right atrium and right ventricle is unchanged. heart size is normal. aortic knob calcifications are present. mediastinal and hilar contours are unremarkable. bilateral breast implants are visualized. minimal blunting of the left costophrenic angle on the lateral view is unchanged, and could reflect chronic pleural thickening. no focal consolidation, pleural effusion or pneumothorax is otherwise demonstrated. there are mild multilevel degenerative changes. remote fracture of the left <num>th rib posteriorly is again seen.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] since prior radiograph, the lung volumes are increased; however, there appears to be increased bilateral diffuse opacities likely due to pulmonary edema. a more focal consolidation at the right base is concerning for atelectasis or possible aspiration. et tube is <num> cm from the carina. ng tube is seen coursing below the diaphragm. no pneumothorax. cardiomediastinal silhouette is unchanged.What are the key findings of this report? [/INST] interval worsening of bilateral diffuse opacities in the setting of increased lung volumes is concerning for worsening pulmonary edema. also focal opacity at the right base may represent aspiration. these findings were discussed with dr. <unk> by dr. <unk> <unk> telephone at <num> p.m. </s>
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<s>[INST] the <unk> radiograph from <time> shows increased near-complete opacification of the left hemithorax. two left chest tubes remain in place. the aerated right lung is grossly clear. the heart and mediastinum cannot be accurately assessed. the followup radiograph from <time> shows slightly increased gaseous distension of the stomach, and no other significant interval change. the <unk> radiograph shows decreased gaseous distention of the stomach, and no other relevant change.What are the key findings of this report? [/INST] increased near complete opacification of the left hemithorax, which is likely due to a combination of worsening atelectasis or increased large pleural effusion. </s>
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<s>[INST] pa and lateral views of the chest provided. the appearance of the chest is unchanged with mild reticular opacities which could reflect mild edema or underlying fibrosis. no large effusion or pneumothorax. no convincing signs of pneumonia. cardiomediastinal silhouette appears normal. external artifact projects over the right shoulder. bony structures appear intact.What are the key findings of this report? [/INST] scattered bilateral reticular opacities raise concern for mild edema versus mild fibrosis. overall appearance is unchanged. </s>
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<s>[INST] pa and lateral chest views were obtained with patient in upright position. analysis is performed in direct comparison with the next preceding ap single view chest examination of <unk>. on the present examination, the heart size is unchanged and within normal limits. no configurational abnormality is present. the pulmonary vasculature is not congested. the on previous single view chest examination identified right lower lobe area hazy infiltrate has disappeared. no new abnormalities are seen in the right hemithorax. on the other hand, there is now a smaller hazy infiltrate on the left-sided lung base and the lateral view suggests it is located in the periphery of the left upper lobe lingula abutting the heart border. no development of pleural effusions and no pneumothorax in the apical area.What are the key findings of this report? [/INST] regression of previously identified right lower lobe infiltrate but development of a smaller left-sided lingula infiltrate during the same interval. considering patient's history of hiv, pcp infection is included in the diagnostic list. </s>
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