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<s>[INST] the heart size is normal. the mediastinal and hilar contours are within normal limits. the pulmonary vascularity is normal. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is present. deformity of the left <num>th rib posteriorly appears to represent a chronic fracture, though is new in the interval. no acutely displaced rib fractures are visualized.What are the key findings of this report? [/INST] no acutely displaced fractures identified. likely remote fracture of the left posterior <num>th rib. no acute cardiopulmonary abnormality. if there is continued clinical concern for an acute rib fracture, then a dedicated rib series is recommended. </s>
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<s>[INST] a right-sided picc terminates in the mid svc, unchanged in position compared the prior study. lung volumes are slightly low resulting crowding of the pulmonary bronchovascular markings and an apparent mild increase in heart size. no pneumothorax, consolidation or pleural effusion seen. visualized bony structures are unremarkable in appearance.What are the key findings of this report? [/INST] no significant interval change when compared to the prior study. </s>
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<s>[INST] median sternotomy wires are intact. heart size is normal. postoperative cardiomediastinal silhouette and hilar contours are unremarkable. no evidence of pulmonary edema. no dense consolidation to suggest pneumonia. small left-sided pleural effusion. lungs appear hyperinflated, unchanged.What are the key findings of this report? [/INST] <num>. small left-sided pleural effusion. no frank interstitial edema or evidence of pneumonia. <num>. hyperinflated lungs. </s>
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<s>[INST] the bilateral lower lobe consolidations have substantially improved. no new consolidation is identified. the patient has had median sternotomy with tricuspid and mitral valve replacement. there is no pneumothorax. moderate cardiomegaly is stable. small pleural effusions have resolved.What are the key findings of this report? [/INST] resolving bilateral lower lobe pneumonia. resolved pleural effusions. </s>
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<s>[INST] the lungs are clear. there is no evidence of pneumonia, pneumothorax, or pleural effusion. cardiac silhouette is normal in size.What are the key findings of this report? [/INST] no evidence of acute cardiopulmonary process. </s>
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<s>[INST] compared to the prior study, lung volumes are lower accentuating heart size and pulmonary vascularity. moderate to severe enlargement of the cardiac silhouette appears slightly increased from prior. the left chest wall pacemaker is in unchanged position with the lead terminating in the right ventricle. there is mild pulmonary edema which appears new from prior.What are the key findings of this report? [/INST] slightly increased cardiomegaly with new mild pulmonary edema. </s>
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<s>[INST] cardiac, mediastinal and hilar contours are normal. pulmonary vasculature is normal. minimal patchy bibasilar opacities likely reflect atelectasis. no focal consolidation, pleural effusion or pneumothorax is present. no acute osseous abnormalities detected.What are the key findings of this report? [/INST] minimal patchy opacities in the lung bases, likely atelectasis. developing infection, however, is not completely excluded in the correct clinical setting. </s>
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<s>[INST] <num> views were obtained of the chest. the lungs are well expanded and clear. there is no pleural effusion or pneumothorax. the heart is normal size with normal cardiomediastinal contours.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>
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<s>[INST] a single ap supine chest radiograph was obtained. the lungs are well expanded and clear. there is no focal consolidation, effusion, or pneumothorax. the tip of a right ij line terminates in the mid svc. aortic arch calcifications and pleural plaques are mild.What are the key findings of this report? [/INST] appropriate right ij position. no pneumothorax. </s>
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<s>[INST] there has been interval decrease in size of bilateral pleural effusions which are now small, left greater than right. bibasilar atelectasis persists, but has improved. no new consolidations or pneumothorax is detected. cardiac contour is mildly bulbous, but not enlarged. mediastinal contours are within normal limits.What are the key findings of this report? [/INST] interval decrease in size of bilateral pleural effusions, which are now small, left larger than right. </s>
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<s>[INST] as compared to prior chest radiograph, lung volumes are decreased. increased lung base opacities likely reflect progression of multifocal bronchoalveolar carcinoma. there is substantial increase of bilateral pleural effusions. evaluation of the cardiac silhouette is somewhat limited by overlying opacities. a right-sided port-a-cath catheter is in unchanged position. there is no pneumothorax.What are the key findings of this report? [/INST] <num>. increased lung base opacities likely reflect progression of multifocal bronchoalveolar carcinoma. <num>. substantial increase of small left and moderate right pleural effusions. </s>
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<s>[INST] interval intubation with the tip of the endotracheal tube tip projecting <num> cm above the carina. the gastric tube projects over the body of the stomach. increasing bilateral diffuse airspace opacities which can be seen in the setting of multifocal pneumonia and pulmonary edema. small left pleural effusion. no pneumothorax identified. the size of the cardiac silhouette is mildly enlarged.What are the key findings of this report? [/INST] increasing and diffuse bilateral airspace opacities, concerning for pulmonary edema however superimposed multifocal pneumonia cannot be excluded. </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 similar study of <unk>. the heart size remains unchanged and is normal. the patient is status post surgical intervention for a traumatic aortic injury with following pseudoaneurysm. multiple surgical clips around the area of the aortic arch. pulmonary vasculature is not congested and no new acute infiltrates can be identified. the previously described mild elevation of the left-sided hemidiaphragm and blunted lateral pleural sinus is again noted. comparison on the lateral view suggests that increasing scar formations have occurred, but there is no evidence of new acute free pleural effusion.What are the key findings of this report? [/INST] no evidence of acute pneumonia. comparison with previous examination indicates that the prominence of the aortic pseudoaneurysm has increased slightly. referring physician, <unk>. <unk> was contacted by telephone at <time> p.m. increasing prominence of previously described pseudoaneurysm warrants followup with ct angiography or consultation with surgical team performed initial repair after trauma. </s>
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<s>[INST] as compared to chest radiograph from the same day, triangular retrocardiac opacity has not substantially changed, more suggestive of left lower lobe atelectasis. linear subsegmental atelectasis also has not substantially changed. small left pleural effusion. heart size is top normal. right-sided picc terminates in the low svc. dobhoff tube is only partially imaged below the diaphragm.What are the key findings of this report? [/INST] probable left lower atelectasis and small effusion. </s>
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<s>[INST] the heart is normal in size. the mediastinal and hilar contours appear within normal limits. there is no pleural effusion or pneumothorax. the lungs appear clear. similar moderate rightward convex curvature is centered along the mid to lower thoracic spine.What are the key findings of this report? [/INST] no evidence of acute cardiopulmonary disease. </s>
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<s>[INST] the endotracheal tube has been pulled back and now ends <num> cm above the carina. the nasogastric tube ends in the stomach. left basilar opacity has almost resolved. the right lung is clear. there is no pneumothorax or pleural effusion. the aortic knob is calcified. the heart size is normal.What are the key findings of this report? [/INST] <num>. the endotracheal and nasogastric tube are now in appropriate position. <num>. the left retrocardiac opacity has almost resolved. </s>
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<s>[INST] pa and lateral views of the chest demonstrate the lungs are well expanded and clear. the cardiomediastinal silhouette is unremarkable. there is no pleural effusion, pulmonary edema, pneumothorax, or focal airspace opacity.What are the key findings of this report? [/INST] no acute cardiopulmonary pathology. </s>
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<s>[INST] compared with prior radiographs on <unk>, there has been interval loosening of one screw in the upper sternum. the sternum has overall improved alignment compared with prior. the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.What are the key findings of this report? [/INST] interval loosening of one screw in the upper sternum, with overall improved alignment of the sternum compared with prior. </s>
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<s>[INST] a calcified right breast prosthesis is noted. right-sided central venous catheter tip terminates in the mid svc. heart size is normal. mediastinal and hilar contours are unremarkable. small right pleural effusion is noted. no focal consolidation, pulmonary vascular engorgement, or pneumothorax is identified. right posterior <unk> and <num>th rib fractures are minimally displaced. clips are seen in the right upper quadrant compatible with prior nephrectomy. l<num> compression deformity is chronic.What are the key findings of this report? [/INST] <num>. mildly displaced right posterior <unk> and <num>th rib fractures. <num>. small right pleural effusion. no pneumothorax. </s>
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<s>[INST] ap single view of the chest has been obtained with patient in semi-upright position. comparison is made to the next preceding similar study dated <unk>. the findings on this portable chest examination are unaltered. previously identified right internal jugular approach central venous line remains in unchanged position. cardiomegaly as before. hazy densities over the lung bases persist. the pulmonary vasculature remains congested with marked perivascular haze as before. no pneumothorax is seen.What are the key findings of this report? [/INST] persistent findings compatible with chf, no significant improvement during the latest one day interval. </s>
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<s>[INST] heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. apart from minimal left basilar subsegmental atelectasis, the 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] there is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. the cardiomediastinal contour is normal. <num> small granulomas in the right lung base are stable from <unk>.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] pa and lateral chest radiographs demonstrate a normal cardiomediastinal contour with a heart which is top-normal in size, unchanged. lungs are fairly well-aerated, without focal consolidation, pleural effusion, or pneumothorax. the visualized upper abdomen is unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] the lungs are well expanded and clear. there is no pleural effusion or pneumothorax. the heart is normal in size with normal cardiomediastinal contours aside from prominence of the right mediastinal border which is due to a tortuous brachiocephalic vein as shown on previous chest cts.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>
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<s>[INST] there is persistent hyperinflation of the lungs and bullous emphysema of the upper lung fields, with flattened hemidiaphragms consistent with severe copd. scarring at the left lower lobe is unchanged. no evidence of focal lung consolidation. no pleural effusion or pneumothorax. the cardiomediastinal silhouette is unremarkable.What are the key findings of this report? [/INST] severe bullous emphysema has not changed since the prior study. no new focal consolidation concerning for pneumonia. </s>
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<s>[INST] frontal and lateral chest radiographs demonstrate low lung volumes, which resulted in a heart which is top normal in size. the cardiomediastinal is normal. the lungs are clear without pulmonary edema or focal consolidation. old left lateral rib fractures are noted, with adjacent pleural thickening. there is no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] no evidence of pneumonia. </s>
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<s>[INST] the endotracheal tube terminates <num> cm above the carina. the enteric tube is seen terminating below left hemidiaphragm. lung volumes are markedly low with atelectasis in the lower lungs. the heart appears enlarged though poorly assessed. the upper lungs appear well aerated. there is dextroscoliosis of thoracic spine, otherwise bones soft tissue structures are unremarkable. the trachea is midline.What are the key findings of this report? [/INST] <num>. endotracheal tube terminates <num> cm above the carina. <num>. enteric tube is seen below the left hemidiaphragm. <num>. bibasilar atelectasis. </s>
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<s>[INST] ap single view of the chest has been obtained with patient in semi-upright position. comparison is made with the next preceding similar study obtained on <unk>. the patient remains intubated, the ett terminating in the trachea some <num> cm above the level of the carina. comparison with the next preceding study, a right-sided lateral chest wall approach small caliber pigtail terminating terminating chest tube has been placed. drainage of the pleural effusion must have been effective as the previously existing right-sided density has decreased markedly so that the right-sided diaphragm can now be identified. the lateral pleural sinus, however, appears still to be mildly blunted. there is no evidence of pneumothorax on either side in the apical area. some degree of perivascular haze exists in both lungs, similar as before.What are the key findings of this report? [/INST] appropriate placement of pigtail chest tube right base with effective elimination of previously existing pleural effusion. </s>
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<s>[INST] single portable view of the chest. no prior. low lung volumes are seen. there is increased density projecting over the first right anterior costochondral cartilage. this could be potentially due to degenerative changes; however, given asymmetry, two-view chest x-ray suggested when patient is amenable. otherwise, lungs are grossly clear. cardiomediastinal silhouette is within normal limits. osseous and soft tissue structures are unremarkable. no free air is seen below the diaphragm.What are the key findings of this report? [/INST] no acute cardiopulmonary process. nodular density projecting over the right first costochondral cartilage area, potentially degenerative; however, two-view chest x-ray recommended on a nonurgent basis to exclude underlying lung lesion. findings were communicated to scrub nurse in the o.r. with dr. <unk> at <time> p.m. on <unk>. </s>
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<s>[INST] the lungs are clear. there is no effusion, consolidation, edema or pneumothorax. cardiomediastinal silhouette is within normal limits. hardware is identified within the right humeral head. surgical clips noted in the upper abdomen.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 unremarkable. the lungs are clear. there is no pleural effusion or pneumothorax. again noted is minimal scoliosis of the thoracic spine.What are the key findings of this report? [/INST] no acute intrathoracic abnormality. </s>
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<s>[INST] patient is rotated to the left. within this limitation, the lungs are clear. left chest wall dual lead pacing device is again noted. the cardiomediastinal silhouette is grossly unchanged. anterior flowing osteophytes along the spine suggests dish. degenerative changes are seen at the shoulders bilaterally.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. streaky lingular opacity likely reflects atelectasis. the remainder of the lungs are clear. no pleural effusion or pneumothorax is seen. blunting of the left costophrenic angle is chronic and may represent pleural thickening. there are no acute osseous abnormalities. remote left-sided rib fracture is noted.What are the key findings of this report? [/INST] mild lingular atelectasis. </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] biapical scarring is noted. linear opacity at the left lung base is most suggestive of atelectasis and likely scarring. the lungs are otherwise clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities identified.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] the lung volumes are low-normal. there are no consolidation, opacities, masses, pneumothorax, or pleural effusion appreciated. the cardiomediastinal silhouette and hilar silhouettes are normal size. the heart size is top-normal. there is no acute bony abnormality nor evidence of acute fracture.What are the key findings of this report? [/INST] <num>. no acute cardiopulmonary process. no radiographic evidence of acute nor latent tb. </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 are well inflated and clear. the cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. there is no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] portable ap semi-upright view of the chest provided. dialysis catheter is in unchanged position. aicd is in unchanged position. midline sternotomy wires are again seen. the heart remains mildly enlarged. there are no definite signs of infection or pulmonary edema. mediastinal contour appears stable. bony structures are intact.What are the key findings of this report? [/INST] mild cardiomegaly. tubes in appropriate position. no overt edema or signs of pneumonia. </s>
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<s>[INST] pa and lateral views of the chest provided. mild pulmonary edema is again noted. there is no large pleural effusion seen. the heart and mediastinal contour is stable with atherosclerosis of the unfolded thoracic aorta. patient's chin obscures the lung apices partially. the bony structures appear intact. kyphotic angulation of the t-spine again noted.What are the key findings of this report? [/INST] mild interstitial pulmonary edema. </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] cardiopulmonary process. </s>
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<s>[INST] frontal and lateral views of the chest demonstrate no signs of pneumonia or chf. no effusion or pneumothorax. no free air below the right hemidiaphragm is seen. cardiomediastinal silhouette is normal. bony structures are intact.What are the key findings of this report? [/INST] no acute findings to account for patient's right upper quadrant pain. </s>
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<s>[INST] small bilateral pleural effusion. mild cardiomegaly. no overt pulmonary edema. mild dependent atelectasis. prior bilateral shoulder hemi arthroplasties.What are the key findings of this report? [/INST] small bilateral pleural effusions and mild dependent atelectasis </s>
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<s>[INST] ap and lateral views of the chest. right central venous line is no longer seen. the lungs are clear. there is no effusion or consolidation. the cardiomediastinal silhouette is within normal limits and notable for median sternotomy wires and mediastinal clips. no acute osseous abnormality detected. calcification seen adjacent to the right greater tuberosity, potentially calcific tendinitis or bursitis.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] the heart is normal in size. the mediastinal and hilar contours appear within normal limits. there is no pleural effusion or pneumothorax. the lungs appear clear. surgical clips project over the left axillary region. bony structures are unremarkable.What are the key findings of this report? [/INST] no evidence for acute cardiopulmonary disease or suspicious radiographic findings. </s>
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<s>[INST] heart size is mildly enlarged. the mediastinal and hilar contours are unremarkable. the pulmonary vasculature is normal. the lungs are clear. no pleural effusion or pneumothorax is present. no acute osseous abnormalities identified.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] tiny right apical pneumothorax, similar. probable tiny left apical pneumothorax, decreased. sternotomy. right ij central line tip in the low svc. heart is enlarged, improved. borderline pulmonary vascularity, improved. there are tiny pleural effusions, improved on the left, more apparent on the right. minimal basilar atelectasis, improved. chronic left clavicle fracture. minimal retrosternal pneumomediastinum, in keeping with recent surgery.What are the key findings of this report? [/INST] tiny right apical pneumothorax, similar. tiny pleural effusions </s>
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<s>[INST] a right apical pigtail catheter has been placed with interval re-expansion of the right pneumothorax, which is small in size. a tiny left apical pneumothorax is stable. a small amount of pneumopericardium and moderate right chest wall subcutaneous emphysema are not appreciably changed. the lungs are clear.What are the key findings of this report? [/INST] status post placement of right apical pigtail catheter with re-expansion of the right lung and decrease in small right apical pneumothorax. otherwise no significant interval change. </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 normal. no acute osseous abnormalities identified.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] portable upright chest radiograph demonstrates low lung volumes with moderate bilateral pleural effusions. a left chest tube has been placed in the interim, with resultant decrease in size of left pleural effusion. airspace opacity in the left lower lobe likely reflects reexpansion pulmonary edema. the cardiac silhouette and mediastinal contours are notable for a known anterior mediastinal mass. there is no pneumothorax.What are the key findings of this report? [/INST] interval left chest tube placement with decrease in size of left pleural effusion and resultant reexpansion edema in the left lower lobe. there is a right moderate pleural effusion remains. </s>
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<s>[INST] there is massive cardiomegaly present. pacemaker is in unchanged position. no significant effusion. ct localization peribronchial cuffing is noted consistent with some congestive change. no good evidence of pneumonia.What are the key findings of this report? [/INST] no good evidence of a pneumonia. some congestive changes suggested although some of this may reflect the technique </s>
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<s>[INST] the patient is status post median sternotomy and cabg. a right internal jugular central venous catheter tip terminates in the mid/low svc. heart size remains mild to moderately enlarged. mediastinal and hilar contours are normal. no pulmonary edema is demonstrated. there is minimal atelectasis in the right lung base. no focal consolidation, or pneumothorax is identified. minimal blunting of the costophrenic angles bilaterally suggests trace bilateral pleural effusions.What are the key findings of this report? [/INST] central venous catheter tip in the mid/low svc. no pneumothorax. trace bilateral pleural effusions. </s>
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<s>[INST] there has been interval intubation with endotracheal tube tip projecting approximately <num> cm above the carina. an esophageal catheter courses below the diaphragm with tip projecting over the left upper quadrant, likely within the stomach. there is a large left pleural effusion and small right pleural effusion, as seen previously, with underlying left lower lung consolidation. no pneumothorax is detected on this single supine view. pulmonary vascular prominence persists without radiographic evidence for overt pulmonary edema. heart size is difficult to evaluate in the setting of overlying pleural effusion.What are the key findings of this report? [/INST] interval intubation and placement of an esophageal catheter in standard positions. </s>
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<s>[INST] lung volume is low. there is no consolidation, pneumothorax, or large pleural effusion. cardiomediastinal silhouette is normal size. there is no pulmonary edema.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. no pulmonary edema is seen.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] since the chest radiograph obtained <num> day prior, there has been interval removal of an ng tube and placement of the dobhoff tube, which terminates in the expected location of the gastric body. lung volumes are low, but otherwise clear without focal consolidation. heart size and cardiomediastinal borders are unchanged. there are no pleural effusions.What are the key findings of this report? [/INST] a dobhoff tube terminates within the gastric body. </s>
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<s>[INST] tracheostomy tube is unchanged in position. a right-sided picc line is unchanged in position with the tip overlying the upper svc. the moderate to large left pneumothorax has increased in size from the preceding chest radiographs, now with a basal component (previously only apical). a left pleural effusion is decreased in size from the preceding study. known emphysema is unchanged. the cardiac silhouette is top normal in size. the hilar and mediastinal contours are stable. a peg tube is noted in the left upper abdomen. large retrocardiac atelectasis is unchanged.What are the key findings of this report? [/INST] increased moderate to large left pneumothorax with decreased small left pleural effusion. findings were discussed by dr. <unk> with dr. <unk> by phone at <time> p.m. on <unk>. </s>
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<s>[INST] the heart size is mildly enlarged. lung volumes are slightly low. mediastinal and hilar contours are within normal limits. there is crowding of bronchovascular structures without pulmonary edema. patchy opacities in the lung bases likely reflect areas of atelectasis, with no focal consolidation, pleural effusion or pneumothorax identified. no acute osseous abnormalities seen.What are the key findings of this report? [/INST] low lung volumes with patchy bibasilar atelectasis. </s>
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<s>[INST] portable supine chest radiograph <unk> at <time> is submitted.What are the key findings of this report? [/INST] the right internal jugular swan-ganz catheter has been substantially pulled back and now has its tip in the pulmonary outflow tract. the left internal jugular central line is unchanged in position. nasogastric tube is seen coursing below the diaphragm with the tip not identified. the intra-aortic balloon pump has its tip only <num> cm below the top of the aortic knob. overall, the lungs appear clear with continued resolution of interstitial and pulmonary edema. there are likely very small bilateral pleural effusions. overall cardiac and mediastinal contours are unchanged. </s>
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<s>[INST] the lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. cardiac and mediastinal silhouettes are normal. no acute fractures are identified. surgical clips are noted in the right upper abdomen.What are the key findings of this report? [/INST] no acute cardiopulmonary process. rib views can be obtained for further characterization if necessary. </s>
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<s>[INST] the cardiac, mediastinal and hilar contours are within normal limits. the pulmonary vascularity is not engorged. hazy ill-defined opacity in the left lung base may reflect pneumonia. persistent branching opacity within the right upper lobe again may reflect bronchiectasis. there is no pleural effusion or pneumothorax. no acute osseous abnormality is identified.What are the key findings of this report? [/INST] hazy ill-defined opacity in the left lung base is concerning for infection. persistent branching tubular opacity in the right upper lobe, likely reflective of bronchiectasis. </s>
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<s>[INST] single ap view of the chest provided. tracheostomy tube is new. lung volumes are low. retrocardiac atelectasis and left basilar atelectasis is mild-to-moderate. no pleural effusion or pneumothorax. hilar contours are normal. minimal pneumomediastinum is new from <unk>.What are the key findings of this report? [/INST] <num>. no pneumothorax. minimal pneumomediastinum is new from <unk>. <num>. tracheostomy tube is new. </s>
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<s>[INST] lungs are fully expanded and clear. trace dependent and fissural effusions. heart size is normal. cardiomediastinal and hilar silhouettes are normal. incidental note made of a moderate hiatal hernia.What are the key findings of this report? [/INST] no focal consolidation, but trace bilateral pleural effusions. moderate hiatal hernia. </s>
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<s>[INST] enteric tube extends below the diaphragm with the tip out of view of this film. left-sided subclavian line terminates at the upper svc. the et tube is relatively low, approximately <num> cm above the carina. the left-sided pic line terminates at the left axillary vein, unchanged in position compared to the prior exam. right perihilar opacities are unchanged, however there has been an interval increase in the left perihilar opacities, which may be secondary to pneumonia or atelectasis. left sided pneumomediastinum is new. there is no large pleural effusion. the visualized osseous structures are unremarkable.What are the key findings of this report? [/INST] <num>. new pneumomediastinum. this could be secondary to barotrauma, however airway/esophageal trauma should also be trauma. <num>. stable right perihilar opacity. interval increase in left perihilar opacity, compared to the prior exam. this could be secondary to worsening atelectasis, or pneumonia. <num>. et tube is slightly low, measuring approximately <num> cm above the carina. these findings were initially discussed with dr. <unk> by dr. <unk> by phone at <unk>:<unk> a.m. on the day of the exam, and subsequently with dr. <unk> at <num>:<unk>p on the day of the exam. </s>
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<s>[INST] single portable view of the chest demonstrates mild cardiomegaly. opacities at the right lower lobe as well as retrocardiac areas are likely atelectasis. no large pleural effusion or pneumothorax. old rib deformities are noted on the left.What are the key findings of this report? [/INST] no acute process </s>
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<s>[INST] the lungs are clear. there is no focal consolidation, effusion, or edema. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.What are the key findings of this report? [/INST] normal chest x-ray. </s>
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<s>[INST] low lung volumes are somewhat improved. left infrahilar atelectasis persists. there is no focal consolidation, pleural effusion or pneumothorax. mild pulmonary edema is unchanged. heart size is moderately enlarged and exaggerated by low lung volumes. tracheostomy tube midline. dual channel dialysis catheter ends in the right atrium.What are the key findings of this report? [/INST] mildly improved low lung volumes. no evidence of pneumonia. </s>
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<s>[INST] pa and lateral views of the chest. the lungs are clear consolidation or effusion. the cardiomediastinal silhouette is within normal limits. atherosclerotic calcifications noted at the aortic arch. mild midthoracic dextroscoliosis is noted. no acute osseous abnormalities detected.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] ap view of the chest. a left internal jugular central venous line has been pulled back slightly and now ends in the upper svc. no focal consolidation. small bilateral pleural effusions are seen, and there has been decrease in previously seen left pleural effusion. no focal consolidation or pneumothorax. the cardiomediastinal and hilar contours are normal.What are the key findings of this report? [/INST] left ij central venous catheter has been pulled back and now ends in the upper svc. small bilateral pleural effusions, left pleural effusion has decreased. </s>
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<s>[INST] supine portable ap view of the chest provided. endotracheal tube is seen with its tip located approximately <num> cm above the carina. orogastric tube terminates in the left upper abdomen. the lungs are clear. cardiomediastinal silhouette is normal. no bony abnormalities.What are the key findings of this report? [/INST] et and og tubes positioned appropriately. </s>
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<s>[INST] frontal and lateral radiographs of the chest were acquired. there is re-demonstration of a left-sided pacemaker with associated right atrial and right ventricular leads, not significantly changed in position. new patchy left mid to lower lung opacities likely project over both the left upper and lower lobes on the lateral radiograph. the right lung is clear. a rounded retrocardiac opacity is redemonstrated, most consistent with a small hiatal hernia. the heart size is normal. the mediastinal contours are normal. there are no pleural effusions. no pneumothorax is seen. anterior wedging of a lower thoracic vertebral body is new compared to the prior study from <unk>. multilevel degenerative changes of the thoracic spine are noted.What are the key findings of this report? [/INST] <num>. findings concerning for left mid to lower lung pneumonia, likely involving both portions of the upper and lower lobes. recommend follow-up to resolution. <num>. compression deformity involving a lower thoracic vertebral body, new compared to the prior study from <unk>, but otherwise age indeterminate. <num>. unchanged small hiatal hernia. </s>
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<s>[INST] sternotomy wires are intact. et tube is <num> cm above level of the carina and has improved in position. left-sided surgical <unk> noted. new mild pulmonary edema and bilateral pleural effusions, moderate sized on right and small on left. new right upper lobe ovoid opacity with air bronchograms may represent aspiration pneumonia. no pneumothorax. heart size, mediastinal and hilar contours are normal.What are the key findings of this report? [/INST] <num>. new right upper lobe pneumonia likely due to aspiration. <num>. new mild pulmonary edema with new moderate-sized right pleural effusion and small left pleural effusion. results were conveyed via telephone by dr.<unk> to dr.<unk> on <unk> at <time>pm within <num> minutes of observation of findings. </s>
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<s>[INST] the lungs are clear without focal consolidation, effusion, or edema. the cardiomediastinal silhouette is stable noting moderate cardiomegaly and atherosclerotic calcifications at the aortic arch. no acute osseous abnormalities identified. surgical clips seen in the right upper quadrant and within the neck.What are the key findings of this report? [/INST] cardiomegaly without acute cardiopulmonary process. </s>
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<s>[INST] on the background of emphysema there has been minimal interval increase of bilateral diffuse reticular opacities with a perihilar predominance when compared with recent radiograph. there is a focus of more confluent consolidation in the right lower lobe. there is no pleural effusion or pneumothorax. mild-to-moderate cardiomegaly is stable.What are the key findings of this report? [/INST] <num>. confluent consolidation in the right lung base is compatible with right lower lobe pneumonia. <num>. mildly worsened pulmonary edema on the background of emphysema. <num>. bilateral upper lobe nodules seen on prior ct cannot be properly assessed with this examination. </s>
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<s>[INST] frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. hilar and mediastinal silhouettes are unremarkable. heart is moderately enlarged, unchanged. mild pulmonary vascular congestion is more conspicuous since prior but previous pulmomnary edema has virtually resolved.What are the key findings of this report? [/INST] chronic moderate cardiomegaly and pulmonary vascular congestion. </s>
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<s>[INST] the cardiac, mediastinal and hilar contours are normal. the pulmonary vascularity is normal. small left pleural effusion is noted with mild left basilar opacification likely reflecting atelectasis. the right lung is clear without evidence of a right-sided pleural effusion. no pneumothorax is present. there are no acute osseous abnormalities.What are the key findings of this report? [/INST] small left pleural effusion with associated left lower lobe compressive atelectasis. </s>
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<s>[INST] as compared to prior chest examination, there has been interval placement of a right-sided port-a-cath catheter with its tip terminating in the low svc. the lung volumes are decreased accentuating the bronchovascular structures. the cardiomediastinal and hilar contours are normal. there is no definite focal consolidation, pleural effusion or pneumothorax.What are the key findings of this report? [/INST] low lung volumes, however no acute cardiopulmonary process. </s>
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<s>[INST] a right-sided chest tube remains in place, though the tip has now moved inferiorly into the costophrenic sulcus. a large right-sided effusion is not significantly changed compared with <unk>. minimal aerated right lung is similar in appearance, as is chronic collapse of the right upper lobe. a moderate-to-large sized left pleural effusion has increased in the interim, with adjacent atelectasis of the basal segments of the left lower lobe.What are the key findings of this report? [/INST] only a small amount of residual aerated lung is present in the right chest. on the left, an effusion has increased in size, resulting in collapse of the basal segments of the left lower lobe. </s>
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<s>[INST] two pa and one lateral chest radiographs were obtained. compared to the prior study three days ago, there has been improved aeration of the pulmonary opacity in the left anterior lateral base. minimal atelectasis and small effusion at the right knee are unchanged. diaphragm flattening consistent with copd is unchanged. no new consolidation, effusion, or pneumothorax is present. the cardiac and mediastinal contours are normal. degenerative changes in the thoracic spine and wedge deformity of t<num> are unchanged.What are the key findings of this report? [/INST] improved aeration at the left base over the last three days. </s>
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<s>[INST] since the prior exam, the right anterior chest tube has been removed. two chest tubes remain unchanged. there is no evidence of pneumothorax. cutaneous <unk> are noted along the right chest. since prior exam the left picc tip is now pointing inferiorly in the mid svc. a right subclavian central venous catheter is also present with tip in the mid svc. an ng tube is noted with the tip below the hemidiaphragms. the side port is sitting near the gastroesophageal junction. a left pigtail catheter is in unchanged position. there is no definite pulmonary edema. probable small bilateral pleural effusions are unchanged. lung volumes remain low. opacities in the right middle, left upper, and both lower lobes are unchanged. the cardiomediastinal silhouette is stable. again noted is a mildly widened mediastinum, stable from prior exams.What are the key findings of this report? [/INST] <num>. removal of the right anterior chest tube. no evidence of pneumothorax. <num>. left picc with the tip pointing inferiorly in the mid svc. <num>. stable bilateral scattered opacities. </s>
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<s>[INST] patchy bilateral pulmonary opacities most pronounced in the right mid lung and lower left lung persist. these are unchanged. the heart and mediastinal structures are unremarkable and stable in appearance. the bony thorax is grossly intact. numerous metallic radio opacities are again projected in the region of the ge junction and upper abdomen. there is no significant change.What are the key findings of this report? [/INST] no significant interval change. </s>
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<s>[INST] since the prior cxr performed yesterday morning, has been interval removal of the endotracheal tube and enteric tube. there are new diffuse alveolar opacities, most likely pulmonary edema. engorgement of the azygous vein also confirms fluid overload. no large pleural effusions or pneumothorax. heart size is top normal.What are the key findings of this report? [/INST] <num>. interval removal of et tube and enteric tube. <num>. new mild to moderate pulmonary edema. </s>
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<s>[INST] the lungs are clear without focal consolidation, effusion, or pneumothorax. 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] the lungs are mildly hyperinflated, with flattening of the diaphragms on the lateral view. bilateral interstitial opacities are compatible with pulmonary edema, unchanged from <unk>. retrocardiac consolidation is also unchanged and is likely atelectasis. the heart remains mildly enlarged. the mediastinal and hilar contours are unremarkable. a large hiatal hernia is again noted. the aorta is diffusely calcified.What are the key findings of this report? [/INST] mild to moderate pulmonary edema, unchanged from <unk>. a followup chest radiograph after diuresis is recommended to exclude an underlying chronic lung disease and establish a new baseline. </s>
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<s>[INST] the heart size is normal. the mediastinal and hilar contours are unremarkable. lungs are clear and the pulmonary vasculature is normal. no pleural effusion or pneumothorax is present. 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 heart size is normal. the mediastinal and hilar contours are unremarkable. ill-defined multifocal opacities are noted throughout the right lung concerning for pneumonia. the left lung appears clear. minimal blunting of the right costophrenic sulcus suggests a small pleural effusion. no pneumothorax is identified. there are mild degenerative changes in the thoracic spine.What are the key findings of this report? [/INST] findings concerning for multifocal pneumonia in the right lung. probable small right pleural effusion. </s>
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<s>[INST] interval improvement of the diffuse reticular opacities. no acute focal consolidation. the cardiomediastinal silhouette is not enlarged. no pleural effusions or pneumothorax.What are the key findings of this report? [/INST] interval improvement of the diffuse reticular opacities. </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. no fractures are identified. please note that if there is continued concern for rib fracture, a dedicated rib series is suggested. </s>
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<s>[INST] pa and lateral chest views were obtained with patient in upright position. available for comparison is the next preceding portable chest examination of <unk>. the heart size remains within normal limits. no configurational abnormality is identified. thoracic aorta of ordinary <unk>. the descending aorta follows in a slight curvature the moderate degree of right-sided scoliosis observed in the thoracic spine. there are some degenerative changes in the form of osteophytic reactions at the vertebral body edges, but no vertebral body compression fracture is identified. pulmonary vasculature is not congested and there are no signs of new acute parenchymal infiltrates. lateral and posterior pleural sinuses are free. no pneumothorax exists in the apical area. in comparison with the next preceding study, the, at that time existing, left-sided port-a-cath system has been removed.What are the key findings of this report? [/INST] no evidence of acute pulmonary parenchymal infiltrates. </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 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 the prior study there is no significant interval change.What are the key findings of this report? [/INST] no change. </s>
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<s>[INST] lung volumes are normal and lungs are clear. no pleural effusion, pneumothorax or focal airspace consolidation. heart is top-normal in size but unchanged. the 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] retrocardiac opacity obscuring medial left hemidiaphragm is potentially atelectasis however infectious process cannot be excluded. patient is status post left upper lobectomy with volume loss of the left hemithorax and post surgical changes at the left hilum. chronic blunting of left costophrenic angle noted. there is no effusion or pneumothorax. the cardiomediastinal silhouette is normal. left posterior rib changes likely postsurgical. no evidence of free air below the diaphragm.What are the key findings of this report? [/INST] retrocardiac opacity obscuring medial left hemidiaphragm potentially atelectasis however infectious process cannot be excluded. consider pa and lateral chest radiograph if patient amenable. recommendation(s): consider pa and lateral chest radiograph if patient amenable. </s>
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<s>[INST] a single portable ap supine view of the chest was obtained. a right internal jugular central venous catheter terminates in the proximal right atrium. cardiomediastinal silhouette is unchanged. again seen are diffuse bilateral interstitial opacities in a predominantly nodular pattern with increased background haziness, probably representing superimposed edema. moderate bilateral pleural effusions are new. no pneumothorax.What are the key findings of this report? [/INST] <num>. diffuse bilateral interstitial nodular opacities, increased background haziness probably represents increased interstitial edema. <num>. interval development of moderate bilateral pleural effusions. </s>
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<s>[INST] there is an increase in lower lobe opacity seen best on the lateral view. the upper lung zones are clear. cardiac, mediastinal and hilar contours are normal.What are the key findings of this report? [/INST] lower lobe opacity seen on lateral view, cannot exclude early pneumonia. </s>
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<s>[INST] the lungs are clear without focal consolidation, pleural effusion or pneumothorax. there is no pulmonary edema. the heart is normal in size, and the mediastinal contours are normal.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 demonstrate a hiatal hernia with an air-fluid level visualized in the mediastinum, unchanged. there is no focal consolidation, pleural effusion, or pneumothorax. there is a hazy opacity adjacent to the hiatal hernia which may represent adjacent atelectasis. there are mild vascular calcifications of the aortic arch.What are the key findings of this report? [/INST] hiatal hernia. no acute cardiopulmonary process. </s>
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<s>[INST] ap and lateral views of the chest. there is a right upper lung, somewhat rounded opacity as seen on previous exam. again, this remains concerning for neoplasm. the lungs are otherwise grossly clear noting some right basilar atelectasis. left chest wall single lead pacing device seen with lead tip in the right ventricular apex. cardiac silhouette is enlarged but stable in configuration. atherosclerotic calcification is seen within the aorta.What are the key findings of this report? [/INST] no definite acute cardiopulmonary process. right upper lung rounded opacity again concerning for malignancy. </s>
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<s>[INST] heart size is normal. mediastinal and hilar contours are within normal limits. lungs are clear. pulmonary vascularity is normal. no pleural effusion or pneumothorax is present. no acute osseous abnormalities are present.What are the key findings of this report? [/INST] normal chest radiograph. </s>
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<s>[INST] frontal and lateral views of the chest are compared to previous exam from <unk>. somewhat linear left basilar opacity is again seen suggestive of atelectasis. elsewhere the lungs are clear of consolidation or effusion. again seen is prominent mediastinal contour superiorly on the right, potentially due to tortuous vessels however as previously suggested nonurgent ct suggested to further characterize. degenerative changes seen at shoulders bilaterally.What are the key findings of this report? [/INST] no definite acute cardiopulmonary process. upper mediastinal contour on the right as on prior potentially due to tortuous vessels however ct scan suggested on a nonurgent basis unless already performed or if older films become available to document significant stability. </s>
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