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<s>[INST] one portable ap upright view of the chest. sternotomy wires are seen in the appropriate position. there are multiple mediastinal clips from prior cabg. bilateral peribronchial cuffing and predominantly central confluent opacities consistent with pulmonary edema has progressed compared to <unk>. there are bilateral pleural effusions, left greater than right. no pneumothorax.What are the key findings of this report? [/INST] increased pulmonary edema with bilateral pleural effusions. </s>
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<s>[INST] single portable view of the chest. left central venous catheter is no longer seen. there are bibasilar effusions, larger on the left than the right, not significantly changed. mild pulmonary vascular congestion is again noted. cardiomediastinal silhouette is essentially unchanged. no acute osseous abnormalities identified.What are the key findings of this report? [/INST] no significant interval change since prior noting left greater than right pleural effusions. underlying consolidation cannot be excluded. mild pulmonary vascular congestion. </s>
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<s>[INST] the degree of opacification of the right lung has increased, particularly in mid upper parts of the colon. in the left mid lung, there is also new patchy opacity, somewhat rounded; development of a new area of malignant involvement is not excluded. although the degree of pleural effusion, if any, on the right is difficult to assess, a component of pleural effusion is likely with atelectasis, but no definite pleural effusion is demonstrated on the left side.What are the key findings of this report? [/INST] <num>. worsening opacification of the right lung. <num>. new vague left mid lung opacity, infectious versus malignant. </s>
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<s>[INST] cardiac silhouette remains enlarged. pulmonary edema has improved with residual minimal interstitial edema remaining. patchy and linear atelectasis at left lung bases is also slightly better. small pleural effusions are probably unchanged in the interval. compression deformity at the thoracolumbar junction has been present on older studies dating back to at least <unk>.What are the key findings of this report? [/INST] improving pulmonary edema with residual mild interstitial edema remaining. </s>
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<s>[INST] portable chest radiograph demonstrates interval placement of a dobbhoff tube with tip obscured from view but well below diaphragm. of note, the dht appears to still have wire in place. in addition, there is likely coiling of the tube in the pharynx. after confirming with team placing dobbhoff, the tube was fixed to the patient's cheek at the time of x-ray and thus not draped across the neck. there is stable left picc line with tip in the mid svc. otherwise, there is a minimal improvement of the pulmonary edema with a stable small left pleural effusion. unchanged moderate cardiomegaly present. normal mediastinal and hilar contours.What are the key findings of this report? [/INST] dobbhoff tube with tip in stomach with wire still in place is likely coiled in the pharynx. per primary team, this tubing was not overlapping outside patient's neck at time of radiograph. recommend repositioning. <unk> discussed these findings with dr. <unk> at <time> p.m. on <unk> via telephone. </s>
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<s>[INST] heart size is normal. the mediastinal and hilar contours are unchanged, with a small hiatal hernia noted. . 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] ap upright and lateral views of the chest provided. mild cardiomegaly again noted. there is mild hilar congestion with interstitial pulmonary edema. no large effusion or pneumothorax. no overt signs of pneumonia though subtle pneumonia difficult to exclude in the correct clinical setting. calcific densities overlie the left scapula as on prior. degenerative changes at the right shoulder noted.What are the key findings of this report? [/INST] mild interstitial pulmonary edema. difficult to exclude a superimposed subtle pneumonia. </s>
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<s>[INST] endotracheal tube terminates approximately <num> cm above the level of the carina. enteric tube terminates left upper quadrant, in expected location of the stomach. right internal jugular central venous catheter terminates in the low svc. no pneumothorax is seen. the cardiac and mediastinal silhouettes are stable. there are low lung volumes. left mid lung subsegmental atelectasis is seen.What are the key findings of this report? [/INST] endotracheal tube terminates approximately <num> cm above the level of the carina. enteric tube terminates in the left upper quadrant, expected location of the stomach. subsegmental left mid lung atelectasis. </s>
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<s>[INST] severe cardiomegaly appears increased compared to the prior examination. indistinctness of the pulmonary vasculature suggest mild to moderate edema. limited evaluation, but apparent increased opacification of the lung bases may reflect edema, but infection is also a consideration. right greater than left pleural thickening appears similar compared to the prior examination. small bilateral pleural effusions are possible. no pneumothorax. a left pectoralis dual-chamber cardiac pacemaker and leads are unchanged in position.What are the key findings of this report? [/INST] mild to moderate pulmonary edema. coexisting infection at either lung base cannot be excluded given the limitations of this examination. dedicated pa and lateral radiographs could be considered for further evaluation. </s>
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<s>[INST] the left pleural effusion has decreased in size compared to the prior study, with unchanged adjacent compressive atelectasis. moderate right pleural effusion is unchanged. pleurx catheters are partially visualized bilaterally. a left chest port-a-cath terminates at the right atrium. right sided picc terminates in the lower svc. esophageal stent is again noted. there is no pneumothorax.What are the key findings of this report? [/INST] interval decrease in left pleural effusion. unchanged moderate right pleural effusion. bibasilar atelectasis. </s>
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<s>[INST] compared to the prior study the picc line tip is pulled back slightly with the tip in the subclavian vein not yet in svc. otherwise the appearance of the lungs are unchanged.What are the key findings of this report? [/INST] picc line with tip in the subclavian vein. </s>
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<s>[INST] the cardiomediastinal and hilar contours are within normal limits. there is minimal biapical pleural thickening. lungs are otherwise well expanded and clear. there is no focal consolidation, pleural effusion or pneumothorax. degenerative changes are noted along the lower thoracic spine.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] frontal and lateral chest radiographs demonstrate low lung volumes. no appreciable pleural effusion is identified on the right. a small pleural effusion is identified on the left with an adjacent new developing consolidation which may represent atelectasis or pneumonia. there is no overt pulmonary edema. heart size is enlarged but stable when compared to prior examination. a right internal jugular line tip is seen terminating at the level of the low superior vena cava. no pneumothorax is identified. sternotomy wires are intact.What are the key findings of this report? [/INST] small left-sided pleural effusion with adjacent consolidation concerning for developing pneumonia vs. atelectasis. these findings were communicated to the ordering physician by telephone by dr. <unk> at <time> on <unk> at the time findings were discovered. </s>
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<s>[INST] the lung volumes remain low. there is interval improvement in aeration of the left lung with decreased size of left pleural effusion from <unk> and significantly decreased from <unk>. a left pleural pigtail catheter is in similar position. a smaller right pleural effusion is unchanged. no pneumothorax is seen. there is improved but persistent mild left pulmonary edema, likely related to reexpansion. the cardiomediastinal contours are exaggerated by low lung volumes but likely within normal limits.What are the key findings of this report? [/INST] interval decreased size of left pleural effusion with improved but persistent left reexpansion pulmonary edema. </s>
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<s>[INST] no pleural effusion is seen. there is no pneumothorax. the cardiac silhouette is mild to moderately enlarged, similar to prior given differences in technique. there is pulmonary vascular congestion. no definite focal consolidation is seen.What are the key findings of this report? [/INST] pulmonary vascular congestion and persistent cardiomegaly. </s>
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<s>[INST] pa and lateral views of the chest were provided. dual-lead pacer is in unchanged position with leads extending into the region of the right atrium and right ventricle. the heart is top normal in size. linear opacities in the lower lungs are most compatible with scarring or linear atelectasis. a focal eventration of the right hemidiaphragm is again noted. no large effusion or pneumothorax. no overt signs of edema or pneumonia. mediastinal contour is stable. bony structures are intact. no free air is seen below the right hemidiaphragm.What are the key findings of this report? [/INST] linear opacities in lower lungs, most compatible with scarring or atelectasis. </s>
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<s>[INST] there are small bilateral pleural effusions with overlying atelectasis. there is interval development of diffuse increase in interstitial markings bilaterally and prominence of the hila suggesting fluid overload, new since the prior study earlier today. the cardiac and mediastinal silhouettes are stable. a large bore catheter from an inferior approach is again seen unchanged in position terminating at the inferior cavoatrial junction/right atrium.What are the key findings of this report? [/INST] small bilateral pleural effusion with overlying atelectasis. interval development of increased interstitial markings bilaterally and slight increase in prominence of the hila suggest fluid overload. </s>
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<s>[INST] frontal radiograph of the chest demonstrates unchanged moderate left pneumothorax. the position of the catheter tip is also unchanged as well as the appearance of the heart and lungs.What are the key findings of this report? [/INST] no change in appearance of moderate-sized left pneumothorax since the prior study from <time> p.m. </s>
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<s>[INST] no change in the positioning of the right-sided chest tube. right basilar atelectasis is persistent, with improved left lower lobe aeration. the heart is persistently moderately enlarged, without evidence of pneumothorax or pulmonary edema. a small to moderate right pleural effusion persists. no pneumothorax.What are the key findings of this report? [/INST] persistent small to moderate right pleural effusion and right basilar atelectasis. continued monitoring with pa and lateral radiographs, when feasible, is advised. </s>
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<s>[INST] there is no evidence of focal consolidation, pleural effusion, or pneumothorax. prominent pulmonary hilar vasculature is consistent with mild vascular congestion. the heart size continues to be mildly enlarged.What are the key findings of this report? [/INST] mild pulmonary vascular congestion with continued cardiomegaly. no focal consolidation or pleural effusion. </s>
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<s>[INST] frontal and lateral views of the chest were obtained. lungs are clear without focal consolidation. the lungs appear relatively hyperinflated. no focal consolidation, pleural effusion or evidence of pneumothorax is seen. cardiac and mediastinal silhouettes are unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. lungs appear relatively hyperinflated. </s>
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<s>[INST] the initial radiograph of <time> shows interval removal of the nasogastric tube. sternotomy wires are intact and aligned. bilateral pigtail catheters are unchanged in position. an endotracheal tube terminates at the level of the clavicles. a left ij central venous catheter terminates at the junction of the brachiocephalic vein and svc. there is no pneumothorax. moderate right and small left layering pleural effusions are slightly increased on the right. moderate cardiomegaly despite the projection is also unchanged. an unchanged retrocardiac airspace opacity may either be due to infection or atelectasis. the followup radiograph of <time> shows interval placement of a feeding tube, which enters the stomach. aeration at the left lung base continues to improve. there is no other significant interval change.What are the key findings of this report? [/INST] nasogastric tube replaced with a feeding tube, which enters the stomach. slightly improved aeration at the left lung base. otherwise no significant interval change. </s>
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<s>[INST] lung volumes are low. there is mild pulmonary edema. there is interval increase of the left retrocardiac opacity, likely representing atelectasis, but cannot rule out pneumonia. the cardiomediastinal silhouette and hila are normal. sternotomy wires are seen, as well as moderate degenerative changes at the right glenohumeral joint.What are the key findings of this report? [/INST] mild pulmonary edema and left retrocardiac opacity, likely atelectasis. </s>
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<s>[INST] the lungs are clear of focal consolidation, pleural effusion or pneumothorax. coarse interstitial markings are seen. the heart size is mildly enlarged. the mediastinal contours are normal. there is a right cardiac pacer with leads terminating in appropriate position.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] the lungs are clear besides mild left basilar atelectasis. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities, degenerative changes are noted at the ac joints bilaterally.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 provided. retrocardiac opacity is consistent with left lower lobe pneumonia. right lung is clear. cardiomediastinal silhouette is normal. no large effusion or pneumothorax. bony structures are intact. no free air below the right hemidiaphragm.What are the key findings of this report? [/INST] left lower lobe pneumonia. </s>
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<s>[INST] cardiomediastinal silhouette is within normal limits. lungs are clear. there is no pleural effusion or pneumothorax. bones are grossly unremarkable.What are the key findings of this report? [/INST] no acute intrathoracic abnormality. </s>
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<s>[INST] right pic catheter tip projects over distal svc. tracheostomy tube is in unchanged position. left subclavian central venous catheter has been removed. lung volumes are slightly increased since prior. the right lung base opacity has resolved. small left pleural effusion has decreased in size. left lung base consolidation is unchanged, most likely atelectasis. mild pulmonary edema or mild perihilar pulmonary vascular congestion persists. there is no pneumothorax. hilar and mediastinal silhouettes are unchanged. mild-to-moderate cardiomegaly is stable.What are the key findings of this report? [/INST] <num>. in comparison to <unk> exam, there is mild decrease in small left pleural effusion. <num>. left lung base consolidation, most likely atelectasis, is unchanged. <num>. right lung base opacity has largely resolved. </s>
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<s>[INST] assessment of the lungs is somewhat limited due to exclusion of the extreme left lung base laterally from the radiograph. with this limitation in mind, the imaged portions of the lungs are clear. heart size, mediastinal and hilar contours are normal. there are no pleural effusions or acute skeletal findings.What are the key findings of this report? [/INST] no radiographic evidence of pneumonia, but periphery of left lower lung has been excluded from the radiograph. if warranted clinically, the patient could return for repeat radiograph of this region at no additional charge. </s>
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<s>[INST] since <unk>, bilateral pneumothoraces, right greater than left, are appreciated. the right pneumothorax is seen <num> cm from the apex and extends laterally. the left pneumothorax is seen <num> cm from the apex. lung volumes remain low with continued bibasilar atelectasis. known right chest tube positioning is slightly changed. the cardiomediastinal silhouette is normal. worsening marked subcutaneous emphysema along the right chest wall, may be due to positioning of the chest tube.What are the key findings of this report? [/INST] <num>. interval development of bilateral pneumothoraces, right greater than left, since <unk>. <num>. worsening subcutaneous emphysema along the right chest wall may be due to chest tube positioning. </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. there has been no definite change.What are the key findings of this report? [/INST] no evidence of acute cardiopulmonary disease. </s>
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<s>[INST] the patient is status post coronary artery bypass graft surgery. the heart is at the upper limits of normal size. the mediastinal and hilar contours appear unchanged including unfolding of the thoracic aorta. the lung volumes are low. the interstitium is mildly prominent suggesting slight congestion, but there is no focal opacity, pleural effusion or pneumothorax. a vague nodular opacity projects over the right mid lung along the course of teh right posterior seventh rib. thin flowing syndesmophytes are present, and the bones are probably demineralized to some degree. surgical clips project over the right upper quadrant.What are the key findings of this report? [/INST] <num>. findings suggestive of slight congestion, but no definite pneumonia. <num>. vague density projecting over the right mid lung also overlapping with interstitial change in the course of the right posterior seventh rib. to see whether this density may persist and require evaluation as a potential nodule, when clinically appropriate, standard pa and lateral views are recommended to evaluate further. the findings and recommendations were discussed with dr. <unk> at <time> pm on the same day by telephone. </s>
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<s>[INST] frontal and lateral chest radiographs demonstrate bilateral interstitial abnormalities which have been slowly progressive on chest radiographs since <unk> and ct chest in <unk>. the azygos vein and pulmonary vessels are more prominent and mild cardiomegaly is slightly increased, suggestive of superimposed heart failure. there is no focal opacity suggestive of pneumonia. no effusion or pneumothorax is seen.What are the key findings of this report? [/INST] <num>. interstitial abnormality which has been slowly progressive on chest radiographs since <unk> and ct chest in <unk>. <num>. likely superimposed heart failure. the findings were entered into the critical communications dashboard by dr. <unk> at <unk> on <unk>. </s>
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<s>[INST] pa and lateral views of the chest were obtained. lung volumes are low. heart is normal in size and cardiomediastinal contour is unremarkable. bibasilar linear opacities likely represent atelectasis; however, developing consolidation at the right base is not excluded. a small right pleural effusion is noted on the lateral view. there is no pneumothorax.What are the key findings of this report? [/INST] <num>. low lung volumes and bibasilar atelectasis. developing consolidation at the right base, not excluded. <num>. small right pleural effusion. </s>
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<s>[INST] the heart is moderately enlarged, and there is mild pulmonary vascular congestion/edema. on the lateral view, there is increased opacity projecting over the posterior costophrenic angles. lung volumes are decreased, and no other focal consolidation or pneumothorax is seen. no large pleural effusion is seen.What are the key findings of this report? [/INST] cardiomegaly with mild pulmonary vascular congestion/edema. increased opacity projecting over the posterior costophrenic angles on the lateral view, potentially atelectasis although superimposed infection cannot be excluded. </s>
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<s>[INST] repeat ap and lateral chest radiographs demonstrate a right subclavian central venous catheter tip remains in place in the mid svc. there is a remnant right apical pneumothorax, unchanged. there is opacity near the right heart border and right lower lung. subcutaneous gas on the right thoracic wall is unchanged. the pulmonary vasculature is normal. there is a small right pleural effusion. rib fractures are not well seen.What are the key findings of this report? [/INST] <num>. small residual right apical pneumothorax. <num>. sequelae of known lacerations in the right lung, unchanged. </s>
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<s>[INST] the cardiomediastinal and hilar contours are within normal limits. lungs are well expanded and clear. there is no focal consolidation, pleural effusion or pneumothorax.What are the key findings of this report? [/INST] normal chest radiographs. </s>
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<s>[INST] new patchy and linear opacities have developed in the left lower lobe, most marked in the retrocardiac area. cardiomediastinal contours are stable in appearance, and there are no pleural effusions.What are the key findings of this report? [/INST] left lower lobe opacity, which could be due to atelectasis, aspiration or infectious pneumonia. </s>
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<s>[INST] heart is enlarged, stable. subcutaneous cardiac defibrillator. mildly increased pulmonary vascularity stable. few linear bands of atelectasis and/or scarring. widened left ac joint, may be posttraumatic or postsurgical. tiny right pleural effusion, some fluid in the right minor fissure. .What are the key findings of this report? [/INST] increased heart size, pulmonary vascularity. tiny right pleural effusion. </s>
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<s>[INST] the cardiomediastinal silhouettes are normal. the bilateral hila are unremarkable. there is a sub-optimal inspiratory effort. there is right mid lung and left lower lung atelectasis. otherwise, the lungs are clear. there is no pulmonary vascular congestion. there is no pneumothorax or pleural effusion.What are the key findings of this report? [/INST] no acute cardiopulmonary process. low lung volumes. </s>
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<s>[INST] the heart is mildly enlarged. the mediastinal and hilar contours appear unchanged. there is a reticular abnormality in the right lower lung, particularly in the right lower lobe. although interstitial opacification appears very similar on the lateral view, opacification in the right cardiophrenic angle appears somewhat increased, possibly due to a worsening underlying interstitial process. other possibilities include increasing atelectasis associated both with an eventration of the hemidiaphragm and a prominent pericardial fat pad, developing bronchopneumonia is also a possibility. there is no pleural effusion or pneumothorax. bony structures are unremarkable.What are the key findings of this report? [/INST] patchy right infrahilar opacity superimposed on previously seen interstitial lung disease. differential considerations for this appearance include worsening interstitial lung disease with or without superimposed developing pneumonia versus atelectasis associated with elevation of the right hemidiaphragm. correlation with clinical symptoms and laboratory data is recommended. short-term followup radiographs may be helpful to evaluate further if clinically indicated and if a potential source for infection is not otherwise identified. </s>
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<s>[INST] the lungs are clear. 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] doppler off tube is malpositioned, coiled just to the left of the if present. lung volumes are low. bibasilar atelectasis is mild. no pneumothorax. no mediastinal widening. heart is probably mildly enlarged. mediastinum, potentially in a tortuous esophagus or hiatal herniaWhat are the key findings of this report? [/INST] ng tube probably coiled in the distal esophagus. </s>
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<s>[INST] frontal and lateral views of the chest demonstrate low lung volumes. there are small pleural effusions, no focal consolidation or pneumothorax. hilar and mediastinal silhouettes are unchanged. the heart is mildly enlarged. there is mild pulmonary edema. stable appearance of mid thoracic vertebral body compression deformities.What are the key findings of this report? [/INST] small bilateral pleural effusions, mild cardiomegaly and pulmonary edema. </s>
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<s>[INST] right-sided picc tip terminates at the junction of the svc/proximal right atrium. the cardiac silhouette size is normal. mediastinal contours are unremarkable. there are low lung volumes with crowding of the bronchovascular structures. patchy opacities in the lung bases likely reflect areas of atelectasis. no pleural effusion or pneumothorax is seen. there are multilevel degenerative changes in the thoracic spine.What are the key findings of this report? [/INST] low lung volumes. patchy bibasilar opacities likely reflect atelectasis. </s>
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<s>[INST] no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. heart and mediastinal contours are within normal limits.What are the key findings of this report? [/INST] no radiographic evidence for acute cardiopulmonary process. </s>
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<s>[INST] continued improvement of the previously bilateral parenchymal opacities. no new focal consolidation is seen. the cardiac and mediastinal contours are unchanged. left-sided central line is unchanged in position, and the gastric tube has been removed and there is no longer seen on this radiograph.What are the key findings of this report? [/INST] continued improvement and resolution of the previously seen bilateral parenchymal opacities. </s>
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<s>[INST] upright portable radiograph of the chest demonstrates persistent elevation of the left hemidiaphragm, with low lung volumes bilaterally. there is unchanged displacement of the trachea towards the right secondary to a very tortuous intrathoracic aorta. the heart is borderline enlarged in size, unchanged since the prior study. there is no evidence of pulmonary edema. there is no evidence of subdiaphragmatic free air. no pneumothorax is present.What are the key findings of this report? [/INST] no acute cardiopulmonary process. no evidence of subdiaphragmatic free air. </s>
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<s>[INST] the lungs are clear. there is no pneumothorax. the heart and mediastinum are within normal limits. regional bones and soft tissues are unremarkable.What are the key findings of this report? [/INST] clear lungs with no evidence of pneumonia. </s>
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<s>[INST] no focal consolidation, pleural effusion, or evidence of pneumothorax is seen. the cardiac and mediastinal silhouettes are stable and unremarkable. no pulmonary edema is seen. no displaced fracture is identified.What are the key findings of this report? [/INST] no acute cardiopulmonary process. no significant interval change. </s>
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<s>[INST] heart size remains mild to moderately enlarged. the mediastinal and hilar contours are similar. pulmonary vasculature is normal. no focal consolidation, pleural effusion or pneumothorax is present. no acute osseous abnormality is visualized.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] frontal and lateral views of the chest demonstrate normal lung volumes. there is no pleural effusion, focal consolidation or pneumothorax. hilar and mediastinal silhouettes are unremarkable. heart size is normal. there is no pulmonary edema. partially limited upper abdomen is unremarkable.What are the key findings of this report? [/INST] no evidence of acute cardiopulmonary process. </s>
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<s>[INST] the lungs are clear without consolidation or edema. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] patchy left lower lobe opacity could be due to atelectasis or less likely subtle/very early pneumonia. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.What are the key findings of this report? [/INST] subtle left lower lobe opacity more likely due to atelectasis versus less likely subtle/ very early pneumonia. </s>
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<s>[INST] the lungs are normally expanded and clear. there is no focal airspace opacity or pulmonary edema. heart size is top normal. the mediastinal and hilar contours are normal. there is no large pleural effusion. there is no pneumothorax.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] the left pleural effusion has increased in size, now moderate. otherwise, there is little overall change in the right paramediastinal interstitial abnormality. normal heart size and mediastinal contours. no pneumothorax.What are the key findings of this report? [/INST] increase in size of moderate left pleural effusion. </s>
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<s>[INST] there has been interval removal of the right-sided internal jugular catheter. no pneumothorax seen. there is a small right pleural effusion. no consolidation seen. the heart is not grossly enlarged.What are the key findings of this report? [/INST] no pneumothorax seen. small pleural effusion on the right. </s>
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<s>[INST] prior left upper lobe atelectasis has resolved. there is no mild to moderate pulmonary edema. more confluent regions of opacity noted at the lung bases, right greater than left. blunting of posterior costophrenic angle suggests small effusions. there is moderate cardiac enlargement potentially progressed since prior.What are the key findings of this report? [/INST] cardiomegaly with mild to moderate pulmonary edema and small pleural effusions. more confluent right greater than left basilar opacities which could represent superimposed infection. </s>
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<s>[INST] ap portable semi upright view of the chest. endotracheal tube is seen with its tip located approximately <num> cm above the carina. the ng tube courses into the upper abdomen. there are bilateral lower lung opacities, right greater than left, new from prior concerning for multifocal pneumonia. no large effusion or pneumothorax. heart size is normal. mediastinal contour is stable. bony structures appear intact.What are the key findings of this report? [/INST] tubes positioned appropriately. multifocal pulmonary opacities concerning for multifocal pneumonia. </s>
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<s>[INST] heart size is normal. the aorta is mildly tortuous. mediastinal and hilar contours are normal and the lungs are clear. pulmonary vasculature is normal. no pleural effusion or pneumothorax is seen. there are mild multilevel degenerative changes in the thoracic spine.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] portable ap radiograph of the chest demonstrates a right-sided picc, terminating at the cavoatrial junction. additionally, there is a nasogastric tube which is seen coursing along the expected location of the esophagus and below the diaphragm, nonacute. a calcified ventriculoperitoneal shunt projects over the right hemithorax. since the prior study, there has been interval improvement in bilateral pleural effusions, although a small right pleural effusion persists. multiple vascular clips project over the left axilla and hemithorax. linear scarring along the left upper mediastinum may be due to prior radiation fibrosis. there is no evidence of pneumothorax. the bilateral hemidiaphragms are flattened, consistent with emphysematous change. hazy opacification within the right lung base as well as the left lung base is likley due to atelectasis.What are the key findings of this report? [/INST] bibasilar atelectasis and slight interval improvment in extent of right pleural effusion since the prior study. no evidence of pneumonia. </s>
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<s>[INST] frontal and lateral views of the chest were obtained. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. cardiac and mediastinal silhouettes are unremarkable. no displaced fracture is seen. 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] the lungs are clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities identified. air-filled distended loops of bowel likely colon visualized in the abdomen. no free intraperitoneal air.What are the key findings of this report? [/INST] no acute cardiopulmonary process. moderately distended loops of bowel seen in the abdomen forage clinical correlation suggested. </s>
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<s>[INST] a right ij central venous catheter terminates in the distal svc, unchanged. bilateral airspace opacities have improved, with significantly decreased right costophrenic angle opacification, possibly representing a small effusion. there is no pneumothorax. moderate cardiomegaly is unchanged. median sternotomy wires and prosthetic valves project in unchanged location.What are the key findings of this report? [/INST] interval improvement in bilateral airspace opacities, small opacity in the right costophrenic angle may represent a small right pleural effusion. </s>
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<s>[INST] frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs without focal consolidation, pleural effusion, or new thorax. the visualized upper abdomen is unremarkable. no picc is visualized.What are the key findings of this report? [/INST] no picc visualized. normal chest radiograph. </s>
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<s>[INST] there is interstitial pulmonary edema, which has worsened in comparison to prior chest radiograph. there is a left retrocardiac opacity with silhouetting of the diaphragm and air bronchograms. heart size is stable. the mediastinal and hilar contours are stable. no pneumothorax is seen. again visualized is a calcified mitral annulus.What are the key findings of this report? [/INST] <num>. left retrocardiac opacity with air bronchograms, which likely represents atelectasis, although underlying pneumonia cannot be ruled out. <num>. worsening interstitial pulmonary edema. </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] normal chest x-ray. </s>
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<s>[INST] the lungs are well inflated and clear. the cardiomediastinal silhouette, hilar contours, and pleural surfaces are within normal limits. there is no pleural effusion or pneumothorax. left shoulder hardware is noted.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] the lungs are clear without effusion or pneumothorax. the cardiac silhouette is normal in size, the mediastinal contours are normal. there is no displaced rib fracture. if there is concern for rib injury, recommend repeat dedicated views with bb marker to mark the site of pain.What are the key findings of this report? [/INST] no acute chest pathology. </s>
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<s>[INST] since <unk>, substantial pulmonary edema is improved, small bilateral pleural effusions are presumed, mild bibasilar atelectasis and severe cardiomegaly is unchanged. lung volumes remain low. no pneumothorax.What are the key findings of this report? [/INST] substantial pulmonary edema is improved, small bilateral pleural effusions are presumed, and severe cardiomegaly is unchanged since <unk>. </s>
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<s>[INST] there are median sternotomy wires which appear intact. there are surgical clips projecting over the mediastinum. lung volumes are somewhat low, and there is prominence of the pulmonary vasculature without frank pulmonary edema. there is no focal airspace opacity. there is no pleural effusion or pneumothorax. given ap technique, the heart size is likely normal. there are significant degenerative changes at the ac and glenohumeral joints bilaterally.What are the key findings of this report? [/INST] <num>. persistent pulmonary vascular congestion without frank pulmonary edema. <num>. no focal airspace opacity to suggest pneumonia. </s>
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<s>[INST] ap upright and lateral views of the chest provided. no radiopaque foreign bodies seen within the imaged field. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. pectus excavatum deformity of the sternum is noted. no free air below the right hemidiaphragm is seen.What are the key findings of this report? [/INST] no acute intrathoracic process. no radiopaque foreign body in the imaged soft tissues. </s>
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<s>[INST] the lungs are clear. there is no effusion or pneumothorax. the cardiomediastinal silhouette is within normal limits. there is no visualized pneumomediastinum. there is no free air below the diaphragm. radiopaque foreign body compatible with a straightened safety pin seen in the anterior soft tissues of the upper abdomen, projecting superiorly. surgical clips seen along the anterior abdominal wall.What are the key findings of this report? [/INST] straightened safety pin seen in the anterior subcutaneous tissues, projecting superiorly. although no free intraperitoneal air is identified, the depth of the pin is uncertain and intraperitoneal extension cannot be excluded. </s>
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<s>[INST] the expected location of right midline in the right upper arm is not included in the frontal view and is not well evaluated on the lateral view. . the heart is not enlarged. no chf, focal infiltrate, effusion, or pneumothorax is detected. no catheter or other line is seen over the chest itself. possible mild scoliosis in the upper thoracic spine.What are the key findings of this report? [/INST] the expected location of a midline catheter (upper arm) is not effectively included on this examination. in order to image a midline catheter in conventional placement, images should include the upper arm/humerus and axilla. no catheter seen within the chest. no acute pulmonary process identified. </s>
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<s>[INST] frontal and lateral views of the chest were obtained. the heart is of normal size with normal cardiomediastinal contours. the aorta is tortuous with scattered calcifications. the lungs are clear without focal consolidation. no pleural effusion or pneumothorax. emphysema is noted, but with low lung volumes. severe bilateral glenohumeral osteoarthritic changes are again seen.What are the key findings of this report? [/INST] emphysema. no acute cardiopulmonary process. </s>
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<s>[INST] cardiac silhouette size is normal. the mediastinal and hilar contours are unchanged. there is no pulmonary vascular congestion. lungs are clear. 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 process. </s>
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<s>[INST] the lung volumes are low. the cardiac, mediastinal and hilar contours appear unchanged. there is streaky left mid to lower lung opacification which suggests atelectasis. this appearance blurs the left costophrenic sulcus, making it difficult to exclude a small pleural effusion. there is no evidence for pleural effusion on the right.What are the key findings of this report? [/INST] streaky left mid-to-lower lung opacities, which are probably compatible with atelectasis. if pulmonary symptoms are present or there is other clinical concern for pneumonia, then short-term followup pa and lateral radiographs could be considered to evaluate further. </s>
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<s>[INST] the patient is status post median sternotomy and valve replacement. mild cardiomegaly is present. right-sided pacemaker device is noted with leads terminating in the region of the right atrium and right ventricle. widening of the superior mediastinal contour is noted, which could be due to low lung volumes and the presence of mediastinal fat. there is crowding of bronchovascular structures with mild pulmonary vascular congestion noted. patchy retrocardiac opacity likely reflects atelectasis. no large pleural effusion or pneumothorax is seen. there are no displaced fractures identified.What are the key findings of this report? [/INST] mild pulmonary vascular congestion with patchy retrocardiac opacity likely reflecting atelectasis. widening of the superior mediastinal contour may be related to low lung volumes; comparison with prior radiographs would be helpful, if there is continued concern for acute traumatic injury within the chest, a chest ct is recommended. </s>
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<s>[INST] diffuse increased interstitial markings are again seen suggesting vascular congestion. there is no confluent consolidation, effusion or pneumothorax. cardiomediastinal silhouette is stable. median sternotomy wires are again noted. no acute osseous abnormalities.What are the key findings of this report? [/INST] pulmonary vascular congestion. </s>
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<s>[INST] ap portable supine view of the chest. tracheostomy tube projects over the superior mediastinum. there is a layering small left pleural effusion. right lung is clear. no overt signs of edema or pneumonia. cardiomediastinal silhouette is normal. no supine evidence for pneumothorax. bony structures appear intact.What are the key findings of this report? [/INST] small layering left pleural effusion. </s>
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<s>[INST] compared with prior chest radiograph and chest cta, there is an apparent increase in opacification of the left lower lobe and associated small pleural effusion. the right basilar opacity is not significantly changed from prior and is known to represent metastatic disease. cardiomediastinal and hilar contours are unremarkable. there is no pneumothorax. the port-a-cath catheter ends in the right atrium in unchanged position.What are the key findings of this report? [/INST] new left basilar opacity with associated small pleural effusion may represent pneumonia. right basilar consolidation is known to represent metastatic disease and is unchanged from 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 acute cardiopulmonary abnormality. </s>
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<s>[INST] left-sided aicd device is noted with single lead terminating within the right ventricle. the heart size is mildly enlarged. mediastinal and hilar contours are unremarkable. there is no pulmonary edema, focal consolidation, pleural effusion or pneumothorax. no acute osseous abnormalities are present. there is mild scarring within the lung apices.What are the key findings of this report? [/INST] mild cardiomegaly without evidence of congestive heart failure or pneumonia. </s>
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<s>[INST] pa and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. cardiomediastinal silhouette is normal. bony structures are intact. no free air below the right hemidiaphragm.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>
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<s>[INST] again seen is a left chest port-a-cath with distal tip projecting over the mid/low svc. lung volumes are slightly low. allowing for changes due to this, the cardiomediastinal silhouettes are stable and within normal limits. the bilateral hila are unremarkable. the lungs are clear without focal consolidation. there is no evidence of pulmonary vascular congestion. there is no pneumothorax or pleural effusion.What are the key findings of this report? [/INST] no acute cardiopulmonary process. no significant interval change compared to the prior study. </s>
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<s>[INST] frontal and lateral views of the chest are compared to previous portable film from <unk> and ct abdomen and pelvis from <unk>. there is blunting of the right lateral costophrenic angle which is unchanged and likely in part due to extrapleural fat and possible pleural thickening which is partially visualized on prior ct abdomen. the lungs are otherwise clear. there is no definite pleural effusion. cardiomediastinal silhouette is within normal limits. previously seen left-sided tunneled ij line is no longer visualized. osseous and soft tissue structures are unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] the lung volumes are somewhat low, with elevation of the left hemidiaphragm with a large gastric bubble and air-filled loops of bowel in the left upper quadrant. mild atelectasis is present at the left lung base. the heart is top-normal in size, and right mediastinal. fullness is likely due to enlargement of the ascending thoracic aorta. there is no pleural effusion, pneumothorax, pulmonary edema, or focal consolidation. no displaced rib fractures are identified.What are the key findings of this report? [/INST] no evidence of pneumonia or displaced rib fracture. likely enlargement of the ascending thoracic aorta. </s>
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<s>[INST] frontal and lateral views of the chest were obtained. dual-lead left-sided pacemaker is again seen with leads extending to the expected positions of the right atrium and right ventricle. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. cardiac and mediastinal silhouettes are stable. degenerative changes are again seen along the spine.What are the key findings of this report? [/INST] no acute cardiopulmonary process. no significant interval change. </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] interval placement of a right picc line, the tip extending to the superior cavoatrial junction. a left apically directed chest tube is present. persisting pneumomediastinum and subcutaneous emphysema over the left chest and over both sides of the neck. a small left pneumothorax is newly noted. unchanged small left pleural effusion and overlying atelectasis.What are the key findings of this report? [/INST] small left pneumothorax as well as pneumomediastinum and subcutaneous emphysema. a left chest tube is in place. interval placement of a right picc line extending to the superior cavoatrial junction. </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. ascending aorta remains prominent. aortic arch calcifications are noted. descending aorta is tortuous. heart is normal in size. there is no pulmonary edema.What are the key findings of this report? [/INST] no evidence of acute cardiopulmonary process. </s>
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<s>[INST] cardiomediastinal silhouettes are stable. the bilateral hila are unremarkable. new since prior are subtle opacities at the medial lung bases bilaterally. elsewhere there is no focal consolidation, pulmonary edema, or pulmonary vascular congestion. there is no pneumothorax or pleural effusion.What are the key findings of this report? [/INST] new subtle opacities at the lung bases bilaterally which could, in the correct clinical setting, represent sequelae of aspiration or pneumonia. </s>
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<s>[INST] since the prior radiograph, there has been interval placement of an enteric tube that is coiled within the distal esophagus. lung volumes are extremely low. there is new platelike atelectasis at the right lung base. no evidence of pneumonia or pneumothorax. note that a portion of the right lateral chest wall and right costophrenic angle are out of view. no acute osseous abnormalities.What are the key findings of this report? [/INST] <num>. interval placement of an enteric tube is coiled within the distal esophagus. <num>. new platelike atelectasis at right lung base. </s>
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<s>[INST] pa and lateal views of the chest. the lungs are clear. the cardiac, mediastinal, and hilar contours are normal. there is no pleural effusion or pneumothorax. no evidence of free air.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>
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<s>[INST] ap portable upright view of the chest. airspace consolidation is noted in the lower lungs left greater than right concerning for pneumonia. patient is intubated with the tip of the endotracheal tube residing <num> cm above the carina. an ng tube courses into the left upper quadrant though the distal side port is in the lower esophagus. cardiomediastinal silhouette is unremarkable.What are the key findings of this report? [/INST] lower lung opacities concerning for pneumonia. et tube somewhat high-riding. consider advancement by <num> cm for more optimal positioning. </s>
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<s>[INST] the lungs are well inflated and clear. the cardiac silhouette is mildly enlarged, as before. the thoracic aorta is tortuous and calcified. there is no pleural effusion or pneumothorax. median sternotomy wires and surgical clips are again noted. there is scoliosis of the thoracolumbar spine.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] there is no pleural effusion, or pneumothorax. mild bibasilar atelectasis is similar compared to <unk>. emphysematous changes are noted in bilateral lungs. cardiomediastinal and hilar silhouettes are normal size.What are the key findings of this report? [/INST] no radiographic evidence of pneumonia. </s>
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<s>[INST] compared to <time> the same day and allowing for differences in technique, the left apical/ upper lung peripheral pneumothorax is slightly smaller. otherwise, the overall appearance is quite similar.What are the key findings of this report? [/INST] slight interval decrease in size of left pneumothorax. a tiny residual pneumothorax is likely present. </s>
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<s>[INST] pa and lateral chest radiographs were provided. lungs are well expanded. there is no focal consolidation or pneumothorax. blunting of the right costophrenic angle is likely due to a small pleural effusion. the cardiomediastinal silhouette is normal. there are no displaced fractures.What are the key findings of this report? [/INST] small right pleural effusion. no evidence of pneumonia. </s>
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<s>[INST] there is a left-sided pleural effusion present with blunting of the costophrenic angle. trace pleural fluid is seen on the right side as well. there is associated compressive atelectasis at the left side. a paraesophageal hernia is present. heart size is normal. there are aortic arch vascular calcifications present. mild degenerative change is present throughout the thoracic spine.What are the key findings of this report? [/INST] <num>. moderate left pleural effusion. <num>. paraesophageal hernia. </s>
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