there has been interval placement of a left internal jugular central line which has its tip in the mid to distal svc. no pneumothorax. the nasogastric tube is seen again coursing below the diaphragm with the tip coiled within the stomach. there are persistent bibasilar patchy opacities with improved aeration in the right upper lung. findings would be consistent with fluctuating pulmonary edema rather than an infectious process. probable small layering bilateral effusions. overall cardiac and mediastinal contours are unchanged. a right shoulder replacement is incompletely visualized.