Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen is the bilateral small pleural effusions and left base atelectasis . Cardiac silhouette is unchanged . There is no pneumothorax . Again noted is the median sternotomy wires , valve replacements , and Dobhoff tube in expected positions . Changes in the right proximal humerus consistent with previous fracture better seen on shoulder radiographs from ___ .
    OUTPUT:
    
No significant change in appearance of small bilateral pleural effusions and left base atelectasis since ___ .