Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen are patchy ill - defined opacities in lung bases worrisome for infection or aspiration . Emphysematous changes of the upper lobes are again noted . No pleural effusion . No pneumothorax or pulmonary edema . The heart is normal in size . Mediastinal contour and hila are unremarkable . Limited assessment of the osseous structures are notable for diffuse demineralization and loss of vertebral body height , unchanged since prior examination .
    OUTPUT:
    
1 . Possible bibasilar infection or aspiration . 2 . Emphysema with upper lobe predominance .