Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been interval decrease in small bilateral pleural effusions . Lungs are hyperexpanded , with biapical hyperlucency , flattening of the hemidiaphragms , and widening of the retrosternal clear space . Mild bibasilar atelectasis persists . Neoesophageal contour is within normal limits , without pneumomediastinum . Moderate cardiomegaly is unchanged . The aorta is tortuous and calcified . There are mild degenerative changes in the thoracic spine .
    OUTPUT:
    
1 . COPD . 2 . Small residual effusions . 3 . Moderate cardiomegaly .