Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate enlargement of the cardiac silhouette persists . The mediastinal contours are unchanged . There is continued moderate pulmonary edema , not substantially changed in the interval . Hilar contours are similar . There are small bilateral pleural effusions , perhaps increased since the previous study . No pneumothorax is present . Moderate multilevel degenerative changes are noted in the thoracic spine .
    OUTPUT:
    
Moderate pulmonary edema , similar compared to the previous study , with increased small bilateral pleural effusions .