Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is no focal consolidation , pleural effusion or pneumothorax . Right apical calcifications are unchanged . The cardiomediastinal silhouette is unchanged . Median sternotomy wires are intact . The aorta is tortuous . Imaged upper abdomen is unremarkable . There are severe degenerative changes at the glenohumeral joints bilaterally .
    OUTPUT:
    
No acute cardiopulmonary process or significant change since ___ .