Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a large hiatal hernia with an air - fluid level . The cardiac , mediastinal and hilar contours are stable . There is again pleural effusion or thickening on the left side which is probably unchanged since the most recent study . Mild spurring appears stable at each lung apex . Aside from minimal atelectasis at the left base , the lungs appear clear . Moderate S - shaped curvature to the thoracolumbar spine is again noted . Mild compression deformities are suspected but not well characterized at the thoracolumbar junction . The bones appear demineralized .
    OUTPUT:
    
Large hiatal hernia . No evidence of acute cardiopulmonary process . No short - term change .