Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: As before , the diaphragm is flat there is increased AP dimension , consistent with COPD / emphysema . No findings to suggest pneumonia . Cardiomegaly persists . Pulse generator and right ventricular electrode are in expected and unaltered positions . Aortic valve prosthesis is again noted . The aorta is tortuous . Widened right paratracheal stripe and is likely from vascular structures and unchanged . Bones are osteopenic with several of the thoracic vertebral bodies not well seen because of this but there is no definite bone lesion .
    OUTPUT:
    
No evidence for pneumonia with chronic findings as discussed above .