Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: No focal consolidation is identified . The heart is moderately enlarged again , unchanged from prior examination . The mediastinal and hilar contours are unremarkable . No definite pleural effusions or pneumothoraces are seen . Degenerative changes are once again present along the lower thoracic spine .
    OUTPUT:
    
No evidence of acute disease .