Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is re-demonstration of a left - sided pacemaker with right atrial and right ventricular leads , not significantly changed . The heart size is normal . The mediastinal contours are normal . There is no pneumothorax . A small to moderate quantity of fluid is seen layering within one or both of the pleural spaces posteriorly on the lateral projection , new compared to the prior radiograph from ___ . Multilevel degenerative changes of the thoracic spine are noted .
    OUTPUT:
    
New small - to - moderate possibly bilateral pleural effusions . Otherwise , no acute intrathoracic process .