Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperexpanded consistent with COPD . The diaphragms appear more flat and compared to the prior radiograph , which may be due to a better inspiration or small bilateral pleural effusions . The cardiomediastinal silhouette is normal . Pulmonary vasculature is normal . There is no pneumothorax .
    OUTPUT:
    
Interval flattening of the diaphragms , which may be due to hyperexpansion and a better inspiration , or small bilateral pleural effusions .