Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated , compatible with COPD . Otherwise , lungs are clear . There is no pleural effusion , pneumothorax or focal airspace consolidation . Heart is normal size . The mediastinal and hilar structures are unremarkable . Cervical fusion hardware and a lumboperitoneal shunt are partially evaluated .
    OUTPUT:
    
No change from 4 days prior .