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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We are pleased that our article<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> merited the attention of Garc&#237;a Llopis et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> and we would like to thank them for their interest in clinical medicine&#44; at a time when a certain technocracy prevails&#44; which apparently sidelines the value of anamnesis and the physical examination in preparing the clinical diagnosis&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A recent study<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> showed that&#44; for patients who have gone to emergency departments due to chest pain and had negative results in the blood biomarkers and electrocardiogram and no signs of acute ischemia&#44; the performance of noninvasive examinations &#40;coronary angiography by computed tomography or stress test&#41; leads to longer hospital stays&#44; more examinations&#44; radiation and costs&#44; without improved clinical results&#44; compared with the exclusively clinical assessment&#46; This means the clinical value is still relevant&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In their book <span class="elsevierStyleItalic">La comunicaci&#243;n no verbal</span> &#40;Nonverbal Communication&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> a communication expert stated that most individuals are conscious of the movements of other people&#39;s hands&#44; but generally ignore them&#44; taking for granted that these are no more than meaningless gestures&#46; The author goes on to say that gestures can&#44; however&#44; communicate and can sometimes help clarify a message&#44; especially when the verbal message is unclear&#46; At other times&#44; gestures can unwittingly reveal emotions&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">It is true that our study<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> could have been adjusted for age&#44; atypical manifestations and for many other clinical factors and variables&#46; However&#44; following the initiative of certain authors&#44;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> we wanted to investigate only the unequivocal meaning &#40;by itself&#41; of hand gestures in the general population who visited an emergency department due to chest pain&#44; especially considering that illustrious medical treatises have considered this issue&#44; such as the case with Levine&#39;s sign&#44; which is pathognomonic of coronary artery disease&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Nevertheless&#44; we agree with the criterion of certain experts<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> that any expressive sign by the patient&#44; such as gestures&#44; should be considered and interpreted&#44; within logical limitations&#44; as demonstrated in our study&#46;</p></span>"
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