About

Irene M. Estores, MD, is an associate professor at the University of Florida College of Medicine in the Department of Physical Medicine and Rehabilitation. She serves as the residency program director and the director of the Integrative Medicine Program at the university. Dr. Estores attended medical school at the University of the Philippines and completed an internship in internal medicine followed by a residency in Physical Medicine and Rehabilitation at the Johns Hopkins and Sinai Hospital joint program in Baltimore, Maryland. She has received acupuncture training at the University of Miami Center for Complementary and Integrative Medicine and applies this training to the management of musculoskeletal and neuropathic pain. Her professional memberships include the American Academy of Medical Acupuncture, the American Academy of Physical Medicine and Rehabilitation, the American Society for Clinical Hypnosis, and she is a Board Member on the American Board of Integrative Medicine. Her interests encompass chronic pain, healthy living, stress management, Long COVID treatment, spinal cord trauma, and spinal injury. Dr. Estores's practice integrates her expertise in medical acupuncture, mind-body medicine, and spirituality in healthcare, reflecting her belief that her medical practice is both a vocation and a spiritual path. She is actively involved in research, including studies on autonomic dysfunction post-COVID-19 and supporting the transition to adult care for patients with inflammatory bowel disease. In addition to her clinical and research activities, she teaches courses related to medicine and pain management and is committed to fostering resilience and wellness in her patients.

Research topics

• Medicine
• Physical therapy
• Internal medicine
• Psychology
• Physical medicine and rehabilitation
• Clinical psychology
• Medical education
• Bioinformatics
• Intensive care medicine
• Family medicine
• Psychiatry
• Pathology
• Psychotherapist

Selected publications

• Impact of age at diagnosis on college adjustment in students with inflammatory bowel disease

  JPGN Reports · 2025-01-13

  articleOpen access

  Abstract Objectives Little is known about the experience of college students with inflammatory bowel disease (IBD) and the factors associated with transition readiness, academic adjustment, and alternatively, those associated with academic hardship and attrition. Methods Survey‐based cross‐sectional studies, including those addressing disease‐specific quality of life (Short Inflammatory Bowel Disease Questionnaire), IBD disease activity (Harvey–Bradshaw Index and Patient Simple Clinical Colitis Activity Index), college adjustment (Student Adjustment to College Questionnaire), transition readiness (Transition Readiness Assessment Questionnaire [TRAQ]), and self‐efficacy (inflammatory bowel disease self‐efficacy scale). Results The surveys were completed by 135 participants (59 IBD patients [37 Crohn's disease and 22 ulcerative colitis]; 76 controls). Participants with IBD were matched with respect to age, gender, academic status, and involvement in extracurricular activities. Participants endorsed making important college decisions associated with their disease and were significantly more likely to live at home ( p < 0.001), take fewer credits ( p < 0.02), and more likely than controls to have their education interrupted ( p < 0.0005). Participant age at diagnosis was an important factor associated with college adjustment, with older age at diagnosis having the most association with the ability to adjust to college life. As expected based on prior literature, TRAQ scores suggested better than expected transition readiness in college students with IBD ( p < 0.0006) with subscores revealing that female students are better at managing health issues and daily activities. Conclusion IBD affects the college experience of students–patients significantly and can have life‐long implications. Newly diagnosed students are at risk of poor college adjustment impacting academic performance and their future success. Male students are at greater risk than female students of poor transitioning to adult IBD care. Students with IBD should receive enhanced and age‐specific modern IBD care.

  PublisherOA PDFDOI

• Multilevel Determinants of Long COVID and Potential for Telehealth Intervention

  Ethnicity & Disease · 2024-08-01

  articleOpen accessSenior author

  Background: Post-coronavirus disease 2019 (COVID-19) syndrome, or long COVID, has a variety of symptoms, but little is known about the condition. This study evaluated the association between individual factors, social determinants of health, and the likelihood of long COVID by assessing internet usage as an indicator of viable access to telehealth. Methods: Data from the 2022 National Health Interview Survey identified adults who (1) reported a previous COVID-19-positive test and/or diagnosis and (2) experienced long COVID. A 2-stage selection model predicted COVID-19 infection in the first stage and long COVID in the second stage. To test the potential use of telehealth, binary dependent variable regression evaluated internet usage among respondents with long COVID. Results: About 40% (N=10,318) of respondents had tested positive/been diagnosed with COVID-19, but less than 20% of them (N=1797) had long COVID. Although older respondents were less likely to have COVID (odds ratio [OR]=0.48; 95% confidence interval [CI]=0.44, 0.53), they were more likely to experience long COVID (OR=1.63; CI=1.37, 1.93). Relative to White individuals, Black individuals were less likely to have COVID (OR=0.78; CI=0.69, 0.89) but significantly more likely (OR=1.21; CI=1.09, 1.64) to experience long COVID. Long COVID was also more likely among low-income earners (first income-to-poverty ratio quartile OR=1.40, CI=1.14, 1.72; second income-to-poverty ratio OR=1.37, CI=1.14, 1.64) and those without a college degree (OR=1.42; CI=1.01, 1.66). There were no statistically significant differences in internet access between racial, geographic, or income groups. Conclusion: Long COVID is significantly more likely among Black individuals and low-income households than among their counterparts, but with few recourses available, telehealth service delivery could be a feasible intervention mechanism.

  PublisherOA PDFDOI

• Proof-of-Concept of an Integrated Yoga and Psychological Intervention in Mitigating Distress Among Diverse Women With Gynecologic, Gastrointestinal, and Thoracic Cancers

  Integrative Cancer Therapies · 2024-01-01 · 5 citations

  articleOpen access

  Background: Fear of cancer recurrence (FCR), cancer-distress, depression, and anxiety are prevalent concerns among women with gynecologic and other understudied cancers, especially among women of color and lower socioeconomic status (SES). Evidence indicates that mind-body interventions are effective in reducing such distress. This study evaluates (1) proof-of-concept of an integrated group yoga and psychological intervention in alleviating distress among women with gynecologic, gastrointestinal, and thoracic cancers and (2) differences in efficacy across social and economic factors. Methods: One hundred twenty-five participants were enrolled in a 10-week, single-arm, integrated group intervention utilizing mindfulness meditation, psychotherapy skills, and yoga. They completed measures of FCR, cancer-distress, depression, and anxiety at baseline and following intervention. Mixed-linear models evaluated change in outcomes across the intervention and moderating effects of age, minority status, and SES among 51 participants with available data. Results: Reductions in total ( b = −2.06, P = .012) and somatic depressive symptoms ( b = −1.79, P = .002) and state anxiety ( b = −6.21, P = .005) were observed across the sample. Higher SES was associated with greater reductions in psychosocial distress related to FCR ( b = −0.74, P = .050), and in total (b = −1.06, P = .049) and affective depressive symptoms ( b = −0.76, P = .006). Women of color experienced greater declines in somatic symptoms compared to non-Hispanic White women ( b = −2.71, P = .031), with women of color experiencing lower SES exhibiting greatest reduction in these symptoms ( b = 1.73, P = .026). Conclusions: This study demonstrates proof-of-concept that an integrated psychological and yoga intervention may reduce depressive symptoms and state anxiety among women with gynecologic, gastrointestinal, and thoracic cancers, with racial and/or ethnic minority status and SES moderating some of these effects. Future research should examine intervention feasibility and acceptability among diverse women with cancer and evaluate efficacy using a randomized controlled trial design. Trial registration: ClinicalTrials.gov NCT03385577

  PublisherDOI

• Assessing Psychological Resilience and Distress Among Graduate Health Profession Students During the COVID-19 Pandemic

  Global Advances in Integrative Medicine and Health · 2023-06-23 · 9 citations

  articleOpen accessSenior authorCorresponding

  Background: Resilience, a person's ability to adapt to adverse events, is associated with positive outcomes, especially in the field of healthcare. Research into the effects of the COVID-19 pandemic may help to understand and combat the long-term mental health burden for trainees in health care. Objective: This cross-sectional study aimed to assess the impact of the pandemic on health profession students' educational experiences, determine the association between their self-reported resilience and psychological distress and assess group differences between students from different graduate health profession programs in an academic medical center. Methods: test, Related-samples Wilcoxon signed rank test, Pearson correlations test and Analysis of variance (ANOVA) to analyze the data. Results: Majority of respondents reported that COVID-19 had a negative impact on their education and caused a reduction in educational opportunities (76.6% and 73% respectively). Majority also reported feeling burned out, lonely/isolated, or frustrated by COVID-19 restrictions (70.0%, 67.4%, and 61.8% respectively). Students reported increased use of both avoidant and adaptive coping strategies during the pandemic. Higher resilience scores were associated with higher self-reported stress, fewer burnout symptoms, and better overall well-being. Conclusion: The COVID-19 pandemic significantly affected students in graduate health profession programs. Instructional quality, educational opportunities, institutional trust, peer socialization, and personal health and wellbeing were perceived to be negatively impacted. Students may require additional support and resources from their training programs to mitigate these concerns. Future studies should evaluate the long-term impact of the COVID-19 pandemic among pandemic-era graduate health profession students.

  PublisherOA PDFDOI

• Integrative Medicine in Long COVID

  Physical Medicine and Rehabilitation Clinics of North America · 2023-05-11 · 6 citations

  review1st authorCorresponding
  PublisherDOI

• Effects of a yoga intervention on distress indicators among diverse women with gynecologic, gastrointestinal, and thoracic cancers.

  Journal of Clinical Oncology · 2022-06-01

  article

  12129 Background: Depression, anxiety, and fear of cancer recurrence (FCR) constitute prevalent psychological concerns necessitating further attention in developing supportive care interventions for women with gynecologic, gastrointestinal, and thoracic cancers. Recent evidence indicates that such concerns may be especially severe among underserved women of color and women affected by low-socioeconomic status (SES). The purpose of the present study is to evaluate the magnitude of changes in depression, anxiety, and FCR associated with a mindfulness-based yoga intervention among a diverse sample of women with these cancers. A second aim is to identify how changes in these concerns may differ across sociodemographic groups. Methods: Women with gynecologic ( n=86), gastrointestinal ( n=17), or thoracic ( n=20) cancers were enrolled in a group-based 10-week yoga intervention utilizing mindfulness meditation, relaxation, and gentle yoga. Prior to and following intervention, participants were administered assessments, including the Beck Depression Inventory – Second Edition (BDI-II) to measure depression, the State-Trait Anxiety Inventory (STAI) to assess anxiety, and the Fear of Cancer Recurrence Inventory (FCRI) to evaluate aspects of FCR. Mixed-linear models evaluated change in outcomes from pre- to post-intervention, with conditional models assessing the effects of age, race/ethnicity, and SES on change. Analyses were conducted prior to trial completion due to approaching accrual period termination. Results: The sample demonstrated a mean age of 58.46 ( SD=10.82) and mean SES score of 3.98 ( SD=1.55) using a 1 to 7 composite scale. Twenty-six percent of participants were of racial and/or ethnic minority status ( n=32). Significant declines in total depressive symptoms, somatic depressive symptoms, state anxiety, and psychological distress due to FCR were observed across the sample. Higher SES was associated with significantly greater reductions in total depressive symptoms and affective depressive symptoms, specifically. Women of color experienced significantly greater declines in somatic symptoms compared to non-Hispanic White women. Conclusions: This mindfulness-based yoga intervention was associated with significant reductions in depressive symptoms, state anxiety, and psychological distress related to FCR among women with gynecologic, gastrointestinal, and thoracic cancers. Higher SES and underserved race/ethnicity status moderated some of these effects. Future research should explore the efficacy of this intervention among diverse women in a randomized clinical trial context. Clinical trial information: NCT03385577.

  PublisherDOI

• Appraising Important Medical Literature Biases: Uncorrected Statistical Mistakes and Conflicts of Interest

  Frontiers in Medicine · 2022-07-22 · 1 citations

  articleOpen accessSenior author

  OPINION article Front. Med., 22 July 2022Sec. Family Medicine and Primary Care https://doi.org/10.3389/fmed.2022.925643

  PublisherOA PDFDOI

• Intermittent Fasting: Potential Utility in the Treatment of Chronic Pain across the Clinical Spectrum

  Nutrients · 2022 · 24 citations

  • Medicine
  • Intensive care medicine
  • Physical therapy

  Dietary behavior can have a consequential and wide-ranging influence on human health. Intermittent fasting, which involves intermittent restriction in energy intake, has been shown to have beneficial cellular, physiological, and system-wide effects in animal and human studies. Despite the potential utility in preventing, slowing, and reversing disease processes, the clinical application of intermittent fasting remains limited. The health benefits associated with the simple implementation of a 12 to 16 h fast suggest a promising role in the treatment of chronic pain. A literature review was completed to characterize the physiologic benefits of intermittent fasting and to relate the evidence to the mechanisms underlying chronic pain. Research on different fasting regimens is outlined and an overview of research demonstrating the benefits of intermittent fasting across diverse health conditions is provided. Data on the physiologic effects of intermittent fasting are summarized. The physiology of different pain states is reviewed and the possible implications for intermittent fasting in the treatment of chronic pain through non-invasive management, prehabilitation, and rehabilitation following injury and invasive procedures are presented. Evidence indicates the potential utility of intermittent fasting in the comprehensive management of chronic pain and warrants further investigation.

  PublisherOA PDFDOI

• Feasibility and acceptability of a yoga intervention for distress in women with gynecologic, gastrointestinal, or thoracic cancer.

  Journal of Clinical Oncology · 2022-06-01

  article

  e24125 Background: Gynecologic, gastrointestinal (GI), and thoracic cancers account for significant morbidity and mortality in the U.S. Women with these types of cancers frequently experience psychological distress, among other poor outcomes. Previous research has indicated that mindfulness-based interventions, such as yoga, can be effective in decreasing distress in cancer patients. Notably, this research has primarily been conducted in a breast cancer population with limited research assessing the feasibility, acceptability, and/or efficacy of this type of intervention in other prevalent and impactful cancers among women. The purpose of the present study was to assess the Feasibility and Acceptability of a yoga intervention for women with gynecologic, GI, or thoracic cancers. Methods: A total of 124 women diagnosed with a gynecologic, GI, or thoracic cancer in the prior year were recruited via outpatient oncology clinics to participate in a 10-week, group-based manualized yoga intervention entitled “Stilling the Waters of Uncertainty” (Author: E. Kacel) that is nearing the end of accrual. Participants completed an Acceptability evaluation following each yoga session with ratings on a 5-point Likert scale from “not at all” to “extremely.” Feasibility of the study was operationalized as percentage of eligible participants who (a) enrolled, (b) attended sessions, and (c) completed post-intervention assessment. Acceptability was operationalized as the percentage of participants with average session ratings of “very” or “extremely” for intervention usefulness, enjoyableness, safety, clarity, relevance, and likelihood of continuing to practice skills. Criteria for operationalizing Feasibility and Acceptability for this study were defined a priori based on recommendations of Bowen and colleagues (2009). A minimum of 80% for each measure of feasibility and acceptability was set as the a priori threshold of success in each domain. Results: All measures of Feasibility were below the a priori benchmark of 80%: Of the 318 eligible patients approached for participation, (a) 124 patients (39.0%) enrolled; 49/124 (39.5%) attended at least 1 yoga session; 44/124 (35.4%) attended at least 8 sessions; and (c) 41/124 (33.1%) completed post-intervention assessment procedures. At least 80% of attendees rated the intervention as “very” or “extremely” useful, enjoyable, safe, and clear; 75.5% and 79.6% of attendees rated the intervention as “very” or “extremely” relevant and likely to be continued to be practiced. Conclusions: The results of this study indicate that a yoga intervention for women with prevalent non-breast cancer types did not meet a priori criteria for feasibility. However, participants who attended at least 1 session rated the intervention as generally acceptable. Future research is needed to improve study/intervention feasibility in this population. Clinical trial information: NCT03385577.

  PublisherDOI

• Improving burnout and well-being among medicine residents: Impact of a grassroots intervention compared to a formal program curriculum

  Journal of Education and Health Promotion · 2021-07-01 · 11 citations

  articleOpen access

  BACKGROUND: With growing resident burnout, Accreditation Council for Graduate Medical Education issued new requirements for program interventions to optimize resident well-being. Little evidence exists on how to best teach resiliency to residents. This study assesses the impact of both a grassroots intervention and formal resiliency curriculum on resident burnout and well-being. MATERIALS AND METHODS: From November 2016 to August 2017, residents in a large Internal Medicine Residency Program participated in grassroots wellness interventions from the resident-led Gator Council in Gainesville, FL USA. From August 2017 to June 2018, residents participated in a formal program-driven resiliency curriculum. Wellness interventions included monthly morning reports, bimonthly workshops, and biannual noon conferences. Pre- and postintervention Maslach Burnout Inventory (MBI) and Physician Well-Being Index (PWBI) assessed the effect of both interventions on resident burnout and well-being. Statistical analyses used Student's t -test, Fisher's exact tests, and linear regression model. RESULTS: One hundred and twenty-two residents participated in grassroots interventions. One hundred and seventeen (87 residents, 35 students) participated in formal curriculum. Mean MBI scores for all three sections did not differ between pre -and postgrassroots intervention (emotional exhaustion [EE] P = 0.46; depersonalization [DP] P = 0.43; personal accomplishment [PA] P = 0.73]) or between pre- and postcurriculum (EE P = 0.20; DP P = 0.40; PA P = 0.51). Students scored higher burnout levels compared to residents in EE ( P = 0.001) and PA ( P = 0.02). Pre- versus postcurriculum PWBI scores did not differ among residents ( P = 0.20), while PWBI scores improved among students ( P = 0.01). CONCLUSIONS: This study found no improvement in resident burnout or well-being from a bottom-up and top-down approach. Our results imply the need for an early wellness curriculum to improve student well-being given their higher level of burnout. System-wide efforts are vital to combat physician burnout.

  PublisherDOI

Frequent coauthors

• Paresh A. Jaini

  Southwestern Medical Center

  48 shared

• Albert Barrera

  American College

  36 shared

• Jenny Sunghyun Lee

  36 shared

• Regan A. Stiegmann

  36 shared

• Daniel Śliż

  Medical University of Warsaw

  36 shared

• Sami Bég

  Community Living

  36 shared

• Alicja Baska

  Postgraduate School of Molecular Medicine

  36 shared

• Alyssa Greenwell

  Royal Free London NHS Foundation Trust

  36 shared

Education

• M.D.

  University of Florida

• Other, Integrative Medicine

  University of Arizona Center for Integrative Medicine

• Other, Physical Medicine and Rehabilitation (PM&R)

  Sinai Hospital - Johns Hopkins Hospital Inter-institutional program in PM&R

• Other

  University of Miami Center for Complementary and Integrative Medicine

• Other

  Duke University with its Center for Integrative Medicine and Fuqua School of Business