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I'm paranoid.... I use CC and Spybot with my security suite on HP 64
Question has basically been answered here:
http://www.hardforum.com/showthread.php?t=1213288
If you're the sort of goose who installs and uninstalls every random freebie program you ever come across I's suggest adding a registry cleaner to the arsenal, but if you're sensible and selective about what you have installed on the rig that shouldn't be necessary.
The combination of Vista's x64's natural defenses (make sure to configure the firewall for outbound), Windows Defender, and NOD32 should be sufficient in most cases, especially if you utilize UAC.
I tested CCleaner and many registry cleaners on Vista and most caused more harm than good. CCleaner is useful for clearing temporary data, although Windows has Disk Cleanup, but overall I do not see maintenance software as necessary.
What do you mean exactly by "make sure to configure the firewall for outbound"?
Windows key + R (or "run"), then type in secpol.msc (security policy, MS console) and go.
There is a folder to the left that says "Windows Firewall with Advanced Security." If you go inside that, you find you can set rules for inbound/outbound for any type of network connection as well as universally. There is also a freeware program called Vista Firewall Control:
http://www.majorgeeks.com/Vista_Firewall_Control_64-bit_d5577.html
There are no rules set for outbound, is there anything you recommend? Sorry, I don't know much about Network stuff.
I actually made a mistake, you want to run wf.msc (windows firewall, MS console) for direct access to the controls.