Background and Purpose-Vascular death rates and hospitalizations for stroke are increased during influenza epidemics.Influenza vaccination may prevent stroke. We investigated whether influenza vaccination is associated independently with reduced odds of stroke and whether effects are confined to stroke subgroups and winter seasons and shared by other vaccinations. Methods-During 18 months, we performed standardized interviews assessing vaccination status, risk factors, healthrelated behavior, and socioeconomic factors in 370 consecutive patients with ischemic or hemorrhagic stroke or transient ischemic attack (TIA) and 370 age-and sex-matched control subjects selected randomly from the population. Results-Influenza vaccination during the last vaccination campaign was less common in patients (19.2%) than control subjects (31.4%; PϽ0.0001). After adjustment for vascular risk factors, education, health-related behavior and other factors, influenza vaccination (odds ratio [OR], 0.46; 95% CI, 0.28 to 0.77) but not other combined recent vaccinations (OR, 0.80; 95% CI, 0.42 to 1.43) were associated with reduced odds of stroke/TIA. Significant effects were found in men, older subjects (Ͼ65 years), subjects with previous vascular diseases, and regarding ischemic stroke; nonsignificant trends existed in women, younger subjects, and regarding hemorrhagic stroke. In etiologic subgroups of cerebral ischemia, similar effects were found. No protective effects were found during summer months; however, results also varied considerably between both winter seasons examined. Conclusions-These results support the hypothesis that influenza vaccination may be associated with reduced stroke risk.However, residual confounding cannot be excluded, and interventional studies are required to evaluate the role of influenza vaccination in stroke prevention.

Background and Purpose-Leisure-time physical activity protects from stroke. It is insufficiently established whether early lifetime physical activity is independently protective and whether some etiologic stroke subgroups particularly benefit from physical activity. We tested the hypothesis that both recent and early-adulthood sports activities are associated with reduced odds of stroke and analyzed their effects in stroke subtypes. Methods-We performed a case-control study of 370 patients with acute stroke or transient ischemic attack (TIA) and 370 age-and sex-matched control subjects randomly selected from the population and assessed recent and young adulthood sports activities and their weekly duration in standardized interviews.

Screening strategies including primary HPV testing for high-risk subtypes (HPV-16/18) in conjunction with p16/Ki-67 dual-stained cytology can improve the detection of cervical cancer at a lower total annual cost than conventional Pap cytology screening.