The latest patch seemed to make a stab at some of the technical problems, but I don't really see that it improved the basic game. Some of the gameplay (specifically, city support cost) appears to have changed to the player's detriment. It almost seems that Firaxis wants every player to use the exact same strategy in every game, leaving little room for 'alternative' strategic approaches.
Many of the basic annoyances were untouched (maintaining the custom world setup options from game to game -- how difficult can this be?). The patch also reset almost all of my in-game options.
I still have scrolling issues, and avi performance issues. The game is slow to respond to the keyboard at times, and too fast at other times. Many times, building completion, especially wonder completion, scrolls the game out from 'just-under-the-clouds view' to cloud view. Popup windows for the AI leaders seem to take forever.
Overall, patch 1.52 is still not enough. Civ 4 is easily the least competent implementation of the Civ games. I wouldn't recommend it to my friends.