You've got OpenAL installed, right? Check the CVS Builds thread if you don't...
That fixed it. Just some issues now
Occasional missing textures
Shockwaves don't show up. I'm not sure if it's just occasional or not as in I only notice when they're not there, but I'm fairly sure they just aren't.
Large ship 'engine trails' seem to be gone, if that makes any sense. It's just the little circular glow from the engine, and not the lingering trail that has always been there.
edit: Downloaded new shockwave pof, fixed the shockwave problem.
Still the issue with the engine trail things, it's not just for large ships but for every ship. It's highly noticeable.
Still sometimes missing textures but its completely random so there are no solid instances of it occuring to really report for.