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About the items, in Isaac it works like that: when you find and get one item, it is added to the collection, and every items which are already in the collection have a 1:1 chance to spawn besides the other items in the same pool. When an item isn't in your collection, it has something like "1/(3*tot items)" to spawn. And morely when you begin as the item pool is very small (you unlock items by completing the game with each characters), you have "more" chances to find bad items.
But well, as the beginning is so much easier in opposite of the one the game will be in the later levels, it balances the difficulty a quite bit.
And also as the choosed items are random, there can be very easier run than other, altough every run are possible of course ;).
But really, don't think about the items to unlock now because the game will be much harder after every runs, and just play the game normally and try to learn to "dodge" ennemies, and when you find an item and you don't know what it does, always get a look of what he will do, in that way it will help you a lot, because there are some items you really need to beware, like the Dead Cat which will give you 9 lives (and count for 1 of the 3 items to transform you into Guppy) but will reset your life to 1, the Tick, Cursed Skull, and so on.
There are multiple website which give you item informations, for example: http://platinumgod.co.uk/
Bad recommendation mostly, but if you want some fun during the beginning, you can install the SpiderMod which contains multiple tools with a cheat panel, a thing that will allow you to try a lot of things to know if it is good or not... but don't use it to much, or you won't get better^^.
http://steamcommunity.com/sharedfiles/filedetails/?id=379619855&fileuploadsuccess=1
If I don't get a "cool" or "good item" I try to find the habit - and it basically gives me infinite life or - enough regen to the point I can beat the game consistently even without getting "epic fetus" and other OP gear.