Couple plays now (112 minutes? Was I seriously playing for almost 2 hours..?) and I've beaten Mom, unlocked the Womb/Horsemen/cube of meat/etc, as well as Lazarus and Azazel. Kind of wish there was a key rebinder in the game, but whatever.
Only lost against Mom the first run because Monstro's Lung, while powerful, is slower than a dead snail. Yeah you shoot a shotgun of tears all at once, but that thing takes almost 5 seconds to fully charge if you haven't gotten items to speed it up yet. Which I hadn't... Was amusing to see Technology 2 pair up with Chocolate Milk in that it constantly fires while you charge a loogie up.
Achievements are either extremely screwed up right now, or hacked to kingdom come. Claims that 99.9% of players have a bunch of them currently, Including Basement through Dark Boy, which is unlikely.