Note 6 - Accrued Expenses (Detail) - Accrued Expenses (USD $) In Thousands, unless otherwise specified	Sep. 30, 2012	Dec. 31, 2011
Accrued compensation and benefits	$ 9,939	$ 3,323
Accrued selling and professional fees	5,316	4,112
Accrued income and other taxes	6,358	1,546
Accrued medical panel fees	3,323	1,880
Accrued value added tax	19,229	15,812
Other accrued expenses	2,022	1,737
Total	$ 46,187	$ 28,410