Note 6 - Accrued Expenses (Details) - Accrued Expenses (USD $) In Thousands, unless otherwise specified	Jun. 30, 2013	Dec. 31, 2012
Accrued Expenses [Abstract]
Accrued compensation and benefits	$ 8,146	$ 7,217
Accrued selling and professional fees	5,513	5,777
Accrued income and other taxes	3,001	2,384
Accrued medical panel fees	2,453	2,646
Accrued value added tax	15,215	14,872
Other accrued expenses	2,951	3,099
Total	$ 37,279	$ 35,995